Rip Van Winkle Essays (1151 words) - Rip Van Winkle,

Rip Van Winkle Analyzation encompasses the application of given criteria to a literary work to determine how efficiently that work employs the given criteria. In the analyzation of short stories, the reader uses a brief imaginative narrative unfolding a single incident and a chief character by means of plot, the details so compressed and the whole treatment so organized, a single impression results. To expose that impression, the reader explores the workings of seven basic criteria. One particular criterion character effectively supports the central idea in ?Rip Van Winkle? by Washington Irving. The character's type develops with the personality development throughout the story. Three types of characters: round, flat, and stock, appear in most stories. The round character displays a fully developed personality and full emotions. Flat characters, also known as supporting characters, do not develop fully or express complex emotions. A stock character, also known as a stereotype, fits an established characterization from real life or literature. With these three types of characters leading the reader through the story, the reader learns the events taking place as well as the changes in the character's lives. The author keeps the reader informed of the changes affecting the characters throughout the narrative through style. When a character undergoes a fundamental change in nature or personality during the story, the character has dynamic style. However, a character without change defines a static character. Although all characters have a style and type sometimes understanding the differences appears complicated. A chart often helps establish a better understanding of character type and style. The following chart represents the characters used by Washington Irving in ?Rip Van Winkle?: Character Location Type Style Rip (Pro) Paragraph threeLines seven and eight R S Dame Paragraph four R S Wolf Paragraph nineLine one and two F S Derrick Van Bummel Paragraph ten Line seven R D Nicholas Vedder Paragraph tenLines one, two, and three R D Rip Jr. (Son) Paragraph seven R S Judith Gardenier Paragraph forty-sixLines six through eight F S Dominic Van Shaick Paragraph eighteenLine nine S S Brom Dutcher Paragraph thirty-seven S S Strange Figure Paragraph sixteenLine nine S S Commander Paragraph eighteenLines nine and ten S S Rip (Antag) Paragraphs five and eightLines one and twoLines one and four R S Hendrick Hudson Paragraph fifty-nineLine nine S S Peter Vanderdonk Paragraph fifty-sixLines one and two S S Jonathon Doolittle Paragraph thirty S S The author uses one main character, at most, two; only the protagonist and the antagonist exist as major characters. ?Rip Van Winkle?, Washington Irving uses one main character to play both the role of the protagonist and the antagonist. In paragraph three lines, six and seven, the reader meets the protagonist. a simple good-natured fellow of the name of Rip Van Winkle? In paragraphs five and nine, lines one and two, and one and four, respectively, the reader encounters the antagonist. ?The great error in Rip's composition was an insuperable aversion for all kinds of labor.? Rip would rather starve on a penny than work for a pound.? Even though, in both cases where the reader encounters Rip Van Winkle, Rip only counts as one main character. Characterization occurs when the author draws an overall picture of the characters. Characterization happens in two ways in literature, by description and personality. The author uses the words a story to describe a character or imply the appearance of the characters through the text of the story. Introducing the personality of the character to the reader in words give or describe the personality of the characters or the words used imply certain things about the character. The protagonist in ?Rip Van Winkle? the reader first meets in paragraph three, lines seven and eight, a simple good-natured fellow of the name of Rip Van Winkle.? The reader assumes the appearance of Rip from the preceding paragraphs in which the author sets the general timeframe in the colonial era before and after the American Revolutionary war. Musclat best describes Rip because of all of the physical labor done in chores. Rip also had light hair with blue eyes. Rip's dress was that of the day: black suits with fluffy white collars, tri-cornered hats, and brass buckles on the black shoes. Good natured and helpful best describes Rip's attitude, this good faith towards all that eventually lands Rip in

How to Find the Cygnus Constellation

How to Find the Cygnus Constellation The star pattern astronomers know as Cygnus appears high in the sky beginning in July and is still visible late in the year. Its central area is cross-shaped, and that asterism within the constellation is called the Northern Cross. It is one of three constellations that lends a star to the asterism called the Summer Triangle, which is another stargazing feature that is high in the skies during northern hemisphere summer. For gazers in the southern hemisphere who can spot this region of the sky, its a winter constellation.  Its visible to much (but not all) of the southern hemisphere. The Summer Triangle and the constellations that lend their stars to it. Carolyn Collins Petersen How to Find Cygnus Locating Cygnus –  sometimes called The Swan – is fairly easy thanks to the shape of the Northern Cross at its center. If you are in the northern hemisphere, look for the constellation during late July, when it should be almost directly overhead. Once you spot the cross shape, look for the remaining elements of the constellation, which resemble the wings, beak and tail of the swan. The constellation Cygnus with Deneb at the tail of the swan (top) and Albireo (the double star) at the nose of the swan (bottom). Carolyn Collins Petersen The History of Cygnus The starry shape of Cygnus the Swan has long been known to stargazers. This constellation is one of the original 48 constellations of antiquity. The ancient Greeks featured it in many of their legends. Zeus, king of the gods, turned himself into a swan to attract the attention of a maiden named Leda. In another story, a musician and prophet named Orpheus was murdered, and his memory was honored by placing him and his lyre into the sky near Cygnus.   This star pattern was also familiar to stargazers in China, India, and the Polynesian Islands. The bright stars were used as wayfinding guideposts for travelers. The Stars of the Cygnus Constellation The brightest stars in Cygnus are Deneb (also known as alpha Cygni) and Albireo (also called beta Cygni), which resemble the tail and the beak of the swan, respectively. Albireo is a famous double star that can be spotted using binoculars or a small telescope. The stars have different coloration: one has a bright golden color, while the other has a bluish tint. Albireo, the double star in the nose of Cygnus the Swan, can be easily seen through binoculars or a small telescope.   Courtesy N.B., via Wikimedia Commons, Attribution-Share Alike 4.0 license. Cygnus has a great many variable- and multiple-star systems within its boundaries. Thats because it lies in the plane of the Milky Way Galaxy. Stargazers with access to dark skies can often spot a glow that resembles clouds in the region around Cygnus. The glow comes from the millions of stars that lie in the galaxy, and is often referred to as a star cloud.   Astronomers studied the Cygnus region using the Kepler Space Telescope in the search for planets around other stars. They found that the Cygnus constellation has more than a hundred stars that harbor planets, all within about three thousand light-years of the Sun. Some of those stars have multiple planetary systems.  Ã‚   The official IAU constellation star chart for Cygnus the Swan. IAU/Sky Publishing.  Ã‚   Deep Sky Objects in Constellation Cygnus The locations of several deep-sky objects in Cygnus. Carolyn Collins Petersen   Cygnus has several fascinating deep-sky objects within its boundaries. The first, Cygnus X-1, is a binary system, with a black hole slurping up material from a companion star. The system gives off massive amounts of x-rays as the material spirals around the black hole. While it is not possible to see the system without a telescope, its still fascinating to know its there. The constellation also contains many clusters and beautiful nebulae, the most famous of which is the North America Nebula (also known as NGC 7000). Through binoculars, it appears as a faint glow. Dedicated stargazers can also search out the Veil Nebula, which is a huge remnant left over from a supernova explosion that took place more than five thousand years ago.   The North America Nebula is a favorite target for astrophotographers. It has the shape of the North American continent. Through a telescope, it doesnt look this colorful, but long-exposure photographs bring out details and colors of the different gases.   Luc Viatour/https://lucniz.be.   Used with permission under a Creative Commons Attributi

