The critique of We are raising a generation of deluded narcissts Essay - 1

The critique of We are raising a generation of deluded narcissts - Essay Example This is often the scenario among families today. Parents willingly give the latest gadgets to their children to express their love, to keep them up-dated or simply for them to have some â€Å"companion† while the parents are busy working. However, with such mentality, parents are actively culturing a generation of deluded narcissists as Dr. Keith Ablow would term it. The aforementioned psychologist discusses the making of such a generation in his article on Fox News. This paper will analyze and critique the idea that a generation of egocentric kids is being molded through the use of social media and computer games. In We are Raising a Generation of Deluded Narcissists, Dr. Keith Ablow talks about how young people are becoming egomaniac these days. He says that a study of college students show that they are more confident about themselves and their successes even though their grades are showing otherwise. Children engaging in computer games tend to associate with the characters of the games and think that they are as good as the real stars. Moreover, with the use of facebook, they can choose the photographs they like in order to project a wonderful story of their lives. They can also block the friends who dislike them, resulting to a delusional friendship which is fed by the reciprocation of desired feedbacks. They tend to see themselves as loveable because of their thousands of friends on facebook and followers on twitter and not realize that they are not even able to really socialize well in real life. With the belief that this is an epidemic, Dr. Ablow concludes with the challenge to combat it. In the aforementioned article, Dr. Ablow brings into the open what is happening among modern children who are playing computer games and using social media everyday as part of their routines. He brings to the reader’s attention the fact that there is a psychological effect of the

Many of the characters in Of Mice and Men have dreams Essay Example for Free

Many of the characters in Of Mice and Men have dreams Essay Many of the characters in Of Mice and Men have dreams. What are their dreams and how near are any of them to achieving what they want? Of Mice and Men, written by John Steinbeck is a classic novel set in a ranch town in Salinas Valley, California. The novel may have been set here as a result of most of Steinbecks childhood being spent on his fathers farmland. His descriptions of the setting will have been aided by his first hand experience of the ranches of the area. The novel itself documents the lives of Lennie Small and George Milton. With Lennie being mentally challenged he has the psychological capabilities of a five year old. This means he has to be cared for by George because he acts childish and irresponsibly. For this reason, he often causes commotion within the ranch he is working. On many occasions disruption has occurred and occurs, George and Lennie are forced to leave their current ranch and start again at a new one. As they are always moving around, they never have a secure job and are always staying in temporary accommodation. With each time they move to a different ranch they dream more and more of having their own piece of land where they can be their own bosses and live off the crops they grow. This is shown by this quote, and we can live off the fatta the lan' said by George. This is only one of the many dreams that feature in Of Mice and Men, however not one of the dreams featured in this novel are achieved. This reflected the harsh reality of the Great Depression and the racial prejudice in society at the time. Steinbeck set Of Mice and Men during the Great Depression, in the late 1920s and the 1930s. Many migrants came to California, from other parts of the world looking for work as America was seen as the Land of Opportunity. This glimpse of hope inspired many Europeans to emigrate as Europe, at the time, was overcrowded and disease ridden. America was believed to provide cheap land and no rigid class structure existed. These characteristics gave Europeans the chance of a completely different way of life to what they were used to. In 1929, America entered a prolonged period of economic deprivation due to the collapse of the New York stock exchange, The Wall Street Crash. Following The Wall Street Crash, many Americans who had invested great deals of money into stocks and shares lost almost all of their investments. In some cases, people would have lost their houses and life savings. During The Great Depression, failed businesses and long-term unemployment were of the norm. The hopes of those immigrants, who came to America looking for a new life, were dashed by this tragic event. America was certainly not the Land of Opportunity. George and Lennie travelled from ranch to ranch together. This was unusual as most ranch workers would only usually work at one ranch for no longer than a month or two. They would literally not have the time for friendship. This was one of the reasons that the average workers dream was for some sort of companionship. The fact that George and Lennie had travelled together so long is significant as they lived the dream of so many other workers. It would give them the chance of having an alternative dream, one of owning their own land on which they could live off. When travelling from ranch to ranch workers could not carry many possessions and so had nothing to show for their years of working. They would work and work but not really achieve much. They would spend the money they earned and then earn some more and repeat. This is illustrated in the quote, ..work up a stake and blow the stake. A dream would be important as it would give a worker something to work towards instead of working with no real direction in their life. Many of the characters in the novel have dreams. The dream is a form of escape from reality of life. As previously stated, George and Lennies dream is to have a piece of land that they can call their own, tend it, grow crops and raise animals. However, Lennie specifically dreams of caring for rabbits. This shows his immaturity. He says, An have rabbits! George is always repeating this dream to Lennie. When he does depict the dream to Lennie, he uses exaggerative language and gets involved in the dream almost as much as Lennie. Both George and Lennie become excited when the dream is recalled. They swear, Well just say the hell with going to work , animating their eagerness to fulfil their dream. George and Lennies dream eventually fails. This is for a number of reasons. It is mainly because Lennie is such a burden to George. Because of Lennies mental incapability, he has no idea that he is making Georges life miserable. George says, Course Lennies a God damn nuisance most of the time, but you get used to goin around with a guy an you cant get rid of him George is being held back by Lennie as they are constantly forced to change jobs, because of situations the Lennie gets them in to and therefore they cant stay in work long enough to build up any sort of savings. The result of this is that they can not save up the money to achieve the dream. Lennie has limited social skills and so does not know how to interact with people. Instead, he finds comfort in touching things and is too tactile. This causes trouble as Lennie often touches womens clothes and is misunderstood and seen to be abusive. For this reason, George has to keep a constant eye on Lennie. When Candy makes the proposal