The Colector Crimes vs. Drug Crimes :: essays research papers

Various crimes have select penalties in which they be accompanied with. As a part of the American way, fairness and justice is the prime concern in the court of law. However, some specific crimes do not seem to fit the punishment. Although these serious offenses are in fact crimes, their penalties coincide with unlawful acts that effect more people, and therefore should not be of the same punishment. Examples of these unequal ratios are the comparisons between clear up and kidnaping laws to those of drug crimes. These offenses are indeed actions that effect more than one person in a negative way. The victims, along with their families and friends, are impacted dramatically when a person is lost, missing, or even dead. These effects last long after justice is served. But how well is this justice served? Are murderers on the same levels of drug offenders?First level murder is the most heinous crime with the harshest penalties in the American judicial system. No other offense will a llow the same punishments to convicts, which honestly makes unblemished sense. However, second degree murder calls for up to a $25,000 fine and/or four to twenty years in prison, (Rockton site). This crime, voluntary manslaughter, is the deliberate and intentional murder of a person. Along with this crimes penalty, there is an equal punishment if the act was drug related. For possessing fifteen grams of cocaine without intent to sell, an offender will be exposed to the same consequences as if they would have shot and killed a young woman in the middle of a crowded building, (Hoffman Estates site). Possession of that amount of cocaine is indeed an offense, but does it equal the loss of a life? If this criminal was selling this amount, the charge should be higher since more people are affected. For example, it would be suicide if one were to overdose on the amount of cocaine, but if an overdose was a result of ones sales, than this action would be dubbed involuntary manslaughter, or the unintentional act leading to a death. However, this consequence is only of possession, not supplying to another person who could harm themselves. Another example of these extreme penalties is the normal link between kidnaping and possession of methamphetamine. Possession of five grams of methamphetamine with intent to sell is obviously a disgusting way of life, but so is the abduction of a person.

Destructive Jealousy in Iago and Othello Essay -- essays research pape

Jealousy has the power to destroyDiscuss the ways in which Shakespeare uses both characters Othello and Iago to convey this message.Following the recent study of Shakespeares tomboy Othello, we found a lot of information about the count and the theme jealousy. Shakespeare wrote tragedies, comedies and histories, all were in five acts of poetry. My definition of jealousy is where someone has something or is adequate to do something that another person can do. They are jealous because the other people are able to and have the things they want but cant get. The play Othello is in Shakespeares group of tragedies, because of the deaths and misfortunes. The main characters in Othello are Othello himself, iago, Cassio, Desdamona and maybe Emilia the play has jealousy and gullibility in it. Othello is a subdued man in a white society. Iago is jealous of cassio because he became Othellos lieutenant. Iago is jealous because he felt that he was the one to get that position, because he believed that he deserved it, but did not receive what he wanted. Cassio has turned into a bit of a playboy and slept with women, possibly iagos wife. Here are a a few(prenominal) ingeminates about Othello, iago says, I do suspect a trusty moor hath leaped into my seat. I do think this is saying, that iago is thinking that Othello has slept with his wife emilia. The next quote shows that, iago wants to do to Othello what he did to him. Revenge. Till ive evened with him, wife for wife. Iago shows his potential of jealousy to become so destructive. Iagos wife emilia says to Desdemona (Othellos wife), who would not make her economise old to make him a monarch? Iago also starts to say things about cassio like, for I fear cassio with my night cap too. Iago... ...ed in the extreme. Here iago is admitting to macrocosm manipulative. At the end othello again feels isolated and feels completely vunerable throughout. The audience could see him as a mix between confident and in charge as well as being very insecure. Othello stabs iago wanting to wound him, iagos reply is, I bleed sir, but not killed which was what othello wanted.. iago ends up being interpreted away to be tortured and othello wants this as living is more of sa punishment. Iago is clever and manipulative and has a good understanding of people. He is evil throughout shakespeares play and he knows it. He also blames others for active manipulation of them. demand me nothing, what you know, you know. Iago plants the idea of desdamona in othellos mind. Initially othello does not believe him, but iago continues to manipulate othello and othello lets him do it.

Essay --

Study has identified the fond regard patterns as secure, anxious/ preoccupied and avoidant in children. These attach manpowert patterns can have a positive or negative impact on the quality of their future romantic kinds. Romantic relationship quality is one of the most important relationships in magnanimoushood. When individuals fall in love their attachment style is already in place and operating. An understanding of adult attachment is important to begin to understand the effects of attachment patterns on relationships. It contributes significantly to a personal well-being. Based on childrens behaviors during their mothers presence, absence, and return patterns attachment styles may also be transfer to the romantic partner during adult relationships (Feldman, 2011). both children and adults feel anxious when separated from their attachment figures are nearby. Adult romantic attachment relationships are made clear by proximity-seeking, safe haven and secure base. (Bru mbaugh, Fraley, Heffernan, & Vicary, 2012). Seeking proximity with their romantic partners may be useless and avoidant people may try to keep a distance from others and remain independent. Romantic partners are overly sensitive to proximity of their partners and signs as a possible threat. Individuals work extremely hard to maintain closeness with their romantic partner and have exaggerated negative emotions when they fail to do so. Adult attachment patterns are the foundation of individuals understanding and expectations about relationships and directs their social interactions. Anxiety and avoidance attachments are two of the most common factors in romantic relationships. Anxious attachments is find by the desire to be close with others a... ...m to maintain the relationship. Adolescents with avoidant and anxious attachment patterns have a greater conflict in opposite sex relationships (Miga, Hare, Allen, & Manning, 2010). affixation theory is used to predict if singl e individuals out of a group would date or enter a committed romantic relationship in the future. Anxious individuals showed eagerness to commit and fall in love with a romantic partner. Avoidant attached individuals were shy about commitment and fall in love. previous involvement in a committed romantic relationships and self-perceived physical attractiveness are part of dating assessment success. As part of the research men show their desire for greater intimacy in order to start a relationship. Women show a greater desire to start a family. Both men and women are most likely to live together or get married (Schindler, Fagundes, & Murdock

Review Of The Red Lantern :: essays research papers

There are some movies about biographystyles in China and then there is &8220Raise the Red Lantern. The film parallels &8220The conclusion Emperor in how a master controls his subjects within his domain. Out of all the Chinese movies that I have extensively viewed, this was the only one that actually, and effectively, captures the lush background of life during this time period. The film entirely takes place on the grounds of a wealthy master whose only chore seems to be deciding which one of his tetrad wives to sleep with on a given night. In viewing the movie, we are forced to feel sympathetic to the fourth cocotte. She was the youngest among the other three who arrives at the nation after studying at the university. Cherished memories of her life before arriving there were ultimately destroyed. In one instance, the master burned the fourth mistress&8217s flute that her deceased father gave to her. The film evokes feelings of sorrow and disgust, but it manages to fill in humoro us bits that alleviate the tense mood. The film revolves around the master&8217s polygamist lifestyle and his utter dominance over his wives. When one mistress was good to him, he would decide to sleep with her that night. At the beginning of the film you get the arbitrariness that the forth mistress doesn&8217t want to sleep with the master, but that changes as the film goes on. Sleeping with the master that night meant the lanterns outside your room were lit up and, an added incentive, was being able to get a foot massage that night. The massage seemed to be the most rewarding part of being at the estate. The master&8217s decision of who to sleep with that night evoked jealousy between the &8220sisters. This increased the excitement of the movie and led to the main struggle between the fourth mistress and the three other women. The fourth mistress&8217s anger and lack of control creates hostility in the household. Her behavior creates a downward spiral, which leads to the deaths of two distinguished characters.

Communicating Information in Radioheads Music Albums :: Internet Net World Wide Web Media

RadioheadIt is an eventful feature of the ideological system to impose on pot the feeling that they really are incompetent to deal with complex and important issues theyd better leave it to the captain. One device is to develop a star system, an arrange of figures who are often media creations or creations of the academic propaganda establishment, whose deep insights we are supposed(a) to admire and to whom we must happily and confidently assign the right to have got our lives and to control international affairs... --Noam Chomsky, The Chomsky ReaderPasted on the inside of a Radiohead EP, Chomskys name serves as a reminder to the point these musicians are attempting to make the essence of gist is largely lost when reality is based on modern modes of information. In other words, the information one takes in is delivered in such an impersonal way, via multi-media, that the self-importance is scattered in the saturation of these various mediums in an attempt to coiffe informatio n, or life. The word impersonal is used in the sense that the delivery has teentsy to do with the pith. Radioheads latest release, OK Computer, is ab bring out just that. Everything spinning out of control, says front man Thom Yorke of Radioheads latest album. Control is lost in the oversaturation of information, in which the complexity of information is so widespread that in a post-modern society centre no longer adds up to a total, but instead schizophrenic patches with exclusively relation to itself and not to anything else. It is in this where the fear of depthlessness in our society as a whole is felt.Take the advertising used by MTV for example. It is merely a barrage of extremely quick cuts, in which one can hardly make out what each image is. First it may be an eyeball, hence a car, them some white space, past a mathematical graph, then a plant, etc. After this the networks name is seen with the airdate of its newest show. Nothing had any relation to the beside, or to the network or show, save only the fact that they were pasted next to one another. Post-modern critiquers such as Frederic Jameson would argue that this is a staple of post-modern depthlessness and schizophrenia prime in todays society. The fact is, this advertising by MTV is seen as exciting and in the raw edge due to the realization that todays society is so numbed down by media that the meaning isnt needed in such an advertisement because the medium sends the message of world cool.Communicating Information in Radioheads Music Albums Internet Net World considerable Web MediaRadioheadIt is an important feature of the ideological system to impose on people the feeling that they really are incompetent to deal with complex and important issues theyd better leave it to the captain. One device is to develop a star system, an array of figures who are often media creations or creations of the academic propaganda establishment, whose deep insights we are supposed to admire and to whom we must happily and confidently assign the right to control our lives and to control international affairs... --Noam Chomsky, The Chomsky ReaderPasted on the inside of a Radiohead EP, Chomskys quote serves as a reminder to the point these musicians are attempting to make the essence of meaning is largely lost when reality is based on modern modes of information. In other words, the information one takes in is delivered in such an impersonal way, via multi-media, that the self is scattered in the saturation of these various mediums in an attempt to order information, or life. The word impersonal is used in the sense that the delivery has little to do with the meaning. Radioheads latest release, OK Computer, is about just that. Everything spinning out of control, says front man Thom Yorke of Radioheads latest album. Control is lost in the oversaturation of information, in which the complexity of information is so widespread that in a post-modern society meaning no longer adds up to a total, but instead schizophrenic patches with only relation to itself and not to anything else. It is in this where the fear of depthlessness in our society as a whole is felt.Take the advertising used by MTV for example. It is merely a barrage of extremely quick cuts, in which one can barely make out what each image is. First it may be an eyeball, then a car, them some white space, then a mathematical graph, then a plant, etc. After this the networks name is seen with the airdate of its newest show. Nothing had any relation to the next, or to the network or show, save only the fact that they were pasted next to one another. Post-modern critiquers such as Frederic Jameson would argue that this is a staple of post-modern depthlessness and schizophrenia found in todays society. The fact is, this advertising by MTV is seen as exciting and cutting edge due to the realization that todays society is so numbed down by media that the meaning isnt needed in such an advertisement becaus e the medium sends the message of being cool.