Student press freedom Assignment Example | Topics and Well Written Essays - 750 words

Student press freedom - Assignment Example The freedom of the press is quite vast, such that a few politicians have referred to the public press as the fourth estate, essentially conferring on it the same degree of importance and significance as the other three branches of the government. It can conduct its own inquiries in search of truth, in the name of public interest, like investigative journalism in which certain anomalies involving public funds can be uncovered, as an example. Freedom of the press carries with it vast powers but imposes the strict standards of ethics and principles adopted by the members of the press who consider their job as a profession. As such, the press refers originally to previous regimes in which news and information are obtained from newspapers, but in todays digital world, press also refers to all types of media available, like print, radio, television, and Internet (e-mails, blogs, and social networking sites) where information can spread very quickly indeed on a worldwide basis. The right to exercise this freedom is synonymous with all the responsibilities to exercise it in a responsible manner, to prevent abuses, promote welfare, and maintain journalistic independence. This paper discusses some of the issues involving the laws on media, and in particular, the specific sub-topic of freedom of the student press. In this regard, students who work in their own student or school publications learn firsthand the basics of what responsible journalism is all about, gaining valuable experience in the exercise of this important basic constitutional right.

Second Language Acquisition Term Paper Example | Topics and Well Written Essays - 2750 words

Second Language Acquisition - Term Paper Example The common argument has been that the acquisition of second language skills is difficult, especially for non-native speakers (Jordens and Lalleman, 7). However, this argument has been disputed by another argument holding that acquiring second language skills is not difficult. Rather, it is the poor formulation of teaching curriculum and inappropriate design of instructional methods that create the perception that the acquisition of proficiency in the second language for non-native learners is difficult (Rutherford, 47). Second Language Acquisition is akin to the process of children acquiring their speech, meaning that it requires meaningful interaction between the subject and the target language, most especially related to natural communication (Sanz, 14). My thesis, then, aims to argue that several factors affect the effective acquisition of a second language. Just as the case is with children acquiring their early speech communication skills, Second Language Acquisition entails the speakers having little concern for the utterances, and more emphasis on the delivery of the intended messages, and how the message will be interpreted (Sanz, 21). In this respect, Second Language Acquisition mostly has to do with what the learners of the second language do in the process of acquiring the skills of communicating using the second language. Nevertheless, the manner in which the second language is taught to the learners has a great influence on how well the learners will understand and acquire the skills of a second language. Therefore, while teaching a second language, it is essential that the teacher adopts a holistic approach (Gruber-Miller, n.p.). The learners of a second language have to go through different stages before they can eventually become proficient in the second language.  

Cost of Resource Essay Example for Free

Cost of Resource Essay The allocation and cost of resources need to be carefully monitored if a project is to be delivered on-time and on-budget. At a minimum this section will contain the following: Allocation of resources to project tasks (both labor and material) Cost estimates for project resources Gantt diagram showing duration estimates for all tasks and their sequencing (including precedence relations) and highlighting any critical path(s) arising from task dependencies ultimately determining the minimal duration of a project In addition summarize any relevant facts about the project duration, number or type of resources, critical task sequencing, or how duration estimates were arrived at, and any financial implications (for example, budget or cost reports of the project as well) Develop a baseline for your project plan so that all future variances are captured. Write 3 to 4 pages on your findings. When it comes to succeeding in college, there are many influential factors. In fact, even your choice of seat can make a difference. Try to score a seat near the front of the lecture hall rather than one right next to the exit. You are more likely to stay engaged and can ask your professor questions easily.