of entering their dream in exchange for three hundred dollars, George suddenly sees some possibility of the dream succeeding. Before, he had merely used the dream as a pacifier for Lennie and had lulled himself into believing that it may happen so that he could continue bringing hope to Lennie. I think that sub-consciously he always knew that the dream would never be a reality. With Candys financial input, the dream could realistically be achieved within the month. However, an abrupt end to their hopes arrives. Lennie, in his childlike way, cannot conceive of the line where stroking stops and hurting begins in terms of petting, and he ends up accidently killing two animals by petting them violently. Most horrifically, at the climax of the story, he kills Curlys wife in the same way. The fact that he killed her was the final blow to the dream. I think I knowed from the very first. I think I knowed wed never do her, George says as he realizes the dream is inevitable. Lennie was inevitably going to be hunted down and shot on site. George, who is forced to join the manhunt for Lennie, decides that the kindest way out for both him and Lennie is to kill him when he finds him. He does this by luring Lennie into a false state of trust by reciting their dream to him one last time. This sends Lennie off into death with his dream in his head. You can argue in some way Lennie has achieved his dream. Curlys wife has a dream common to the period and today. She believes that she has the talent to become a Hollywood actress. She was convinced of this as when she was younger; she acquainted herself with a Hollywood director who deemed her suitable to be an actress in the movies. This is shown in a quote taken from a passage spoken by Curlys wife, An I coulda sat in them big hotels, an had pitchers took of me..An all them nice clothes they wear. Because this guy said I was a natural. This guy told her she would receive a letter from him explaining where to meet to develop her acting career. Her explanation of why she didnt become an actress is idealistic at best. She believed that her mother stole that letter. However, this is an optimistic justification. It just so happens that shortly after Curleys wife was given the hope of becoming an actress, she met Curley. When she realised that her dream of becoming an actress was truly over, she decided to marry Curley. She may have done this as, at the time, it was very difficult for a woman to get a job and live on her own. The main profession of women then was housewife. Most women would marry a modest worker but marrying a rich man who owned a ranch was a bonus. Life would be easy for Curleys wife as she would not have to lift a finger. As there was such discrimination towards women, Curleys wife found herself being ignored by the men on the ranch. She was not paid much attention by Curley and was seen by him as more of a trophy than a wife. These are the main reasons that Curleys wife is not happy. She openly expresses that she does not even love Curley. I dont like Curley. She regrets that she married him in the first place. She was not able to speak to anyone during the day as all of the men were out on the fields working. This causes her to be extremely lonely. At any chance she can she will speak to someone. When she speaks to Lennie in the barn, she says, Why cant I talk to you? I never get to talk to nobody. I get awful lonely. This shows that she craves friendship. She is often prying on the men just looking for someone to talk to. She justifies this by saying to Slim Hi, good lookin. Im tryin to find Curley, Slim. The fact that she does not even have a name and is instead referred to as Curleys wife shows her status on the ranch. It shows that she is so insignificant that she is not even deemed important enough to warrant a real name. She is looked down on and shown no respect by most of the men on the ranch. She also has the dream to be treated as equal to the men on the ranch. This is similar to Crooks dream. He just wants to be accepted by everyone else on the ranch. However, both Crooks and Curleys wife have similar dreams which would lead you to think that they would sympathise with each other. The reality is quite opposite. Curleys wife approaches Crooks in an aggressive manor and speaks to him in a demoralising way. She says, Well you keep your place, then Nigger. I could get you strung up on a tree so easy it aint even funny! She perhaps speaks to Crooks with no respect as he is the only person on the ranch over whom she has a higher status. Crooks and Candy try to enter George and Lennies dream. They both do this for their own reasons. Candy is worried about his future on the ranch. He believes that is nearing the point of becoming useless to the ranch owner. He needs some security so that when he does become of no use, he can settle down somewhere. Crooks feels socially isolated and needs to go somewhere that he will be treated as an equal. George, Lennie and Candy do not discriminate against Crooks as much as most. This is the reason that he would feel comfortable living in a house with them. Candy, when he enters the dream, provides financial power. He has three hundred dollars that he is willing to invest in the dream. When he first tries to join the dream, George responds in a negative and coy way. He says You know a place like that? [Candy] Spose I do? Whats that to you? [George]. However, when George considers Candys proposition, he starts to think that the dream may actually become a reality. Candy is afraid that if he does not get somewhere that he can retire to, he may have no one to care for him. Eventually he will be seen of no use and disposed of, much like his dog. Crooks joins the dream as he feels he needs a shelter from society, somewhere that he is accepted for the person that he is and not judged by his skin colour or his disability. Crooks has no status and is treated with no respect on the ranch. He is frustrated with all of the racism directed towards him. He says, If I say something, why, its just a nigger saying it Crooks had a taste of equality when he was a child. He was accepted by white children and has perhaps not accepted the fact that he is now a social outcast. He says, The white kids come to play at our place, an sometimes I went to play with them, and some of them was pretty nice He remembers what it was like to be an equal and wants to experience that feeling again. This is one of the reasons the Crooks joins the dream. Candy will soon be too old and frail to keep his job at the ranch. The fact that he only has one hand means that his job opportunities are very limited. He, much like Crooks, has no one in his life. He just watches workers come and go from the ranch. He would have somewhere to belong if he joined the dream. This is a very important psychologically as having a place to call home can give Candy a reason to carry on living. All of these characters have dreams and their dreams are important to them. They all give their character some sort of goal to aim for and a light at the end of the tunnel. I believe Steinbeck is trying to make a point by including all of these dreams. I think he is trying to say that without dreams, we are all lost in our lives. We all need some sort of dream to keep us motivated. I think the novel was written to show the stranglehold that the Great Depression had on America in the 1930s. It also shows how hard the life of an itinerant worker was. Of Mice and Men was very a descriptive and informative book. It made me realise that dreams, however small or big, are vital in life.

