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Thursday, November 28, 2019

5 Words Often Mistakenly Used in Place of Others

5 Words Often Mistakenly Used in Place of Others 5 Words Often Mistakenly Used in Place of Others 5 Words Often Mistakenly Used in Place of Others By Mark Nichol When writers, amateurs and professionals alike, employ words or phrases they have heard spoken but not seen written, they often mistakenly use a homophone or near homophone of the intended word. Each of the sentences below includes a word that is often used erroneously. A discussion and revision accompanies each example. 1. Given punk rock’s innate tendency to flaunt convention, the style fits the subject matter in its own roughshod sort of way. Flaunt, a verb meaning â€Å"show off,† is frequently confused for flout, a verb meaning â€Å"show disregard for†: â€Å"Given punk rock’s innate tendency to flout convention, the style fits the subject matter in its own roughshod sort of way.† 2. Others honed in on what they consider the company’s poor customer service and monopolistic tendencies. Hone means â€Å"sharpen† or â€Å"make more effective,† but what is meant here is home, as a verb meaning â€Å"proceed† or â€Å"direct attention toward†: â€Å"Others homed in on what they consider the company’s poor customer service and monopolistic tendencies.† 3. She had been the principle trial attorney for the public defender’s office. Both principle and principal derive from the Latin term princeps, meaning â€Å"prince† (the Latin word is also the origin of prince), but principle serves only as a noun, while principal, which can be a noun that refers to a key or leading person or to an amount of money, is also an adjective meaning â€Å"most important,† as in this sentence: â€Å"She had been the principal trial attorney for the public defender’s office.† 4. They were fulfilling a central tenant of the democracy envisioned by our founders. Though tenant and tenet both stem from the same Latin word, tenere, meaning â€Å"hold,† the former refers to someone who rents or leases property, while the latter, meaning â€Å"principle,† is the correct choice for this sentence: â€Å"They were fulfilling a central tenet of the democracy envisioned by our founders.† 5. Her deep-seeded resentment erupted one day in a spontaneous burst of indignation. â€Å"Deep seeded† seems to make sense in a reference to an emotion that is submerged in someone’s psyche, but there is no such idiom; the correct phrase is â€Å"deep seated†: â€Å"Her deep-seated resentment erupted one day in a spontaneous burst of indignation.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Misused Words category, check our popular posts, or choose a related post below:45 Synonyms for â€Å"Food†15 Types of Documents90 Verbs Starting with â€Å"Ex-†

Sunday, November 24, 2019

Critically Compare the Concepts of Equal Opportunities and Sports Equity in British Sport Essays

