Entrepreneurship and Venture Creation Essay Example | Topics and Well Written Essays - 4000 words - 1

Entrepreneurship and Venture Creation - Essay Example They seek to provide high quality goods at low costs through innovation. This factor together with wealth creation led to economic growth. Entrepreneurs seek to invest money in small and medium market enterprises. This leads the niche market to flourish and strengthen the economy. This is why a society only receives consideration of prosperity as to the degree to which it encourages and rewards entrepreneurship (Stel 2005 pg 18). In many liberal economies, entrepreneurship pursuit receives high priority as opposed to its consequences. However, careful evaluation reveals that this behavior creates a credit crunch that leads to financial turmoil. The economic and social impacts of entrepreneurial activity with no regulation lead to short-term benefits (Acz, 2010 PG 78). Yet, in the end national markets, economies, individual and firms suffer severely resulting into huge value destruction. This essay seeks to analyze the theory of entrepreneurship and its relation to the UK economy coming from recession. It will discuss different types of entrepreneurial activities. It indicates how each activity affects economic performance. Entrepreneurship before the recession was unregulated. This led to issues arising in the capitalist economies leading due to short-term profits and speculation bubbles. The entrepreneurs experienced adverse effects of economic factors beyond their control. These include limitation of amount of credit available, decrease in demand and reductions in confidence levels. This resulted in business closures, loss of employment and economic stagnation. The capitalist economy present at the time though highly adaptive and robust held a crisis between its relationships to the society (Stel, 2005 pg 124). The freedom it gave to an enterprise to engage in wealth creation and maximization was in contrast to the society expectation of responsibility. The old entrepreneurial theory receives its basis from the capitalist theory of growth.

The Companions Are the Source of Much Grief for Odysseus Essay Example for Free

The Companions Are the Source of Much Grief for Odysseus Essay Odysseus, the strong, courageous, dedicated hero, travelled for miles on end to return to his home land of Ithica and to bring with him the twelve fleet ships carrying his loyal companions. However throughout this epic poem Odysseus’ companions have been the bearers of much grief for Odysseus, in many ways from questioning his leadership to simply dying in battle. And slowly during this epic poem each of his twelve fleet ships has been struck down. The stories of Odysseus’ companions begin from the very opening of book nine, on the coast of Ismarus home to the Cicones. Odysseus and his men â€Å"sacked the place and destroyed its men folk† after taking their women and their vast spoils, Odysseus warned his men to dispatch with haste. But they were not quick minded enough, and a tremendous battle broke out between Odysseus and his men and the Cicones. Seventy two of Odysseus’ men were brutally killed. We can see here that this would cause much grief for Odysseus and his remaining companions, for his men had made it through the battle of Troy and where rejoicing to be returning home to Ithica, now he would have to return to grieving families awaiting their heroes return and for some, now their hero’s would never return. This is a classic example of the kind of grief Odysseus feels throughout the epic poem, because this is how many of his companions have presented Odysseus with grief, through death. Whether it was falling in battle or devoured by a monstrous creature. For instance when, Odysseus and his remaining companions sailed to the island of the Cyclopes, where with twelve companions, he entered the cave of the Cyclops Polyphemus. This giant devoured, one after another, six of the companions of Odysseus, and kept Odysseus and his other men as prisoners in his cave. Witnessing their loyal companion’s cannibalistic murders right in front of them Odysseus and his men â€Å"wept and raised their hands to Zeus in horror.† This again must have made Odysseus overridden with grief for not only did he watch his men be killed but he was the one that led them to this ferocious one eyed monster. Again he has lost more of his men which means more grieving families; at home in Ithica questioning the Gods for the death of their loved ones. However, death is not the only way that Odysseus is exposed to grief some of the monsters that Odysseus and his followers encountered would not kill his men but simply make them forget all longing for home, and the nostros that they were feeling. One of these monsters would be the Lotus-eaters, â€Å"a race that eat the flowery lotus fruit.† Some of his companions were so much delighted with the taste of this flower that they wanted to remain with the Lotus-eaters and think no more of Ithica. This must have caused much anguish for Odysseus as he did not know how to help his compelled comrades. But being the intelligent and strong hero he is he â€Å"used force to bring them back to the hollow ships, and they wept on the way† but once on board he tied them up and continued with his voyage. The sirens also allow men to forget their home for with their beautiful voices would sing bewitching songs to drive these men to their death. Luckily with the help of Circe the sorceress who told Odysseus that if he wanted to hear the sirens song and live that he should allow his men to tie him to the mast of his ship while they covered their ears with softened bees wax and steer the boat onward while Odysseus listened. Odysseus, in the epic poem has also encountered Companions that have questioned and mistrusted his leadership; this is that of Odysseus’ second in command of Odysseus’ ship during the voyage back to Ithica after the Trojan War his name was Eurylochus. In the Odyssey he is portrayed as an unpleasant, cowardly individual who undermines Odysseus and stirs up trouble. When Odysseus and his men arrive on the island of Aeaea home to Circe Eurylochus is chosen to lead a group of twenty-two men to explore the island. While touring the island they see Circe’s house and all but Eurylochus enters, he himself suspects Circe’s trap and when the men are turned into pigs he runs back to warn Odysseus. Odysseus prepares himself to confront this witch and save his crew however Eurylochus refuses to guide him to Circe’s palace and urges Odysseus to escape and leave the men to their fate. This must have caused an uncountable amount of grief and pain for Odysseus for Eurylochus was his second in command, Odysseus therefore must have trusted this man with his life and thought rather highly of him. Then for him to tell him to abandon his loyal companions who have been there for him since Troy and save himself must have hurt Odysseus a great deal. After Odysseus returns from Circe’s palace having rescued his companions, Eurylochus insults Odysseus and threatens to kill him. Here we see Odysseus being befriended and almost killed by his second in command obviously causing much grief for our brave hero. Overall I feel that the companions are the source of much grief for our fearless hero. However most of them did not wish to bring grief upon their leader. For most it was simply an unfortunate death leading to Odysseus grieving for the loss of them.