Case Study: Elderly Patient with Several Concerns

Case Study: Elderly Patient with Several Concerns Daniel Littlewood   Case study Mrs Hiruni Jupangati You are an Enrolled Nurse working in the small public hospital in Cattelanbaa, rural QLD. This is your first job since completing the Diploma of Nursing and you have been working here for the past month. Mrs Hiruni Jupangati (born 20/05/1929) was admitted by her GP last night with exacerbation of asthma. She was born in Sri Lanka but migrated to Australia with her Australian Aboriginal husband whom she met during the 2nd World War. He worked as a stockman for a nearby cattle station until he retired to their small house in town 25 years ago. Their eldest son left home as a teenager and hasnt maintained contact with the family. Mrs Jupangati has 2 other children a daughter who lives on a sheep station just out of town, and a son who is a remote Aboriginal health worker in the NT. Mrs Jupangati has lived alone since her husband of 68 years died suddenly from a stroke 9 months ago. Although she is eligible for a place in a nursing home in Bigganbad, the regional centre 650km away, she is determined to see out her days at home. She receives support from the community nurse for wound care and her daughter who visits weekly to help with housework etc. She enjoys pottering in her vegetable and herb gardens, cooking Sri Lankan food, watching cricket and making robes for the Katina ceremony. Hiruni likes to spend time every day meditating, chanting from the Pali canon, and burning incense. The Buddhist monk visits once a month from Bigganbad and she attends the annual Poson and Katina festivals in Brisbane with her daughter. Mrs Jupangati has some mild short term memory loss and her GP noted she seemed somewhat confused during his visit. While she is normally independent in performing her ADLs, Hiruni attends to them once or twice per week. She wears a light pad for some urge urine incontinence. After 45 years of smoking heavily she stopped 5 years ago. Mrs Jupangati had excision of cataracts and insertion of IOL 2 years ago and wears glasses for reading. She can mobilise short distances independently with a walking frame. Mrs Jupangati has Osteoarthritis in her back, right hip and both knees. She had a left total hip replacement 6 months ago and is on the waiting list for the other joint replacements. She was diagnosed with Type 2 Diabetes Mellitus (DM) 5 years ago and has required insulin for the past 3 years. Her BGLs have been reasonably stable over that time. Along with Asthma and Diabetes, Mrs Jupangatis medical history includes Rheumatic fever as a child, Ischaemic Heart Disease (she had CABG 25 years ago), Congestive Cardiac Failure (CCF), and Chronic Obstructive Pulmonary Disease (COPD). At age 67 Mrs Jupangati had a left mastectomy and axillary clearance for breast cancer. Treatment included radiation and chemotherapy. There has been no apparent reoccurrence although she has not complied with follow-up mammograms which can only be done in Bigganbad. Mrs Jupangati has had four admissions to the local hospital in the past 6 months. One was for a fall and the other 3 for exacerbation of COPD and respiratory tract infections. She has a small skin tear on her right forearm, a diabetic ulcer on her left foot, and 2 small scratches from gardening on her right lower leg, all of which are being managed by the community nurse GP. Mrs Jupangati has several missing and decayed teeth. She is complaining of painful areas on her coccyx and red right heel since watching the recent cricket test series on TV. She wears hearing aids though needs reminding to use them. Patient observations on arrival to the hospital were as follows: Height 150cm Weight 87kg BP 160/90 Pulse 108 irregular Respirations 32 Temperature 37.8C O2 saturations 84% room air BSL 8.2mmol/l Urinalysis pH 6.0, SG 1010, Nitrates +, Leukocytes ++, Blood ++, urine cloudy and offensive Current Medications: Lantus Actrapid Seretide and Ventolin inhalers Panadol Osteo Voltaren Gel (her daughter gave this to her last week to help with arthritic pain) Oxycodone PRN Frusemide Enalapril Prednisolone Atorvastatin Coloxyl and Senna Pending investigations: Chest X-Ray Blood tests Spirometry Mid-stream urine (MSU) Other orders: TED stockings Bed rest with toilet privileges Oxygen @ 2L/min via nasal prongs Fluid balance bowel charts Q2:Identify, list and briefly outline the use for the equipment required to obtain all of Hiruni Jupangatis observations and complete the assessment form. A2: As written in (Tollefson, J., Watson, G., Jelly, E., Tambree, K., Bishop, T, 2015, pp.10-30, 66-98) the equipment required to carry out the observations for Mrs Jupangati are: Gloves and hand wash aid in preventing spread of infection. Height and weight scales needed to find BMI. Calculator to work out BMI. Blood Pressure and sphygmomanometer with BP cuff to take blood pressure. Stethoscope to listen to heart beat. Pen torch to check if PEARL. Watch for RR and pulse rates. Thermometer with probe covers take temperature. Pulse oximeter to get Mrs Jupangati SpO2 level. Urinalysis Commode, bedpan as required/ PPE/ specimen container/ urinalysis bottle with regent strips/ paper towel/ perineal care equipment/ watch/ pen and paper. BGL Glucometer/ cotton balls or gauze/ lancet/ sharps container/ testing strip/ diabetic chart/ warm water. Computer / relevant forms and pen to document data collected. Satisfactory Needs revision Q3:List five (5) strategies you could implement to enable Heroin to meet her emotional, psychosocial and spiritual needs. Identify 3 ways you would ensure both her privacy and confidentiality