Communicating Information in Radioheads Music Albums :: Internet Net World Wide Web Media

RadioheadIt is an nitty-gritty(a) feature of the ideological system to impose on people the feeling that they really are incompetent to deal with complex and important issues theyd better leave it to the captain. One device is to develop a corpus system, an array of figures who are often media creations or creations of the academic propaganda establishment, whose deep insights we are suppose to admire and to whom we must happily and confidently assign the right to make our lives and to control international affairs... --Noam Chomsky, The Chomsky ReaderPasted on the inside of a Radiohead EP, Chomskys inverted comma serves as a reminder to the point these musicians are attempting to make the mettle of meaning is largely lost when reality is based on modern modes of information. In other words, the information one takes in is delivered in such an electroneutral way, via multi-media, that the self is scattered in the saturation of these various mediums in an attempt to suppose in formation, or life. The word impersonal is used in the sense that the rescue has little to do with the meaning. Radioheads latest release, OK Computer, is ab emerge just that. Everything spinning out of control, says front man Thom Yorke of Radioheads latest album. Control is lost in the oversaturation of information, in which the complexity of information is so widespread that in a post-modern society meaning no longer adds up to a total, but instead schizophrenic patches with only proportion to itself and not to anything else. It is in this where the fear of depthlessness in our society as a whole is felt.Take the advertising used by MTV for example. It is save a barrage of extremely quick cuts, in which one can just make out what each image is. First it may be an eyeball, indeed a car, them some white space, then a mathematical graph, then a plant, etc. After this the networks name is seen with the airdate of its newest show. Nothing had any relation to the succeeding(a), o r to the network or show, save only the fact that they were pasted next to one another. Post-modern critiquers such as Frederic Jameson would argue that this is a staple of post-modern depthlessness and schizophrenia found in todays society. The fact is, this advertising by MTV is seen as exciting and bully edge due to the realization that todays society is so numbed down by media that the meaning isnt needed in such an advertisement because the medium sends the message of cosmos cool.Communicating Information in Radioheads Music Albums Internet Net World Wide Web MediaRadioheadIt is an important feature of the ideological system to impose on people the feeling that they really are incompetent to deal with complex and important issues theyd better leave it to the captain. One device is to develop a star system, an array of figures who are often media creations or creations of the academic propaganda establishment, whose deep insights we are supposed to admire and to whom we mu st happily and confidently assign the right to control our lives and to control international affairs... --Noam Chomsky, The Chomsky ReaderPasted on the inside of a Radiohead EP, Chomskys quote serves as a reminder to the point these musicians are attempting to make the essence of meaning is largely lost when reality is based on modern modes of information. In other words, the information one takes in is delivered in such an impersonal way, via multi-media, that the self is scattered in the saturation of these various mediums in an attempt to order information, or life. The word impersonal is used in the sense that the delivery has little to do with the meaning. Radioheads latest release, OK Computer, is about just that. Everything spinning out of control, says front man Thom Yorke of Radioheads latest album. Control is lost in the oversaturation of information, in which the complexity of information is so widespread that in a post-modern society meaning no longer adds up to a total , but instead schizophrenic patches with only relation to itself and not to anything else. It is in this where the fear of depthlessness in our society as a whole is felt.Take the advertising used by MTV for example. It is merely a barrage of extremely quick cuts, in which one can barely make out what each image is. First it may be an eyeball, then a car, them some white space, then a mathematical graph, then a plant, etc. After this the networks name is seen with the airdate of its newest show. Nothing had any relation to the next, or to the network or show, save only the fact that they were pasted next to one another. Post-modern critiquers such as Frederic Jameson would argue that this is a staple of post-modern depthlessness and schizophrenia found in todays society. The fact is, this advertising by MTV is seen as exciting and cutting edge due to the realization that todays society is so numbed down by media that the meaning isnt needed in such an advertisement because the mediu m sends the message of being cool.

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Have chosen the story called Facing poverty with a rich girls habits by Suck Kim. She starts out with very descriptive details on how her and her family went from the white picket fence and maids to staying with people and not having much at all. Another rase I believe she tried to make was that she didnt fit in very well, there were other Koreans in the school, even in the same class as her entirely they didnt have much in common. She had playmates but that didnt last very long she didnt speak English. Skims purpose in writing his story was to mainly prescribe how she lost everything in a blink of an eye and ended up over here in America.This story would be nonfiction, and I would say her auditory sense would be the people who have been by means of the struggle, the ones who have been there in life. Skims attitude comes off in the beginning as snotty, mad, an upset teenager, but when youve been through something dramatic like that you couldnt say you wouldnt feel angry. During the middle, it seems like she learns to deal with it, and realizing its part of life but Xx far from easy, but towards the end it seems like shes to a greater extent laid back ND humble about life.My outlook on this story is that it was very eye catching from the title facing poverty with a rich girls habits to the very last word. It was very interesting to say the least. Knowing that unexpected things to happen in life, and that not only did she have to move but to have to learn a whole new language, a whole new culture ,and to leave everything behind that she once knew is really tough on an adult let alone a child. Eve been there many times. Overall Id say this was one of the best stories Ive read.

An examination of the presentation of two magazine advertisements Essay

There are two magazine advertizings advertising two separate products both jewellery in nature. A stainless stain Rolex watch named the Rolex gather doh dull II. An expensive sophisticatedly practiceed watch for batch of the wealthy businesspersons category. The other a Jewels of Aphrodite silver exclusive threesome take a hop suitable for a gift to a venerater or a self-indulged treat, this is aimed at the average workingpersons category as it says Need send no bullion now, and For only i 75. 00, both money saving phrases. Both have a key selling point.The advertisement for the Rolex oyster doh dull II key selling point is the fact that the Rolex is boldly shown in a large painting at the bottom of the page. This catches the attention of the proof withdrawer and quickly conveys the subject and nature of the advertisement. This withal intrigues refs to read the article, which means that they allow bring out more about the product and get a founder understandi ng of the piece, therefore increasing the chance of a sale. The advertisement for the Jewels of Aphrodite silver Triple ring has a similar key selling point.The ring is boldly situated at the go through centre of the entire page. This is the first image that the reader will acknowledge and will catch the attention of the reader and quickly convey the subject and nature of the advertisement to them. Also the title of the advertisement Jewels of Aphrodite, gives an instant sense of wealth and adventure to the advertisement beguiling the reader to read the rest of the article therefore increasing the chance of a sale. Examples of imaginative and factual language are apparent in the presentation of both advertisements. wizard advertisement advertises a sliver triple ring, which has been entitled the Jewels of Aphrodite silver triple ring in gold font. Aphrodite was a heavenly Greek goddess of sweetie and love from Roman Greek times. The ring does non contain or consist of Aphrodit es jewels. But if it did, however, the ring would be of astonishing value. This portrays the ring to be of an extremely higher value than the asking price. This draws attention to the advertisement as concourse are drawn to the sheer wealth portrayed by the advertisement, this is also emphasised by the gold font.This then seems to be an astonishing bargain when the ring is priced at seventy-five pounds. This will create a boost in sales as it forges the bargain to be of greater saving than what actually exists. The order form is entitled take now to secure your order This makes the reader think that the product is in demand and that the order form must be sent with haste in order to obtain one. The Rolex gather GMT dull II advertisement uses factual language in its presentation. Quotes are used in this presentation For Sir Norman Forster, good design is generated by peoples needs.He has answered these needs with outstanding architectural solutions in his native England, throu ghout Europe and most notably in Hong Kong. It was treasures design for the head quarters of the Hongkong and Shanghai Bank that confirmed his position at the forefront of international architecture. This quote emphasises the importance of Sir Norman shelter, and how much he is revered internationally. It emphasises the fact that massive international corporations turn to Sir Norman Foster when in need, and he answers them perhaps portraying him to be more important, bigger, and more mightily than these corporations who come to him.Sir Norman Foster is thus seen to be a in truth big, important man to the reader. He is wearing the Rolex oyster GMT Mater II showing that the Rolex collect GMT Mater II is The Watch for people of his class. To the reader this may give the impression that if the watch is good enough for soul as revered as Sir Norman Foster, then it is more than good enough for him or her. An example of imaginary language in the Rolex Oyster GMT Mater II adv ertisement includes the entire school schoolbook.It uses ambiguous language to represent a link between Sir Norman Fosters work, and the Rolex Oyster GMT Mater II. For example when it says Good design is generated by peoples needs. He has answered these needs with outstanding architectural solutions This could be talk of the town about the watch answering peoples needs all over the world, or Sir Norman Fosters architecture designs answering peoples needs. Also This supremely elegant mental synthesis epitomises many of Fosters beliefs as an architect. This can be seen as a metaphor with the building representing the watch epitomising many of Fosters beliefs as an architect. The interior is extraordinarily light and airy. This is achieved by a complex of steel supports which leave vast clear spaces This is another good example of the ambiguous language used. Showing the unique architectural structure of the building that also relates to the watch. This language is used for the same settle in both adverts. It is used to give a positive view on the product and fashioning the product an object of desire.Persuading the reader that the product is something that would be lastly worth possessing. Having this language presented in the title is a better way of presenting it, as this is the initial information that the reader digests, therefore leaving a positive impression. Presenting it in a block of pen means that the reader will not be as lured to read a block of writing as to a more visual or digestible document. There are typical phrases presented in both advertisements. The Jewels of Aphrodite silver Triple ring advertisement has many examples of typical phrases. For only i 75.00 is very typical, trying to emphasise and give the impression that the asking price is only a fraction of the lawful value. You need send no money now is another example of a typical phrase. The aim of this is to convince the reader that they are getting a good deal and that th ey are in control. The reader will be more willing to purchase the product of the finance is not immediate. The general intend impact on the audience from both advertisements is that the product that they are selling is an object of desire. They would be revered to if in possession of the product as it is ultimately worth possessing.There are typical phrases presented in the Rolex Oyster GMT Mater II advertisement Is it any surprise he should wear a Rolex? This is giving emphasis to the point that he is a man who is revered internationally so consequently there is only one watch for him the Rolex Oyster GMT Mater II. This has the effect on the reader that makes the watch appear at a higher level of desirabi lightedy as it is underlining that the Rolex Oyster GMT Mater II is the watch for people of his class. One immediate difference that is clearly visible is the background food colour.The advertisement for the Rolex Oyster GMT Mater II has a simple plain white colour bac kground contrasting with the black font. This gives the advertisement a contemporary, sophisticated feel to it. Although it posses this quality, the colour does not have an enticing effect to the reader to draw them in to view the advertisement. This strongly affects the effectiveness of the advertisement to the reader. The Jewels of Aphrodite silver Triple ring however, has very enticing qualities. The background colour is a deep, plentiful alluring purple with complementing white, symmetrical, silhouettes of religious statues.To contrast, this already has a visual advantage over the Rolex Oyster GMT Mater II advertisement, as it will lure more readers to it as the colours are more eye catching and attractive. It gives the advertisement a sense of mysticality, exploration, and wealth. This will make more of an impression on the readers mind and will make then remember the product, or desire the product to a higher degree. The text colour of the Rolex Oyster GMT Mater II advert isement contrasts with the background colour making the text stand out to the reader giving it a contemporary sense.The text font is not very bold making it unpalatable to read. The colour scheme in the picture of Sir Norman Foster, top central to the page, is related to the advertisement. In the picture, Sir Norman Foster is surrounded by completely white background and surroundings. This is linked to the background of the advertisement. Completely white. Sir Norman Foster is wearing black in the picture. This represents the link between him and the text in the advertisement, showing that the text is related to him. In the background right of Sir Norman Foster is one of his famous metallic masterpieces of architectural art.This represents the watch in the foreground of the advertisement. Both are of a stainless steel colour and are represented as masterpieces. This colour co-ordination is very effective in showing the link between Sir Norman Foster and his internationally recognis ed designs, and the Rolex Oyster GMT Mater II. The colour of the watch is diverse from the general colour scheme of the advertisement. This makes the watch appear to be superior and different from the rest. The entity of this colour scheme creates a contemporary feel. It gives the watch images of sophistication and wealth.The Jewels of Aphrodite silver Triple ring advertisement colour scheme compliments the ring. The background consists of a deep muddy rich purple colour, the same as the Jewels on the ring. Aphrodite was the heavenly Greek goddess of beauty and love and this is a colour associated with love. Therefore both colours convey love and romance. Also in the background are faint silhouettes of two white statues standing as pillars, as if to be the entrance to a temple or similar. Surrounding the ring is a subtle, restrained white glow. Signifying purity and perfection.This white glow compliments the silhouettes beneath the purple, conveying the image that the ring is lin ked to the statues making the ring appear to be holy, and sacred. Sparkles have been added to the corners of the ring making it appear to be glistening relating the ring to wealth and luxury. The background purple is increasingly dark all the way down the centre of the page. Around the ring the background is brighter as if the ring has lit it up. It appears as if the ring has come from the darkness and lit up the surroundings similar to the fracturey of hidden treasures. This conveys that the ring is full of adventure.It is a sacred treasure to be discovered and the reader can discover it. The gold colour of the title Jewels of Aphrodite creates an image of wealth and prosperity, assuring the reader of the wealth of the product and the value of owning the product. Subtitles are in a light blue, cobalt ultramarine colour. This contrasts with the purple and makes the subtitles appear bold and stand out. The text of the subtitles is black opposing the light blue, turquoise colour mak ing the text apparent to the reader. This makes the information in the advertisement more digestible as it is broke down into sections.The Order Form consists of a faint yellow colour and has a red title, Post now to secure your order. The red signifies danger and importance to the reader making the s evident immediately. Urging the reader to hasten and buy the product. The entity of this colour scheme gives the ring a sense of wealth and class. It creates images of wealth, prosperity and affluence. The layout of the Rolex Oyster GMT Mater II advertisement oozes sophistication. The layout of the almost symmetrical block text mounted on a plain white background gives the whole advert a sense of sophistication and contemporary design.The title is spread crosswise the top of the page in the same format as the text. This is a better way of presenting the title as apposed to having a diversified, more decorative font. The picture of Sir Norman Foster is central to the top of the page. The text is presented round the picture. This signifies his importance and significance, as the advert appears to revolve around Sir Norman Fosters picture, as if he is the core of the Rolex advertisement, as if he is the front of the advertisement. The large colour image of the Rolex communicates the nature of the advert quickly and effectively.This draws the attention of the reader and will entice them to read the text. This layout reflects the target audience to be sophisticated successful businesspeople who very contemporary and have wealth. The layout of the Jewels of Aphrodite silver Triple ring advertisement is very original. The first piece of information is the price at the top of the page An Exclusive Silver Triple Ring For Only i 75. 00* This will be the first piece of information that the reader will take in. This will make them curious to find out what is marked at this price.The main concentrate is on the ring at the top centre of the page following on from the title . This grasps the attention of the reader and will entice them to read the text and find out more about the product. Subsequently the subtitles follow. They are positioned further down the page, as it is only relevant information to the reader if they are interested in purchasing the product. At the very bottom of the page is an exploded diagram of the ring split into three layers. This gives the reader the impression that they are getting more value for their money, i. e. three rings for the price of one.In the bottom right corner of the page is the order form. This is presented at the bottom, as it is only relevant to the reader if they have read all of the text above and wish to make a purchase. This layout reflects that target audience to be average workingpersons. All that phrases presented boldly in the advertisement are all to do with low finance and superficial wealth. After a careful examination of the presentation of these two magazine advertisements I have come to the con clusion that the Rolex Oyster GMT Mater II advertisement is the more successful advertisement.My reason for this is that the aim of this advertisement is to give the Rolex Oyster GMT Mater II an image of sophistication, and contemporary design. It does not try to persuade the reader that they are getting a good bargain for their money but to make the object more desirable. The Rolex Oyster GMT Mater II advertisement is simple and easy to digest, whereas the Jewels of Aphrodite silver Triple ring advertisement has a lot of information and does not convey it well. The Rolex Oyster GMT Mater II advertisement uses almost all factual language and does not need to use imagery to sell the product.This has a greater positive effect on the reader as they feel that they are being interchange genuine quality, as apposed to inferior, superficial products. The Rolex Oyster GMT Mater II advertisement is plain and spacious, making an easy view. But the Jewels of Aphrodite silver Triple ring advertisement is cluttered uninviting to view. Also the Rolex Oyster GMT Mater II advertisement uses a practical example of a consumer of the product who is approve the watch showing the reader that it is the genuine article and that they can see for themselves how superior the product really is.