Critically Compare the Concepts of Equal Opportunities and Sports Equity in British Sport Essays Critically Compare the Concepts of Equal Opportunities and Sports Equity in British Sport Essay Critically Compare the Concepts of Equal Opportunities and Sports Equity in British Sport Essay Critically compare the concepts of equal opportunities and sports equity in British sport This paper aims to compare the ideas of equal opportunities and sports equity with regard to sport in Britain. Within this structure, there will be particular emphasis on the theoretical approaches that are used to look at equality in British sport. A key part of this comparison is the study of (social) equality; this includes formal, radical and liberal interpretations of equality. The arguments and suggestions will be reinforced and supported by literature and other texts outside of just the sporting context. Many sports historians such as Holt (1989) say that sport, pre 20th Century, was almost private and restricted to the upper class minority. Recreational sports had a complex set of laws (i. e. tennis) this was to restrict participation from the lower classes. Another vestige of the times was the limitation of sport to women; this was not necessarily written law but was accepted none the less. Racism in sport was not tackled or even considered until well into the 20th century when the government introduced laws and legislation that banned prejudice based on race. As a consequence of these legalities, many recognised sporting institution in Great Britain have introduced policy and recommendations to deal with the problems of ‘inequality’ within their respective organisations. Nevertheless, as indicated by Guttman’s analysis (1978), continuous development in recent years has slowly begun to break down certain barriers to equality. Should someone wish to investigate further into actual modern equality work they can access a variety of net resources. A quick look at equality policies of the Football Association for example demonstrates that work is being done for the purpose of equality. Guttman (1978) even goes so far to say that in many sports worldwide, participants of any circumstance and environment are encouraged to participate. He also states however that equality in sport and its aims is seen by some as a distant achievement, it remains unrealistic. Guttman’s (1978) study illustrates that as sport entered the 2nd half of the 20th century, systems that control other components of a balanced society would also affect modern sporting institutions in the same way In order to better understand the aim of this paper, a number of key terms need some more clarity. The first term that needs defining is ‘equality’ and more pecifically ‘basic equality’. According to Baker (2004) basic equality is the concept that people have the same worth and are consequently worthy of equal interest and value. Many would argue that certain individuals and groups have earned more respect than other people and therefore inequalities should exist. Maybe w hat we should be considering is a minimum level of equality, a fundamental idea of equality whereby people all exist at the same point of respect. This would mean putting a threshold on what it is to be human. As indicated by Craig and Beedie (2010) the study of equality is an area of fascination to many sporting sociologists. Coakley (2003, p326) states, that this curiosity is established because many believe that sport goes beyond monetary and economic inequalities. A common belief is that sport is available to all; irrelevant of which equality strand someone may fit into (age, race, ethnicity etc). According to Craig and Beedie (2010) some consider the sporting domain a discrimination free arena; where a result is contested on fair grounds and the result goes to those with the most aptitude or skill. Another key term is stratification. This is a way of breaking down the different levels of society based on their sociological group. This helps to highlight the in/equality that is present in sport. A number of actual examples have been highlighted by Craig and Beedie (2010). Examples of these stratification layers include; the system of class formation affects the poor, the working class, and the lower/ middle and upper classes, these structures all seem to be highly rigid. The concept of social class is best recognised by using Marxist ideas of capitalism, where the idea of equality is seen in financial terms. Feminism however opposes the theory that ‘class stratification’ is the most important foundation of social inequality. Justifications about the gender distinctions in a sporting context vary from those concentrated on a biological argument to the arguments that place more impetus on the social understanding of gender. There is a repeated and constant emphasis in sport and society on the power of patriarchal arrangements; this too is present in sport. Liberal equality can be a little difficult to decipher in that it accepts basic equality but denies some other aspects of equality. The main principle according to Baker (2005) is that inequality of income and power cannot be alleviated. Equality as a concept plays the part of controlling inequalities so that income and power are more fairly distributed. In a way it can be said that liberal equality requires supporting the bare minimum that people are allowed and have access to, whilst controlling the advantage experienced by those that have more. Baker (2005) further states that the main underlying belief of liberal egalitarianism is the upholding and support of the most basic rights that all should have access to. Equal opportunity of course plays a key part in this study. Liberal equality is often used in conjunction with equality of opportunity. This is where groups or individuals have equal access to the opportunity to gain higher representation within their respective circles. It is rooted in the idea that inequalities in power will be ever present. Baker (2004) summarises this sentiment, he claims that the point of equality of opportunity is for everyone to get a fair chance in the sociological struggle, within a society that is unequal. Baker (2004) describes equal opportunity as the belief that everyone in society deserves a fair chance to contest over the positions in society that carry the most power. This concept was first used officially in the French Declaration of human rights in 1789. It states that everyone can hold a position â€Å"within their abilities† (French Declaration of the rights of man 1789). These days institutions everywhere boast equality policies and equality laws that make the discrimination based on gender and race in social institutions against the law In support of this, equal opportunity claims that nobody ought to benefit or suffer from their social circumstances; any prosperity and expectation ought to come about due to personal skills and endeavours. Rawls (1971) labels this concept ‘fair equal opportunity’. He believes that education should be used as a vehicle by the lower classes to develop the skills that would put them into a more advantaged situation. Equal opportunity is unachievable whilst those in positions of power use their influence to achieve hierarchy over others. Liberal equality approaches do not take into account the characteristics of structured inequality. Powerful social stigmas are not dealt with. We can therefore conclude that people’s opinions and beliefs (inequality) cannot change whilst such stigma still exist. Some would argue that this is good in theory but education doesn’t actually function in this way. A different aspect of equal opportunity includes establishing policies and legislation to assist people from minority groups in getting work and schooling/qualifications. Were people from minorities perhaps not supported properly in schools or education institutions then this could be down to them not having ‘equal opportunities’ to progress as the majority do. Baker (2004) appears to believe that the biggest sign of equal opportunity within an organisation is seen in the participation rates. A more comprehensive liberal equality view is that of Rawls (1971). This states that inequalities ought to favour those that need them the most. For those that believe in liberal equality this is not always the final solution however; improvements can be made to a number of factors contributing to equality, including: education, sport, the economy etc. A fine-tuning to these frameworks rather than completely overturning them is often the preferred way to achieve to equality. In order to understand liberal equality properly however, something to compare it to is required. Radical approaches to equality oppose the liberal view of equal opportunity. It maintains that in order to eradicate inequality much larger steps should be taken. Inequalities should not just simply be dealt with after recognition. â€Å"The key to this much more ambitious agenda is to recognise that inequality is rooted in changing and changeable social structures, and particularly in structures of domination and oppression. These structures create, and continually reproduce, the inequalities which liberal egalitarianism sees as inevitable. † (Baker 2004, 18) This handsomely describes the way in which radical equality aims to eliminate equality compared to the liberal view. As oppose to the liberal view of concentrating on the power distribution allocated to individuals, the radical view allows for advantage to more than just individuals, but groups. On the contrary to liberal ideas of how power is allocated, the radical approach attempts find answers in the social connection between related parties. Another trend of the liberal approach is to reward individuals with their own triumphs and indeed failures. The radical approach on the other hand tends to attribute these triumphs and failures to larger social occurrences. As indicated by Baker (2004) many argue that the liberal approach to equality differs from that of equality of outcome. However, the radical approach, as does the liberal approach encourages choice as the final outcome. There is no reason that both approaches to equality cannot allow for choice. In order to summarise the above comments â€Å"basic egalitarianism tends to concentrate on subsistence needs, liberal egalitarianism on the idea of a decent standard of living and radical egalitarianism on what people need for a full human life† (Baker 2004, 19) In order to fully understand this task, we must also look at the origins of sport in the UK. During the late 1800s (Victorian period) Great britain went through a major reform, this is commonly known as the ‘Industrial revolution’. It was driven by invention, engineering breakthroughs and class restructuring. A movement from farming and agriculture towards Industrial urban based work meant that labourers moved from the countryside to the city. This mass movement of workers into factories allowed the newly middle class employers considerate control over the workforce and the opportunity to influence the way workers should spend their leisure time. Throughout this era of reform, sport was still however considered an activity of the higher classes. The control exerted over the masses encouraged employees and workers into a different way to spend their leisure time. Structure in recreation became encouraged. According to Townson (1997) this became the norm as the middle classes had fears that the increasingly large urban population may become unruly. The idea of ‘rational recreation’ became the name of this notion. Over the years the bourgeoisie anticipated discomfort among the working class. Towards the end of the 19th century in Great Britain the concept of ‘Muscular Christianity’ (Holt 1989) was established in order to distract the masses from want to reform (Holt 1989) â€Å"The very idea of a play discipline would have seemed absurd, yet this is what a growing band of bourgeois idealists advocated during the second half of the century† (Townson 1997). Sport and recreation had been introduced by the bourgeoisie. This helped maintain a healthy labour force and diverted masses away from ‘urban radicalism’. It was during this time that the upper classes and more advantaged started to consider the importance of fairness through reform and education. While sport for the masses still took on a rational recreation edge, sport was undergoing a period of change. A combination of factors leading to this change included an emphasis on health through exercise (due in part to inferior performances from the British forces in South Africa) and an increasing emphasis on professionalism. Sports clubs and facilities were made available by middle class. Key factors that occurred during the Victorian period according to Davis (2000): An ethical code produced by the bourgeoisie became associated with sport Realisation of fair-play (introduction of rules and equal conditions) Freedom at weekends gave people more time for recreation. Sport in education was limited to gym and discipline The second notable phase in british sport history swaying further towards equality was the establisment of the Wolfenden report of 1960. This was written for the Central Council of Physical Recreation by an autonomous group of individuals to determine the state of sport in the UK. According to Rous (1960) it was published to demonstrate the inequalities and problems that existed in UK sport in comparison with its peer countries. After the publication of the wolfenden report the government took yet a further step towards a more interventionist approach by establishing the GB sports council in 1972. Collins (2003) claims that this was an important step for the government, as it allowed authorities to make social and welfare provision for public sport After new labour came to power in 1997, sport was given a new social status. The organisation of UK sport structure at the time was considered an obstacle to governments recently set out aims: Increased youth participation Increased succes in elite sport This quote taken from Department of Culture, Media and Sport (DCMS) demonstrates the awareness that some had of the state of sport within the UK â€Å"There is a need for a radical rethink of the way we fund and organize sport, we offer a modernizing partnership with the governing bodies of sport† (DCMS 2000 p19). In the same review they also threaten Governing Bodies within sport with withdrawal of funding should they not meet required governmental targets. The 3rd and perhaps most important stage of movements towards equality came in the shape of sporting equity. Sport England (2000) very broadly defines sports equity as fairness in sport. According to Sport England (2000) sports equity is in place to make sport more accessible to everyone period. It is a concept larger than sports equality and all strands of equality are made irrelevant. Equity: In its simplest sense, ‘fairness’; the process of allocating (or reallocating) resources and entitlements, including power, fairly and without discrimination. It may also use positive action initiatives and measures to address existing inequities. † (Sport England 2000 p39) As already stated inequalities date back to the beginnings of sport, in some ways they were institutionalised (Sport England 2000). After all the development i n sport however, cases of inequality do still exist. Even in todays modern society there are still only a handful of for example; ethnic minority ‘power’ in sport. Coaches seem to remain white, middle class. However, these inequalities are now recognised and agencies are putting in structures to improve the situation for these inequalities â€Å"Sport England is committed to supporting governing bodies in their quest to overcome inequality in sport† (Sport England 2000, p3). Equity in sport came around relatively late. A number of thngs happened which really pushed the equity movement forward. Equity issues came under the spotlight during the Macpherson Report and the stephen Lawrence inquiry. Both of these highlighted the extent of discrimination still present in society. Sporting campaigns and government iniatives have pushed for further equity in sport and according to Sport England (2000) but have committed to further action in the future. â€Å"It cannot be assumed that any sport is open and accessible to all members of the community† (Sport England 2000, p4). Even the sport england equity page recognises that more needs to be done to secure access to sport for all. Further policy will be encouraged and implemented. Society is changing and the existence of organisations, societies or clubs that exclude large sectors of the population from their activities, whether directly or indirectly, is viewed as anachronistic and increasingly unacceptable†. (Sport England 2000, p3). This quote demonstrates that the government is aware of the mass change in stance towards inequality. Despite the emergence of sports equity policies and propositions; inequalities still exist in sport. This can be seen in the recent Luis Suarez racism case and the John Terry racism case. These examples demonstrate that equality exists at the highest level. Equality work needs further development, much in the same way sports equity has developed. References Baker, J. ; Lynch, K. ; Cantillon, S. ; and Walsh, J. (2004) Equality: from Theory to Action London: Palgrave. Coakley, J (2003) Sports in Society: Issues and controversies. New York: Mcgraw-Hill Collins, M. F. with Kay, T. (2003). Sport and social exclusion. London: Routledge. Craig P and Paul Beadie (2010) Sport Sociology. 2nd Edition. Active Learning in Sport Davis, B. et al. (2000) Physical Education and the Study of Sport. UK: Harcourt Publishers Ltd Department for Culture, Media and Sport. (2001a). Elite Sport Funding Review (chair, J. Cunningham). London: DCMS. Guttman, A (1978) From ritual to record. New York. Columbia press Holt R. (1989) Sport and the British: A Modern History. Oxford: Clarendon Rawls, J. A. (1971) A Theory of Justice. Cambridge, MA: Harvard University Press Sport and the community : the report of the Wolfenden Committee on Sport 1960 Sport England, June (2000). Governing Body Resource Pack. Planning for sport. Factfiles: Sports equity Stanley Rous. Chairman, Executive committee, C. C. P. R. 1960 Nigel Townson 1997 The British at Play – a social history of British sport from 1600 to the present