are maintained while she is an inpatient. A3: Understanding how Mrs Jupangati culture belief view health care will help to tailor questions and treatment plans to the Mrs Jupangati needs. By asking Mrs Jupangati about her religious and spiritual practice, you can learn something about Mrs Jupangati health care choices and preferences. Get to know Mrs Jupangati health problems will help you to develop a care plan for Mrs Jupangati, also involve Mrs Jupangati in her care plan. Anticipate Mrs Jupangati needs this will show Mrs Jupangati that you do care and that you want to provide Mrs Jupangati with the best plan of care possible. Gain Mrs Junpangati trust by providing consistent, respectful and patient-focused care, follow through on commitments and have an accepting attitude rather than being judgmental (Crisp, Douglas, Rebeiro, Waters, 2016 pp 447- 449 ). Three ways you would ensure Mrs Junpangati privacy are environment which is drawing curtains, closing windows and doors. No gossiping about her to staff members and patie nts. Do not post anything about her on social (Crisp et al., 2016 p225). Satisfactory Needs revision Q4What communication techniques would you use when interviewing/assessing Hiruni and explain briefly how they would assist you. A4: Active listening is taking an interest in what Mrs Junpangati has to say through verbal signal, nonverbal gestures, and body language. Using active listening will help build trust with Mrs Junpangati(Crisp et al., 2016 p222 ) . Using body language and gestures is important in making a connection with Mrs Junpangati, by taking the time to make eye contact, smiling, leaning forward and focusing my attention on Mrs Junpangati will help make a connection with her(Crisp et al., 2016 p223). Asking open end questions will require Mrs Junpangati to expand on her answer. English is Mrs Junpangati second language Junpangati may have difficult communicating, then closed questions may be required. Mrs Junpangati cultural difference and ESL may require me to prompt her, using clarification/validating techniques to build trust(Crisp et al., 2016 p224 ). Satisfactory Needs revision Q5:Review Mrs Jupangatis vital signs and observations. Identify whether they are within the normal range. If they are not within normal range state what the normal range and variance is and what the variance may indicate. Discuss your relevant duty of care expectations as an EN. A5: An EN duty of care expectations are to document, ensuring confidentiality of all vital signs and observations immediately after they are done. Any abnormalities of the vital signs and observations should be reported immediately to the RN so further action can be taken (Crisp et al., 2016 p173). Satisfactory Needs revision Q9:Identify four (4) potential risks in collecting the MSU and discuss what you, as the EN, would do to minimise these risks. Briefly state what relevance an environmental policy/procedure would have to Mid-Stream Urine collection/testing. A9: Four potential risks are contamination, infection, urine spill and incorrect labelling. These risks can be minimise by making sure the container is sterile, not touching the inside of the container, the specimen is taken mid-stream as required. Wear gloves to avoid infection and contamination and follow hand hygiene policy. Use ppe such as gloves, apron and glasses in case it splashes everywhere. To avoid incorrect labelling fill out the label before you give the container to Mrs Junganati, verify with Mrs Junganati details as the label is fill out and make sure the correct test procedure is written on the label as well (Crisp et al., 2016 pp 648-658 ).The relevance an environmental policy/procedure would have to a mid-Stream Urine collection/testing is it would tell you how to dispose of the urine and container correctly (Crisp et al., 2016 pp 132-133). Satisfactory Needs revision Q10:Explain good documentation standards/principles you would use as an EN caring for Mrs Jupangati. A10: Good documentation standards/principles are making sure all documents are focussed, accurate. Complete, timely, understandable, always objective and legible. On every document must be the unique identifier or medical record number, patients full name, DOB, gender. For good documentation entries must be neat, legible and English, must have proper grammar and spelling, must be accurate and clear, use black ink which is easily reproducible, use approved symbols and abbreviations, use the 24hr clock time sequenced, all entries from students must be countersigned by clinician who is supervising, all entries must be signed by author, followed by name and designation, make sure all entries are factual (Crisp et al., 2016 pp178-181). Satisfactory Needs revision Q13:Using your knowledge of anatomy and physiology identify and discuss three (3) possible causes of Mrs Jupangatis collapse. A13: Mrs Jupangati has osteoarthritis in her back, right hip and both knees. She also had a total left hip replacement 6 months ago and is on the waiting list for other joint replacements. She has also been admitted to hospital in the last 6 months with a fall. Mrs Jupangati has arthritis along with osteoarthritis which cause the cartilage or cushion between joints breaks down leading to pain, stiffness and swelling. Mrs Jupangati may have fell because her joints gave way or they lock up (Nazarko, 2015). Mrs Jupangati has type 2 Diabetes, she is taking insulin injections for her type 2 diabetes. Mrs Jupangati is obese which may be the cause she has type 2 diabetes. With Type 2 diabetes, the pancreas usually produces some insulin. But either the amount produced is not enough for