Effectiveness of Online Advertising Essay

Growing internet substance abuser base, increasing measure spent on the internet, wideband penetration into the households and fragmented media consumption of consumers are driving advertisers towards the sports stadium of online advertize. But there are a few limitations to this sector as well, the primary one and but(a) being low broadband penetration in the country. Thus, the field of online advertising promises growth as it is synergistic, posts specific consumers and has no geographical or time boundaries. With the financial aid of all the primary and secondary data collected and analyzed, certain trends and conclusions came forth.The first and foremost thing in this project was to understand the influencers (online advertising agencies). Why motley sectors are getting into the field of online understanding, what are the features of an online advertisement, what are the advantages of internet as a fair over other forms of media, objectives of an online campaign, which sectors are investing in this field and what are the limitations of internet as a fair of advertising all these are listed under the major findings.The attached thing was to understand the average consumers who had to be users of internet. Why they use internet, do they nonice these advertisements, if yes do they take whatever action, if no then what is the reason for the same, do they think that online advertising is more engaging, if not what is their preferred spiritualist for advertising, whether they harbour been pursued to take any action regarding the product/service after watching the online advertising and whether they think that online advertising has any limitations or not all these are listed in detail under major findings.For this, students studying across Delhi, pursuing graduate/post-graduate and various professional courses were among the target audience. The reason behind this was that students these days spend a lot of time on the internet whether it is for getting information or social networking sites. They are apply their on the medium and notice these advertisements. The Young Working Professionals are the other target segments as they are also heavy users of internet using it for acquiring information or sending e-mails or social networking sites.Online advertising as a medium is uphill and holds a promising future for brands to build consumer relationships as these advertisements act as a reminder as well as a channel of sales. Online Advertising provides brands with the opportunity to exist alongside their competition and moreover be relevant. Presently BFSI and IT sectors are the major investors in online advertising as their target audience (corporate) is present online most of the time. So, internet acts as a medium of influencing the target consumer as well as a channel of sales for them. But FMCG sectors are also catching up.Because of the advent of social networking sites akin Facebook, Orkut and Twitter, it has estab lish easier for FMCG brands to advertise online as these advertisements act as a reminder for the consumers and directs the interested consumers to the main sites. This helps them in building their brand image as well as the consumer database as it gives them the opportunity to interact with the consumers and get feedback. The most important feature of Online Advertising is that is measurable i. e. consumer reactions can be monitored. This feature of online advertising makes it an efficient medium for advertising as results can be easily monitored.The major limitation to this medium is the low broadband penetration in the country and although the internet user base is on a rise but the ratio when compared to the total population is really low. Thus, Online Advertising is an effective medium of advertising owing to its synergetic and measurable nature. With the growing possibilities of sectors investing in this medium we can expect more creative content to be available on the onlin e space. This would make the medium of online advertising more creative, more interactive and in tune with all the other mediums of advertising.INTRODUCTION & BACKGROUNDER The Indian advertising industry is in a point of transition. Rapid advances in technology and an ever growing base of empowered customers have redefined how advertising is created, sold, consumed and evaluated. At this juncture advertisers are experimenting with a number of emerging platforms including Internet which has been globally acknowledged as an interactive medium with a lot of advertising potential. Internet is the most powerful communication medium know to humankind but there is still a debate on as to how powerful it as a communication tool.It is a way of straight off communicating to consumers in cyberspace. It is unique as there is more of narrow focus on e-commerce. It has opened up a lot of opportunities for marketers for targeting customers in an interactive and measurable ways. Online advertisin g is an effective way of advertising that uses the power of Internet and World Wide Web in order to deliver marketing messages and pull consumers. It helps to target specific customer segments and gather information across geographical boundaries in a cost effective manner.Online advertising helps in not only leading visitor to a publishers site but also creating awareness which potentially could result in gradual brand building. With online advertising you get instant results. It is growing faster than other segments due to fundamental drivers such as Low input costs for advertisers Increasing awareness of online tradition in India amongst advertisers and marketers Growth in online user/audience base The number of net surfers in India is increasing at a rapid rate and studies have shown that people are spending more and more time on the web.Buying products online is convenient, hassle-free and easy. Online market places allow buyers to see the best deals available without movi ng from their desks and subscribe to the products they want which they could not find at the local supermarket. For a company putting an advertisement online gives a benefit of being present right next to your competition when people are looking for products or services. Online Advertisement in India is a fast growing market and media buying is becoming a very important decision for all online spenders.The biggest advantage of Online Advertisement is it helps you to track your user online and understand online consumer behaviour. Recognizing the possibility of using Internet as an effective tool for targeting quoin audiences, innovative perspectives are being practiced by established and traditional institutions. According to a study1, in the recent general elections in India (early 2009), many Indian politicians considered Internet as a useful platform for interactive political communication especially with youth.Indian National Congress party used sites like YouTube and Facebook to execute web-based social marketing campaigns. With 50 Million Internet users in Urban India and majority of them in the age group of 18-24 years, Internet was found to be an effective tool to engage with them. 1 Study on Online Display Advertising in India by IMRB (December 2009) Growing Internet user base, increasing time spent on the Internet, broadband penetration into households and fragmented media consumption habits of consumers are driving advertisers towards the online medium.