Thursday, November 21, 2019

Stake holder and share holder- Essay Example | Topics and Well Written Essays - 500 words

Stake holder and share holder- - Essay Example Most corporations run through the watch of shareholders. The shareholders demand obligations from the management of the firm. The shareholders have a say in the corporation depending on their share prices. The level of their financial measure in the corporation determines their level of influence. Shareholders share the profits of the company based on the percentage of their shares. It also applies to losses. Stakeholders are individuals who have interests in the corporation. The company has no obligation towards the stakeholders. Employees are the perfect example of stakeholders (James & Jerryl.1996, pp. 1-4). With the current world where globalization has taken effect, it is important for a company to pursue profitability. The corporations should fit themselves into the market economy using proper tools to maximize their profits. For good profitability, the company should have a certain responsibility, for example, social responsibility. It is evident responsibility, and profitability is contradictory, but they have to go together in any corporation. To ensure companies survive, they should produce high profits. The profits depend on the responsibility of the networks within the corporation, such as the people (Reed & Freeman, 1983, pp. 1-19). In most cases, shareholders emphasize on profitability over responsibility. It is the perspective of the shareholders. The shareholders believe the corporations have full control from the owners. They attribute the companys success to factors such as share price, economic profits, and dividends. In addition, they rely on the management to give in their best, for great success of the corporation. The shareholders do not believe responsibility will make the corporation attain success. Any society will not measure the companys success by their level of social responsibility, according to the shareholders perspective. Furthermore, their perspective does recognize the

Wednesday, November 20, 2019

Buddism Essay Example | Topics and Well Written Essays - 2250 words

Buddism - Essay Example Buddhism is considered a philosophy and a religion at the same time, due to various reasons. First, it is a philosophy since it is a way of life. People have to adhere to the set standards of the way of life to be connected to the religion. Without focusing on this, one cannot be considered to be a Buddhist. In its philosophy or way of life, it is stated that people allied to Buddhism should have acceptable standards of behavior. This means that all the people in the religion have to adhere to the set standards to be considered as followers of the religion and philosophy. In many instance, the people have to connect their way of life to an awakening call. They have to change their way of life as they have been â€Å"awaken† from their previous lifestyle. This shows that when a person is joining Buddhism, they have to change their way of life to fit the religion. This will go a long way in ensuring the religious norms are observed to utter optimum. Buddhism as a philosophy in t he world has been elaborated to mean love for wisdom. The people in Buddhism must have unending love for wisdom to develop as straight and obedient followers of the religion. Since this is the vital element of the religion, anyone wishing to join the religion must adhere to the philosophy of awakening, and elaborate on unending need for wisdom. In the Buddhism teaching, people with freedom have to lead a better way of life due to their decisions on matters in the world (Keown, 6). With their increasing wisdom, they are able to make decisions that are for the benefit of their life and the religion as a whole. As a Buddhist, the immortal love for wisdom is a practical lesson that should be adhered to and protected. Since this is the core element in the religion, the love for wisdom was split into three main parts. Simplifying the love for wisdom was a practical element that ensured the people allied to the religion understood the message to core. In the first presumed path of the love for wisdom, a person allied to the Buddhism religion should lead a moral way of life. This is an acceptable standard that has been highlighted by the Buddhism culture. All the people that are in the religion should have a connection to other people that lead a moral life. As such, there is a need to have universal way of life, which is moral. This is by avoiding any activities that may be deemed mortal to the Buddhism culture. As such, leading a universal way of life that is moral is an element that needs to be achieved in the Buddhism culture. According to the Buddhism philosophy, people have to consider their away of life as sacred and only attempt activities that are acceptable. This is both in the society and the normal way of life (Keown, 7). With such in mind, the Buddhism culture will have a dominant society that initiates morality in the society. When a person leads a moral life, it creates a scenario where people accept the religion and its philosophical grounds. In bringi ng up the Buddhism culture, the prince, Buddha had been distracted in his early life. He was raised in the loyal life as a prince and had loyal life of ease. This was a life that would shield him from the miseries and cruelties of the world, which made the prince, live lavishly. However, he was often distracted by sensual pleasures and this led to luxurious living. With such a living, he had never encountered any form of

Monday, November 18, 2019

Great Raid Essay Example | Topics and Well Written Essays - 750 words

Great Raid - Essay Example Many of the American troops that had surrendered in the course of the Bataan Battle were sent to the prison camp in Cabanatuan. This development came after the Bataan Death that took place in March of the same year. The Japanese, following this news rushed to transfer many of the prisoners to different parts of the country, leaving behind more than 500 POWs, most of whom were American but also comprised other allied civilians and POWs in the particular prison camp in Philippines. The prisoners faced a lot of hardships at the camp, with many of them dying from the hard labour and harsh conditions that they were being subjected to. Some of the brutal conditions that characterized life at the prison camp included malnourishment, severe torture and many other chronic diseases that the POWs contracted. With no one showing concern over their fate the health of most of the POWs deteriorated making them succumb to the harsh condition. In fact, after Gen, Douglas MacArthur and many of the American forces went back to Luzon, the POWs feared for the lives as they thought that they were going to be executed. Following the need to free the POWs, strategic planning was started by the leaders of the Sixth Army, who were collaborating with Filipino guerrillas. According to Alexander (2009), the initial idea was to send a sizeable army with the main responsibility of recuing and freeing the POWs. After thorough planning, a group of more than one hundred Scouts and Rangers including guerrilla fighters made a journey of more than 30 miles to the camp. It is believed that the planning and execution of the strategy in rescuing the POWs started in 1944 when Gen. Douglas MacArthur’s army managed to land on Leyte. This development was enough to pave the way for liberation of the POWs and other civilian prisoners. Later, the American forces idea to consolidate their army in the rescue process was realized by the camp soldiers, who responded