the bodys needs, or the bodys cells are resistant to it. Symptoms of diabetes may include fatigue, blurred vision and loss of consciousness (rare). Type 2 diabetes also increases your risk of a stroke. Mrs Janpangati might have miss her insulin medication, which means glucose cannot make it into the cells to provide energy to the body, which may have cause Mrs Janpangati to have fatigue, blurred vision and loss of consciousness which cause her to fall (Nazarko, 2015). Mrs Jupangati was admitted last night with exacerbation of asthma. She was admitted with a very high respiratory rate. Mrs Jupangati use to smoke for 45 years. Mrs Jupangati has COPD and asthma which cause narrowing of the airways. Mrs Jupangati is not able to get the required amount of air into her lungs because she unable to take a full breath. Mrs Junpangati is tachycardia which means her heart is working hard to supply the body with more oxygenated blood, which means the lungs have to work faster to oxygenate the blood as well. Mrs Jupangati may have had an asthma attack which may cause her unable to breathe and lose consciousness, which cause her to fall and hit her head (Nazarko, 2015). Satisfactory Needs revision Q15:List Mrs Jupangatis analgesic medications. Outline the process you would use to assess the need to give the opioid. Is an [E]EN authorised to administer the opioid? If so, explain how legislative and regulatory standards support this practice and how the EN would ensure these requirements are met whilst performing this activity. A15: Mrs Jupangatis analgesic medication is Oxycodone and Panadol Osteo. To assess to see if Mrs Jupangati needs her Oxycodone PRN a pain assessment will be required. A pain assessment consists of provoking/palliative factors what makes the pain better or worst. Quality what the pain feels like in the patient words. Region and radiation, where is the pain, does it radiate, does it occur anywhere else, have the patient point to where the pain is. Severity, have the patient rate their pain using a pain rating scale, ask the patient how much pain they have at rest and how much pain they have at movement. Time, when the pain began and how long did the pain last. Patients understanding of the cause of pain and what treatments have they tried to relieve it (Crisp et al., 2016 p1336). An EN can administer the opioid because it is a control drug. For a EN to administer Mrs Jupangatis opioid they must have written in instruction from one of the following dentist, doctor, nurse practitioner, p hysician assistant or surgical podiatrist and a doctor, dentist or registered nurse supervise, or they can give control drug to a person if has been dispense for that person doctor, dentist or registered nurse supervise (Queensland Government, 2016). Satisfactory Needs revision Q16:Review Mrs Jupangatis medical history medications. Identify urgent patient education needs, describe how you would go about this and who you would involve. A16: Diabetes, Mrs Jupangati needs to lead a heathier lifestyle I would involve the following doctor, dietician or nutritionist, accredited exercise physiologist/physiotherapist and her daughter. Blood glucose Mrs Jupangati needs to check her blood glucose levels at home to making sure she is within normal limits and Mrs Jupangati must take the required medication so the following people should be involve the RN, her community nurse and Mrs Jupangati daughter to ensure she carry out this. Pressure Area Care, Mrs Jupangati needs education on pressure injuries, how her diabetes will increases the risks, what can Mrs Jupangati do to minimise these risk and how Mrs Jupangati can care for her pressure injury. People to get involved doctor/RN speak to her and her daughter and community nurse. Wound care, involve Mrs Jupangati, daughter and community nurse. Nutrition get the following people involved nutritionist and her daughter. Advise them of what Mrs Jupangati should be eating and avoiding. Oral hygiene Mrs Jupangati needs to be refer to a dentist, educate Mrs Jupangati, community nurse and daughter, educate them on steroid medications effect on Mrs Jupangati teeth and educate them on mouth care. ADLs/hygiene involved Mrs Jupangati , community nurse and her daughter, explain to them why hygiene is so important when you are a diabetic because it can cause sores to become infected a lot easier. How to use puffers/spacer, involve Mrs Jupangati, community nurse and her daug hter. Explain the process with them and show them as well. When teaching Mrs Jupangati reduce environmental distractions, to compensate for Mrs Jupangati hearing loss and with Mrs Jupangati attention and concentration. When talking to Mrs Jupangati use a low-pitched voice, speak clearly and slowly, and face Mrs Jupangati while talking. Encourage Mrs Jupangati to use her hearing aid. Ask the Mrs Jupangati questions to verify that she has understood what been said, and give written information as backup to what youve presented orally to Mrs Jupangati. Mrs Jupangati has impaired vision, use adequate diffused light, and avoid having Mrs Jupangati face a direct source of light. Make sure Mrs Jupangati has her prescription glasses, make sure she is wearing them, and use large print for labels and instructions. Keep teaching sessions short for Mrs Jupangati between 10 to 15 minutes and schedule them to allow Mrs Jupangati to rest as needed. When teaching Mrs Jupangati any activity or skill, the pace must be set Mrs Jupangati(Crisp et al., 2016 pp 2 6-7) . Satisfactory Needs revision Q17:Identify potential causes of Mrs Jupangatis poor oral condition and describe how you could assist her in maintaining proper