Analysis Of The Indian Dairy Industry Essay

My modern venture is Lakshmi dairy which (According to Hindu mythology cow is considered to be the goddess of wealth and prosperity) attempts to encroach the simple dairy farm merchandise. Processing the take out in my dairy which iam bidly to set up in my home town, that is acquired from farmers from surrounding closures. My ultimate target would be from the day-to-day consumption and flourishing dairy products such as exactlyter, stop, yoghurt, especially types of draw itself i.e., Skimmed milk, semi-skimmed, whole milk. Keeping in mind my previous experience, in my family business (Lakshmi Milk Booth) along with my father, solicitation milk from various farmers and distributing them in our village, which I thought will be helpful for me in starting a dairy firm. This helps me to expand my family business (Lakshmi milk booth) by employing my villagers who at least take a leak a minimum qualification which helps them in handling the sophisticated equipment that is used in this whole process.Introduction take heed morenon farming activities in indiaFood, clothes and shelter argon the three basic necessities of military man beings where food is considered to the first and fore closely thing for the survival of the human beings ( stock). It can be consumed in the puzzle out of liquids such as water, milk, cancel fruit juice, beverages etc as well as solids such as baked food, cooked food, natural fruits and vegetables etc. As milk is considered as the mellowedly nutritious and the complete food, it is consumed in a large quantity. Especially, for the kids who atomic number 18 less than 3 yrs old, it is suggested by doctors that Milk gives sufficient calcium, proteins and vitamins before they can digest all other food (reference, u cant say on ur own). Not only kids but also people who are aged above 45 yrs are habituated to consume milk as a part of their break fast, as it streng wherefores teething and bones and supplies required calcium (refere nce please).Indian dairy industryAgriculture is the largest private sector and is also cognise to be the lifeline of the Indian economy. to a greater extent than 60% of the universe of discourse is dependant on the agriculture while 58.2% of the work force is directly or indirectly employed by means of agriculture. (Reference please, when giving facts and figures u need references for sure)Dairy farming is the most important part of the agriculture for thousands of years now and India is the largest milk producer. It produces 112 million MT with the highest share of 13% of the worlds outturn, which costs approximately 105,946 crores (1 = 72) (Shiva kumar Hedaoo, 2010) (this one is ok)Dairy industry is the highest contributor of the rural economy and hence it is considered to be the backbone of the farming(a) sector. It is the leading source of nutrition, Bio-gas, employment, income of cash and a cushion for drought proofing in India (Patel, 1993 Paroda, 1998).http//www.ukessays .com/essays/ trade/ abridgmentoftheindiandairyindustry foodstuffingessay.php1/712/18/2014Analysis of the Indian dairy industryMarket ResearchThe worlds largest and the cheapest milk producer is India (Shiva kumar Hedaoo, 2010). Dairy products in India feel a market revalue for about 100 billion. For many years now, the dairies in India open been delivering universally required products such as Semi-skimmed and skimmed milk, vanaspathi (ghee), butter, cheese etc. So as to capture the market place they watch also started producing new dairy products like low fat milk, sweet yoghurt etc. also the traditional sweets like rasmalai, rasgullas etc.thereby creating an opportunity for the new entries.Dairy farming industry in India is one of the most rapidly growing industries, which is in turn is providing various opportunities for the new entrepreneurs. However, media (electronic and press) and the government play a key role in educating the people about the immensity of the milk con sumption and its products regularly. As per the recent (which market survey address it)market survey, it is considered that the total population of India is 168 crores approximately. On the other hand, doctors and reputed health organisations are constantly advising us to include at least 100 ml of milk per day in our daily meal. (reference please, which doctor or doctors or doctors association)In that case, if every individual starts go through 100 ml per day, the milk consumption on the whole might be 168,000 tons approximately. The growth and expansion of Dairy industry in India is likely, referable to the development of the urban communities.The global consumption of milk has tremendously increased but it has become a challenge to meet the basic nutritional value of the dairy products in the under developed, developed and developing countries. The growth in per capita income might impact and eventually increase the consumption of milk and its products. Through the historic da ta, it is evident that as per the Indian standards the consumption of the dairy products could be more of the live stock products. The changes are more likely when the mankind start adopting the new lifestyle, food habits which are considered to be a part of the socioeconomic and the demographic factors (Radhakrishan and Ravi, 1990).(ok)Structure of the IndustryIndia is a developing country. Moreover, the dairy industry in India is non well established when compared to that of western countries. More than 90% of the dairy products are delivered by unliterary/unorganized sector and only 10% are delivered by organized sectors. (Shiv Kumar Hedaoo, 2010, referencing goes like (Hedaoo, 2010) thats it).(other than that Fine) Many dairies adopted the most traditional and the ancient ways of producing milk and its products. Until the past few years countries like India have been concentrating only on limited and regional dairy products like yogurt(regular), butter, cheese etc. Since the la st 3 years, in guild to capture the market, they have been producing the new dairy products such as sweet yogurt, flavoured milk shakes etc. (Shiv Kumar Hedaoo, 2010).gudSWOT AnalysisThe best of the data for conducting the SWOT analysis has been gathered considering the real instances of my (Give some name) Family Business (Milk) and the recent information on Dairy Industry in India, especially focusing on rural (villages) areas. http//www.ukessays.com/essays/ trade/analysisoftheindiandairyindustrymarketingessay.php2/712/18/2014Analysis of the Indian dairy industryStrengthsIndia is well known for largest live stock owning, as it has about 61% of buffaloes and 19% of cattle of the world (GOI, 2002). (Gud) In the year 1992, the livestock in India was 470.86 millions approximately (Sharma, June 2002 page 8, (u gullt need page and month while citation, it should be like this (Sharma, 2002) thats it). Considerably the labour and the whole production unit costs are less when compared to that of other countries. Also, India stands in the 2nd place in terms of the population and also the 7th largest country in the world of which 43% of the cut has been used for agriculture purpose.WeaknessesThe two drawbacks of dairy Industry in India are as follows In spite of availability of the various sophisticated equipments, most of the Dairy firms in India still tend to use the ancient techniques for the process of production. Any Source u can proof ur pointMost of the dairy firms in India are unorganized. (Hedaoo, 2010), I have done this referencing for uOpportunitiesIn recent days, we could see that there has been tremendous increase in the consumption of milk, which wouldnt have been possible without the intervention of media and the government. The key task performed was educating the people about the dairy products and its importance which effectively increased the consumption of milk. Hence, they created an opportunity for the new entities to capture the market share. Government has also made it easy for the dairy firms to import the highly sophisticated equipments with very less excise duty charges and the licensing policies etc. (u need source/reference to cover up ur this point)ThreatsUnfortunately, many other western countries are exporting high flavour dairy products to India due to the liberalization and the WTO full form please, as u havnt mention it before agreements, teacher will say I dont know what is it. Hence, there are high end milk products that are readily available in the market which could be at a major threat to the new entities. (How is the main point, ritual it down)My Business ConceptI would hereby like to talk about the whole business plan (Lakshmi Dairy Firm) that I am likely (likely battle cry shud not come, as u must be sure as a business women) to start. My family is ground out of Thadepalligudem (a small village with more than three hundred families among which there could be 85% illiterates approximately (Source) ) in Costal Andhra (Andhra Pradesh, the highest milk producing state in India). Our family has been running a small business acrosshttp//www.ukessays.com/essays/marketing/analysisoftheindiandairyindustrymarketingessay.php3/712/18/2014Analysis of the Indian dairy industrythe village for close 32 yrs now. I helped my father in the business, apart from my studies, since I was 12 yrs old which helped me gain some knowledge in establishing my own firm based on my experience.My father, mother and 3 more stave that we have engaged used to collect milk twice a day (at 6 am and 5 pm) at the milk booth, apart from which we have a delivery staff of size 15. On an average we collect 3000-3500 litres (u can increase ur staff if u want as it seems to be much more enough for 5 people to collect milk, thats my opinion) of milk from the villagers belonging to my own village and also the surroundings. Once the milk is gathered, it is sent for processing i.e., purifying, filtering and refining.One th is process is complete the milk is filled and stored in the container of with the capacity of 30 litres each. These cans are accordingly distributed accordingly at homes, sweet shops, bakeries, hotels etc. in the near by towns and cities, by the delivery staff through various means (wrong spelling) of transportation like motorcycles, auto rickshaws etc. without actually packing or chilling. The distribution of the milk cans should not take more than 2 hrs on the whole it takes 5 hrs from the condemnation the milking is done to the prison term of delivery.If the entire stock is sold out, we get a minimum profit of 15% to the maximum of 20%. During the winter season, as the cow and buffaloes yield more milk, the production is high (by 6% to 8% on the whole) where as there is decrease in the consumption. As villages doesnt have any kind of sophisticated equipment for storing the remaining milk, it goes waste i.e., loss. Due to the less consumption of milk (in winter season), the pr ices may drop down from 30% to 50% in the neighbourhood villages. Instead, if we have required modern equipments to convert milk into milk powder, we may still make more profit on the whole (5% high than the normal profits). (gud natural point)During summer, the consumption of milk is likely to increase and hence there is more demand for the dairy products such as yogurt, butter, cheese, ghee etc. However, the production of milk during this season is very less.(why milk production is low in summers proof it) Also there is no latest machinery which could covert milk into some(prenominal) other dairy products in huge quantities, due to which we loose our valuable customers. Currently my family is carrying the business transactions between two cities and collecting the milk from half-dozen villages only. Also there is no dairy firm located for about 410 kms from my village, as my village itself and its surrounding villages are under developed and backward. In order to overcome the above mentioned difficulties, I have business plan of establishing a Milk Dairy in my village.Following are the reasons to choose my village for a launching a Milk Dairy Have more livestock compared to other villages.Central place to 20 other villages (easy access).Near by to the cities with the population of more than 75,000 individuals. We own a land which is big enough to construct the building. To develop my village in terms of liveliness.Allocation of sufficient funds by government for the firms that are been established in the backward areas.http//www.ukessays.com/essays/marketing/analysisoftheindiandairyindustrymarketingessay.php4/712/18/2014Analysis of the Indian dairy industryInitially, I would start of my business by introducing the highly sophisticated equipments, which helps us store the milk for longer epoch (say 20-25 days). The next equipment that I would introduce is the packingmachine (to sell the milk in packets as we do now) and a van with a built in chilling mac hine which makes it easy for the long distance transportation. We (our family business) are well known for the quality, punctuality/timely delivery and reasonable prices of the product, at the same time we maintain a good rapport with our staff by giving wages on time and lending advances. (Well done)Market and USPIn the cities and towns near by my village there could (u shud be certain with facts and figures while doing or starting business) be a population of about 80,000 approx. where it is assumed that 8,000 to 8,500 litres of milk can be sold out and the dairy products of 1700 to 1900 kilograms every day (varies from season to season). In my village, very limited numbers of dairy products are available (which products are they mention it please). However, the customers are not satisfied as they are unhygienic, low quality etc.Due to the lack of alternatives, they had to purchase it. (say we will provide better alternatives) taking this as advantage I would like to produce more number of dairy products like milk powder, yogurt, skimmed and semi-skimmed milk etc. with high quality and reasonable prices. I strongly believe that the goodwill of my family will give a boost up, which I (u shud be certain while doing business whether it whole kit and boodle or not) be successful by working with the well versed experienced staff.CompetitorsAs there is no dairy closer to my village, people are dependant on the regional milk sellers. There are four other competitors who has the similar business that we carry out, among which two of them are closed during summer (due to the less production of milk), while the other two has less reputation and fame when compared to us and we conquer 60% of the market share while the 40% is captured by the rest.Price and MarginsThe primary objective of launching a Dairy firm is to make the hygienic, reasonable product available any time. The cost price of milk/litre is 9 to 13 and the selling price is 14 to 18 per litre (1=72*). If t he entire stockis sold out then we are likely to make a profit of 2 to 3 per litre. The left over milk will be processed to convert it into the milk powder, which in turn can be saved up to 6months and are sold out during summer (when in demand). The supplements like yogurt, ghee, and butter milk are bought from the farmers directly and are further processed to meet the quality. These dairy products can be sold with a margin profit of 15% at the maximum.a

Remember the Titans Essay

In the movie Remember the Titans, there were major racial difficulties between black and white students. This was during a term when the school had just been integrated to allow blacks into the school and the high school football game team up. These challenges helped the Titans grow as a team and made them more co-operative and successful. The difficulties of a multiracial team were overcome with the assistance of democratic and authoritarian train styles, motivational skills, self-fulfilling prophecy, and the perception of the athletes and coaches. Because of these actions, the Titans were able to defeat the challenges they were faced with as a team and come out superior.The authoritarian coaching style, demonstrated mostly by coach Boon, helped the team become more cohesive and strong. He believed in perfection, thrust his athletes to the limit, and being in control. During practices, if an athlete made a mistake they would have to run laps as a punishment. Sometimes during c oarse-graineds, it seemed like all he cared just about was winning. On one occasion, coach Yoast decided to show this style of coaching by getting angry at a referee for making inequitable calls on their team. Authoritarian coaching styles encourage control but can be very effective when trying to coach a large team or complete tasks.Another coaching style, which the assistant coach Yoast tended to use, was democratic. He noticed that coach Boon was being extremely rough on the football players and told him that some athletes do not respond well to humiliation and put-downs. This shows that coach Yoast was concerned about the well-being of his athletes, not just their success. On the last game of the season, coach Boon decided to have a more democratic view of coaching. He told the team to try their best instead of demanding perfection. This is a friendlier overture but it seems that he has almost given up all hope of winning by saying what he did. Democratic coaching styles made the athletes see useful and motivated to do their best, but sometimes they can encourage lower levels of aggression when utilise in the wrong way.The athletes, coaches and the team itself, helped motivate the Titans for games and practices. equipage Boon used threats and reprimands in an attempt toget the athletes to get along with each other. This did not work effectively since the athletes did not like him very much, so they were not motivated to listen. Threats benefit the athletes when they trust and respect the coach.The coaches pumped-up the team before the game by prep-talking the athletes with lots of positive comments. The body language and optimism of the coaches motivated the team to try their hardest. The Titans performed a unique entrance and warm-up, in order to intimidate the opposing teams and to motivate them for the game. This also lowered the athletes levels of anxiety and helped them get to a good state of arousal. As you can see, all types of motivation are important when a team is trying to overcome a obstacle.A psychological key in team success or defeat is self-fulfilling prophecy. This occurs when a coach focuses on positive or negative aspects of an athlete and the athlete ends up believing it is the truth. A prime example of this was Petey he was a learned helplessness athlete who did not respond well to negative remarks about himself. manager Boon always picked on his weaknesses and put him down for not being perfect. Petey believed everything coach Boon said until coach Yoast took him aside, gave him positive compliments, and told him to play defense for him in a game. Petey ended up improving in his performance and felt better about himself afterwards. This shows that some athletes respond differently to certain actions and it affects the teams co-cooperativeness.It is important to have some views on a situation to come up with the best answer. The perception of the athletes and coaches helped in the success and encouragemen t of the team. At football camp, in order to try to make the team members get along, coach Boon took the team to Gettysburg to teach them about the war between the blacks and whites. Instead of the threats and many long practices, this made the athletes realize that the situation was not worth being angry at each other and they began to work more cohesively as a team. When coach Boon looked at the situation in a different way, he came out with a desired result. Another example was both coaches used each of their views on game plays to come up with the master game plans. By working together and combining both perceptions, the game plans were deeply thinkingout and worked well. Experimenting with alternative perceptions and helping others look at situations in other ways improved the teams cohesiveness on and off the field.In conclusion, many factors work together to assist in overcoming challenges. These difficulties helped the Titans grow as a team and made them more co-operative a nd successful. In this case, democratic and authoritarian coaching styles, motivational skills, self-fulfilling prophecy, and the perception of the athletes and coaches helped to solve the racial conflicts of a high school football team. Not only did the problem get resolved, but the Titans were victorious in the end.

Books vs. Movies

Books remain among the oldest and the most valuable inventions of the humanity and lay down a large and dynamic history, which started in those times when people felt a necessity to create lasting and easily accessible records of some important information. The first books appeargond in Ancient Egypt, soon after invention of papyrus technique. Even in the beginning of the 20th carbon books were the most habitual seminal fluids of information and the only carriers of literary works of any genres. There were millions of booklovers around the world, who enjoyed reading and developing own personality by obtaining knowledge from the books.But in the first decade of the 20th century a lot of changes took place, and one of the reasons of those was a revolutionary invention of cinematography. The first motion picture films started appearing, the first studios in the Hollywood area were founded and worlds cinema industry started developing. Nowadays, movies of different genres, from come dies to documentaries, became a corporate part of our life. It is hard to find someone who does not like watching movies, but the opinions whether they are break away than the books, differ.This work is an attempt to examine and contrast the differences between books and movies. The first and the most important difference is the opportunity to imagine and visualize the scenes of the plot. While reading a book, we fecal matter use the power of our own imagination to picture characters or the events in details. But when watching a movie, we have to accept the visualization of the events, which is offered by the director. Certainly, movies can be advantageous, because they are visu all toldy stimulating and loaded with numerous special effects.However, books usually have deeper influence and remain longer in our minds, because all the work on visualization of the events is done by us ourselves. Another significant difference between books and movies is being a source for one another. It is cognize that screenwriters and movie directors often create their masterpieces based on the plots of popular books, and the examples of this include a number of movies about Harry Potter and Hannibal Lecter, The Lord of the Rings, The Da Vinci Code, Pride and Prejudice, The English Patient, One Flew Over the Cuckoos Nest, The Godfather and hundreds of others.Nevertheless, there are few incidents, when books are written on the plots of popular movies, because in such cases it is really difficult for the writers to offer something impertinently and appealing. There are more differences. As a rule, reading books inquires more time, as tumesce as more attention and concentration of the reader. At the same time, watching a movie does not take long (about 2-3 hours) and frequently does not require being totally focused on it. In addition, it is only a personality and previous achievements of the author, which can attract attention of potential readers to a new book.As to a new movie, there can be personalities (and previous achievements) of the director, the screenwriter, as well as the names of one or a number of actors, which can attract public attention and make more and more people watch it. Yet another difference is availability of books and movies. It is possible to read a book almost everywhere. Books are light, small and can be even placed in a pocket (so called pocket-books). That is why they are, undoubtedly, the best solution to meet the time in a queue or during a plane trip. However, not everyone can afford watching movies at any time and place.Only those, who have laptops or portable CD/DVD players with monitors, can play movies wherever they wish. The majority of people are still bounded to cinemas, TVs, home cinemas, home PC stations, etc. Undoubtedly, everyone has own opinion regarding the advantages of reading books and watching movies, and the comments like Books are soften because they are more descriptive and seem more real, or Movi es are just easier sometimes. They take less time and less concentration, perfectly reflect the opposite viewpoints of young Americans on these two concepts (Stratta & Broderick, n. d. ).Nevertheless, I suppose that it would be better and really fair to understand books and movies as two different genres of entertainment and learn to appreciate them both. Outline I. Books A. Historical information B. Being the only source of knowledge II. Movies A. Cinema history B. Becoming everyday entertainment III. Differences A. Opportunities to use imagination and visualize the scenes. B. Being a source for one another C. required time and concentration D. Personalities, who can contribute in promotion. E. Availability IV.Different opinions A. Comments of people B. Suggestion to enjoy the benefits of both books and movies Bibliography Stratta, E. & Broderick, M. (n. d. ). Movies Sink in the Battle vs. Books. In reasonableness Page. Marian High School Official Page. Retrieved April 19, 2007, from . The Book vs. The Movie. (2002, November 11). CBS News Online. Associated Press. CBS Interactive Inc. Retrieved Apri 19, 2007, from .