Friday, November 15, 2019

Intervention to Increase Exercise Levels of Diabetes Patient

Intervention to Increase Exercise Levels of Diabetes Patient An intervention to increase the participation levels of Physical Activity in patients diagnosed with Type II diabetes Background Physical activity is an increasingly important health issue with physical inactivity being associated with many chronic diseases. Physical inactivity has been identified as the fourth biggest risk factor for mortality, accounting for 6% of deaths globally [1]. However, despite strong evidence in support of the health benefits of physical activity, few people actually meet the recommended guideline level [2]. In 2008, less than 20% of adults aged 65-74 met the recommended level of physical activity [3]. Diabetes is the fifth most common cause of death in the world [4] affecting around 250 million people worldwide, a figure expected to increase to over 336 million by 2030 [5]. Type II diabetes is widespread amongst 90% of diabetic patients, found to be more common in older adults [6]. Obesity accounts for 80-85% of Type II diabetics, making it the most potent risk factor [7]. Research has shown that regular physical activity has positive benefits for Type II diabetes in that it improves body’s sensitivity to insulin and helps manage blood glucose levels [8], as well as improving an individual’s physical and mental well-being. This Indicates that physical activity is vital in both preventing and treating Type II diabetes, as well as preventing further chronic health conditions. Literature Review Self-determination theory (SDT) [9] accounts for the processes that facilitate motivational development and how the social environment can enhance or diminish self-motivation. SDT is a popular social-cognitive theory, which maintains and has provided support for the proposition that all human beings have fundamental psychological needs: competence, autonomy, and relatedness. Satisfaction of these basic psychological needs (BPN) leads to intrinsic or extrinsic motivation which influences the level of self-determined motivation an individual possesses, whereas preventing these needs promotes controlled motivation or amotivation [10]. Motivational interviewing (MI) is a scientifically tested counselling method, viewed as a useful intervention strategy in the treatment of lifestyle problems and disease. The concept of MI evolved from the experience of treating alcoholism, first described by Miller in 1983 [11]. Miller and Rollnick defined MI as ‘a directive, client-centred counselling style for eliciting behaviour change, by helping clients to explore and resolve ambivalence’ [12]. MI is a particular way of helping clients recognise and do something about their current or potential problems. It is viewed as being particularly useful for clients who are reluctant or hesitant about changing their behaviour. A systematic review and meta-analysis [13] of 72 randomised controlled trials shows that MI in a scientific setting outperforms traditional advice giving in the treatment of a range of behavioural problems and diseases. It also shows that MI had a significant effect in approximately three out of four studies, with an equal effect on physiological (72%) and psychological (75%) diseases [13]. Large-scale studies are now needed to prove that it can be implemented into daily clinical work in primary and secondary health care. Research [14] has shown MI to be an effective intervention for weight loss and improving glycaemic control. Patients with Type II diabetes were randomly allocated to an MI group, a Cognitive Behavioural Group Training (CBGT) or a control group and tested before and after each intervention. The findings of this study showed that in MI and CBGT, mean Body Mass Index (BMI) was significantly lower than the control group, indicating MI and CBGT is a useful intervention in helping adults with type II diabetes lose weight [14]. MI has been criticised for lacking a coherent theoretical framework for understanding its process and efficacy. It is believed that SDT can offer such a framework [15]. MI and SDT are based on the assumption that humans have an innate tendency for personal growth toward psychological integration, and that MI provides the social–environmental facilitating factors suggested by SDT to promote this tendency [15]. Aim To evaluate the effectiveness of using motivational interviewing to increase the level of physical activity of older adults diagnosed with type II diabetes, through satisfying their basic psychological needs. Design A randomised control trial design will be used, to establish a cause and effect relationship between the intervention – MI, and the outcome – increase in physical activity. A control group will be used to compare against the intervention group, allowing the researcher to see if MI has a specific effect on the intended behaviour change (increase in physical activity). It also allows any potential ‘other factors’, away from the attention of the intervention which may contribute to an increase in physical activity to be identified. The participants, to prevent selection bias, will be randomly allocated to a group using a computer. Sample Participants need to be classified as physically inactive (participate in less than 30 minutes of moderate-intensity exercise, 3 times a week), diagnosed with Type II diabetes and aged 65+. Participants will be recruited through letters sent out via General Practitioners (GPs) to patients and through advertisements in health centres and doctors surgeries. Although currently classified as physically inactive the participant must be willing to engage in physical activity, and therefore must gain medical clearance, from their GP, to participate in the study. The recruitment of participants will be done throughout England in order to gain a large, reliable sample which can be generalised to the wider population. Intervention Miller and Rollnick [12] suggested that MI is based on the following principles: express empathy, develop discrepancy, avoid argumentation, roll with resistance, and support self-efficacy [12]. The strategies of MI are more persuasive than forced, more supportive than argumentative, and the overall goal is to increase the client’s intrinsic motivation so that change arises from within [15]. The practitioner should aim to produce a social environment satisfying participants BPN, which should promote their motivation to participate in physical activity. The structure provided by the practitioner, such as helping the client develop appropriate goals and providing positive feedback, targets the psychological need for competence. The provision of autonomy support by using client-centred strategies like rolling with resistance, exploring options, and letting the client make decisions, all support the need for autonomy. The involvement of the client by the practitioner in terms of ex pressing empathy, demonstrating an understanding and avoiding criticism support the need for relatedness [16]. To increase the likelihood of physical activity participants can chose whether their MI sessions are at their local leisure centre or hospital, or via telephone calls. The intervention program will last for 18months. In the first three months the participants will receive weekly sessions, then from month three to six they will have fortnightly sessions, and for the final 12months they will receive one session per month. A follow up study will also be completed 24months after the intervention started. It is important that practitioners provide the participants with knowledge, guidance and support to enable them to make decisions. The control group will have social phone calls and meetings like the intervention group but no MI in the sessions they will just be encouraged to maintain their current physical activity level. Assessment The outcome of the intervention will be measured at intervals: baseline, 3 months, 6 months, 12 months and 18 months. A follow up study will also be completed 24months after the intervention started. The study will adopt three measures. The first is a general questionnaire measure to obtain demographic information, such as participants’ age, sex and current physical activity levels. The second measure is the Physical Activity Scale for the Elderly (PASE) [17]. PASE is a valid, brief and easy scored survey designed specifically to assess physical activity in epidemiologic studies of persons age 65 years and older [17].The final measure used will be the Basic Need Satisfaction Scale [18]. This will assess the extent to which the participant felt their practitioner was satisfying their BPN. All these measures have been found to be valid and reliable. The same measures will be used at each interval to assess changes/improvements, as well as being used in the follow up to see if th eir behaviour change has been sustained. Limitations There are a few limitations to consider. Firstly, the study aims to recruit a large sample of participants for a long period of time; it will be hard for the researcher to keep all the participants for the duration, resulting in a high dropout rate, making the result unreliable and un-generalizable. Secondly, the intervention requires time, especially at the start when the participant is required to attend weekly meetings. If the participant(s) has a lack of time then they are not going to be able to attend weekly meetings as well as completing the physical activity. In term of the intervention used, MI is based on the idea that a client must be willing to work with a professional to change behaviours, a client in denial will be unaffected by MI questions and advice. Also, outside influences maybe stronger, meaning that in a clinical setting the participant is motivated to change but when they return home they may return back to original behaviour.