Principle of Separate Legal Personality

Principle of Separate Legal Personality Principle of Separate Legal Personality Separate Legal Personality Concept developed in Company Law, relating to the legal status between a Company Limited by Shares and its owners. The Principle was first accepted in Salomon v Salomon, a landmark case which is often considered to have established one of the most important principles within Company Law; A Company is a distinct legal personality from that of its owners. Because of this Separate Legal Personality is also known as the Salomon Principle. The ‘separate entity’ doctrine (that the company is an entity separate to its shareholders) established very early in Salomon’s case (Salomon v Salomon Co [1897] AC 22). Each regular individual has a lawful identity, importance it holds rights, commitments and obligations. At the point when a Company is consolidated, that is enrolled in the Companies Office and issued with a Certificate of Incorporation; it excessively has a legitimate identity. However a Company cant work all alone, obliging human intercession to direct business for its sake. The guideline of Separate Legal Personality builds that a Company has lawful rights and commitments that are unique and separate from its parts (holders/shareholders). Moreover the benefits and obligations of a Company Limited by Shares have a place solely to the Company and its parts cant be sought after as by and by obligated for the activities of the Company. This division of the Company from its parts is known as the Veil of Incorporation. Example The guideline of Separate Legal Entity can been seen in play in the late Irish case Quigley Meats. The Plaintiffs for this situation (the Quigleys) supplied the Defendants with meat produce for their restaurant. The Quigleys were of the feeling that they were managing the Defendants by and by, however instalments for produce were constantly made to the Quigleys from a Company account. The Defendants got into some money related trouble and quit paying the Quigleys for the produce. The Quigleys then chosen to seek after the Defendants through the Courts for the unpaid bills. The Court at first found for the Quigleys requesting the Defendants to pay the obligation of â‚ ¬26,000. However the respondents advanced contending that they couldnt be discovered by and by at risk as the obligation was for their Company to pay. The High Court concurred with the Defendants because when they did pay the Quigleys they had paid with checks which had the Companys name printed on them, in this manne r they should have realized that they were managing a restricted obligation organization and not people. (Quigley Meats Ltd v. Hurley [2011] IEHC 192) Piercing the Corporate of Veil The lodestar of organization law has remained the honesty of the different identity of the organization: the corporate cloak might be lifted in the most compelling of circumstances. The result is an absence of clarity in the exact lawful privileges of the shareholders and their connection with the governing body. When to lift The case law has showed that the courts are by and large hesitant to lift the corporate shroud. Yet, the points of confinement of a periodic choice of a court to lift the corporate shroud is not closed. It is, hence, hard to foresee the circumstances in which the courts will puncture the corporate shroud, and there is by all accounts an inclination to rehash the wheel each one time it is contended. Courts have approached veil–piercing cases in an ad hoc manner with underlying policy considerations in mind. As Rogers AJA confirmed in BriggsvJamesHardieCoPtyLtd: The threshold problem arises from the fact that there is no common, unifying principle, which underlies the occasional decision of courts to pierce the corporate veil. Although an ad hoc explanation may be offered by a court which so decides, there is no principled approach to be derived from the authorities (Briggs v James Hardie Co Pty Ltd Ors (1989) 16 NSWLR 549 at 567) When deciding to disregard the separate legal personality principle Jenkinson-J, in DennisWilcoxPtyLtdvFederalCommissionerofTaxation, stated that a court should do so, â€Å"†¦only if [they] can see that there is, in fact or in law, a partnership between companies in a group, or that there is a mere sham or faà §ade in which that company is playing a role, or that the creation or use of the company was designed to enable legal or fiduciary obligations to be evaded or a fraud to be perpetrated† (Dennis Wilcox Pty Limited v Federal Commissioner of Taxation (1988) 79 ALR 267) Fraud The corporate veil may be lifted where there has been an extortion or other break of the law. The extortion and sham contention alludes to the utilization of a partnership by the controller to avoid a lawful or guardian commitment, where the company is utilized as an issue to cover genuine commitments. As the Full Federal Court noted in Donnelly-v-Edelsten â€Å"the contention [of fraud] is, obviously roundabout. It can just succeed if the contention of sham succeeds. On the off chance that an organization is a sham or veneer then it has fused only to mask the truth of its operations or dodge commitments. (Donnelly v Edelsten (1994) 13 ACSR 196 at 256) To penetrate the corporate shroud for misrepresentation, the organization must have the plan to utilize the corporate structure as a part of such a route as to deny the offended party some for every current lawful right. All the more particularly, the organization is consequently used in a way to evade a lawful commitment. To be clear, it is for the most part reasonable to structure organizations to dodge a future risk, for instance in a hazardous business wander that may come up short, however courts may not permit an organization to be structured to abstain from performing a current legitimate obligation. In any case, such contentions can be scrutinized for dismissing the different element guideline. Concerning a sham enterprise, Windeyer J has held if an organization is appropriately joined and enlisted under the Corporations Act and the best possible records are kept in due structure and the recommended returns made, it keeps on existing as an issue substance. In that sense it is a reality and not a sham. (Peate v Federal Commissioner of Taxation (1964) 111 CLR 443 at 480) Group Enterprise Any uniqueness from the standard of independent corporate identity is prone to be joined by a recession of constrained corporate obligation. This is, maybe, most clear in a corporate gathering structure. The gathering endeavour ground incorporates circumstances in which a corporate gathering is acting in such a way as to make every individual substance vague and, consequently, the corporate cloak is lifted to treat the guardian organization as subject for the demonstrations of the auxiliary. Figures that show that two or more organizations were occupied with a gathering venture include ;( Ramsay, I. â€Å"Piercing the Corporate Veil in Australia† (2001) 19 CSLJ 250 at 257) †¢There is an element of partnership or group accounting present; †¢Obvious influence of control extending from the top of the corporate structure; †¢The extent to which the companies were thought to be participating in a common enterprise with mutual advantages; †¢The relationship between the two companies is that of parent and subsidiary; †¢overlapping directors, officers, and employees, †¢One company in the structure acts as agent for the controlling entity; and †¢There is an element of sham or facade present, that is, the corporate structure is used to evade legal or fiduciary obligations. As Rogers AJA affirmed in Briggs-v-James-Hardin--Co-Pt-Limited--Ors †¦ the recommendations†¦ that the corporate shroud may be penetrated where one organization activities complete command and control over an alternate is altogether excessively short-sighted. Rogers AJA went ahead to perceive that it is a business reality that a