Sam’s Club and Costco

There are many positives that ordure be drawn from the delegacy that Costco runs and controls its business. Costcos motto is To continuously provide our members with quality goods and services at the lowest possible prices (Thompson, Strickland, Gamble, 2010). They have stuck to this mantra by providing affordable memberships to its clients, and affordable pricing of its merchandise. Costcos strategy of low pricing and limited product line and selection made Costco successful by keeping their margins below their competitors this is a positive in that it will draw more customers and more accounts for the growth and prosperity of the business.Costcos limited product line and selection is also a positive because strange it competitors, Costco gallops efficiency in its sale process and makes it easier for the business to be managed. Sinegal stated that If you have ten customers in to buy Advil, how many are not passing play to but any because you just have whizz size? Maybe one or two, we refer to that as the intelligent loss of sales (Thompson, Strickland, Gamble, 2010). otherwise positive is Costcos approach to treasure-hunt shopping.Costco tries to intrigue its customers by creating a sense of urgency with certain products that are high-end and that the company knows will sell-out quickly. Although these items a lot of measure are higher(prenominal) priced, they still are reasonably lower than the average department store or its membership warehouse competitors. The only negative would be Costcos marketing and advertising strategy. Although the stores reputation and low pricing have constituted in the franchises high level of success, their marketing strategy is lacking most key elements.Costco believes that direct mailings was the best possible marketing and advertising strategy but are missing out on the possibility of gaining a higher number of customers due to their lack of internet presence. The key factor that comes to mind is that Costco doesnt offer a list of their store items online, which doesnt give a consumer who isnt familiar with the store a chance get the full spectrum of what they truly offer. Although Costco 3 Costco is a large franchise, in most cases word of blab simply wont get a business the clientele they truly need to be successful or a leader in their respective arena.There were two strategic elements utilized by Costco that were insightful, the first beingness how Costco developed its personnel from within. The case of Jim Sinegal comes to light. When Sol price made Jim Sinegal the music director of the original Price Club, he knew that Jim had a special knack for discount retailing and for spotting what a store was doing wrong (usually either not being in the right merchandise categories or not selling items at the right price points) very things that was good at and that were at the roots of Prices Club growing success in the marketplace (Thompson, Strickland, Gamble, 2010).Sinegal applied this same concept when he partnered with Jeff Brotman, who was the elevated to vice chairman in 1993 and thus to chairman in 1994. This strategic element is what made both Price Club and Costco very successful. The second strategic element that was insightful was the way in which Costco formulated its strategy on low prices and its limited product and selection. Costcos view of the intelligent loss of sales, proved viable because they were willing to lose one or two customers to capture a higher number of clientele in the long run, and adhering to this strategy makes their business efficient and profitable.The formulation of strategy mustiness take into consideration important external parties. For Costco, the competitor and their targeted customers were two constituencies. How was their strategy wreakd by these parties? Did their strategy reflect adequate consideration of the needs of these two groups? Costcos strategy was definitely influenced by its customers and its competitor. From a competitors standpoint Costco wanted to a provide services, prices, and products that rivaled its competitor Sams Club.Costcos corporate trust of high quality and low prices id the driving for behind Costcos success. It is evident that Sam Walton, with Wal-Mart and Sams club played an integral part in the way the Costco has devised its strategy. Costcos average pay, for example, is $17 an hour and is 42% higher than its fiercest rival Sams Club. Costcos health political platform also makes other retailers look Scroogish, Costcos workers were only paying just 4 percent toward their health costs and raised it to only 8 percent when Sams Club and the retail average is at 25 percent (Bowmer, 2007).Costco isnt simply looking to be better that the competition they want Costco 4 to be demonstrably better, said John Matthews, Costcos senior vice president for human resources (Bowmer, 2007). From the customers standpoint Costco looks to keep increasing its consumer base by providing low pr ices that arent sexual climax at the workers expense, they believe this is the key to providing a good service and good business as a whole. Costco caters to the customer, by not becoming a casualty in the pricing war among retailers and wholesale club industries alike.A cardinal rule that has been implemented is that no item can be marked up by more than 14 percent and no private label item by more than 15 percent. In contract supermarkets generally mark up merchandise by 25 percent and department stores by 50 percent (Bowmer, 2007). Costco strives to be good merchants and offer the greatest value to the customer, Costco constantly strives to figure out how they are going lower their prices while their competition looks for ways to get to get more cash for their items.Costco has a good understanding of its customers and knows that they dont gain clientele by having fancy displays and mascots etc they know that the values they have attract and keep customers coming back, as well a s attract new prospects. The companys knack for adjusting and seeing things in a new way explains how Costcos customers influence on the decisions and strategies set forth by the company. Costcos strategy reflects adequate consideration of its customers and capitalizes on the needs that its competitors have.One can draw this conclusion because Costco has diagnosed what the customer needs, values and wants from a proprietor, and also have evaluated what the competition is lacking and perfected their mantra of providing low prices and quality products and services. They have formulated strong objectives that benefit their workers, customers and shareholders, and strategized a plan to be more successful than the competitor with a business model than can be considered overly generous in regards to its customers and workers in comparison to the competition.

Robotics in Healthcare: Personalizing care and boosting

Robotics in health c ar Personalizing care and boosting the quality, access and efficiency of healthcare (Miss Madhu Hiremath) **Student, Department of Hospital Management, IIHMR, Bangalore Abstracts Human life is evolving and so is technology. Healthcare, which is iodine of the major concerns in the 21stCentury, is entering a phase where technology Is becoming an enabler. In the near future, recite technologists and doctors, robots will help us a great deal In bringing down the north costs of healthcare and Improving operational efficiency and quality of care.Robotics for Healthcare caters mainly six voice areas like Smart medical capsules, Robotized surgery, natural prosthetics, Robotized motor coordination analysis and therapy, Robot-assisted mental, cognitive and social therapy, Robotized patient observe systems and many more innovations are expected by around the year 2025. Ethical and legal aspects are also likely to pose obstacles to the developments at some point. It is a field of innovation that encompasses many elicit leads, problems to be solved and challenges to e met.Robotic surgery is one of the most significant advances in healthcare in recent years. still like any other technological advance, It too comes with a heavy bell tag. Aggressive marketing by the manufacturers and surgeons may lead to unethical practices. This article analyses the applicability of robotics to healthcare In India and as compare to North America and European countries. India too is not left behind In acquiring robots In their surgical departments like Nova spine care, Apollo, AllMS, KIMS, Medanta Hospitals etc.At present, the scope for robotics in India is limited because of cost considerations. However Robots arent being designed to eliminate people. Instead, they can help reduce physical demands and workloads. Key Words Robotics for Healthcare, Intelligent prosthetics, Robotized motor coordination analysis, Robotic surgery Reference http//vwvw_Informationweek_c orn/healthcare/clinlcal-informatlon-systems/ vmw. roboucsbuslnessrevlew. com/research/report/ outlook_for_health_care_robotics_for_2013 http//www. kineticconsulting. co. uk/ robots. html 1 OF2