Wednesday, November 13, 2019

The Failure of Napoleon?s Russian Campaign :: essays research papers fc

Napoleon Bonaparte was seemingly invincible. Under his command, the Grande Armee had conquered much of Europe, and was viewed by others as an austere foe. Though despite all this, Napoleon made a fatal mistake: he entered Russia. Of the 600,000 troops that reached the Russian border, only 100,000 made it out (Moore, Online). Through the Russian Campaign the seemingly indomitable man of Napoleon began to crumble at the base, and after numerous fatal errors, the foundation fell. Napoleon’s Russian Campaign of 1812 resulted in failure. Napoleon unleashed his armies to Russia in June of 1812. The initial reason for the start of the Russian Campaign was that of desertion (Bloy, Online). This became evident when Czar Alexander I of Russia left the Continental System. While hurting Britain’s economy, the Continental System also hurt Russia’s. Soon enough, Napoleon sent over 600,000 troops to Russia, hoping to straighten out the czar (Burnham, Online). The czar seemed not to be worried, and readily commanded two Russian armies to protect their country. The initial attacks against the Russians were relentless, and the two armies were readily overwhelmed. On June 24 the two Russian armies retreated, under the command of General Barclay de Tolly and General Bagration (Moore, Online). The Czar Alexander was cunning, and instead of directly confronting the Grande Armee, he would always retreat. This greatly irritated Napoleon, who pressed on further and further, deep into Russia (Sparknotes, Online). However, t his process of enticement and retreat seemed to be working, as the battle-hungry Napoleon kept on proceeding. Knowing that they could not win a fight by force, the Russians were cunning and traded space for time with the French. By this time, the Russians had developed the â€Å"scorched-earth† policy, which was the destruction of one’s own land (Burnham, Online). Whenever the Russians would retreat, they would burn all the land behind them. This greatly angered Napoleon, mainly because one of his most formidable strategies in war was using the land of the enemy for his own resources (PBS, Online). Napoleon had gravely underestimated the Russians. The gravest threat to the Russian forces was a direct, large-scale confrontation with Napoleon’s army, but such a colossal battle was surely inevitable. Despite the constant retreating, the Grande Army did engage the Russians in one significant conflict: the Battle of Borodino. The Russians, under the control of General Mikhail Kutusov, assembled massive defensive positions in await for Napoleon’s army.