guardian organization as a rule does activity complete control over a backup, subsequently, uncovering the inborn blemish of a strict application of the different substance standard to corporate gathering. (BriggsvJamesHardieCoPtyLimitedOrs (1989) 16 NSWLR 549) Commits a Tort In spite of the fact that the courts have been more slanted to penetrate the corporate cover in contract claims, there are signs that courts are readied to lift the corporate cloak and make a guardian organization subject in connection to torts submitted by a gathering organization which includes: (a)Cases of agency, partnership or trust between the subsidiary and parent company: Briggs v James Hardie Co Pty Ltd (1989) 16 NSWLR 549; Spreag v Paeson Pty Ltd (1990) 94 ALR 674 (b)attribution of direct liability by reason of the parent company and subsidiary both owing a duty of care to the tort claimant according to the limiting tests of reasonable foreseeability and proximity, chiefly demonstrable by a level of actual control over day-to-day operations of the subsidiary (CSR Ltd V Wren (1998) Aust Tort Rep 81-461) akin to the subsidiary being a mere faà §ade (James Hardie Co Ltd v Hall (1998) 43 NSWLR 554 at 579-584) Effects of Corporate Separate Personality Transferable Shares The way that an organization is lawfully separate from its parts encourages the exchange of shares. The issue of shares is viewed as an issue method for raising capital for the organization (albeit littler brokers are regularly pulled in by the idea of fuse just as an issue to ensure themselves from potential boundless obligation). The trading of shares on the open market additionally prompts straightforwardness since it goes about as an impetus for administration to lead the business in a sensible way. This straightforwardness empowers more prominent investigation by pariahs of the organizations undertakings and diminishes the opportunity for deceitful conduct, along these lines enhancing the attractiveness of the shares. It additionally implies that financial specialists have the capacity get the imperative data they require keeping in mind the end goal to assess the organization before entering into business exchanges. From the organizations perspective, on the other hand, this st raightforwardness can regularly prompt divulgence of data that they would have liked to withhold and place them in a more helpless position with contenders. Ownership of Property Where an organization holds property in its name, this has a place singularly the organization and the shareholders have no restrictive rights (other than for the estimation of the shares they hold). This gives shareholders and workers more security than if a chief decided to leave his position and had the capacity authorize a deal and division of any organization property or resources he possessed. This position thusly makes the shareholders ventures more appealing and secure. Notwithstanding, this may be to the impediment of a merchant who possessed the organization property before joining yet neglected to accordingly dole out the protection approaches to the organization. This was delineated in Macaura v Northern Assurance Co wherein Mr Macaura had protected timber under his name and this was then decimated by a blaze. The insurance agency declined to pay out on Mr Macauras case, expressing that he had no insurable enthusiasm toward the timber as it was claimed by the organization . In the same way, a guardian organization does not have an insurable enthusiasm toward its auxiliary organizations, even where they are completely possessed by it. Distinct legal identity A standout amongst the most noteworthy impacts of corporate separate identity is that the organization expect a different character from that of its parts. Regardless of the fact that an organization is possessed by and large by one shareholder, the organization has a totally separate identity from that single person. This is affirmed by the main instance of Salomon v A. Salomon Co Ltd in which the House of Lords held that the organizations demonstrations were its demonstrations, not those of Mr Salomon by and by. As an issue, Mr Salomon was not generally subject for his organizations obligations. It is important, then again, that the Court did perceive that there would be circumstances in which they would be arranged to move far from that standard and lift the cover of fuse and discover people subject where they had acted insincerely, deceitfully or irrationally. Limited Liability Because of the way that the organization is a different lawful individual, it takes after that its parts wont for the most part be subject for its obligations and commitments. This gives the shareholders an extraordinary level of security, since it implies that they find themselves able to benefit from the accomplishments of the organization whilst being protected in the information that their individual risk is constrained to the estimation of the shares they have obtained. On the other hand it ought to be noted that those parts who take part in the administration of the organization wont essentially be secured from individual obligation. Also, the idea of restricted risk may not be alluring to potential loan bosses who may require extra security for their credit. Ability to sue and liability of be sued The primary advantage to brokers of joining is the idea of restricted obligation; on the other hand, this can demonstrate to the impairment of outsider lenders who enter into exchanges with the organization. Whilst the leasers will have the capacity to sue the organization itself, they will most likely be unable to recoup their cash if the organization is wiped out. It ought to be noted additionally that an organization has the capacity sue its debt holders for non-instalment. So it is a lawful person that can both sue and be sued. Problem with the Salomon Principle The focal issue with the Salomon rule is a moral one. It is the backwards of the second advantage, talked about instantly above, when seen from the viewpoint of individuals managing the organization from the outside. In the event that Aron Salomons property is secured, then individuals managing the organization have just got the organizations own particular resources accessible to them if the organization goes into indebtedness. This implies that an ambitious person in the position of Aron Salomon may give less mind and regard for the need to arrange genuinely and reasonably with outsiders on the grounds that the business visionary confronts no extraordinary individual danger of misfortune, past injured pride and the trust of a beneficial business (aside from what is said beneath in regards to fake exchanging). Thus, different shareholders in an organization bear no individual danger of misfortune if the organization falls flat in light of the fact that the constrained risk which is allowed by our organization law by definition confines their individual liabilities. When we include the greater part of this together, we land at a position whereby the whole economy is inhabited by organizations whose shareholders and administration bear a minimal immediate moral obligation or misfortune if those organizations ought to fall flat. The morals of that economy get to be faulty if nobody confronts the danger of open finished, individual misfortune. Conclusion The impacts of corporate separate identity are expansive. An organization is viewed as an issue element in its own particular right and, in that capacity, its parts have constrained obligation for its obligations and commitments. The organization has the capacity own property in its own particular name and issue shares to raise capital. It has the capacity sue debt holders and likewise be sued by its leaders. At long last, a central normal for corporate separate identity is that of interminable progression, which brings about a continuation of the organizations presence paying little respect to its parts.