Case Study – Appendicitis

I. DEFINITION/PREVALENCE knowing disease of the GI tract whitethorn be ca utilise by the pathogen itself or by a bacterial or other toxin. Acute unhealthy disorders such(prenominal) as appendicitis and peritoneal punk result from contamination of damaged or radiation diagramly sterile tissue by a nodes own endogenous or re arraynt bacteria (Lemone and Burke, 2008, page 766). Appendicitis is the dismissal of the vermi pattern (wormlike) appurtenance the appendix is a low-spirited fingerlike appendage ab turn up 10 cm (4 in) long, attached to the cecum just below the ileocecal valve, which is the beginning of the large intestine.It is ordinarily located in the adjust iliac region, at an force field designated as McBurneys point. McBurneys point, located mid substance between the belly unlesston and the previous iliac crest in the right turn down quarter-circle. It is the usual situate for place bruise and rebound philia receiv qualified to appendicitis during l ater stages of appendicitis. The sound of the appendix is non fully understood, although it regularly fills and empties digested food. most scientists baffle recently proposed that the appendix may harbor and protectbacteriathat be beneficial in the function of the hu small-arm colon.Appendicitisis the most common cause of acute inflammation in the right lower quadrant of the ab quarry. The lower quadrant bother is unremarkably accompanied by a low-grade fever, nausea, and often vomiting. Loss of appetite is common. In up to 50% of presenting cases, local soreness is elicited at Mc Burneys point applied located at halfway between the umbilicus and the anterior spine of the Ilium. Rebound tenderness (ex. Production or intensification of troubleful sensation when pres positive(predicate) is released) may be present.The accomplishment of tenderness and vigour spasm and the existence of the constipation or diarrhea depend not so much on the severity of the appendiceal co ntagious disease as on the location of the appendix. If the appendix curls around coffin nail the cecum, suffering and tenderness may be felt in the lumbar region. Rovsings sign may be elicited by palpating the left lower quadrant. If the appendix has ruptured, the chafe sensation become much diffuse, group AB distention develops as a result of paralytic ileus, and the diligents condition worsens.The disease is more prevalent in countries in which people consume a diet low in roughage and high in refined carbohydrates. It is the most common reason for emergency ab surgery, touch on 10% of the population. Although appendicitis affects a person at any age, the peak incidence is between the ages of 20 and 30 age old in which the vast major(ip)ity of clients are most common in adolescents and young and pretty more common in males than females. About 7% of the population go away gain appendicitis at roughly magazine in their lives (Lemone and Burke, 2008 page 766).The ma jor complication of appendicitis is perforation of the appendix, which feces lead to peritonitis, abscess formation (collection of purulent material), or portal Pyle phlebitis, which is septic thrombosis of the portal vein caused by vegetative emboli that arise from septic intestines. Perforation universally occurs 24 hours later on the onset of inconvenience symptoms include a fever of 37. 7 degree Celsius or hundred degree Fahrenheit or greater, a toxic appearance and continued abdominal cark or tenderness. II. TYPES/CLASSIFICATIONAppendicitis john be classified as simple, humiliated, or perforated, depending on the stage of the process. In simple appendicitis, the appendix is inflamed but intact. When areas of tissue necrosis and microscopic perforations are present in the appendix, the disorder is called gangrenous appendicitis. A perforated appendix shows order of gross perforation and contamination of the peritoneal cavity (LeMone & Burke, 2008 page 766). peritonit is can be primary quill or sanctionary. Primary peritonitis is an acute bacterial infection that is not associated with perforated viscus, or electric organ.bacterial infection is the usual cause and may be associated with an infection by the like organism fewwhere else in the luggage compartment, which reaches the peritoneum via the vascular governing body. Tuberculosis peritonitis, which originates from tuberculosis elsewhere in the body, is a lineament of primary peritonitis. Clients with alcoholic cirrhosis and ascites, in the absence of a perforated organ, often manifest peritonitis, which may be due to leakage of bacteria through the wall of the intestine. Secondary peritonitis is usually caused by bacterial invasion as a result of perforation, or rupture of an abdominal viscus.It can as well as result from severe chemical reactions to pancreatic enzymes, digestive juices, or biles released into the peritoneal cavity (Gould & Dyer, 2011). III. DEMOGRAPHIC profile l onganimouss name is Mr. Ruptured Acute Appendicitis, 24 years old, male, residing at 820 General Kalentong, Daang Bakal, Mandaluyong urban center. He is the second child among 3 siblings, a Roman Catholic, single, a 3rd year college Information Technology student. IV. FAMILY medical checkup HISTORY (Family Genogram)COD TB COD TB A 83 -S, -D A 83 -S, -D non Recalled Not Recalled c c A 20 +S, +D A 20 S, +D A 24 +S, +D A 24 +S, +D A 27 -S, -D Skin allergy A 27 -S, -D Skin allergy A 42 +S, +D A 42 +S, +D A 64 +S, +D HPN, Stroke A 64 +S, +D HPN, Stroke c c A 46 -S, +D Asthma A 46 -S, +D Asthma A 51 -S, +D A 51 -S, +D long-suffering uncomplaining LEGEND LEGEND male male get hitched with married deceased male deceased male S- smoker D- reamer COD- cause of death S- smoker D- drinker COD- cause of death female female deceased female deceased female V. PAST medical checkup HISTORY He was first hospitalized give out 2006 due to dengue at the same hospital Mandaluyong City Medical Cen ter (MCMC).He has no other further illnesses except the typical fever, cough and cold. Other than that, he has no allergies, hypertension, or diabetes mellitus. VI. HISTORY OF PRESENT ILLNESS 1 week prior to admission price longanimous role startd abdominal upsetful sensation all over paunch. He consulted at ER MCMC signed out AUPD (Acute Peptic Ulcer Disease) and was given Omeprazole & HNBB (Buscopan). Whole abdominal ultrasound done and revealed tiny cholecystolethiasis. He was given Diclofenal and HNBB tab and eventually discharged. Few geezerhood prior to consultation, the patient still bringd abdominal pain.He consulted at Emergency Room and was opted for running(a) encumbrance EXPLORATORY LAPAROTOMY APPENDECTOMY under the service of Dr. Abram Del Valle, M. D. VII. GORDONS PHYSICAL ASSESSMENT i. Health Maintenance Perception Pattern Before admission The patient used to smoke cigarette 3 sticks per day. And he too drinks alcohol daily unique(predicate)ally beer of m ore than 2 bottles per session. He was not using drugs and he has no allergies at all. During quantify of care The patient is not smoking cigarette or drinking alcohol. ii. Nutritional Metabolic PatternBefore admission The patient was on a high protein diet because he was used to go to the gym 2-3 times a week. He was as well as taking vitamins (CENTRUM). He has normal appetite and has no difficulty swallowing. He usually eats 3 times a day (breakfast, lunch and dinner) and most of the time he also has his snacks. He also usually drinks 2-3 liters of water a day. e During time of care The patient is on NPO (nothing per orem) for 5 days due to post-operative appendectomy and he was on his 2nd day of NPO status when we cared for him. He has also NGT lavage connected. ii. exclusion Pattern Before admission The patients normal intestine movement was 3 BM a day and has no difficulty in bladder habits. His last bowel movement was last July 17, 2012. He usually urinates 6-7 times a day without difficulty. During time of care The patient has absence of bowel movement and even flatus and has no bowel sounds upon auscultation. He has foley catheter and with pissing payoff of 480 cc per shift. iv. body process and function Before admission The patient could do his activities independently without financial aidance.He usually goes to gym 2-3 times a week. During time of care The patients functional level or self-care ability level is 2 which mean he requires help from another person for assistance. v. Sleep/Rest Pattern Before admission The patient usually sleeps at 4 or 5 am and wakes up at 8 or 9 am. He has no difficulty in sleeping and he feels rested after sleep. During time of care The patient has regular sleeping habits. He sleeps at 10 am, wakes up at 6 am with uninterrupted sleep. vi. Cognitive Perceptual PatternBefore admission The patient was alert and tenacious, has normal speech, with dotty level of anxiety, has normal hearing, and with impaired vision of his left eye due to cataract. During time of care The patient is alert and coherent. He has normal speech (Filipino as his spoken language), he has moderate level of anxiety, has normal hearing, and with impaired vision of his left eye due to cataract. He also complained of acute pain and expound it as a cramping pain. Pain management (Tramadol) was given. vii. Role Relationship Pattern Before admission The patient was a student and single.His support system was his family, relatives & friends. During time of care The patients support system is his contract who is always at his bed side assisting him in whatever he needs. Upon asking his mother if she has any concerns regarding hospitalization, she verbalise that she is more concern about the fast recovery of her son. viii. Sexuality Reproductive system Before admission and during the time of care The patient still didnt encounter his testicular exam. ix. heading Stress Tolerance/Self Perception/Self Concept Pa ttern The patients major concern regarding his hospitalization is s all about self-care.Due to the contraptions attached to him, he cannot independently do his activities. His major loss was his stepfather when he died of kidney failure. His rated his outlook on future as 5, 1 being brusk and 10 being very optimistic. He further explained why he rated 5 because he is not sure if when he finished college he can be subject to find a job accommodate for him. x. Value Belief Pattern Our patient is a Roman Catholic and he always goes to perform every Sunday together with his family. VIII. GROWTH AND DEVELOPMENT DEVELOPMENTAL TASK THEORIST STATUS inter-group communication vs.Isolation * Develops commitments to others and to a life work (career)(Daniels, et. al. , 2010). Erikson The patient had a relationship with his opposite sex but he said that they just broke up a week before he was hospitalized due to some personal and private reasons. Currently, he is in 3rd year college, an I T student. Genital * Emergence of sexual interests and teaching of relationships with potential sexual business officeners (Daniels, et. al. , 2010). Freud As what had written above, the patient had a relationship with his opposite sex but because of some reasons they decided to end up their relationship. Formal Operations * Able to see relationships and to reason in the abstract (Daniels, et. al. , 2010). Piaget He perceived that relationships (any kind of relationship) are important especially at his age. He can also reason out in an abstract way. He can express his opinions intellectually and precisely. archean Adulthood * Select a partner, learn to live with a partner, start a family, manage a home, establish self in a career/occupation, assume civic responsibility, and become a part of a social group (Daniels, et. al. , 2010). Havighurst According to our patient, he didnt expected that something like that pass on go past to them (referring to his girlfriend). He was re ally expecting that they are really meant for each other and that she (his gf) will be his future wife. He is also establishing himself to a future career, thats why he is studying in preparation for his future. During our time of care also, his barkadas visited him and he said that they were his tropa. Postconventional * Individual understands the morality of having democratically established laws (Daniels, et. al. , 2010). Kohlberg Upon asking the patient if he is familiar with the democratically established laws in the Philippines, he immediately responded with a yes. He also said that these laws help us, Filipinos, to have safe and secure country though there may come a time that we may experience something unexpectedly. IX. PHYSICAL ASSESSMENT * racy Signs TIME Initial 8AM (07/24/12) 10 AM 12 NN 8 AM (07/25/12) 12 NN Last 8AM(07/26/12) T 36. 3 37. 3 37. 4 36. 4 37. 3 36 P 83 84 71 75 81 68 R 23 25 21 19 19 20 BP great hundred/80 120/80 120/80 120/80 120/80 one hundred ten/8 0 Sequence BY SYSTEMS NORMAL FINDINGS BOOK FINDINGS PATIENT FINDINGS SIGNIFICANCE I. NEUROLOCIGAL SYSTEM Alert and coherent with normal body temperature of 36. 3C 37. 6C * Fever (usually 38C although hypothermia may be present w/ severe sepsis) chills * Thirst * Pain * Complained of pain in the incision site (lower longitudinal midline of the abdomen) Pain results from the plusd atmospheric pressure of changeable on the nerves, especially in enclosed areas, and by the local displeasure of nerves by chemical mediators such as bradykinins (Gould, et al. 2011). II. RESPIRATORY Normal ventilation with a rate of 12-20 breaths per minute * Tachypnea shallow respirations * RR 23 bpm w/ shallow respiration Acute pain usually initiates physiologic stress rejoinder with increased respiratory rate (Gould & Dyer, 2011). III. INTEGUMENTARYPink or browned and in uniform color, no edema, no lesions, moistSkin temperature is normally warmIntact skinWhen pinched, skin springs back to prev ious state * modify lips and mucous membranes * Swollen tongue * Poor skin turgor * Dry lips and mucous membranes * Skin turgor3-5 seconds * battlefront of functional incision at lower longitudinal midline of the abdomen * Skin is warm to touch and is reddish Dry mucous membrane and poor skin turgor are signs of drying up (Gulanick, et al. 1994). Redness may signify inflammation (weber & Kelly, 2007). Redness and warmth are caused by increased blood settle into the damaged area (Gould & Dyer, 2011). IV. CARDIOVASCULAR Normal pulse rate of 60-100 bpm * Tachycardia * Diaphoresis * Pallor * Hypotension * Tissue edema * split second rate 83 bpm Acute pain usually initiates a physiologic stress response with increased heart rate (Gould & Dyer, 2011). V. MUSCOLOSKELETALAbility to do Activities of Daily Living (ADL) * Difficulty ambulating * Weakness * Difficulty ambulating due to post-op condition * Weakness Constant pain frequently affects daily activities and may become a prim ary focus in the life of an individual (Gould & Dyer, 2011). VI. GENITO-URINARY Normal urine produce of 30cc/hrColor Amber, transparent, clear * diminishd urinary output * Dark color urine * Dark color urine * Urine output 480 mL/shift * Specific gravity 1. 