oral health. A17: Cause of Mrs Jupangati poor oral condition are diabetes if Mrs Jupangati poorly managed her diabetes she is at an increased risk of tooth decay and gum infections (Diabetes Victoria, 2016). She is a former smoker which can cause mouth decay. She is taking Prednisolone which may lead to bone loss in her mouth. She is taking steroids which can cause oral thrush. Mrs Jupangati has medicine for high blood pressure, analgesics and ACE inhibitors which cause insufficient saliva which cause gum disease because saliva keeps the mouth healthy (NPS MedicineWise, 2016). While Mrs Jupangati is in hospital I will help her with her oral care by assisting her with oral care twice a day. By assisting Mrs Jupangati I will educate Mrs Jupangati on why it is importance to do her oral care and it will get her in a routine. Educate Mrs Jupangati about diabetes and gum disease that she needs to have her BGL at the right level, needs to take her medication correctly and is to test her BGL regularly. Satisfactory Needs revision Q18:Discuss the potential cause of Mrs Jupangatis painful coccyx reddened right heel and explain why this might have occurred. Outline how the EN will manage this concern effectively. A18: Mrs Jupangati is 87years old, has diabetes, and limited mobility. As people age their subcutaneous fat diminishes and their skin texture flatten out. The loss of skin texture allow the epidermis to peel away, increasing the likelihood of skin tears. Mrs Jupangati has lost her skin texture and has poor blood flow to her extremities, especially legs and feet due to her diabetes. Mrs Jupangati poor glucose levels may result in a reduced blood supply which makes them more prone to infection, ulcers and pressure injuries As Mrs Jupangati has been watching the cricket sitting down for a long period of time without moving, she would be applying pressure on her coccyx and her heels on the couch. This would have interfere with her circulation because she was applying pressure which would have cause tissue death. The EN will need to do a waterlow risk assessment Mrs Jupangati must be move every two hours, the EN will need to put a mepilex INSITU on Mrs Jupangati heel and coccyx . Mrs Jupangati must have a wedge pillow under her shins and be given an air bed. The EN can wash and dry the area as well. The EN must educate Mrs Jupangati on pressure injury care and prevention, advising Mrs Jupangati to move every couple of hours. Informing Mrs Jupangati to use non-cosmetic moisturisers on her skin, check regularly for red or sores areas, and about hygiene (Crisp et al., 2016 pp724-736). Satisfactory Needs revision References       Crisp, J., Douglas, C., Rebeiro, G., Waters, D. (2016). Potter Perrys fundamentals of nursing (5 ed.). Australia: Harcourt Publishers Group Pty Diabetes Victoria. (2016). Diabetes long-term effects. Retrieved 2 19, 2017, from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/diabetes-long-term-effects Nazarko, L. (2015). Modifiable risk factors for falls and minimizing the risk of harm. Nurse Prescribing, 13(4), 192-198. Retrieved from CINAHL database http://web.ebscohost.com NPS MedicineWise. (2016). Prednisolone (corticosteroids (oral and injectable)). Retrieved 2 19, 2017, from http://www.nps.org.au/medicines/hormonal-and-metabolic-system/corticosteroids-oral-and-injectable/prednisolone-corticosteroids-oral-and-injectable Queensland Government. (2016). Health (Drugs and Poisons) Regulation 1966. Retrieved from https://www.legislation.qld.gov.au/LEGISLTN/CURRENT/H/HealDrAPoR96.pdf Tollefson, J., Watson, G., Jelly, E., Tambree, K. (2015). Essential clinical skills: Enrolled/division 2 nurses. (3 ed.). Melbourne, VIC, Australia: Cengage Learning Australia.

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The Atkins Diet: Is it healthy? Dr Robert Atkins Born: 17-10-1930 Died: 17-04-2003 [IMAGE]Dr Atkins, the creator of the Atkins Diet. His unconventional theories on nutrition have changed the way Americans think about eating. Atkins low-carbohydrate approach and 4 step program have become an obsession for many people at a time when two thirds of Americans are overweight or obese. But the Atkins diet has its disagreement, some of whom say that its emphasis on high cholesterol foods can make it dangerous. The Atkins diet promises that not only you will lose weight and not be hungry with a low carbohydrate diet, but you’ll also be on the road to better heart health and memory function, as well as other wellness benefits. Dr Atkins’ philosophy is that if you follow his diet and eliminate highly refined carbohydrates, you will:  · Burn fat fast, instead of carbohydrates, and lose weight quickly.  · Stave off hunger between meals because high-protein diets are more satiating than high carbohydrates ones. As protein digested slowly in the system, high protein diets also stabilise blood sugar levels, which can prevent common conditions such as fatigue, depression, headaches, joint and muscular pains.  · Improve your health; because as you burn fat you will eliminate toxins stored in fat cells. The diet plan allows you to eat foods that many dieters have only dreamed about. The diet plan is said to work even if other diets have left you feeling depressed and deprived. The diet Atkins at a glance: * Sets few limits on the amount of food you eat but instead severely restricts the kind of food allowed on your plate: no refined sugar, milk, white rice, or white flour * Allows you to eat foods traditionally regarded as â€Å"rich†: meat, eggs, cheese, and more * Claims to reduce your appetite in the process * On the Atkins diet, you’re eating almost pure protein and fat.