Sunday, November 10, 2019

Written Critique of Drug Therapy in Nursing Practice

According to Wayne K. Anderson, Dean, State University of New York, School of Pharmacy, â€Å"statistically, if you take six different drugs, you have an 80% chance of at least one drug-drug interaction. † The drug regimen of Mrs. Brown includes six drugs that may interact with each other if not administered and monitored carefully. This is the reason why healthcare providers should be aware of the possible adverse affects that may happen related to her drug regimen. Necessary precautions should be observed to get the full benefits of the needed drugs and minimize possible drug-drug interactions. Nursing Management Mrs. Brown has a history of seizure, therefore, necessary measures should be provided to ensure the patient's safety. It is also known that seizure is one of the many side effects of the drug metronidazole (Drugs. com, 2010). To prevent injury to patient, the nurse should provide comfort and safety measures if the CNS effect occurs such as siderails, and assistance with ambulation if dizziness and weakness are present† (Karch, 2006, p. 170). Since Mrs. Brown has numerous risk factors and health conditions, the nurse should â€Å"monitor for drug-drug interactions to arrange to adjust dosages appropriately† (Karch, 2006, p. 47). The drug regimen of Mrs. Brown may present several adverse effects that should be observed, the nurse â€Å"monitor adverse effects and provide appropriate supportive care as needed to help patient cope with these effects† (Karch, 2006, p. 347). To achieve therapeutic effects, it is also important that the nurse is aware how to â€Å"administer the drug as prescribed in appropriate relationship to meals† (Karch, 2006, p. 572). The nurse should provide supportive management to the drug regimen so she should â€Å"monitor the patient's clinical status closely especially during the initial stages of treatment† (Karch, 2006, p. 34). This includes daily monitoring of serum lithium and phenytoin levels, blood glucose, prothrombin time (PT) and hepatic functioning. It is essen tial to promote compliance to the patient. The nurse should â€Å"provide thorough patient teaching, including drug name and prescribed dosage, as well as measures for avoidance of adverse effects, warning signs that may indicate possible problems and the need for monitoring and evaluation to enhance patient knowledge about drug therapy† (Karch, 2006, p. 347). Some of the teaching points that should be included are any sign of blood loss ( petechiae,bleeding gums, bruises, dark colored stools, dark colored urine) to evaluate the effectiveness of warfarin and symptoms of phenytoin toxicity, including drowsiness, visual disturbances, change in mental status, nausea, or ataxia. Indications and Actions The indications and actions of Mrs. Brown's regimen is presented to help verify the purpose of the drugs and their effects on the overall condition of the patient. Metronidazole (Flagyl, MetroGel, Noritate) Metronidazole is used for the treatment of intestinal amebiasis, trichomoniasis, inflammatory bowel disease, H. pylori infection causing peptic ulcers, bacterial vaginosis, and anaerobic infections and perioperative prophylaxis in colorectal surgery† (Kee & Hayes, 2006, p. 470). In this case, it is also used to treat abscesses in the pelvis caused by susceptible anaerobic bacteria. It is classified as â€Å"an antiprotozoal agent that acts to inhibit DNA synthesis in susceptible protozoa, leading it to unable to reproduce and subsequent cell death† (Karch, 2006,p. 169). Paracetamol (Acetaminophen) Acetaminophen is indicated for the treatment of pain and fever associated with a variety of conditions, including influenza; for the prophylaxis of children receiving diptheria-pertussis-tetanus (DPT) immunizations; and for the relief of musculoskeletal pain associated with arthritis† (Karch, 2006, p. 241). Paracetamol was prescribed for the presence of pain in the client's perineal area. Metformin (Glucophage) â€Å"Metformin is a biguanide compound used for the management of type 2 diabetes† (Kee & Hayes, 2006, p. 787). In this case, the patient was known to have diabetes. This medication could be considered as a new mechanism for the management of her type 2 diabetes. This oral diabetic agent â€Å"acts by decreasing hepatic production of glucose from stored glycogen† (Kee & Hayes, 2006, p. 787). It is said to diminish the increase in serum glucose after meals and lessen the degree of postprandial hyperglycemia. Phenytoin (Dilatin) â€Å"Phenytoin is the protoype hydantoin used in the treatment of tonic-clonic seizures and status epilepticus, as well as in the prevention and treatment of seizures after neurosurgery† (Karch, 2006, p. 342). Since the patient has a history of seizure disorder, this medication was prescribed for maintenance. It acts as â€Å"an anticonvulsant drug that works by suppressing sodium influx through the drug binding to the sodium channel when it is inactivated, thus prolonging the channel inactivation and thereby preventing neuron firing† (Kee & Hayes, 2006, p. 341). Warfarin ( Coumadin) â€Å"Warfarin (Coumadin) is an anticoagulant drug in oral form that is used to maintain a state of anticoagulation in situations in which the patient is susceptible to potentially dangerous clot formation† (Karch, 2006, p. 38). The patient was given this medication since she has a history of atrial fibrillation that makes her susceptible to thrombus and embolus formation. The drug Warfarin inhibits the formation of thrombus and embolus formation by decreasing certain clotting factors. â€Å"Warfarin causes a decrease in the production of vitamin K-dependent clotting factors (II [prothrombin], V II, IX and X) in the liver† (Karch, 2006, p. 740). Lithum Carbonate â€Å"Lithium is used as a mood stabilizers which is used to treat bipolar affective disorder† (Key & Hayes, 2006, p. 399). Mrs. Brown has a bipolar mood disorder so this drug was prescribed to control her periods of mania and depression. It is said to function in several ways, â€Å"it alters sodium transport in nerve and musle cells; inhibits the release of norepinephrine and dopamine, but not serotonin, from stimulated neurons; increases the intraneuronal stores of norepinephrine and dopamine slightly; and decreases intraneuronalcontent of second messengers† (Karch, 2006, p. 330). Common Drug Interactions Drug to Drug Interactions Metronidazole (Flagyl, MetroGel, Noritate) This drug is known to produce interactions with phenytoin, oral coagulants and lithium. â€Å"Coadministration with a nitromidazole may increase the serum concentration of phenytoin† (Drugs. com, 2010). It is known to induce microsomal liver enzyme activity such as phenytoin that may accelerate the elimination of metronidazole resulting in reduced plasma; impaired clearance of phenytoin has been reported† (DailyMed, 2009). In this case, pharmacologic responses and serum phenytoin should be checked frequently whenever metronidazole is being administered to the patient. The drug dosage should be adjusted as necessary. Another thing to do is to educate the patient the signs and symptoms of phenytoin toxicity for immediate physician notification. â€Å"Metronidazole has been reported to potentiate the anticoagulant effect of warfarin and other oral coumarin anticoagulants, resulting in a prolongation of prothrombin time† (DailyMed, 2009). Mrs. Brown should be advised to report any signs of bleeding to her physician. INR should be checked frequently for adjustments in warfarin dosage, specifically after starting or discontinuing metronidazole. And lastly, lithium is said to produce interactions when administered with metronidazole. â€Å"Concurrent use of metronidazole with lithium may provoke lithium toxicity due to reduced renal clearance† (Rxlist, 2010). Since Mrs. Brown has a bipolar mood disorder, lithium is a long drug regimen. The serum lithium and creatinine levels should be monitored after the initiation of metronidazole. Phenytoin (Dilantin) Besides the impaired clearance of phenytoin with the use of metronidazole, there are other drug interactions that can happen in reference to Mrs. Brown's drug regimen. It is said that Phenytoin can increase the effects of anticoagulants. â€Å"The hydantoins displace the anticoagulants and aspirin, causing more free drug and increasing their activity† (Kee & Hayes, 2006, p. 342). Still, it is important to check on the prothrombin time (PT), phenytoin level and prothrombin time of the patient during the administration of both drugs. â€Å"Signs of an active bleed include coughing up blood in the form of coffee grinds (hemoptysis), gum bleeding, nose bleeds, cola- or tea-colored urine (hematuria), and black, tarry stools (hemoccult positive)†. Brown should be observed and notified to the physician. It is also said that the use of phenytoin can lead to â€Å"increased hepatotoxicity with acetaminophen† (Karch, 2007, p. 952). Lithium interacting with Phenytoin â€Å"may either increase or decrease the effectiveness of lithium or increase or decrease the effectiveness of the drug† (Raber, 2010). Phenytoin level and lithium serum level should be checked frequently to monitor the effectiveness of these drugs. Warfarin (Coumadin). Aside from the drug interactions of warfarin to both Metronidazole and Phenytoin, there is an existing interaction between Metformin and Warfarin. It is said that Metformin â€Å"oral hypoglycemic drugs for diabetes can displace warfarin or dicumarol from the protein-bound site, causing more free-circulating anticoagulant† (Kee & Hayes, 2006, p. 663). Due to this possible interaction, it is important to monitor the blood glucose level and prothrombin time (PT). The patient should be informed of the signs and symptoms of hypoglycemia and bleeding so that she could report it to the health care team immediately. Warfarin also interacts with paracetamol (acetaminophen); it said that â€Å"some investigators advise that the hypothrombinemic response to warfarin can increase when acetaminophen is taken in a dosage of more than 2 g per day for longer than one week† (Ament, Bertolino & Liszewski, 2000). Since Mrs. Brown has a prescription of 1000mg to be taken four times a day, her dosage is more than 2g per day. â€Å"If acetaminophen therapy is needed, the dosage should be as low as possible, and the drug should be taken for only a short period. In addition, the INR should be monitored closely† (Ament et al. 2000). Metformin (Glucophage) Meformin has moderate drug interaction with the drug Phenytoin. It is said to diminish the efficacy of oral diabetic agents and insulin. â€Å"These drugs may interfere with blood glucose control because they can cause hyperglycemia, glucose intolerance, new-onset diabetes mellitus, and/or exacerbation of preexisting diabetes† (Drugs. com, 2010). There should be close monitoring of Mrs. Brown's blood glucose level in order to observe hypoglycemia in the patient. Lithium (Eskalith) Lithium has drug interactions with Metronidazole and Phenytoin. It is also established that lithium may diminish the therapeutic effects of insulin and oral anti-diabetic agents. â€Å"In one study, 10 psychiatric patients treated with lithium carbonate for 2 weeks demonstrated elevated blood glucose levels and impaired glucose tolerance tests. There have also been isolated case reports of hyperglycemia, impaired glucose tolerance, or diabetes mellitus in patients on lithium, although a causal relationship has not been established† (Drugs. com, 2010). The