Freedom and Kate Chopins Story of an Hour Essay -- Story Hour essays

Freedom and The Story Of An Hour      Ã‚  Ã‚   When I first read Kate Chopin's "The Story Of An Hour", my instinctual response was to sympathize with the character of Mrs. Mallard.   This seemed to me to have been intended by the author because the story follows her emotional path from the original shock upon hearing of her husband's supposed death to her gradual acceptance of the joy she feels in anticipating her new freedom to the irony of her own sudden death.   However, one fact cannot be overlooked when judging my personal reaction to this piece. Because this story's theme is basically an issue of what a woman has the right to expect from her life, the fact that I am a woman living in a society where freedom and independence are valued above all else weighs heavily on the way I look upon the actions of Mrs. Mallard and also on the way I judge Chopin's message.      Ã‚  Ã‚   It is interesting to note that even in the story's opening, before Mrs. Mallard's response has run it's full course,   her reaction to the news of the accident which is presumed to have killed her husband is already being contrasted to the one   which society would deem appropriate.   It is mentioned that "She did not hear the story as many women have heard the same, with a paralyzed inability to accept its significance"(pg 275, P3). Though upon discussion of the story I found that this sentence had placed a kernel of suspicion in the minds of some as to the authenticity of Mrs. Mallard's display of emotion, I had taken once, with sudden, wild abandonment"(pg 275, P3) endeared her to me all the more because I felt that it meant she was very much in touch with the workings of her heart andimmediately at their mercy, and this made her reacti... ....   As a woman who wants what these women wanted, I find this hard to grapple with.   I appreciate the fact that this story was written in a time when feminism was unheard of, but I wish that Chopin, who had been liberated enough to conceive of a character who would think like Mrs. Mallard, could also have imagined a situation in which she could have survived. Work Cited: Chopin, Kate. "The Story of An Hour." The Norton Anthology of Short Fiction. Ed. R.V. Cassill and Richard Bausch. New York: W.W. Norton and Company, 2000. 106-109. Works Consulted: Cixous, Helene. "Laugh of the Medusa." Feminisms: An Anthology of Literary Theory And Criticism. Ed. Robyn R. Warhol and Diane Price Herndl. New Brunswick, New Jersey: Rutgers University Press, 1991. Moi, Toril. Sexual/Textual Politics. New York: Routledge, Chapman and Hall, 1988.   

Friendship Through the Years :: Friendship Essay Personal Narrative

Friendship Through the Years Two sets of twins live in the house cattycorner to mine. All four are girls, and all four are in diapers. The oldest set of twins, Michelle and Caitlin, are my age, and we quickly become playmates. Caitlin has striking red hair that drapes the bottom of her shoulder blades. She is so outgoing she would chat with a hobo on the street if her mother were not there to stop her. Michelle, on the other hand, is quieter and more reserved. She is an inch or two shorter than the kids her age, and lacks the confidence that dominates her sister's personality. She clings to me. Her shy personality coincides with my bold and adventurous one. She willingly becomes my sidekick, and joins me in numerous neighborhood adventures. We travel the grassy plains, and trek across the muddy rivers, stopping only for the occasional diaper change, and the pacifiers that fall behind. Our friendship is uncommon, exciting, and pure, but I am too young to treasure this rare gift that God has given me. It is first grade, and not has much changed. Michelle's short stature has only grown more apparent, and the increasing number of people surrounding her has become overwhelming. She clutches onto me, too afraid to meet her taller, bolder classmates. At recess, Michelle and I select the multicolor u's that link together to make chains. We plop ourselves down on the gray, matted carpet and begin to make necklaces and bracelets. Something makes us chuckle, and before you know it we are grabbing at our sides with laughter pains. Michelle laughs so hard that she pees all over our beautiful creations that we, and the classroom, left on the floor. Her angelic smile turns immediately into an expressionless stare. I look into her puppy eyes and watch tear after tear streak down her cheeks into the pee that surrounds her. I want to take that pain away from her. I want all those small, watchful eyes in the class to glare at me instead of innocent little Michelle. It is sixth grade and the Green Springs Special Chorus, which Michelle and I are a part of, is going to the junior high school to sing. Our choir is singing seventies music, and we are required to wear seventies clothes. Michelle and I are matching from head to toe. Our attire consists of blue felt poodle skirts, white shirts, black scarves, and starch-white Ked's shoes.