McDonald s Rebirth Through a Low Growth Strategy Essay

For several decades McDonald’s experienced uninterrupted growth in sales, profits, and number of stores opened. When the company seemed to reach maturity in life cycle, one CEO’s decision for a low-growth strategy started the rebirth of McDonald’s. In its early years, McDonald’s success was founded on principles of high quality standards and service. However, as time passed, their standards and controls slipped and same store sales began a downward trend. Some insisted that the dip in same store sales was evidence of market saturation. However, McDonald’s executives disagreed. With strong support, one McDonald’s CEO went on a new-store binge. As McDonalds continued its unprecedented expansion, relations with franchisees deteriorated because corporate owned outlets were cannibalizing franchisee’s profits. Another CEO began to acquire other fast-food restaurants, but that model failed as it proved a drain on profits. McDonald’s was struggling to keep its growth mode. Then James Cantalupo took the reigns and began a low-growth strategy that turned the company’s fortunes around as he slashed capital expenditures by 40% by closing poorer performing restaurants and adding fewer new restaurants. Eighteen months into Cantalupo’s stint as CEO, McDonald’s stock price rose from eighteen dollars per share to just over twenty-four dollars per share. Just as McDonald’s fortunes seemed to turn, James Cantalupo died suddenly of a heart attack. SWOT Analysis Internal Strengths & Weaknesses: Among McDonald’s greatest strengths are its brand recognition, strong advertising, and market share. It was the most valuable fast food brand worldwide in 2013 with an estimated brand value of eighty-five billion dollars, three times its closest competitor, Starbucks [see appendix 1.1]. McDonald’s strength of brand recognition can primarily be attributed to its strong advertising and market share. This is evidenced by a 1970’s survey which revealed that ninety-six percent of children identified with Ronald McDonald, ranking him second only to Santa Clause. Furthermore, McDonald’s uses high-profile sponsorships and major advertising campaigns to maintain awareness and promote new launches (e.g. 2014 FIFA World Cup and 2014 Winter  Olympics). In 2013, its advertising expenditure in the United States alone was 1.43 billion dollars [for details see appendix 1.2]. McDonald’s has won its market share via strong marketing/advertising efforts and providing convenience for its customers. When McDonald’s accelerated growth period ended, it had approximately 13,000 domestic restaurants. The belief was practical; the more stores in a city, the more per-capita transactions would result. As of 2013, McDonald’s had 35,429 restaurants worldwide- 14,276 of which are domestic (Statista, 2015). McDonald’s other internal strengths include: partnerships with big brands (e.g. Disney), international presence, localized food menus, and revenue. Now that we have examined McDonald’s internal strengths, lets examine the company’s internal weaknesses. Among McDonald’s greatest internal weaknesses are its negative publicity, low presence of corporate social responsibility, high employee turnover, and low strategy differentiation. McDonald’s is heavily criticized for offering unhealthy foods to its customers, further exacerbating the obesity problem in America. The documentary film â€Å"Super Size Me†, which explores the health consequences of a diet based solely of McDonald’s, is one example of the negative publicity surrounding McDonald’s. Environmental groups often criticize McDonald’s for a lack of sustainable sourcing of beef products (USA Today, 2014). This reflects poorly on McDonald’s for having a weak presence of corporate social responsibility. Furthermore, McDonald’s has a high employee turnover as it offers low paying and low skilled jobs. These jobs are often seen negatively by employees and usually result in high employee turnover. This is an internal weakness because it increases training costs and adds to McDonald’s overall costs. Lastly, McDonald’s has low strategy differentiation. It has become incredibly difficult for McDonald’s to differentiate itself from other fast food restaurants; thus, forcing McDonald’s to compete on price rather than features. This is an internal weakness because price wars reduce a company’s gross margin, which results in deteriorating profits. McDonald’s other internal weaknesses include: Declining market share, disgruntled franchisees, quality and taste of products, slowed revenue and income growth. External Opportunities & Threats: McDonald’s is in the unique position to rebrand itself by offering healthier menu options and increasing its corporate social responsibility. In 2006, McDonald’s newly redesigned logo and restaurant layout are being credited for 8-9% sales growth. Furthermore, McDonald’s has the unique opportunity to be the first fast food restaurant to source 100% of its ingredients from sustainable production. Younger generations are very conscientious of the impact their purchasing habits have on the environment. The aforementioned opportunities can be done still pursuing a low growth strategy. But, McDonald’s still has opportunities for growth. Economic research suggest that China’s middle class is on pace to grow from six percent of its population to fifty percent of its population by 2020 (Business Insider, 2014). McDonald’s has historically targeted middle class families, so there is plenty of opportunity for growth in China. If McDonald’s is able to make a more localized menu and provide an atmosphere that can strike the right accord with the Chinese culture then McDonald’s has the opportunity to flourish in China. Among McDonald’s greatest threats are the growing segment of health conscience consumers and the strength of competition. The health conscience consumer, a growing segment of society, poses both a threat and opportunity for McDonalds. The change in customer’s habits represents new needs that must be met by McDonald’s. In an attempt to cater to this market, McDonald’s has added salads, fruit, and oatmeal to their menu. Additionally, they have eliminated trans-fat oil- a product blamed for the nations obesity. Other areas of concern are the threat posed by Starbucks, which plans to offer a breakfast and lunch menu. McDonald’s strongest competitor remains Yum! Brands- owner of popular fast food chains: Taco Bell, Pizza Hut, KFC, and Wing Street [see appendix: 1.1. Other external threats include: saturated market, macroeconomic factors. Recommendations The central strategic decision that needs to be addressed is whether McDonald’s will commit to rebranding itself so that it is seen not only as an economical food destination, but as an appealing high quality one as  well. The societal shift to a more health conscience consumer provides McDonald’s such an opportunity. Alternatives to