blood glucose level should be checked frequently after starting or discontinuing lithium therapy. Drug to Food, Drug to Herbal, Drug to OTC drugs Interactions Metronidazole Metronidazole has a significant interaction with ethanol. â€Å"Use of alcohol or products containing alcohol during nitroimidazole therapy may result in a disulfiram-like reaction in some patients† (Drugs. com, 2010). Necessary precautions should be made in relation to use of ethanol and ethanol-containing products. Mrs. Brown should be instructed not to take alcohol beverages and alcohol-containing products. It is said that â€Å"alcohol beverages should not be consumed for at least a day after completion of metronidazole therapy† (Drugs. om). Metronidazole has an interaction to the herb milk thistle. â€Å"Milk thistle has been reported to protect the liver from harm caused by some prescription drugs. While milk thistle has not yet been studied directly for protecting people against the known potentially liver-damaging actions of metronidazole, it is often used for this purpose† (Morazz oni & Bombardelli, 1995). Phenytoin Phenytoin has moderate interaction with alcohol and food. The effects of alcohol on the therapeutic level of Phenytoin depend on the duration of its consumption. â€Å"Acute consumption of alcohol may increase plasma phenytoin levels. Chronic consumption of alcohol may decrease plasma phenytoin levels† (Drugs. com, 2010). Phenytoin (oral drug) could be given with or without food in a consistent manner. Give with food if patient complains of GI upset ( Karch, 2007). The bioavailability of Phenytoin is said â€Å"to decrease to subtherapeutic levels when the suspension is given concomitantly with enteral feedings† (Drugs. com, 2010). Antacids containing calcium may decrease the blood level of phenytoin while aspirin (more than 1500 mg/dl) may increase the blood level of phenytoin (Epilepsy. om, 2010). Phenytoin also will lower the blood levels of other types of medication like acetaminophen (Epilepsy. com, 2010). Warfarin Patients taking Warfarin should not take Vitamin K-rich foods like â€Å"liver, broccoli, brussels sprouts, spinach, Swiss chard, coriander, collards, cabbage, and other green leafy vegetables† (Drugs. com). There are also particular medicines that should not be taken for they m ay cause serious bleeding problems in the stomach and intestines and alterations in blood clotting. These particular medicines are as follows: â€Å"acetaminophen (Tylenol), aspirin, and NSAIDs including celecoxib (Celebrex), diclofenac (Voltaren), ibuprofen (Motrin, Advil), indomethacin, naproxen (Aleve, Naprosyn),and others† (Drugs. com, 2010). It is also said that the patient should â€Å"avoid eating cranberries, drinking cranberry juice, or taking cranberry herbal products† (Drugs. com, 2010). Warfarin can interact with the following herbal products: â€Å"garlics, gingko biloba, ginseng or St. John's wort†. (Drugs. com, 2010). Metformin Drugs that can raise the blood sugar affecting the use of Metformin include medicines to treat colds and allergies while drugs that lower blood sugar include some nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, and sulfa drugs (Bactrim)† (Drugs. com, 2010). Alcohol should also not be taken concomitantly with this drug. â€Å"Alcohol lowers blood sugar and may increase the risk of lactic acidosis while taking this drug† (Drugs. com, 2010). There could be increased risk for hypoglycemia if the drug is taken with â€Å"juniper berries, ginseng, garlic, dandelion root and celery† (Karch, 2007, p. 58). Lithium Patients taking lithium carbonate should â€Å"avoid drinking large amounts of coffee, tea, or cola, which can cause dehydration through increased urination† (Drugs. com, 2010). Besides having interactions with other drugs in the patient's regimen, lithium also interacts with over-the-counter drugs. â€Å"If Eskalith is taken with certain other drugs, the effects of either could be increased, decreased, or altered such as nonsteroidal anti-inflammatory drugs† (Drugs. com, 2010). â€Å"Patients being treated with lithium should be encouraged not to use the herbal therapy psyllium. If combined with lithium, the absorption of the lithium may be blocked and the patient will not receive therapeutic level† (Karch, 2006, p. 333) Possible Adverse Reactions and Nursing Interventions Metronidazole â€Å"Convulsive seizures have been reported in patient treatment with metronidazole† (DailyMed, 2009). Necessary seizure precautions should be implemented. Mrs. Brown has a history of seizure; this is why the healthcare team should take necessary adjustments to the dosage of metronidazole. Aside from this major adverse reaction, the patient can develop â€Å"unpleasant metalic taste, nausea, vomiting and diarrhea† (Karch, 2007, p. 86). Nursing care for strange metallic taste should be â€Å"frequent mouth care, sucking sugarless candies†, and for nausea, vomiting and diarrhea, the patient should be advised to â€Å"eat frequent small meals† (Karch, 2007, p. 786). In the case of Mrs. Brown, complains of discomfort in her buttocks, pain in per ineal area and offensive odor could mean that she developed cadidiasis as â€Å"known or previously unrecognized candidiasis may present more prominent symptoms during therapy with metronidazole† (DailyMed, 2009). Treatment with candidicidal agent should be instituted to the patient. Other adverse effect can be â€Å"disulfiram-like interaction with alcohol† (Karch, 2007, p. 786). The patient should be always reminded of precautions on ingesting alcohol and alcohol-containing products. Phenytoin â€Å"Nausea,vomiting, diarrhea, constipation and gingival hyperplasia† (Karch, 2009, p. 951) could be present in patients taking Phenytoin. The nurse should â€Å"arrange instruction in proper hygiene technique for long-term patients to prevent development of gum hyperplasia†, â€Å"take drug with food, eat frequent small meals† (Karch, 2007, p. 953). Among the other common adverse effects are â€Å"dizziness ,drowsiness, confusion and headache†. The patient should be advised to â€Å"avoid performing tasks requiring alertness and visual acuity† (Karch, 2007, p. 953). Warfarin The common adverse effects of Warfarin are â€Å"nausea, vomiting, abdominal cramping, diarrhea and hemorrhage† (Karch, 2007,p. 1216). Nurse should advise the patient to â€Å"avoid any situations in which she could be easily injured. † Necessary care should be provided to avoid bleeding in the patient like â€Å"not giving any IM injections† (Karch, 2007, p. 1217). The patient should also be asked to â€Å"report unusual bleeding (from brushing teeth, excessive bruising), black or bloody stools, cloudy or dark urine† (Karch, 2007, p. 1218). Metformin The most significant possible adverse effects of this drug are â€Å"hypoglycemia and lactic acidosis† (Karch, 2007, p. 758). The nurse should â€Å"monitor blood for glucose and ketones† or â€Å"should ask the client any sign of hypo- or hyperglycemic reactions† (Karch, 2007, p. 758). There could also be â€Å"signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat† (Drugs. om, 2010). In this case, it is necessary to â€Å"stop the medication and report to the physician† (Drugs. com, 2010). Lithium The common side effects of Lithium involves CNS manifestions such as â€Å"lethargy, slurred speech, muscle weakness and fine hand tremor; GI manifestions such as nausea, vomiting , diarrhea, thirst; GU effect is polyuria† (Karch, 2007, p. 704). It is important to instruct the client to â€Å"report any signs of toxicity such as diarrhea, vomiting, tremor, drowsiness, muscle weakness† (Karch, 2007, p. 705). The patient should also be prohibited or â€Å"avoid driving or performing tasks requiring alertness† and should be instructed to â€Å"eat frequent small meals† (Karch, 2007, p. 705). Health Education Metronidazole It is impotant to instruct the client to â€Å"not drink alcohol (beverages or preparations containing alcohol, cough syrups)† (Karch, 2007, p. 786). The nurse should also mention to the client that she may experience â€Å"urine with darker color , dry mouth with strange metallic taste, nausea, vomiting and diarrhea† (Karch, 2007, p. 786). Intervention to relieve these side effects should be taught like â€Å"frequent mouth care, sucking sugarless candies for dry mouth; eating frequent small meals for nausea, vomiting and diarrhea† (Karch, 2007, p. 786). Phenytoin Patients taking Phenytoin should be advised to â€Å"take this drug exactly as prescribed with food to reduce GI upset or without food — but maintain the consistency† (Karch, 2007, p. 953). Mrs. Brown should be advised to â€Å"not discontinue this drug abruptly or change dosage, except on advice of health care provider† (Karch, 2007,p. 953). Since Mrs. Brown has diabetes, it should be advised that she should â€Å"monitor blood or urine sugar regularly, and report any abnormality to health care provider† (Karch, 2007, p. 953). She should be advised that she should â€Å"maintain good oral hygiene to prevent gum disease and arrange frequent dental checkups† (Karch, 2007, p. 953). Warfarin It should be advised to the patient to â€Å"not start or stop taking any medication without consulting her health care provider† (Karch, 2007, p. 1217). She should â€Å"carry or wear a medical ID tag to alert emergency medical personnel about the drug† (Karch, 2007, p. 218). She should be instructed to â€Å"avoid situations that may cause injury and have periodic blood tests to check on drug action† (Karch, 2007, p. 1218). Lastly, the patient should be instructed to â€Å"report unusual bleeding, black or bloody stools and cloudy or dark urine† (Karch, 2007, p. 1218). Metformin Some of the instructions t hat should be given to the patient are â€Å"not to discontinue the medication without consulting health care provider and avoid using alcohol while taking the drug† (Karch, 2007, p. 758). She should also be advised to â€Å"monitor blood for glucose and ketones and report any hypo-or hyperglycemia reactions† (Karch, 2007, p. 758). Lithium Health teaching about this drug should include the following: â€Å"take the drug exactly as prescribed, after meals or with food or milk; eat a normal diet with normal salt intake and maintain adequate fluid intake and arrange for frequent checkups including blood tests† (Karch, 2007, p. 705). Mrs. Brown has numerous risk factors and health conditions that may produce drug interactions that may worsen her health. It is known that Metronidazole can produce seizures as its side effect. Considering this, safety precautions should be made since she has a history of seizure. This drug can also impair the clearance of the drug Phenytoin in her system and potentiate the anticoagulant effects of Warfarin. These things should be monitored by the healthcare team for them to make necessary adjustments. Phenytoin can also increase the anticoagulant effect of Warfarin and may either increase or decrease the efficacy of lithium. Necessary drug dosage adjustments should be made to minimize these interactions. Daily blood glucose monitoring should be done and symptoms of hypo- or hyperglycemia should be reported. This is necessary because Warfarin can increase the effects of oral diabetic agents such as Metformin. However, Phenytoin and Lithium can diminish the efficacy of this drug. Thus, it is really important to monitor the client's clinical status and the possible adverse effects of the drug regimen. It is also important to â€Å"offer support and encouragement to help the patient cope with the drug regimen† (Karch, 2006, p. 334).