Care Plan

Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a different philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of th eir disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can gre atly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working with the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy and radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiveness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Ass ess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by patient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about becoming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, DRP.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of he r life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all care is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encouragement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14, measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears. Care Plan Transition Nursing Process Discussion Group 3 Case Study Michael Martinez Is a 24-year-old Marine who was Involved In a motor vehicle accident (MBA) while on leave. His face hit the dashboard, resulting in a fracture of the mandible. Yesterday, he underwent a surgical incommensurable fixation, (wiring of the Jaw) for stabilization of the fracture. As a result of this surgery, he is unable to open his mouth and is limited to a liquid diet. The restricted diet will be necessary for 4 to 5 weeks until the fracture heals. One day post pop, his vital signs are 120/76, T-99. 2, P-82, and R- 20.After medication, is pain level is 3/10. With the exception of facial bruising, his appearance is within normal Limits, Steps of the Nursing Process Patient Information Assessment Objective and subjective data will be entered here. The database presented In the case study will be used. Data is collected and verified from the primary (apt. ) and the secondary (family, friends, health professionals, an d medical record). Analysis of this data provides the basis for development of the remaining steps in the nursing process. Subjective: Patient expresses disinterest in a liquid only diet Objective: wired Jaw Liquid diet Nursing DiagnosisAfter analyzing the assessment data, formulate a priority nursing diagnosis. Remember, a nursing diagnosis is a statement describing the patient's actual or potential response to a health problem that the nurse Is licensed and competent to treat. An actual diagnosis Is written In three parts: diagnostic label (problem) related to_ as evidenced/exhibited by_. A risk diagnosis is written in two parts: Risk for (diagnostic label) _ related to Nutrition: less than body requirements related to Inability to eat solid foods as evidenced by liquid diet post-surgery Planning Goals: Now is the time set patient centered goals.Here you will develop expected selection of interventions based on six important factors outlined in your text. Please write the interven tions you select below in implementation. Patient will be free of signs of malnutrition post dinner time each shift Implementation Here is where the nurse will carry out the plan of care. Then continue data collection and modify the plan of care as needed and document care provided. What nursing interventions will you provide to enhance patient outcomes? Assess patient's weight every shift Calculate bowel sounds Evaluate total daily food intake Provide high calorie, nutrient-rich dietary supplementsEvaluation The purpose of evaluation is to support the effectiveness of nursing practice which is patient-centered and patient-driven. This phase measures the patient's response to nursing interventions and progress towards achieving goals using five elements listed in the text. Did you achieve the goal for this nursing diagnosis? Will you continue the plan of care, revise the plan of care, or discontinue? Reassess patient's lab value daily for signs of malnutrition. If malnourished call health care provider for further orders Patient will weight within 10% of normal body weight every morning Care Plan A. Our client, Mrs.. Thomas has been given the unfortunate diagnosis of metastasis breast cancer. When considering the current and future needs of this client, significant thought and planning must be directed toward the client's level of well being. In the case off terminally ill patient, it is important to help facilitate a high quality of life that encompasses both physical and psychological health. I would recommend initiating palliative care for Mrs.. Thomas.Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a differen t philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of their disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can greatly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working w ith the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy an d radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiv eness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Assess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by p atient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about bec oming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, Dry.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of her life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all c are is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encour agement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14 , measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears.Acknowledge the frustration associated with caregiver responsibilities. Initiate counseling. 2. Help the caregiver problem solve to meet his needs. 3. Set up medication reminders for psychological medications. Implement: 1. Patient openly discusses concerns, uncertainties and fears (SHE). Patient acknowledges frustrations associated with his caregiver responsibilities. Patient attends counseling. 2. Patient participates in problem solving to meet his needs. 3. Patient follows medication reminders and takes medications for his depression. Care Plan A. Our client, Mrs.. Thomas has been given the unfortunate diagnosis of metastasis breast cancer. When considering the current and future needs of this client, significant thought and planning must be directed toward the client's level of well being. In the case off terminally ill patient, it is important to help facilitate a high quality of life that encompasses both physical and psychological health. I would recommend initiating palliative care for Mrs.. Thomas.Palliative care would allow the client to receive a combined and holistic approach for medications, equipment, unseeing, and symptom treatment all fascinated through one program. The community health nurse needs to be careful not to impose ones own perception about quality of life upon the client. With the experience of having helped both of my parents through the dying process, I know that it is important to separate my own experience and perceptions from those of my client. Just as each person takes on life with a differen t philosophy, so it goes with the dying process.The nurse must not assume that the patient's priorities are the same as his or hers. Open communication regarding the patient's wants and needs must be initiated. Though not all patients have had the time or skills to know how to deal with a terminal illness, one of the most important Jobs of the nurse is to connect the patient to the proper resources needed for navigating through the various aspects and stages of their disease process, and to do so without Judgment or bias. B. Many terminally ill patients begin to navigate through the stages of grief as outlined by Elisabeth Kibble-Ross.While caring for this client with a lingering terminal illness such as cancer, my first strategy would be to keep the lines of communication open, managing the patient's emotional and spiritual needs and outlining the stages of grief as the client progresses through them. By initiating a good line of communication, one can recognize and guide both Mr.. And Mrs.. Thomas through denial, anger, bargaining, depression and acceptance (Kibble-Ross). It will be easier to better manage Mrs.. Thomas' physical needs if her psychological social needs have been addressed.My second strategy in helping to improve the quality