Strategic Decision Making McDonald’s has three viable options for continued success. The first two, allow McDonald’s to continue it’s low growth strategy. First, McDonald’s can create and promote an attractive menu that that will grab the attention of health conscience consumers. Second, it can focus on the stronghold it’s gained in the coffee space, as this could be an interesting new endeavor to follow (i.e. a new SBU). The third option would be to pursue a growth strategy for Asia, especially China. However, it must be noted that the growth strategy may burden the company with debt to pay for capital-intensive expenditures, but should it be successful McDonald’s revenues and profits could reach new ceilings. It would behoove McDonald’s to fill the need of the health conscience consumer by adopting and promoting a healthier menu. This can be done without abandoning their staples (e.g. Fries, Big Mac, Happy Meal, and Egg McMuffin). If McDonald’s is able to meet the changes in customer’s needs and habits, there is no reason why they shouldn’t continue to experience growth in sales. I believe that this is the best option because it is not capital intensive, yet it could allow McDonald’s access to a new segment of the market. Furthermore, McDonald’s number of locations provides the health conscience consumer with convenience. Implementation Evaluation and Control The following steps are keys to a successful implementation of a strategic marketing plan: 1. Who are we? Who are our customers? What do our customers want? 2. Set strategic marketing goals: Assess internal strengths and weaknesses then compare your vision/mission to the reality of your external environment. Once you have identified the areas of need, choose specific goals to address those areas. 3. Establish strategic marketing activities/plan of actions: Once specific goals have been set, identify various activities to utilize resources and choose the best course of action to implement. 4. Establish timeline to execute goals and plan of actions: By having a clear understanding of your strategic marketing goals then you  can establish common understanding of when such action plans can be reasonably accomplished. 5. Review and re-evaluate progress: By consistently reviewing and re-evaluating progress in implementing or instituting plan of actions, you can take a proactive approach in making adjustments due to changing business climate, environment, external threats and opportunities that may arise in everyday business decisions. References Brumley, James. (April 23, 2014). McDonald’s Is About To Tap Into A Huge Growth Opportunity. Retrieved from: http://www.businessinsider.com/mcdonalds-expanding-international-2014-4 Horovitz, Bruce. (April 30, 2014). McDonald’s sets 2020 sustainable goals. Retrieved from: http://www.usatoday.com/story/money/business/2014/04/30/mcdonalds-sustainability-fast-food-social-responsibility-restaurants/8513245/ Statista. (February, 2015). Retrieved from: http://0-www.statista.com.leopac.ulv.edu/topics/1444/mcdonalds/

Definition and Examples of Compound Words in English

Definition and Examples of Compound Words in English In morphology, a compound word is made up of two or more words that express a single idea and function as a single word. The most common types of compound words in English are compound nouns (e.g., cheeseburger), compound adjectives (red-hot temper), and compound verbs (waterproof the deck). The rules for spelling compound words are not consistent. Some compound words are written as a single word (eyeglasses), some as two (or more) hyphenated words (brother-in-law), and some as two (or more) separate words (soccer stadium). Examples and Observations As the car pulled into the parking lot, Kenny Dennard whipped a snowball right at the windshield.(John Feinstein, Forevers Team. Villard, 1989)On Sunday afternoons in the summer, my grandfather and I enjoyed eating hot dogs at the ballpark.While we were waiting for our food, I played with my chopsticks. They make excellent drumsticks. I also told Dad all about this big baseball game we were going to play after school the next day.(Dan Greenburg, Zack Files 13: The Misfortune Cookie. Turtleback, 1998)He hid in a cave until the ship had left, only to find that his shipmates had taken pity on him, and left him a barrel of biscuits and a fire, which he kept alight for months. A year later a southbound ship stopped by.(Simon Winchester, Outposts. Penguin, 2003)A diary can take almost any form: written responses to a periodic e-mail reminder, a handwritten notebook, a narrated video, or photos with written commentary.(Kim Goodwin, Designing for the Digital Age. Wiley, 2009)In Aboriginal Au stralia all home building was do-it-yourself.(Tony Dingle, Necessity the Mother of Invention, or Do-It-Yourself. A History of European Housing in Australia, ed. by Patrick Troy. Cambridge University Press, 2000) I became a shop steward immediately and a trustee in 1936. . . . I became the locals secretary-treasurer in 1946.(Mary Callahan, quoted in Rocking the Boat: Union Womens Voices, 1915-1975. Rutgers University Press, 1996)On a hot day, nothing beats walking into a nice, cool, air-conditioned home. Unfortunately, running your air conditioner is expensive and eats up energy.(Eric Corey Freed, Green Building Remodeling For Dummies. Wiley, 2008)Heads of Compound WordsOne part of a compound word is usually clearly its head, in a general way able to represent the meaning of the whole compound. The heads of the various types of compound word are [in capital letters] in this list: bellBOY, spin-DRY, red HOT, inTO, and/OR. It can be seen that in English, the head of a compound word is always the last element, on the right-hand end. (This is not true of compound words in all languages, however.)(James R. Hurford, Grammar: A Students Guide. Cambridge University Press, 1994)Dividing Compound Word sIf you divide a compound word at the end of a line, place the hyphen between the elements of the compound (snow-mobile, not snowmo-bile).(Laurie Kirszner and Stephen Mandell, The Concise Wadsworth Handbook, 2nd ed. Wadsworth, 2008) Metaphorical CompoundsMetaphors furnished with common household objects are figures of speech that we literally live with every day. Some of these comparisons are new, such as a couch potato, a phrase that compares lumpish watchers of television to lumpy potatoes: the longer couch potatoes sit, the deeper they put down their roots.(Richard Lederer, The Play of Words. Simon Schuster, 1990)Complex CompoundsIt is possible to form a compound from two words one of which is itself a compound. For example, we can combine the compound law degree with the word requirement to get the complex compound law degree requirement. This compound can in turn be combined with changes to get law degree requirement changes, and so on. . . . [T]he process is essentially unlimited.(Bruce Hayes. Introductory Phonology. Wiley, 2009)