Development of a Communications Plan for a Corporate Website Launch

AWARDS CEREMONY FOR MEMBERS OF PARLIAMENT AND PROVINCIAL LEGISLATORS AT UNISA on 18 November 2011 GOVERNANCE AND LEADERSHIP PROGRAMME DRAFT COMMUNICATIONS PLAN Background An awards ceremony will be held on 18 November 2011 in Pretoria for 158 Members of Parliament and Provincial Legislatures who have completed the Governance and Leadership Programme. The programme is offered under the auspices of the University of South Africa (UNISA). A total of 293 MPs and MPLs registered for the programme initially but some could not complete their studies on time. The Programme is supported by the South African Legislative Sector, under the guidance of the Speakers’ Forum and Public Administration Leadership Academy, PALAMA. Communication Objectives Parliament considers the role of public representatives to be central in exercising its role as the supreme law-making body in the country. As such, Members of Parliament and Provincial Legislatures need to acquire the requisite skills and competencies that will enable them to approach their work more judiciously and to participate more effectively in Parliamentary processes of law-making, oversight and public participation. Target audience Members of Parliament Members of Provincial Legislatures Speakers’ Forum SALSA General Public Key Messages †¢ The Capacity Building Development Programme enhances Members’ ability to execute their constitutional responsibilities more effectively †¢ Members are able to analyse policy, legislation, strategy more effectively †¢ The role of Parliament and Provincial legislatures is considerably enhanced in the public arena †¢ The South African public gains confidence in the ability of MPs and MPLs to execute their public duties in a responsible manner COMMUNICATION TOOLS Internal Newsletters (Parliament, Legislatures and PALAMA) (Responsibility: Michael Ralo, Gerbrecht van Heerden, PALAMA and provinces) †¢ Intranet and website (Parliament, Legislatures and PALAMA) (Responsibility: Michael Ralo, Gerbrecht van Heerden, PALAMA and provinces) External †¢ Media statement (Radio, TV and print) Action: Media statement drafted, waiting for approval Action: TV, radio and print interviews to be arranged from 14-18 November 2011 Speakers scheduled for interview include the following Members of the Reference Group on Training: Deputy Speaker: National Assembly, Ms NC Mfeketo Deputy Speaker: Free State Legislature, Ms MA Tsopo Speaker: Limpopo Legislature, Mr KA Phala Deputy Speaker: Eastern Cape Legislature, Ms N Moerane-Mamase Deputy Speaker: KwaZulu-Natal Legislature, Mr M Mthimkulu PRINT MEDIA The Star Citizen Beeld Sowetan Daily times City Press Sunday Times Sunday World RADIO & TV Jacaranda Kaya FM yfm SABC Radio News Metro FM Thobela Motswedi Ukhozi Umhlobo Wenene Mohlodi Ligwalagwala SABC TV News Radio 2000 Radio 702 (Responsibility: Michael Ralo, Abe Mokoka – Gauteng Legislature, Sanelisiwe Mbhele – PALAMA and provinces) †¢ Event (Graduation ceremony and gala dinner and photography) (Responsibility: Msimelelo Nyikana, Millie Daweti and Task Team) †¢ Sector-wide publications (Responsibility: Michael Ralo, Parliament) †¢ Sector Annual Report (Responsibility: LSS)

Romanticism and the Scarlet Letter essays

Romanticism and the Scarlet Letter essays Romanticism is categorized as a preference for simplicity and naturalness, a love of plain feelings and truth to common place reality, especially as found in natural scenes. Nathaniel Hawthorne was an anti-transcendentalist and believed in the dark side of man, hence his dark romantic novel The Scarlet Letter. This allegorical novel depends heavily on symbol and character. The novel is chock full of symbolic dimension of images, characters, and descriptions. The Scarlet Letter defines the American Romanticist movement while using symbolic characters and places that give the book seemingly two different stories. The first story denotes the story going on in the book, including the characters. The other story has symbols that speak on morals, religious doctrine, and public mindset. Furthermore the novel can be defined as a romantic novel by analyzing the characters Hester, Pearl, and Dimmesdale for their overall purpose to the story and the symbolism. An important concept of romanticism includes a close connection to the earth and natural scenes. A large occurrence of this comes in the first chapter of the book. The chapter mentions a rose bush outside of the prison. The novel then goes on to outline the rosebush as a beautiful thing that rises out of a bad place. The rosebush symbolizes a beauty that can not be taken away, the human spirit, like that of Hawthorne himself and also of Hester. In addition the prison represents Puritan society, with all of its strict social and moral rules of conduct, and the rose bush symbolizes the individual, standing defiantly on their own, lively and strong, in spite of the society as a whole, against them. Hawthornes use of the rosebush implies that there may be an indestructible human impulse that can survive in people despite social order and natural rights. Another romantic nature symbol is the forest, which symbolizes both safe and evil aspects. An instance of the ...

4 Ways to Take Control of your LinkedIn Endorsements

4 Ways to Take Control of your LinkedIn Endorsements I’m a self-identified control freak when it comes to certain aspects of my life, and as such, I am perpetually perturbed by the Skills Expertise section on LinkedIn. The way this section works, anyone can endorse me for anything – even things I know nothing about! And if enough people endorse me for things I do not consider important, these skills will be prominently displayed at the top of my Skills list. Aargh! You might, like me, get an email almost daily telling you that someone wants to endorse you for â€Å"new† Skills not currently listed on your profile. And if you’re like me, there was a reason you didn’t list that skill in the first place. Either you don’t have that skill or you don’t want to market it. What I do in this situation is press â€Å"Skip† and wait until the next well-meaning person endorses me for skills I don’t have. At the National Resume Writers’ Association Conference in Chicago this past week, LinkedIn endorsements were a hot topic. We are all concerned that the wrong people are endorsing us for the wrong things. In one session about LinkedIn, trainer Dean DeLisle suggested that we take control of our Skills Expertise and stop complaining about it! How can you wield control over this pesky section? Well, let me tell you: Fill in ALL 50 Skills. This way there will be less likelihood of additional, inappropriate skills being added to your profile. You would have to delete one skill to add another. Press â€Å"Skip† to decline adding Skills to your profile. Know that the skills listed at the top of your Skills list are the ones with the most endorsements. If you want different skills to show up there, ask your connections to endorse you for the ones you want to appear at the top! (I am going to do this momentarily. Be forewarned.) As a last resort, you can delete a skill, add it back, and start over from zero endorsements. That will push other skills higher up on your list. Please Take Action! A Request I’ve found that a lot of people seem to endorse me for Blogging, Social Networking, Social Media Marketing, Nonprofits, Career Management, Time Management, and a lot of other things I don’t market as my specialties. My request to you is to endorse me for the list of Skills Expertise that appears below. Please only do so if you are confident that I have the skill! Also note that to endorse a skill, you must be a 1st-degree connection. I invite you to connect with me on LinkedIn if we are not already connected. Hint when endorsing anyone for skills: Don’t default or be limited to the ones suggested at the top of their profile! Scroll down in the profile to the Skills Expertise section and choose from there. You will be able to click on a + sign to choose the skill. For example: Heres my list of requests. Thanks in advance for your support! Resume Writing Executive Resumes Executive Resume Writing Sales Resumes Marketing Resumes C-Level Resumes Senior Management Resumes Supply Chain Resumes Operations Resumes LinkedIn LinkedIn Profiles Cover Letters Professional Bios College Application Essays MBA Admissions Consulting Law School Admissions Consulting Law School Resumes I’m making this request partly as an experiment in service of my e-book, How to Write a KILLER LinkedIn Profile. If I can change the appearance of my Skills Expertise section, then I will be able to stand tall and recommend similar action to my e-book readers in the 8th edition. Also, if you think I am familiar with your skills and want me to endorse you for specific ones, I will do so IF I know your abilities first-hand. Thank you and I look forward to the changing face of all our LinkedIn profiles!