of life for Mrs.. Thomas and her husband would be to manage Mrs.; Thomas' comfort. Working carefully with a palliative or hospice team to manage the physical discomforts of the tangent's illness, can greatly increase quality of life. This is often a critical area of educating the patient on pain control. Patients are often afraid to take pain medications, and therapeutic communication is likely to be necessary. Monsoon). My third strategy would be to set up an interdisciplinary palliative care team to to manage the health of Mrs..Thomas. Terminal illness can be overwhelming for a family, where likely there are other factors – be it financial, familial, psychological, and no one person can manage it all. By working w ith the family to institute a good team or care, the burden can be lifted off the family and this will ideally allow them to care for their loved one without becoming burdened or overwhelmed. It is important to consult the family regarding any spiritual support that they would feel comforting. Is there a minister or spiritual guide currently in their life?If not, would they be open too visit from someone that is akin to their spiritual values? These are questions that should be carefully addressed. C. Nursing Care Plan for Mrs.. Thomas Assessment: Mrs.. Thomas is a 56 year-old female with a history of breast cancer. Mrs.. Thomas is aired with two grown sons, aged 28 and 30 both of which live out of state. Mrs.. Thomas has a strong familial history of braes cancer and one year ago, was treated for a malignant mass in her right breast.After a right mastectomy, chemotherapy and radiation six months ago, the cancer has now returned with subsequent right sided mastectomy, chemotherapy an d radiation. The cancer has now metastasis's to the lungs and the prognosis is now deemed to be â€Å"poor† with â€Å"palliative care now being recommended†. (Task 2). Diagnosis Number One: Acute Pain related to incision secondary to surgical intervention as evidenced by tangent's visible discomfort/crying in bed, pallor, respirations, blood pressure and a report of 8/10 pain. Goal 1.Patient will verbalize a pain rating of 4 or less on a scale of 10 with each assessment. 2. Pain control as evidenced by patient demonstrating ability to use analgesics appropriately, use alternative non-analgesic relief, reported pain to be mild, relaxed body language, vital signs returning to normal Plan 1. Analgesic pain medication as prescribed by physician (Swearing) 2. Use of diversionary and or strategies to assist with pain (SHE Nursing Care Plan Guide) 3. Assist patient with positioning for comfort Implement .Evaluated effect of medication, utilize pain scale 2. Assessed effectiv eness of diversionary strategies (SHE Nursing Care Plan Guide) 3. Assisted with position changes Diagnosis Number Two: Activity Intolerance related to generalized weakness as evidenced by increasing fatigue Goal 1. The nurse will help fascinate a physical therapist to help with mobility 2.. Will ambulate IX around block daily Patient 3.. Patient will fully participate in Tall's within physical limitations without dizziness or change in vital signs by 8/1/14 1 .Assess patient's level of mobility, educate within patient's capability 2. Assess nutritional status. Adequate energy reserves are required for activity. (Swearing) 3. Ambulate patient XX a day 1. Educated patient on benefits of mobility and the proper body mechanics for mobility 2. Encourage nutrition prior to activity and the proper body mechanics for mobility Monsoon) 3. Ambulated patient XX daily Diagnosis Number 3: Ineffective Coping related to financial burden and emotional impact of diagnosis on family as evidenced by p atient's increasing isolation 1.Set up a quality interdisciplinary team incorporating counseling services for the family 2. Patient will demonstrate problem solving techniques Monsoon) 3. Patient ill verbalize acceptance of diagnosis 1. Patient will utilize available support systems and work with counselor for socio psych issues 2. Assist client to identify priorities and attainable goals as he/she starts to plan for necessary lifestyle and role changes 3. Perform actions to facilitate the grieving process (Elsevier) 1. Patient met with counseling services 2. Patient identified priorities and set goals 3.Patient demonstrated knowledge of the 5 stages of grief and how to work through them In order to optimize Mrs.. Thomas functional ability, the care team should strive for all three of the goals in her plan of care to be met. First of all, her pain needs to be managed so that manipulation can be successful, without discomfort. It is quite common for patients to be concerned about bec oming addicted to pain medication as in the case of Mrs.. Thomas. Addiction is â€Å"psychological dependence† on a drug and is not the same as tolerance or physical dependence, according to Oncologist, Dry.Gary Johansson who states that â€Å"In fact, addiction is rare when avoids are used for pain relief†. With proper education and regularly scheduled pain medication, Mrs.. Thomas should be much more comfortable and able to manage other areas of her life more successfully. Once Mrs.. Thomas' pain is under control, she will be able to work through many of the stresses that have mounted since her diagnosis. As Mrs.. Thomas disease progresses, there will come a time when she will no longer be able to care for herself. A new Plan of Care should be created and ready to transition to at that time.At this time the interdisciplinary team should consist of a hospice care which is generally implemented when a patient has less than 6 months to live. When hospice is begun, all c are is transferred to the hospice team. New orders for care, medication, equipment will be set up and time is given to the family or supporting both the patient and their loved ones. Care will focus on making the most out of the time they have left, â€Å"without some of the negative side-effects that life prolonging treatments can have†. Monsoon).Most hospice patients can attain a level of comfort that allows them to â€Å"concentrate on the emotional and practical issues of dying†. Willet-Legislations). Mr.. Thomas is carrying a big physical and emotional burden during his wife's terminal illness. The Thomas family's case is complicated by Mr.. Thomas' chronic depression and high stress occupation. As Mrs.. Thomas' needs escalate and change, so do the needs of the Mr.. Thomas. By facilitating psychological help for Mr.. Thomas, the care team is in turn helping Mrs.. Thomas by easing her worries about her spouse.Patients and families need support, guidance, and encour agement to begin planning for many decisions. Many spouses are weighted with concern about the patients' comfort and impending death as well as every day problems. â€Å"This is an emotionally intense, exhausting, and singular experience, set in a world apart from everyday life patterns†. (Siegel). Mr.. Thomas needs to be reminded that in order to help care and be emotionally supportive to his wife, he needs to take care of himself. Medication reminders and grief support should be set up for Mr.. Thomas.Therapeutic conversation and guidance can make all the difference for the significant other off terminal patient. In addition, Mr.. Thomas needs respite care so that he can be fully present while caring for his wife. Mr.. Thomas should be encouraged to take a walk, a nap, or a restorative A care plan for Mr.. Thomas could be initiated with a nursing diagnosis of: Risk for Caregiver Role Strain. (SHE). Goal: Spouse will report low or no feelings of burden or distress by 8/01/14 , measured by relief stated by spouse. Plan: Encourage the caregiver to talk about feelings, concerns, uncertainties, and fears.Acknowledge the frustration associated with caregiver responsibilities. Initiate counseling. 2. Help the caregiver problem solve to meet his needs. 3. Set up medication reminders for psychological medications. Implement: 1. Patient openly discusses concerns, uncertainties and fears (SHE). Patient acknowledges frustrations associated with his caregiver responsibilities. Patient attends counseling. 2. Patient participates in problem solving to meet his needs. 3. Patient follows medication reminders and takes medications for his depression.