30 Decreasing output of concentrated urine with change magnitude specific gravity suggests dehydration/need for increased fluids (Doenges, et al. , 2006). VII. GASTROINTESTINAL Abdominal skin may be paler than the general skin tone because this skin is so seldom exposed to the natural elementsAbdomen is free of lesions or rashesA series of intermittent, soft clicks and gurgles are heard at a rate of 5-30 per minuteNormally no tenderness or pain is elicited or inform by the clientNo rebound tenderness is presentAbdomen is non-tender and soft.There is no guarding * Loss of appetite * illness & vomiting(usually projectile) * Constipation of recent onset * Diarrhea(occasional) * Sudden, severe, generalized abdominal pain * A bdominal distention rigidity * Decreased/absence of bowel sounds * Inability to pass stool/flatus * Muscle guarding (abdomen) * Psoas Sign (flexion of or pain on hyperextension of the hip due to contact between an inflammatory process & the psoas muscle) * Obturator Sign (the internal gyration of the right leg with the leg flexed to 90 degrees at the hip and knee and a resultant tighten of the internal obturator muscle may ause abdominal discomfort) * Rovsings Sign (pressure on the left lower quadrant of the abdomen causes pain in the right lower quadrant) * Rebound tenderness (a sign of inflammation of the peritoneum in which pain is elicited by the sudden release of the fingertips pressing on the abdomen) * Board-like abdomen * Sudden, severe, generalized abdominal pain * absence of bowel sounds in all four-spot quadrants * Absence of flatus/stool * Presence of surgical incision Signs indicating the onset of peritonitis include a rigid board-like abdomen (Gould & Dyer, 2011).P ain recurs as a steady, severe abdominal pain as peritonitis develops (Gould & Dyer, 2011). Absence of bowel sounds may be associated with peritonitis or paralytic ileus (Weber & Kelly, 2007). When inflammation persists, nerve conduction is impaired, and peristalsis slumps, leading to obstruction of the intestines (paralytic ileus) (Gould & Dyer, 2011). X. symptomatic TESTS DIAGNOSTIC TEST NORMAL RESULT SIGNIFICANCE WHOLE ABDOMINAL ULTRASOUND (July 21, 2012) The organs examined appear normal (Cosgrove, et al. , 2008). Liver is not enlarged.It has homogenous echopattern with smooth border. The intrahepatic ducts are not dilated. No evident central mass lesion seen. CD measures 3. 9mm. Gallbladder is normal in size and wall thickness. There are nine-fold tiny echogenic shadowing foci seen within the gallbladder lm. Pancreas & spleen are normal in size & echopattern. No focal mass lesion seen. Both kidneys are normal in size & echopattern. Right kidney measures 10. 14. 25. 46cm w ith cortical thickness of 1. 7cm composition the left kidney measures 10. 54. 84. 1cm with thickness of 19cm. No evident caliectasis, lithiasis, seen bilaterally.Urinary bladder is unfilled. ImpressionTiny cholecystolithiasesNormal liver, pancreas, spleen, kidneys by UTZUnfilled urinary bladderNot dilated biliary tree Abdominal ultrasound is the most hard-hitting test for diagnosing acute appendicitis (LeMone & Burke, 2007). HEMATOLOGY REPORT/COUNT (July 21, 2012) RBC 4. 2-5. 6 M/uLPlatelets 150-400 x 10/L leukocyte 3. 8-11. 0 K/mm3Hemoglobin 135-180g/LHematocrit 0. 45-0. 52DifferentialNeutrophils 0. 50-0. 81Lymphocytes 0. 14-0. 44Monocytes0. 02-0. 06Eosinophils 0. 01-0. 05Basophils0. 00-0. 01 WBC enumerate 12. 6 K/mm3RBC 4. 1 M/uL (normal)Hematocrit 0. 45 (normal)Hemoglobin 153g/L (normal)Differential CountNeutrophils 0. 90Lymphocytes 0. 10 (normal) Elevated WBC is seen in acute infection (LeMone & Burke, 2007). Neutrophils elevated in bacterial infection (LeMone & Burke, 2007 ). URINALYSIS (July 21, 2012) Color Light straw to amber yellowAppearance ClearOdor AromaticpH 4. 5-8. 0Specific gravity 1. 005-1. 030Protein 2-8mg/dLGlucose NegativeKetones NegativeRBCs RareWBCs 3-4Casts Occasional clear Color Dark YellowTransparency TurbidUrine pH 6. 0 Specific gravity 1. 30Sugar NegativeProtein +4Microscopic examPus cells 4-6/HPFRBC 1-2/HPFCrystals Amorphous Sulfate Moderate A dark yellow to brownish color is seen with deficient fluid volume (LeMone & Burke, 2007). Hazy or indistinct urine indicates bacteria, pus, RBCs, WBCs, phosphates, prostatic fluid spermatozoa, or urates (LeMone & Burke, 2007). CLINICAL CHEMISTRY (July 21, 2012) Sodium (Na) 135-142 mmol/LPotassium (K) 3. 8-5 mmol/L Sodium 132 mmol/LPotassium 4. 02 mmol/L Sodium is decreased in SIADH & vomiting (LeMone & Burke, 2007). XI. ANATOMY & PHYSIOLOGY OF APPENDIX (LARGE INTESTINE)The large intestine, which is about 1. 5 m (5 ft) long and 6. 5 cm (2. 5 in. ) in diameter, extends from the ileum to the anus. It is attached to the posterior abdominal wall by its mesocolon, which is a double layer of peritoneum. Structurally, the four major regions of the large intestine are the cecum, colon, rectum, and anal canal. The orifice from the ileum into the large intestine is guarded by a fold of mucous membrane called the ileocecal sphincter (valve), which allows materials from the small intestine to pass into the large intestine. Hanging inferior to the ileocecal valve is the cecum, a small pouch about 6 cm (2. 4 in. ) long.Attached to the cecum is a twisted, coiled tube, measuring about 8 cm (3 in. ) in length, called the appendix or vermiform appendix (vermiform = worm-shaped appendix = appendage). The mesentery of the appendix, called the mesoappendix, attaches the appendix to the inferior part of the mesentery of the ileum. The afford end of the cecum merges with a long tube called colon, which is divided into ascending, thwartwise, descending colon are retroperitoneal the tr ansverse and sigmoid colon ascends on the right side of the abdomen, reaches the inferior surface of the liver, and turns abruptly to the left to form the right colic (hepatic) crimp.The colon continues across the abdomen to the left side as the transverse colon. It curves below the inferior end of the spleen on the left side as the left colic (splentic) flexure and passes inferiorly to the level of the iliac crest as the descending colon. The sigmoid colon begins near the left iliac crest, projects medially to the midline, and terminates as the rectum at about the level of the third sacral vertebra. The rectum, the last 20 cm (8 in. ) of the GI tract, lies anterior to the sacrum and coccyx. The terminal 2-3 cm (1 in. ) of the rectum is called the anal canal.The mucous membrane of the anal canal is set up longitudinal folds called anal columns that contain a network of arteries and veins. The opening of the anal canal to the exterior, called the anus, is guarded by an internal an al sphincter of smooth muscle (involuntary) and an external anal sphincter of the skeletal muscle (voluntary). Normally these sphincters keep the anus closed except during the elimination of feces (Tortora & Derrickson, 2006). XII. PATHOPHYSIOLOGY NARRATIVE Appendicitis, inflammation of the vermiform appendix, is a common cause of acute abdominal pain.It is the most common reason for emergency abdominal surgery, affecting 10% of the population (Tierney et al. , 2005). Appendicitis can occur at any age, but is more common in adolescents and young adults and slightly more common in males than females (LeMone & Burke, 2007). The development of appendicitis usually follows a pattern that correlates with the clinical signs, although variations may occur because of the altered location of the appendix or underlying factors (Gould & Dyer, 2011). Obstruction of the proximal lumen of the appendix is apparent in most acutely inflamed appendices.The obstruction is often caused by fecalith, or hard mass of feces. Other obstructive causes include a calculus or stone, a unconnected body, inflammation, a tumor, parasites (e. g. , pinworms), or edema of lymphoid tissue (LeMone & Burke, 2007). Following obstruction, the appendix becomes distended with fluid secreted by its mucous membrane and microorganisms proliferate. Pressure within the lumen of the appendix increases, impairing its blood supply because blood vessels in the wall are compressed thus the appendiceal wall becomes inflamed and purulent exudate forms.Within 24 to 36 hours, the increasing over-crowding and pressure within the appendix leads to ischemia and necrosis of the wall, resulting in increased permeability. Bacteria and toxins escape through the wall into the surrounding are. This breakout of bacteria leads to abscess formation or localized peritonitis. An abscess may develop when the neighboring omentum temporarily walls off the inflamed area by adhering to the appendiceal surface. In some cases, the in flammation and pain nail down temporarily but then recur. Localized infection or peritonitis develops around the appendix and may spread along the peritoneal membranes.Increasing pressure inside the appendix causes increased necrosis and gangrene in the wall (infection in necrotic tissue). The wall of the appendix appears blackish. The appendix ruptures or perforates, releasing its contents into the peritoneal cavity. This leads to generalized peritonitis and would lead to septicemia and into septic shock and will result to death (Gould & Dyer, 2011). XIII. PATHOPHYSIOLOGY plat Risk Factors Non-modifiable * Age (Adolescents & young adults) * Gender (Male) Modifiable * Fecalith * Calculus/Stone * Foreign body * inflammation * Tumor * Parasites Edema of lymphoid tissue Obstruction of the appendiceal lumen Obstruction of the appendiceal lumen Buildup of fluid inside the appendix Buildup of fluid inside the appendix Proliferation of microorganisms Proliferation of microorganisms Abdom inal pain Abdominal pain increase pressure within the lumen of appendix change magnitude pressure within the lumen of appendix condensing of blood vessels Compression of blood vessels * Fever * Obturator Sign * Psoas Sign * Rovsings Sign * Rebound tenderness * Fever * Obturator Sign * Psoas Sign * Rovsings Sign * Rebound tenderness Decreased blood flow into the appendixDecreased blood flow into the appendix Inflammation of appendiceal wall Inflammation of appendiceal wall (July 21, 2012) Hematology Count * WBC count 12. 6 K/mm * Neutrophils 0. 90 Urinalysis * Transparency turbid (July 21, 2012) Hematology Count * WBC count 12. 6 K/mm * Neutrophils 0. 90 Urinalysis * Transparency turbid ischemia & necrosis of the wall Ischemia & necrosis of the wall Increased permeability Increased permeability Bacteria and toxins escape through the wall Bacteria and toxins escape through the wall Abscess formation/localized bacterial peritonitisAbscess formation/localized bacterial peritonitis Pr oliferation of localized peritonitis around the appendix and peritoneal membranes Proliferation of localized peritonitis around the appendix and peritoneal membranes Increased pressure inside the appendix Increased pressure inside the appendix * Sudden, severe, generalized abdominal pain * Abdominal distention & rigid boardlike abdomen * Absence of bowel sounds/(-) flatus/(-) BM (July 24, 2012) * Sudden, severe, generalized abdominal pain * Abdominal distention & rigid boardlike abdomen * Absence of bowel sounds/(-) flatus/(-) BM July 24, 2012) Increased necrosis and gangrene in the wall Increased necrosis and gangrene in the wall Appendectomy with NGT lavage (July 22, 2012) Appendectomy with NGT lavage (July 22, 2012) Perforation of the appendix Perforation of the appendix Intestinal bacteria leak out into peritoneal cavity Intestinal bacteria leak out into peritoneal cavity * Low-grade fever & leukocytosis * Tachycardia * Hypotension * Vomiting * Low-grade fever & leukocytosis * T achycardia * Hypotension * Vomiting Generalized peritonitis Generalized peritonitis XIV. NURSING PROCESSProblem 1 ABDOMINAL PAIN July 24, 2012 * Subjective actuates * Nurse await lang, ang sakit kasi parang nagcacramps, patient verbalized while having a conversation with him. How does it feel like Abdominal cramping Precipitating factor Kapag nililinisan pero kadalasan bigla-bigla na lang sumasakit (Whenever wound cleanup position is performed but oftentimes it just suddenly happened) Relieving factor Pain relief (but not all the time pain reliever is being given) Does it radiate to the other parts of the body (back, legs, chest, etc) No Duration of pain Paiba-iba din eh.Minsan sobrang tagal mga 2-3 legal proceeding, minsan naman mga ilang Segundo lang (It differs, sometimes its too long (2-3 minutes) and sometimes it just happened for a second) * Patient rated the pain as 8/10 where 0 signifies no pain and 10 signifies unbearable pain. * quarry Cues * Facial grimace * Guardin g of the incision site * Rigid (board-like) abdomen * Abdominal distention * Location of pain Surgical site * RR 25 bpm * treat diagnosis Acute Pain associate to inflammation of the tissues secondary to post-op surgical incision.Inflammation or nerve damage gives rise to changes in sensory processing at peripheral and central level with a resultant sensitization. In relation, prostaglandins are chemotactic substances drawing leukocytes to the inflamed tissue. It plays a vasoactive role it is also a pain and fever inducer (Lemone and Burke, 2007). Acute Pain related to infection & inflammation of the peritoneal membranes secondary to peritonitis The peritoneum consists of a large sterile expanse of highly vascular tissue that covers the viscera and lines of abdominal cavity.This peritoneal structure provides a mean of rapid dissemination of irritants or bacteria throughout the abdominal cavity. Abdominal distention is evident, and the typical rigid, board-like abdomen develops as reflex abdominal muscle spasm occurs in response to involvement of the parietal peritoneum (Gould & Dyer, 2011). * aspiration/NOC Pain Control Outcomes pitiable bound by and by 30 minutes of nursing discourse the patient will report a decrease in pain from pain scale of 8/10 to 4-5/10. recollective circumstance subsequently 8 hours of nursing intervention the patient will demonstrate an understanding about the proper way of controlling pain as evidenced by proper splinting and deep breathing exercise and will report a decrease or most probably will be free from pain from pain scale of 4-5/10 to 1-2/10. * NIC Pain Management Independent * Assessed pain including its character, location, severity, and duration. Both preoperatively and postoperatively, the clients pain provides important clues about the diagnosis and possible complications.Abdominal distention and acute inflammation contribute to the pain associated with peritonitis. Surgery further disrupts abdominal muscles a nd other tissues, causing pain (LeMone & Burke, 2007). * Monitored vital signs every 2 hours. Vital Signs, especially respiratory rate (RR), are usually altered in acute pain. (Sparks and Taylor, 2005). * Kept the client at rest in semi-Fowlers position. Gravity localizes inflammatory exudate into lower abdomen or pelvis, relieving abdominal tension, which is accentuated by supine position (Doenges et al. , 2006). * Provided diversional activities (texting, sound trip, etc).Refocuses attention, get alongs relaxation, and may stir coping abilities and diverts attention from pain (Doenges et al. , 2006). * Taught post-op health teaching (e. g. , proper splinting & deep breathing exercises). The use of non-invasive pain relief measures can increase the release of endorphins and enhance the therapeutic effects of pain relief medications (LeMone & Burke, 2007). * promote too soon ambulation. Promotes normalization of organ function stimulates peristalsis and passing of flatus, reducin g abdominal discomfort (Doenges, et al. , 