History of Matches - Inventors and Methods

History of Matches - Inventors and Methods If you need to start a fire do you rub sticks together or break out your handy flint? Probably not. Most people would use a lighter or a match to start a fire. Matches allow for a portable, easy-to-use source of fire. Many chemical reactions generate heat and fire, but matches are a fairly recent invention. Matches are also an invention you probably wouldnt choose to duplicate if civilization ended today or you were stranded on a desert island. The chemicals involved in modern matches are generally safe, but that wasnt always the case: 1669 [Hennig Brand or Brandt, also known as Dr. Teutonicus] Brand was an Hamburg alchemist who discovered phosphorus during his attempts to turn base metals into gold. He allowed a vat of urine to stand until it putrified. He boiled the resulting liquid down to a paste, which he heated to a high temperature, so that the vapors could be drawn into water and condensed into... gold. Brand didnt get gold, but he did obtain a waxy white substance that glowed in the dark. This was phosphorus, one of the first elements to be isolated other than those which exist free in nature. Evaporating urine produced ammonium sodium hydrogenphosphate (microcosmic salt), which yielded sodium phosphite upon heating. When heated with carbon (charcoal) this decomposed into white phosphorus and sodium pyrophosphate:(NH4)NaHPO4 - †º NaPO3 NH3 H2O8NaPO3 10C - †º 2Na4P2O7 10CO P4Although Brand tried to keep his process a secret, he sold his discovery to a German chemist, Krafft, who exhibited phosphorus throughout Europe. Word leaked out that the substanc e was made from urine, which was all Kunckel and Boyle needed to work out their own means of purifying phosphorus. 1678 [Johann Kunckel]Knuckel successfully made phosphorus from urine. 1680 [Robert Boyle] Sir Robert  Boyle coated a piece of paper with phosphorus, with a separate splinter of sulfur-coated wood. When the wood was drawn through the paper, it would burst into flame. Phosphorus was difficult to obtain at that time, so the invention was only a curiosity. Boyles method of isolating phosphorus was more efficient than Brands: 4NaPO3 2SiO2 10C - †º 2Na2SiO3 10CO P4 1826/1827 [John Walker, Samuel Jones] Walker serendipitously discovered a friction match made from antimony sulfide, potassium chlorate, gum, and starch, resulting from a dried blob on the end of a stick used to stir a chemical mixture. He didnt patent his discovery, though he did show it to people. Samuel Jones saw the demonstration and started to produce Lucifers, which were matches marketed to the Southern and Western U.S. states. Lucifers reportedly could ignite explosively, sometimes throwing sparks at a considerable distance. They were known to have a strong firework odor. 1830 [Charles Sauria] Sauria reformulated the match using white phosphorus, which eliminated the strong odor. However, the phosphorus was deadly. Many people developed a disorder known as phossy jaw. Children who sucked on matches developed skeletal deformities. Phosphorus factory workers got bones diseases. One pack of matches contained enough phosphorus to kill a person. 1892 [Joshua Pusey] Pusey invented the matchbook, however, he placed the striking surface on the inside of the book so that all 50 matches would ignite at once. The Diamond Match Company later purchased Puseys patent and moved the striking surface to the exterior of the packaging. 1910 [Diamond Match Company] With a worldwide push to ban the use of white phosphorus matches, the Diamond Match Company got a patent for a non-poisonous match which used sesquisulfide of phophorus. U.S. President Taft requested that Diamond Match give up their patent. 1911 [Diamond Match Company] Diamond yielded their patent on January 28, 1911. Congress passed a law placing a prohibitively high tax on white phosphorus matches. Present Day Butane lighters have largely replaced matches in many part of the world, however matches are still made and used. The Diamond Match Company, for example, makes more than 12 billion matches a year. Approximately 500 billion matches are used annually in the United States. An alternative to chemical matches is fire steel. Fire steel uses a striker and magnesium metal to produce sparks which may be used to start a fire.

Caree paper Essay Example | Topics and Well Written Essays - 500 words

Caree paper - Essay Example The ultimate mission of a teacher is to produce a skilled and an informed citizenry. The paper covers the history, requirements, duties, and the job outlook of a high school or a secondary teacher. In the earliest times, cultural, social values, religion, knowledge, traditions, skills, and morality were passed on to generation by informal education. Education was achieved by imitation and observation. It was in oral form. Parents, kids, and extended family acted as teachers to the young. With the complexity of the ancient civilization, customs and knowledge about agriculture, boat building, military, and other activities called for the demand for teachers. The revolutionary war led to an improvement of education in America. Majority of the teachers at the time were male (Saleh & Khine, 2012). Horace Mann in 1647 opened the first free public school. A significant step in the education sector took pace in 1857, coming up with National Teachers Association. It gave rise to the current teacher profession. Becoming a teacher is not easy. A secondary teacher has to pass through high school, complete college and obtain a four-year bachelor degree in the field or subject they wish to teach. In addition, they have to go through one to two years of college in a Credential program. The program entails classes on how to teach. It also tests knowledge of PRAXIS, CBEST, and SSAT (Saleh & Khine, 2012). Teachers are of different types. Each has a unique and a complicated job. Elementary teachers teach grade K to 8. Secondary teachers teach grade 6 to 12. Special Ed teachers teach students with disabilities. The substitute teachers fill in for the absent teachers. Finally, we have the professors who teach in colleges. A secondary teacher teaches in one major subject area like Mathematics, English, Science, History, and Arts. Their daily duties involve making lesson plans, attending lessons, grading papers, assigning grades, contacting parents, keeping attendance and