A Thousand Acres – Summary

Major Works Study Form AP Question 3 Title: A Thousand AcresAuthor: Jane Smiley Biographical Information: Jane Smiley was born in Los Angeles, California and later moved to Missouri, where she went to school until college. She went to Art at Vassar College, and then traveled around Europe where she worked on an archeological dig. She returned to America and became a teacher. She had two daughters and a son. Author’s Style: The author’s style is used to display the mysterious and unsettling feeling in the novel.The book is told from the point of view of Ginny. The rape from the father keeps the tone of the book very disturbing and solemn because Jess and Rose want to keep their sister Caroline free of the problems they had to grow up dealing with. Plot Summary: The plot of this book completely parallels Shakespeare’s play â€Å"King Lear†. Larry Cook acts as the King of the novel, and he runs the farm. He has three daughters, Ginny, Rose, and Caroline. In t he beginning of the novel, Ginny thinks about the intersection and about the road overall where the farm was.Larry King wants love from his daughters to decide in how he should split up his farm. Ginny and Rose are sexually abused in the novel, but the youngest daughter, Caroline does not partake in this absurd scheme, and becomes a lawyer. She marries another lawyer and lives in Des Moines. Larry is respected by his neighbors and takes on the role of being the advisor but then retires for his children to fill his place. Caroline is cut out of the fathers will because he does not think that he is grateful for everything he has already given to her.Ginny and Rose have to take care of their father Larry, and deal with his rude behavior of drunk driving and wasting his money. Larry goes insane and one day runs out into a storm. The family has to go about their lives trying to cover up their family problems from the public, to make it seem like they are just another normal family. Larry curses Ginny with infertility. The storm in the novel displays the chaos of the family within the book, and the hope after the storm gives hope for the family. Larry goes to the farm of his friend Harold Clarke, where Harold’s son has just returned from a very long journey from.Pete ruins the farm equipment that Larry used, but instead of Larry being blinded, Harold is blinded. Caroline sues the farm, trying to say that they are not farming the right way, and Larry needs to run the farm again. Caroline ends up taking care of Larry as he goes crazy. Ty tries to save the farm from going into debt after Pete dies, but is unsuccessful when Ginny leaves in search of becoming a waitress. Then Rose takes over, but later dies from cancer in more debt than she began with. Ginny and Caroline end up having to sell the farm. Setting (describe each setting and its importance):The farm is the main setting of the novel, which parallels the kingdom of King Lear. Larry Cook owns the farm and raises his children on the land. Another setting in the book is the dump. It is where Ginny and Jess go to hang out, and later use it as a place to have sex. Symbols (describe how they contribute to the characterization, conflict, or thematic pre occupation) One of the biggest symbols of the novel is the dump. It is the place where Ginny and Jess have sex. Dumps in general are grimy and disgusting places, and the sex they had fell along the same lines.The foul act of having sex at the dump symbolizes that instead of having sex in a respectable place like a bed, the random objects in the dump hide their secrets. Another symbol is the white dresses. White dresses represent the innocence of the young girls, which is ironic because they are the opposite of pure. The storm represents the chaos in the novel, and arises during the conflict to parallel the chaos in her family life. Another symbol is the garden. After the storm, when she goes outside to look at her garden, she sees there is very little damage.This provides her with hope for the future, because she connected it to the way that if her precious garden can survive a storm, her family can get through their own storm. A final symbol is the farm, because is the kingdom of Larry Cook. It represents his own area that he owns the way King Lear had control over his own kingdom. Thematic Concerns: One of the main themes is that everything is not what it seems to be. Ginny, Rose, and Caroline all had to keep up the appearance with the farm that everything was normal in their family.In reality, everything was completely chaotic with their family life, but from the outside everything seemed fine. They wore white dresses when they went in public to give off the image that they were pure and clean girls, and kept up the farm so that it always looked neat. They have to try their best to hide their family problems, but ultimately Ginny cannot mask the chaos. Water is usually vital to life, but here the water makes Ginny unable to have a baby, and contributes to Rose’s cancer. Key Quotes: (Choose 3 with Page #) â€Å"While they were cooking, I went out to check my garden.Something that always has amazed me is the resilience of the plants. My tomato vines showed no ill effects from the onslaught of the storm weren’t even muddy, since I had made it a point to mulch them with old newspapers and grass clippings† (197. ) â€Å"Away from the farm, it was easier to think of how people went on from these sorts of troubles; it was easier to see a life as a sturdy rope with occasional knots in it† (248. ) â€Å"I told myself that I had to decide what I really wanted and settle for that- every course of action is a compromise, after all† (308).

How to Choose the Right College Major

How to Choose the Right College Major A college major is the main subject that a student studies while attending a college, university, or another academic institution. Examples of popular business majors include advertising, business administration, and finance. Many students begin their college education without a clear idea of what their major will be. Others know from an early age exactly where theyre going and what they have to study to get there. Most people fall somewhere in between; they have a general idea of what they want to study, but are considering other things. Why Choose? Choosing a major doesnt necessarily mean you’ll be stuck doing that particular thing for the rest of your life. Many students switch majors during their college careersome do it quite often. Choosing a major is important because it gives you a direction to aim for and determines what classes will be taken to earn a degree. When to Declare a Major If you’re going to a two-year school, you will probably need to declare a major soon after enrolling because of the short duration of the educational process. Many online schools will often make you choose a major as well. However, if you’re entering a four-year school, you are sometimes not required to declare a major until the end of your second year. Read more about how and when to declare a major. What to Choose The obvious choice for a major is an area you enjoy and are good at. Remember, your career choice will most likely be reflected in your choice of a major, so the majority of your classes will revolve around that area of study. In choosing a career, it would be best to pick something that appeals to you now and will provide you with job prospects in the future.   How to Choose The most important thing to consider when choosing a college major is what you want to do with the rest of your life. If you choose a major that doesnt particularly interest you merely because a job in that field pays well, you could end up with a few bucks in the bank, but be extremely unhappy. Instead, you would do well to pick a major based on your interests and personality. Dont shy away from the hardest college majors if those fields interest you. If you enjoy them, you are more likely to succeed. For instance, if you’re not a people person you probably shouldnt consider a career in human resources. People who don’t like math or numbers shouldnt choose a career in accounting or finance. College Major Quiz If you’re unsure of what major to choose, it may benefit you to take a college assessment quiz to help you pinpoint a college major based on your personality. A quiz of this type isnt infallible but it can give you a general idea of what majors might suit you. Ask Your Peers Consult with the people who know you best. Your family and fellow students may be able to help you decide upon a major. Ask your peers for their advice. They may have an idea or point of view that you haven’t considered. Keep in mind that anything they say is just a suggestion. You dont have to heed their advice; you’re simply asking for an opinion. When You Cant Decide Some students find that they are torn between two career paths. In these cases, a double major may be appealing. Double majors allow you to study two things at once, such as business and law, and graduate with more than one degree. Majoring in more than one area can be beneficial, but it can also be difficultpersonally, financially, and academically. Consider it carefully before taking this path. And remember, you shouldnt be disheartened because you don’t know what direction you want your life to take. Many people don’t choose a major until they absolutely have to, and even then, change majors at least once.