Friday, November 8, 2019

Clay in Ancient Egypt essays

Clay in Ancient Egypt essays No one is certain how early the Egyptians began using clay. They had become fairly adept at using clay by around 5000 B.C., which was the Predynastic Period. The Egyptian civilization was located along the Nile River, and the annual flooding of the Nile made large amounts of clay readily accessible. There is clear evidence suggesting that the Egyptians were the first civilization to use the potters wheel, which they were doing around 2700 B.C. This quickly became a widely-used technique, and by 2400 B.C., statues of potters working at wheels were being used in funerary rites. Even in the Predynastic Period, clay was considered a primeval material which contained essential life-bearing forces (Bianchi 35). A style developed during this period in which red paint was used on buff-colored earthenware. The painting on these often depicted Nile sailing boats complete with cabins and flags, various animals and plants, and geometric forms. These forms were painted randomly around the vessel, because the craftsmen were focused on visual clarity and not in creating the kind of illusions of reality which have preoccupied Western artists from the time of the Renaissance (Bianchi 38). Although its use began in the Middle Kingdom, the Third Intermediate Period, between 1080 and 656 B.C., was the height of the use of faience, or Egyptian paste, which was a glazed, ceramic material similar to porcelain. It was made by adding soluble sodium salts to the clay body, a process which may originally have occurred accidentally, when the wind blew other materials into clay beds. As the object dried, the glaze-forming materials would be deposited on its surface, forming white crystals. When the object was then fired, its surface would be covered in a thin glaze from the crystals. Colorings were often added to faience, most often copper oxide to make a turquoise blue, or more rarely, cobalt oxide to make a d...

Wednesday, November 6, 2019

Essay about Post

Essay about Post Essay about Post-Purchase Consumer Behavior Running head: CONSUMER BEHAVIOR POSTPURCHASE Consumer Behavior Post Purchase Amy Wofford MAN 105 March 6, 2015 Instructor Johnson Abstract The process of buying does not end after the purchase of a good or service. The consumer’s post purchase assessment is directly affected by the pre purchase assumptions, before purchase search, and the confidence about the product Consumer Behavior Post Purchase The process of buying does not end after the purchase of a good or service. The consumer’s post purchase assessment is directly affected by the pre purchase assumptions, before purchase search, and the confidence about the product. After making the purchase, the customer uses the product and then evaluates the experience to determine whether it was satisfactory or unsatisfactory (Rakesh, 2011). The consumer is anticipating that the purchase will be met with some sort of satisfaction. Satisfaction means to meet to the full one's wants, and expectations (Roget, n.d). If the consumer decides that the product or service is not to their liking, it can create cognitive dissonance. Cognitive dissonance is a psychological concept related to self-doubt when making decisions. In marketing, it is often referred to as buyer's remorse, and relates to the uncertainty customers feel after making a tough purchasing decision (Kokmueller, n.d). When a purchase c reates cognitive dissonance, consumers tend to react by seeking positive reinforcement for the purchase decision, avoiding negative information about the purchase decision, or revoking the purchase decision by returning the product (Lamb, 2008). Most people have experienced cognitive dissonance or what it is often referred to as buyer’s remorse at one time or another. People in general usually experience buyer’s remorse when buying something that cost a lot of money. I recently bought a used minivan. The cognitive dissonance I experienced was after I had to do repairs on the van. It cost almost as much as I paid for the vehicle itself. I realized after that I should have done more research before making the purchase to begin with. A few ways to help with the post purchase regrets, is to be sure that you want to make the purchase in the first place. When you are getting ready to buy- do not do it. Take a break to really ask yourself if it’s what is really want ed or needed. Read all reviews of the product or service. Do not ignore the reviews that you don’t want to hear. In Marketing the best way to curve the impact that cognitive dissonance might have on a business is to

Monday, November 4, 2019

Research paper about Gasoline crises Example | Topics and Well Written Essays - 1750 words

About Gasoline crises - Research Paper Example Oil is essential for all the vehicles irrespective whether it is moving on air, water or land. Though many alternative solutions have been suggested as fuel instead of oil for vehicles like solar energy, electrical energy etc, nothing evolved as a permanent and convenient option yet. The exhausting of current oil sources has created major crises in the current world as many experts believe that the available oil resources may last for maximum 30 to 40 more years considering the nature of consumption at present. This paper briefly explains gasoline crises based on the oil price variations and its impact on global economy. Oil is an essential commodity for the world’s economy. It is impossible for us to think about our body without blood. Same way oil is the blood of world economy. Any problems in occurred in this blood (oil) can cause severe damages to the body (economy). Oil is an essential commodity required everywhere, but unfortunately the oil resources are confined to some areas or regions only which made oil trade an essential economic activity in the current world. Major oil producing countries have monopolized the world market and they have varied the prices of oil as per the supply and demand theory. Around three years before the oil prices has reached an all time high of around $ 150 per barrel whereas it has come down to as low as around $ 30 per barrel recently because of global financial crisis and low demand of oil products. America is one of the topmost oil consumers in the world because of the huge amount of automobile vehicles used for different purposes in this country. Irrespective of developed, developing or underdeveloped, all the countries need oil and the oil trade has started between countries as early as the oil and automobiles were discovered. One of the rapidly growing economies in the world Brazil has reportedly engaged in a, bilateral trade of US$ 8.192 billion in 2004 with the Arab countries. (BRAZIL:

Friday, November 1, 2019

International Business Strategy for Ford Case Study Essay

International Business Strategy for Ford Case Study - Essay Example Ford also started to build electric cars. The political forces facing this industry are getting more and more severe. There are many groups in the society which are demanding stricter environmental norms for the automobile industry (Hoffman, 2012, p. 211). Ford has so far done a good job in maintaining the image as a worker’s truck. Ford has attracted the attention of other social and economic groups which have high-class luxury vehicles. Ford operates in many international countries such as Australia, Japan, UK and America where the business operations are conducive. In 1975, the Corporate Average Fuel Economy took effect, and Ford was able to abide by the regulations. Non-compliance with these laws caused heavy fines, which would prove costly to the company. This made Ford manufacturer one of the most fuel efficient and environmentally friendly cars. The Government also discourages Ford to fully automate its operation which would otherwise result in increase of the unemploym ent rate. Economic forces The leading manufacturers of the vehicles were mainly companies from United States, Western European and Japanese companies. Ford used to produce more vehicles outside their home country than within their own country. The auto industry remained fragmented. In 2010, there were a total of 18 manufacturers with their annual output being more than 1 million vehicles. 3-firm concentration ratio which is measured by the units of production was around 31.5 percent. There were many mergers and acquisitions in the auto industry; still they faced new competition from other countries especially India and China. Figure 1: Mergers & Acquisitions among the major automobile manufacturers. (Source: Ledderhos, 2003, p.68) (Source: Ledderhos, 2003, p.67) Strong competition from the companies forced Ford to go for cost reduction through economies of scope, economies of scale, worldwide outsourcing, off-shoring, just-in-time scheduling and collaboration. In spite of the many c ost reduction techniques, the major automakers were still unable to rival the low cost automakers from India, China and elsewhere. The euro zone crisis further exasperated the problem of Ford (Ireland, Hoskisson and Hitt, 2010, p. 75). Social Factors The social factors which affect Ford are the changes in the social classes in the world market. With increasing globalisation the car market is witnessing increase in spending from the middle and upper middle income families all across the world. The lines between the social strata are diminishing. Hence companies all around the world are now targeting the middle income group to increase their volume sales. This helps the motor company in expanding their market across the world. This results in more manufacturers coming out with products which cater to the middle income people and results in rise in competition (Stead, Stead and Starik, 2004, p. 89). The consumers are now demanding better quality, safer vehicles at lower prices which ha ve forced Ford Company to produce cars at cheaper ways like outsourcing the parts of their production in outside countries. Hence the company needs to adopt new processes and methods of creating attractive, unique automobiles