Mobility Management for LTE-Advanced Relay Systems Research Paper

Mobility Management for LTE-Advanced Relay Systems - Research Paper Example These different technologies can cooperate together In order to improve the user’s quality of service and granting mobile users the ability of roaming across different wireless networks in a seamless manner. However, the different characteristics of each wireless technology with regards to QoS brought many challenges for provisioning the continuous services (e.g. audio/video streaming) in a seamless way. In such a heterogeneous environment, to support mobile user’s requirements, a mobility management mechanism is a key issue. Index Terms— Heterogeneous network, LTE-Advanced, Relay System, Vertical Handoff I. INTRODUCTION With the increase in demand and rapid development of wireless communication quality over the past 3 decades, the initial 1G has run into 4G with a high data rate and better mobility support. The 4G technique-International Mobile Telecommunications-Advanced (IMT-Advanced) systems include new capabilities that go significantly beyond those of the I MT-2000. Key requirements of the IMT Advanced systems, for instance, include improved mobility support and cell edge performance, increased spectral bandwidth and efficiency, reduced handover interruption time and reduced User plane latency and Control [1]. Considered as the main trend in future wireless communications, 3GPP LTE-Advanced has advanced features, for instance coordinated multipoint processing, carrier aggregation. It also considered as one of the top candidates towards achieving the IMT Advanced requirements. In 3GPP, high speed train scenario is agreed as the main scenario in Rel11 study item, mobile relay for E-UTRA. Here, when train rushes at a high speed the channel characteristics change and result in Doppler spread. Also the vehicles are vehicles are more crowded than other areas and therefore passengers are more likely to use high data rate services, for instance, browsing, playing games and watching videos so as to pass time [2]. The high data rate transmission requires strong signal strengths and high throughput, plus better mobility management, so mobile relay station for large vehicles are proposed for Broadband Wireless Access (BWA) system. A relay system may be mobile, which means it is a dedicated network node equipped on the vehicles to provide a fixed access link to those travelling on the vehicles. It is very suitable to solve the capacity gain of the high speed vehicles if it is well deployed. In a conventional cellular network, user equipment (UE) is connected directly to a Base Station (BS), and when a user moves away from the cell center, he/she will get less bandwidth which means lower data rates. However relaying technique has been introduced in 3GPP release 10 & 11 to allow establishing an indirect two-hop link between UE and BS through a Relay Node (RN). Relay nodes can also be used to spread out the cell coverage and increase the coverage outside main area (e.g. at cell edge). The two major challenges addressed in this c ontext are maintaining the throughput and ensure a seamless mobility and service continuity to all UEs. Hence, the objective of this paper is to develop, implement, and evaluate intelligent algorithms for next generation wireless communications systems with focus on throughput and service continuity. Specifically, the paper mainly addresses to the following aspects: Relaying in heterogeneous network, resources and mobility management. The rest of the paper is arranged as follows. Firstly, the overview of fixed and mobile relay system is given is Section II. In Section III, the paper presents a Handoff Analysis. Section IV presents a system level simulation and results. The paper concludes with section V. II. FIXED AND MOBILE RELAY SYSTEMS OVERVIEW A. Background

The Crystal Cathedral Essay Example | Topics and Well Written Essays - 2250 words

The Crystal Cathedral - Essay Example It rises up in the centre of the park and has around 10,000 pieces of tempered silver-colored glass windows encased in a network of white steel trusses. The interiors of the cathedral can allow a seating congregation of nearly 3,000 people. If required, the portions of the exterior walls open up which allow additional members to remain in their cars while viewing the worship service in the insides. The glass used on the external surface is reflective. It allows only 8 per cent of light and heat to penetrate to the insides. The building happens to be the world's first all-glass church. The plan comprises of the basic elements of a typical church in a shape of a four pointed star some 460ft by 200ft that reaches up to 128ft at its apex. Its height is even bigger than that of Notre Dame in Paris. The church complex is designed by American architect Philip Johnson and John Burgee. The building is huge in scale, and its all of its walls are clad by mirrored glass to the outside over a steel lattice structure. It has a symmetrical plan and an asymmetrical section. The crystalline shaped and glass-covered steel lattice frames have been used to give the building its present structure and form. In the floor plan of the church, the nave has been squished to pull out the transept. The idea behind doing this was to get the public closer to the performances and the alter place to have a better view of the activities. On further simplification of this geometry, this form has eventually given rise to the form of a star in its plan, with free-standing balconies in three points and the chancel in the fourth corner. The glass hung on the steel lattice frames gives an effect of a non-massive building. On the outsides the mirrored glass makes an entirely mirrored building with only around one tenth of sunlight entering the insides of the building. The construction with a triodetic steel frame helps in venting the hotter air to the outside from its top and it functions as a gigantic chimney. This provides natural cooling the interiors as cool air enters fro m the lower openings. Image 2: the aerial view of the Crystal Cathedral in the park, note its star shaped plan Made almost entirely of glass and a framework of steel, the cathedral is having an angular, mirror-like exterior, a transparent sun-lit interior, a giant television screen, and an altar place made out of marble. The walls and roof are clad in the mirrored glass over a structure of space frame and it helps in attaining passive solar heating in small proportions. The openable strips of the ventilating windows also help in attaining wind cooling. This is needed as the building is located in suburban area of Garden Grove having a climate of mild desert. The apex at the top is made with the help of triodetic steel frame that act as a chimney to carry out wind movements and provide natural cooling. The glass, being reflective by its characteristics, allows only eight per cent of light and heat to penetrate to the insides. The supporting structure is a triodetic steel frame. It works as a giant chimney and allows heat to rise out of the building and preventing a greenhouse effect. The cathe dral has 10,000 panes of reflective glass, which allows only 8% of outside light into the church. This gives the interior a sub watery appearance. The audio services,