Article Review Essay

Article Review Essay Article Review Essay UNIVERSITY OF LA VERNE La Verne, California Article Review Submitted in partial fulfillment of the requirements for the degree of Master of Business Administration Professor Fengmei Gong BUS 510 Management of Information Technology Chiu Ngok Lau College of Business and Public Management Department of Business Administration March, 4, 2015 Article review According to the article research, it has shown that a large number of information technology investments make economic competition, especially in traditional industries. And the main purpose of this article is that the relationship between information technology and the business competition is becoming more and more important. However, information technology invests too much, and company ignores other competitive factors, which lead company to decrease the competitiveness, so if company wants to change the pattern of competition, they need to actively put some new competitiveness. Mentioned in the article, the company could use information technology to improve their management model. Then, through good management model, it improves the competitiveness of the company. Secondly, the innovation could improve competitive advantage and also is an important means to change the competitive landscape. Of course, for the company, innovation is based on the information technology, because company wants to spread quickly, and accurately for new innovation, company should use the information technology. After that, when the company competes in a digital process, they should deploy a unified platform for information technology. In the process, company should solve two deployment of the obstacle that is fragmentation and autonomy. Company could get some common data through this platform that support and implement standardized processes, thereby enhancing the competitiveness .Next, the company could use information technology of innovation to t improve the data analysis, and speed up the business process. Lastly, in terms of communication, information technology could spread from top to bottom or from bottom to top. In the company's decision-making process, it Article Review Essay Article Review Essay Disease state such as Overweight and obese has become a significant concern in the developing countries. Obesity experienced in litigation of an extra adipose tissue in the body. Since the indirect calorimeter is not daily available for approximating energy requirements, many predicting equations have undergone improvised to rate this energy. Of recent, obese patients are at an alarming rate in the patient population. They do require nutritional support. In order to achieve this nutritional help, the resting energy expenditure of the patients is the most fundamental goal to examine. This helps to provide enough calories prevent the muscle eat up and hinder lack of minerals in the body. Indirect calorimetric and anthropometry These readings carried out using the Deltatrac metabolic monitor. It went through regulation on a daily basis before working on it. The patient was in a straight position and not asleep. The readings were in a semi-standard way that went hand in hand with the indirect calorimetric measurements. Those sick did not eat regularly during the measuring period. The readings then carried out at a standard neutral hospital room temperature. Oxygen intake and carbon dioxide released measured and energy use calculated by the weir formula (Moshe, et al 2006 P 973). The activity occurred for about 30 minutes. The use of calibrated electronic stand-up scale assisted in obtaining the weight of the body. Sex, age and the weight of the sick determined through interaction with the patient. Harris-Benedict Equations This is the most commonly used technique for obtaining energy use. In order, to change its accuracy stress factors should join hand. In this case, the body weight becomes the first variable. It becomes exact only when the body is in its normal state and when the body fat content is high the predictions become inaccurate. For obese patient’s body, weights undergo change for it to be effective in the equations. Illness and injuries increasingly complicated the estimations of energy requirements. It based largely on the healthy individuals. In the University of California, for example 65 men and 100 women found possessing the BMIs over 30. Measured energy use then divided by an estimated energy expenditure using the HB problem and the Cunningham equation to find the stress factor for injury and illness. They assumed that the stressed factors in most disease categories are in the set of 1.6 to 2.0. REE Predictive Equations It employed the concordance correlation coefficient to illustrate the use and the reliability of the forecasting equations. To obtain the CCC, we compute precision with accuracy. When, one foresees a range of 95% 105%, he would consider it a fair prediction. In addition, a prediction below that value could be viewed as underestimation but above it became overestimation. Inclusion based on age, sex, weight, and height The exclusion process had the following, which considered only the youths or the elderly (Peckenpaugh, 2010 P 601). For every study, equations are performed with respect to the high values of explained variance. However, additional equations are also fixed when weight and height come together. The average percentage of REE predictions exhibits a measure of truth on a group standard. Therefore, the HB problem is the most commonly used predicative case. This is due to its trained personnel. In addition, it can use other clinical conditions such as the presence of chest tubes, which could otherwise be impossible for the calorimetric measurements.

Business advise Essay Example | Topics and Well Written Essays - 250 words - 1

Business advise - Essay Example This massive drop in revenue may result in the hospital being unable to meet operational cost thus resulting in closure. The first solution to the problem is that the hospital can form its own ACO. Since the hospital has access to funding as a source of capital, it can easily raise money to set up an electronic record of patients (McCaffrey 217).The hospital has trained health professionals who can handle clients. This is extremely beneficial since to hospital will not need any additional funding as it makes use of resources already at its disposal. However, this is time consuming and since most of the patients around already belong to a functioning ACO, it would be very hard to convince them to join the new outfit. Second, the hospital can pot to buy some of the ACOs already in operation. The hospital would spend money on the acquisition only; the rest of the infrastructure is already in place. The challenge in this case would be convincing the doctors involved to selling their venture (McCaffrey 218).The option of buying into an already established ACO would be the most appropriate. Buying existing ACOs is a low level of risk because the system is already functional and has a client base ready to receive

Cancer And The Environment Essay Example | Topics and Well Written Essays - 2500 words

Cancer And The Environment - Essay Example Certain environments, regions, and areas lead to high rates of specific cancers. For example, Asians are at high risk of stomach cancer and Americans, have greater chances of catching breast of prostate cancer. However, when Asians migrate from their native countries to America, the risk of stomach cancer decreases for them and like other Americans, their risk of catching prostate or breast cancer comes near to that of average Americans (USDHHS, 2011). Therefore, exposures to certain environments, regions, and substances will go on to define the risk of various cancers. For example, people who have excessive exposure to benzene, a chemical substance that is found dyes leads to higher risk of bladder cancer. Internal Factors There are certain internal factors, within the body, with also determine the likeness of a person getting cancer. Genetic factors, weaker immune system, abnormal hormone system and others are of a few of these. For example, scientists have discovered few rare fami lies that have been passing on altered genes on to their generations thus increasing their susceptibility to a certain kind of cancer (USDHHS, 2011). Despite the fact that this only account for less than 2-5 percent of all cancers, some people may be born with their inbuilt tendency to catch certain cancer. Genes also play an important in this regard because not all people who are exposed to certain environments get cancer. There are millions of smokers in the world but not all of them get lung cancer, however, there are certain specifications in the genes, which increase or decrease the risk of the person to catch cancer if exposed to certain environments. The study of genes for above-mentioned purposes is known as molecular epidemiology, which is a growing field of study in the field of cancer studies. Interactions of Environmental Factors and Genes Environmental factors like sunlight, toxic substances and chemicals in the environment and prolonged exposure to these factors could lead to serious alterations in our genes and permanent alterations in this regard have the capability to cause cancers (USDHHS, 2011). Despite the fact that researchers have come up with the variety of factors that may cause cancer, gene alterations and increase the risk to cancer but they have still not able to come up with the exact or even tentative amounts of exposure to certain environmental and their combination of genetic factors that would lead to cancer. The Nature of Cancer There are over 100 types of known cancers to the humankind and all of them start within the human cells, which are the building blocks of the body (USDHHS, 2011). The human body has the predefined and controlled system where the older cells die off after a certain period and younger cells take their place. However, cancer acts like a foreign invader in the human body and tries to dictate its own terms of growth of cells, which is greater than the normal growth, rate thus creating a tumor. When these can cer cells increase in number, they become more powerful and start interfering with the functions of tissues thus depriving human body of performing certain functions.