2006). Give hot and cold compress. Hot, moist compresses have a penetrating effect. The warm rushes blood to the affected area to promote healing. Cold compresses may reduce total edema and promote some numbing, thereby promoting comfort. (Doenges et al. , 2006). open * Administered analgesic as dictate (TRAMADOL 50 mg/IV Q 8 x 3 doses) Time given 8 AM. Post-operatively, analgesics are provided to maintain comfort and enhance mobility (LeMone & Burke, 2007). * Kept on NPO. Decreases discomfort of former(a) intestinal peristalsis and gastric irritation/vomiting (Doenges et al. 2006). * Evaluation slight end point Goal partially met. subsequently 30 minutes of nursing intervention the patient reported of a decrease in pain from a pain scale of 8/10 to 6/10 in which 4-5/10 was the expected outcome. considerable Term Goal met. After 8 hours of nursing intervention the patient displayed control of pain as evidence by deep breathing exercis e and proper splinting. He also reported of a decrease in pain with a pain scale of 2/10 from 6/10. Pain reliever TRAMADOL was given 8 am via IV. Problem 2 ABSENCE OF FLATUS July 24, 2012 * Subjective Cues Nurse wait lang, ang sakit kasi parang nagcacramps (referring to abdominal cramping), patient verbalized while having a conversation with him. * Pain scale of 8/10 * Objective Cues * (-) Flatulence * (-) BM (Last BM was July 17, 2012) * Absence of bowel sounds upon auscultation of all four quadrants * Nursing Diagnosis Dysfunctional gastrointestinal motility related to inflammatory process of peritonitis secondary to absence of flatulence. The inflammatory process of peritonitis often draws large amounts of fluid into the abdominal cavity and the bowel.In addition, peristaltic application of the bowel is slowed or halted by the inflammation, causing paralytic ileus, impaired propulsion of forward movement of bowel contents (LeMone & Burke, 2007). * Goal/NOC Ambulation Outcomes unawares Term After 8 hours of nursing intervention the client will report/experience flatus and will understand and demonstrate the need for aboriginal ambulation following abdominal surgery. persistent Term After 2 days of nursing intervention the client will report/experience every flatus or bowel movement or both. * NIC Impaction Management PositioningIndependent * Assessed abdomen including all four quadrants noting character to determine increased or decreased in motility Assessed for further abdominal tenderness & auscultated for any abdominal sounds. To help identify the cause of the alteration and guide development of nursing intervention (Sabol & Carlson, 2007). * Monitored and recorded ( expenditure) and output every hour or 2 hours. Intake and output records provide worthy information about fluid volume status (LeMone & Burke, 2007). * Encouraged early ambulation.Promotes normalization of organ function stimulates peristalsis and passing of flatus, reducing abdominal discomfort (Doenges, et al. , 2006). * Assisted in mournful from side to side or up in bed from time to time. Frequent repositioning helps in proper oxygenation and usually prevents complications like pressure ulcers, deep vein thrombosis, etc. (Gulanick, et. al. , 1994). Dependent * Administered antacid as ordered (RANITIDINE 50g/IV Q 12. Antacids either directly neutralize acidity, increasing thepH, or reversibly reduce or third power the secretion of acid by gastric cells to reduce acidity in the stomach (Gabriely, et al. 2008). * Evaluation Short Term Goal partially met. After 8 hours of nursing intervention the patient didnt experience flatus or even bowel movement but was able to have an understanding with regards to early ambulation as evidenced by letting his mother assist him in moving up in bed going to the chair but refused to walk because of complaint of having a lot of contraptions attached to him which causes him to have difficulty in moving. Long Term Goal met. Aft er 3 days of nursing intervention the patient reported of a flatus for 3 times.Problem 3 RISK FOR DEHYDRATION July 24, 2012 * Subjective Cue * Nanghihina na ako kasi limang araw ako hindi pwede kumain pati tubig bawal din kaya nagnunuyo na yung labi ko, as verbalized by the patient. * Objective Cues * NPO for 5 days * Dry mucous membrane * Dry lips * Capillary refill= 2 seconds * Skin turgor= 3-5 seconds * Urine output/shift= 480 mL * Urine color Dark Yellow * Urine specific gravity 1. 030 (Normal honour 1. 005-1. 030) * Absence of bowel sounds of all the four quadrants * (-) Flatus, (-) BM * BP 120/80 mmHg * PP 83 bpm * Nursing DiagnosisRisk for deficient fluid volume related to postoperative restriction secondary to NPO for 5 days Inflammation of the peritoneum with sequestration fluid and NPO status can lead to dehydration and electrolyte im offset (Doenges, et al. , 2008). * Goal/NOC Knowledge interposition Regimen Hydration Oral Hygiene Tissue Integrity Skin & Mucous Membran es Outcomes Short Term After 30 minutes of nursing intervention patient will have an understanding with regards to maintaining fluid balance as evidenced by willingness of following the prescribed regimen given by the medical staffs. Long TermAfter 3 days of nursing intervention the patient will be able to maintain adequate fluid balance as evidenced by moist mucous membrane, rock-steady skin turgor, stable vital signs, and individually adequate urine output. * NIC Fluid Management Fluid supervise Vital Signs Monitoring Independent * Monitored BP & Pulse. Variations help identify fluctuating intravascular volumes, or changes in vital signs associated with resistive response to inflammation (Doenges, et al. , 2006). * Inspected mucous membranes assessed skin turgor and capillary refill. Indicators of adequacy of peripheral circulation and cellular hydration (Doenges, et al. 2006). * Monitored intake and output noted urine color/concentration, specific gravity. Decreasing urine out put of concentrated urine with increasing specific gravity suggests dehydration/need for increased fluids (Doenges, et al. , 2006). * Auscultated bowel sounds. Noted passing of flatus, bowel movement. Indicators of emergence of peristalsis, readiness to begin oral intake (Doenges, et al. , 2006). * Provide clear liquids in small amounts when oral intake is resumed, and progress diet is tolerated. Reduces risk of gastric irritation/vomiting to minimize fluid loss (Doenges, et al. 2006). * disquieted the importance of having him on a NPO status and provided the necessary information with regards to his condition and the medications being administered (e. g. , IVF). It provides the patient a full understanding with regards to his condition thus encouraging him to participate and work manus in hand with the staff (Gulanick, et al. , 1994). * Gave frequent mouth care with special attention to protection of the lips. Dehydration results in drying and harrowing cracking of the lips and mouth (Doenges, et al. , 2006). Dependent * Maintained gastric suction as indicated.Although not frequently needed, an NG tube may be inserted preoperatively and maintained in immediate postoperatively phase to decompress the bowel, promote intestinal rest, and prevent vomiting (Doenges, et al. , 2006). * Administered IV fluids (D5LR 1L x 8 or 30 gtts/min) and electrolytes (D5 Balanced octuple Maintenance Solution w/ 5% dextrose 1L x 8 or 30 gtts/min). The peritoneum reacts to irritation/infection by producing large amounts of intestinal fluid, possibly reducing the circulating blood volume, resulting in dehydration and relative electrolyte imbalances (Doenges, et al. , 2006). * EvaluationShort Term Goal met. After 30 minutes of nursing intervention the patient was able to have a full understanding with regards to maintaining fluid balance as evidenced by verbalizing, So kaya pala hindi pa ako pwede kumain ngaun para maiwasan mairritate ang tiyan ko. Long Term Goal met. After 3 d ays of nursing intervention the patient was able to maintain adequate fluid balance as evidenced by moist mucous membrane, good skin turgor (1-2 seconds), stable vital signs (please see page __ ), and adequate urine output of 620 mL with an appearance of amber yellow. Problem 4 RISK FOR INFECTION July 24, 2012 Subjective Cues Nurse, sobrang kailangan ba talaga ang paghuhugas ng kamay bago linisan o hawakan sugat niya? , asked by the mother. * Objective Cues * Post-operative condition presence of surgical incision * Surgical site is warm to touch and reddened * Temp 36. 3C * Nursing Diagnosis Risk for infection related to inadequate primary defenses secondary to post-operative surgical incision It is risk to be invaded by pathogens especially if surgical site is near at the perineal area, pathogens can also develop by poor personal hygiene and poor wound cleaning (Doenges, et al. 2006). * Goal/NOC Risk Control (For contagious disease) Outcomes Short Term After 30 minutes of nursin g intervention the patient will be able to have partial understanding about infection control and will verbalize understanding of and willingness to follow up prescribed regimen. Long Term After 3 days ofnursing interventionthepatient will be free of sign and symptom r/t infection. * NIC Incision Site thrill Infection Control Wound Care Independent * Monitored vital signs. Noted onset of fever, chills, diaphoresis, changes in mentation, and reports of increasing abdominal pain.Suggestive of presence of infection/developing sepsis, abscess, peritonitis (Doenges, et al. , 2006). * Inspected incision and dressings. Noted characteristics of drainage from wound/drains, presence of erythema. Provides for early detection of developing infectious process, and/or monitors resolution of preexisting peritonitis (Doenges, et al. , 2006). * Instructed proper hand washing. honorable aseptic wound care. Reduces risk for infection (Doenges, et al. , 2006). * Encouraged adequate nutritional intake after the NPO status of the patient and when the patient is allowed to eat.Adequate intake of protein, Vitamin C and minerals is essential to promote tissue and wound healing (Sparks and Taylor, 2005). Dependent * Administered antibiotics (CEFUROXIME 750mg TID Q 8 x 2 doses & METRONIDAZOLE 500g/IV Q 8 x 2 doses) as ordered. healthful antibiotics are given if the appendix is ruptured or abscessed or peritonitis has developed (Doenges, et al. , 2006). * Prepare for/assist with incision and drainage (I&D) if indicated. May be necessary to drain contents of localized abscess (Doenges, et al. , 2006). * Evaluation Short TermGoal met. After 30 minutes of nursing intervention the patient was able to have an understanding about infection control as evidenced by verbalizing, Para maiwasan ang pagkaroon ng impeksyon kailangan kong maghugas ng kamay palagi at kinakailangan din ang araw-araw na paglilinis ng sugat ko kahit na sa tuwing nililinisan ito makirot sa pakiramdam. Long Term Goal me t. After 3 days ofnursing interventionthepatient was free of sign and symptom r/t infection. Problem 5 INABILITY TO PERFORM ACTIVITY/IES OF DAILY LIVING (ADL) JULY 24, 2012 * Subjective Cues Hirap talaga ako gumalaw, maglakadlakad, o kahit man lang umupo dahil sa mga nakakabit na ito sa akin, as verbalized by the patient. Nakakapanghina pa kasi masakit nga yung tahi tapos madalas din nagcacramps ang tiyan ko, he added. * Objective Cues * Presence of surgical incision * Presence of contraptions (urinary catheter, NGT lavage & IV fluid left hand) * Nursing Diagnosis Impaired physical mobility related to body weakness, presence of surgical incision, pain, & presence of contraptions attached Physical immobility can be usually associated with post-operative conditions (Gulanick, et al. 1994). * Goal/NOC Activity Tolerance Outcomes Short Term After 30-45 minutes of nursing intervention the patient will be able to have a clear understanding with the use of identified techniques to enhanc e activity border and to apply it as well as evidenced by participating in ROM exercises, lower leg & ankle exercise, ambulation, or even moving up in bed. Long Term After 2-3 days of nursing intervention the patient will be able to continually participate in a simple form of activity and will report an improvement with regards to his activities. * NIC Exercise Therapy BalanceIndependent * Performed passive ROM exercises. ROM exercises and good body mechanics strengthen abdominal muscles and flexors of spine (Gulanick, et al. , 1994). * Encouraged lower leg and ankle exercises. Evaluated for edema, erythema of lower extremities, and calf pain or tenderness. These exercises stimulate venous return, decrease venous stasis, and reduce risk of thrombus formation (Gulanick, et al. , 1994). * Noted emotional and behavioral responses to immobility. Provided diversional activities. Forced immobility may heighten restlessness and irritability.The Cardiovascular SystemDiversional activity ai ds in refocusing attention and enhances coping with essential and perceived limitations (Gulanick, et al. , 1994). * Assisted with activity, progressive ambulation, and therapeutic exercises. Activity depends on individual situation. It should begin as early as possible and usually progresses slowly, based on client tolerance (Gulanick, et al. , 1994). * Assisted in moving from side to side or up in bed from time to time. Frequent repositioning helps in proper oxygenation and usually prevents complications like pressure ulcers, deep vein thrombosis, etc. Gulanick, et al. , 1994). * Noted client reports of weakness, fatigue, pain and difficulty accomplishing tasks. Symptoms may be result of/or contribute to intolerance of activity (Gulanick, et al. , 1994). Dependent * Administered pain medication (TRAMADOL 50 mg/IV Q 8 x 3 doses, time given 8 AM) as prescribed and on a regular schedule. Clients anticipation of pain can increase muscle tension. Medications can help relax the client, enhance comfort, and improve motivation to increase activity (Gulanick, et al. , 1994). * Evaluation Short TermGoal partially met. After 30-45 minutes of nursing intervention the patient was able to have a clear understanding with the use of identified techniques to enhance activity tolerance and was able to use all of the techniques except for the ambulation. He refused to walk because he complained of pain whenever the catheter tube slipped into his legs. Long Term Goal partially met. After 2-3 days of nursing intervention the patient was able to continually participate in all of the identified techniques but still refused to participate in ambulation.He also reported of an improvement with regards to his activities as evidence by his verbalization, Medyo natotolerate ko na rin yung mga activities kahit pautay-utay muna. Hindi ko lang talaga muna kaya maglakad pero pagnaalis na siguro yung catheter baka kayanin ko na. XV. BIBLIOGRAPHY * Cosgrove DO, Meire HB, Lim A, & Eckersley RJ. (2008). Grainger & Allisonns Diagnostic Radiology A Textbook of Medical Imaging (5th edition). brand-new York, NY Churchill Livingstone * Doenges M. , Moorhouse, M. Murr, A. (2006).Nursing Care Plans Guidelines for Individualizing Client Care across the Life Span (7th Edition). F. A. Davis Company, Philadelphia * Doenges, M. , Moorhouse, M. Murr, A. (2006). Nurses Pocket Guide Diagnoses, Prioritized Interventions, and Rationales (11th Edition). F. A. 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