Attraction and Mate Selection Essay Example | Topics and Well Written Essays - 750 words

Attraction and Mate Selection - Essay Example Grochowski, 2006). No society encourages its members to select spouse with complete freedom. Moreover the problem with the kin marriage is that it can lead to undesirable genetic consequences in offspring which increases the chances of death before they even grow up. Exogamy is influenced by factors such as size, diversity and sex ratio of the community; it is thought that marriage is an institution that functions to preserve race, class, education and social distinction. The society in which a person lives determines its mate selection; some societies consider people who are related by birth and some consider people who live together in same households, other societies by adoption, marriage or clan. Wikes et al. further states that, in most of the societies a person marries outside one's nuclear family (exogamy) but is encouraged to marry to a member of one's own class, race or religion (endogamy). Thus exogamous group is small and endogamous group is large. In some societies both t hese groups can be equal too as when they are divided into clans and lineages. (2006) Sociological factors also play their part in mate selection. Looking at the homogamy theory, which supports the idea that like is attracted to like, thus people are more likely to choose a mate who is similar to them in many dimensions. "Homogamy theory states that people select mates who are like them in physical characteristics such as height and weight and psychological characteristics including intelligence, interest, attitude, values and personality" (Daniel T. Gilbert, Susan T. Fiske, Gardner Lindzey, 1998). In most of the families it is assumed that their children will marry within same race, status, religious affiliation and ethnic group. People usually search mates within their own race; norms with respect to race are strongly adhered to. Gilbert et al further explains that religion also plays an important part in this selection, in the orthodox, Jewish communities if the son or daughter married outside they were considered dead. People are said to be in same social class if they have similar education, occupation and occupational background. So with similar life experiences they share similar views and thus associate together in similar style of living. People prefer to marry in same socio-economic groups. Age also counts in mate selection as mostly a few years age difference is expected and the husband is considered to be older then wife in most of the societies. These are few common characteristics which people choose in making their mate selection. Psychological factors play an important part in mate selection. "The complementary needs theory states that two need are complimentary if one partners need also satisfies the need of other; for e.g. one enjoys being submissive and other dominant" (Chris Segrin, Jeanne Flora, 2005). The complimentary interaction between the two partners increases their attractiveness to each

Family Court of Western Australia Essay Example | Topics and Well Written Essays - 2000 words - 1

Family Court of Western Australia - Essay Example Court Officials and Counselling Service Staff of the Court gained new insights and skills in these very complex scenarios of family break-ups and litigation. The need to liase more closely with internal as well as outside service providers, such as counsellors, social workers, psychologists, and other experts, brought a greater feeling of common purpose and it was soon clear that a potential model of an integrated family court system was beginning to emerge. The Family Court of Australia was intended to be seen as a â€Å"helping court† with an informal and user-friendly approach, but this soon changed as formalising occurred naturally in response to intense emotional circumstances which would inevitably arise in cases of family especially where prevailing legal activities tended to result in adversarial stances on the part of litigants. It was felt that the system was still limited and the Family Court on its own could not achieve outcomes that would benefit all parties, but particularly the children. In view of the growing number of applications for divorce and threat of disintegration of society, it was felt that greater use should be made of professionals from the social sciences, including psychologists, social workers, and child specialists.

Attraction and Mate Selection Essay Example | Topics and Well Written Essays - 750 words

Attraction and Mate Selection - Essay Example Grochowski, 2006). No society encourages its members to select spouse with complete freedom. Moreover the problem with the kin marriage is that it can lead to undesirable genetic consequences in offspring which increases the chances of death before they even grow up. Exogamy is influenced by factors such as size, diversity and sex ratio of the community; it is thought that marriage is an institution that functions to preserve race, class, education and social distinction. The society in which a person lives determines its mate selection; some societies consider people who are related by birth and some consider people who live together in same households, other societies by adoption, marriage or clan. Wikes et al. further states that, in most of the societies a person marries outside one's nuclear family (exogamy) but is encouraged to marry to a member of one's own class, race or religion (endogamy). Thus exogamous group is small and endogamous group is large. In some societies both t hese groups can be equal too as when they are divided into clans and lineages. (2006) Sociological factors also play their part in mate selection. Looking at the homogamy theory, which supports the idea that like is attracted to like, thus people are more likely to choose a mate who is similar to them in many dimensions. "Homogamy theory states that people select mates who are like them in physical characteristics such as height and weight and psychological characteristics including intelligence, interest, attitude, values and personality" (Daniel T. Gilbert, Susan T. Fiske, Gardner Lindzey, 1998). In most of the families it is assumed that their children will marry within same race, status, religious affiliation and ethnic group. People usually search mates within their own race; norms with respect to race are strongly adhered to. Gilbert et al further explains that religion also plays an important part in this selection, in the orthodox, Jewish communities if the son or daughter married outside they were considered dead. People are said to be in same social class if they have similar education, occupation and occupational background. So with similar life experiences they share similar views and thus associate together in similar style of living. People prefer to marry in same socio-economic groups. Age also counts in mate selection as mostly a few years age difference is expected and the husband is considered to be older then wife in most of the societies. These are few common characteristics which people choose in making their mate selection. Psychological factors play an important part in mate selection. "The complementary needs theory states that two need are complimentary if one partners need also satisfies the need of other; for e.g. one enjoys being submissive and other dominant" (Chris Segrin, Jeanne Flora, 2005). The complimentary interaction between the two partners increases their attractiveness to each

Mary Shelley - Frankenstein Essay Example | Topics and Well Written Essays - 500 words

Mary Shelley - Frankenstein - Essay Example Thus, it is evident that the author incorporates in her novel the important factors in the history of Europe such as the effect of French Revolution on notions of class and identity, the role of the Industrial Revolution on the socio-economic life of the people. As Essaka Joshua maintains, the social comment in Frankenstein is especially inspired by the ideology of the French Revolution and the works of Jean-Jacques Rousseau. â€Å"Critics have recently connected Frankenstein with this period of social upheaval, reading the novel as an ‘allegory of the French Revolution, the attempt to recreate man and the disillusionment and terror that followed.† (Joshua, 23) Therefore, it is essential to realize that the historical and political context of the author has played a crucial role in the writing of the novel. This essay offers a reflective exploration of the political and historical backdrop of the period in which Mary Shelly wrote her celebrated novel Frankenstein. Much o f the critical commentary on Mary Shelly’s Frankenstein has focused on the impact of the historical and political context of the novelist on the major themes, and references in the work.

The Glass Menagerie Essay Example for Free

The Glass Menagerie Essay In reading literary pieces, we tend to compare one character to another that is similar on physical and mental characterization. Alice Walker’s story â€Å"Everyday Use† and Tennessee Williams’s play â€Å"The Glass Menagerie† have different attack, contextualization, plot, conflict, and resolution but they have the same idea of character – Laura in â€Å"The Glass Menagerie† and Maggie in â€Å"Everyday Use. † Laura and Maggie are both physically handicapped. Laura ‘wears a brace on her leg’ while Maggie has scars all through her legs and arms. Both of these characters accept their situations as handicapped. That is why they are being oppressed by the society whether directly or indirectly. Therefore, being physically handicapped of the protagonists in the two stories defines their identity and uniqueness despite of their physical imperfection. Walker’s â€Å"Everyday Use† is a story about a mother having two daughters. Her daughters are opposite to one another. Maggie is a shy woman while Dee is very expressive with her emotions. Dee’s goals are too high to obtain. She leaves her family to acquire her personal goals in life. Ms. Johnson, which is Dee’s mother and Maggie are waiting for her return that is why they clean their house and beautify it so that Dee will become happy once she saw their home. When Dee arrives, Maggie and Ms. Johnson are speechless with her transformation. After lunch, Dee went to her mother’s room and asks for a hand-stitched quilt as a souvenir. Ms. Johnson is holding a ‘precious’ hand-stitched quilt that she will give to Maggie. Dee wants it so she grabs it to her mother’s hands. Maggie understands her sister’s action and even though she really likes the quilt, she let her sister obtain it. However, Ms. Johnson grabs the quilt to Dee’s hands and pulls Maggie into her room and put it to her lap and shows a happy face. Due to disappointment, Dee runs away from their house along with her friend using his friend’s car. William’s â€Å"The Glass of Menagerie† on the other hand is about a woman named Laura. Tom is the narrator of the story. Laura is a shy woman because of her appearance – having her leg being braced. She does not want to enter school because of this. Another reason for this is that she does not want people to look at her and being humiliated by her surroundings. Because of this issue, Amanda whom to be Laura’s mother asks Tom to find a man that will suit Laura despite of her physical situation. Tom found Jim, his co-worker. He asks him to have dinner in their house. When Jim went to the dinner, Laura is afraid to see him because she is attracted to Jim even before. After the dinner, Jim starts talking to Laura. In the beginning, Laura is aloof but as the conversation went on, she becomes comfortable with Jim. â€Å"LAURA: I was out of school a little while with pleurosis. When I came back you asked me what was the matter. I said I had pleurosis you thought I said Blue Roses Thats what you always called me after that I / JIM: I hope you didnt mind. / LAURA: Oh, no I liked it. You see, I wasnt acquainted with many people. (Williams, Chapter 7)† Jim becomes attracted to Laura’s uniqueness that led him in kissing her. After the kiss, Jim says sorry to Laura and tells her that he has a fiance and soon will get married. Even if Laura is upset, she accepts it. Amanda blames Tom for being insensitive by not choosing the right man for Laura. Tom leaves for this reason but even if he tries to begin his life again, Laura’s image emerges within his mind, thinking his offense against her. Laura and Maggie view themselves as weak and incapacitated. They accept their situation in a worst-case-scenario. They do not fight against the common norm of the society towards them. As long as their family accepts them, everything would be fine. However, problems occurred because they admit that they are handicapped and could not obtain things that a usual woman should have. That is why people around them took advantage against them in different cases and issues. In the case of Laura, her mother wants to make her happy and would like her to find a man that will fit her capability as a woman but Amanda did not think of Laura’s feelings towards her action. As she (Amanda) pushes Laura towards Jim, it is clear she has never paused to find out who her daughter really is, nor what her aspirations might be, nor has she ever considered modes of living other than her own (Debusscher, 60). Maggie’s situation is also the same through her relationship with Dee. Because she accepts that Dee should have better life than her, she lets her sister obtain everything that should be rewarded to her. Because of this, she needs to cope up with the demand of others to satisfy them. â€Å"Maggie will be nervous until after her sister goes: she will stand hopelessly in corners homely and ashamed of the burn scars down her arms and legs, eyeing her sister with a mixture of envy and awe. She thinks her sister has held life always in the palm of one hand, that no is a word the world never learned to say to her (Walker 47). † However, at the end of the plot of these two stories, the supporting characters realized the manifestations and effects of their actions in the lives of the protagonists. That is why they resolve their conflicts by way of recognizing the identity of Laura and Maggie as individuals with own uniqueness and sense of womanhood. â€Å"When Maggie spoke and suggested that the quilt be given to her older sister Dee, she (Ms. Johnson) began to see Maggie in a different light. She also learned to appreciate Maggie’s simplicity and goodness as compared to Dee’s sophistication and ambitions (Cuizon). † Like what happened to Maggie’s mother, Tom also accepts the realization that Laura needs sensibility from the people around her and she should experience it through her family. In the end, both the protagonists and the supporting characters reconcile and acquire the realization of reality and live a better life. Works Cited Cuizon, Gwen. â€Å"A Review on Alice Walkers Everyday Use. † HubPages. (2008). 23 November 2008. http://hubpages. com/hub/Alice-Walkers-Everyday-Use Debusscher, Gilbert. â€Å"Tennessee Williams’s Dramatic Charade: Secrets and Lies in The Glass Menagerie. † (2000; pp. 57-68). 23 November 2008. http://www. tennesseewilliamsstudies. org/archives/2000/4debusscher. pdf Walker, Alice. â€Å"Everyday Use. † In Love and Trouble. New York: Harcourt, 1973. 47-59. Williams, Tennessee. â€Å"The Glass Menagerie. † (1944). 23 November 2008. http://pagesperso-orange. fr/absolutenglish-972/notes/uscivi/glassmenagerie/scene_by_scene. htm

Social Media Versus Traditional Media

Social Media Versus Traditional Media What are the benefits of Social Media over Traditional Media? As both traditional and social media are emerging out for the leadership role in commanding and attracting consumer attention, but its worthwhile to limelight on some of the undeniable benefits of social media over traditional media1. Cost:-Social media Field is open to all with almost no barriers to entry to new entrants to create or distribute Social media context. Only time and production costs are the sunk cost involved in social media. With this investment the context rebound with glance in web unlike TV, radio and newspapers. Intimacy:-Social Media can broadcast information to thousands or millions of people at once with superior quality of dialogues and specificity which traditional media lags. Proximity:-Most importantly to say time and distance has virtually disappeared which acted as barriers between customers and the globe. Social Media has brought the globe together by connecting community like never before. Targeting:-Social media has specific advantage over isolating and focusing on brands or products depending on the customers interest by regularly monitoring and sourcing information. Nimbleness: Social media has a unique advantage as it allows brands to adapt to consumers buying and sharing habits almost instantly as it keeps informed about the area of interest of the customers. Measurement:-Social media can measure brand messaging almost instantly with the customers response to brands and each other across networks, platforms and apps.Whereas traditional media rely on long term measurement tools. Exponential:-As difficult it is for a brand to create its base same is for Social media but after it strikes the exponential growth for social media is limitless and repeatable at lower cost. Participatory:- As barriers to entry is almost equal to zero it encourages customers to participate in commercial dialogues.Dream of brands and consumers in dialogue has finally come true through Social media ,thanks to real-time communication tools. Newness:-Social media is well aware of the new preoccupations of customers but still it has the ability to constantly evolve to meet the customers demand. Social media retains with new shines with reflecting light of new re-engaging consumer attention. Future:-Social media has already focused on brand advertisements following on customers eye ball, it will shortly follow customers adoption of mobile community which will bring a new dynamic for social media. Future is bright and vast for Social Media. 1http://simonmainwaring.com/blog/uncategorized/top-ten-advantages-of-social-over-traditional-media/ Is social media disruptive to traditional media? Social Media applications are basically built on Web 2.0 technology. Social Media today has not emerged completely. Observation of the rise of social media reveals that the number of users of Social Media is increasing. The rate of increase of users is also on the rise. The users of social media now, belong to the early majority group. Since the evolution of social Media began recently and the users belong to early majority group, Social Media has a long way to go. Within this short time and less number of users, Social Media has started taking the share away from Traditional Media. Many firms, today think Social Media as the best Marketing Platform considering the advantages of Social Media over traditional Media. Consider the example of Pepsi, which preferred traditional Media over Social Media. Pepsi thinks, it can attract more customers using Social media rather than traditional Media and started investing $20million in Social media campaigning. Dell is the perfect example of success of return on Investment from Social Media. It has gained $6.5 million sales revenues only from twitter in a very short time. It is expecting its revenues to grow substantially from Social media in future. With the success of Dell many firms are embracing Social Media for Marketing. Coca Cola has started a new department for Social Media Marketing, formulated Social Media Strategy and Social Media Policy. Since, Social Media is a networked industry, i.e., the value for a user increases with increase in number of users and as the value for a user is increasing more users are embracing the Social Media. The number of users is also increasing with the increase in complementary products. For example, in Facebook, number of complimentary products is increasing with increase in number of users and vice versa causing Snow ball effect As the value of Social Media is increasing, users of traditional media are moving towards Social media. Even, the number of Social Media sites is increasing, however, different sites serving different users. The evolution of Social Media is not complete. Hence, once the Social Media is evolved completely, traditional media can become obsolete. What is Social Media Marketing and how does it benefit the producers? Social Media Marketing is the use of various social networking sites for the promotion of some product, service, company or organization. Commonly used social media marketing sites are YouTube, Facebook, Twitter, LinkedIn and Wikipedia etc. The marketing done using these resources is said to be Social Media Marketing and it is usually beneficial for the producers in following ways Traditional and social media are struggling between each other to attract the consumer attention even though there are some advantages of social media. Bellow there are some points to strengthen our views2. 1. Cost: The cost factor is quite small for the social media. On the other way the cost entry barrier for creating and distributing the Social media is quite small. There are some short of initial investment in terms of developing the social media and time is also needed but if we discard this two small investment it is almost free. It doesnt bear any additional expense like TV, print media and Radio and move into the wave indefinitely to serve the targeted customers. 2. Intimacy: If we look at the potential pitfall of the traditional media we will see that traditional media normally need to broadcast to its large customer base (may be millions of customers) at a time which robs in terms of the specificity and the dialogue of traditional media. But in case of a social media this draw back could be overcome. 3. Targeting: While targeting a specific segment of the market or the specific segment of the customer the social media is much more specific or in the other way it could be easily distinguished in this respect. In the social media space that particular customer base share their ideas and thoughts about different products of their interest and distribute them among each other. 4. Nimbleness: Social media is much more agile in terms of the external environment change as compare to the traditional media. It takes very less time to respond to the external environment change and impacts the consumer buying and sourcing behavior instantly. But on the other hand traditional media takes a bit more time to take change as compare to the external environment. 5. Measurement: In case of the traditional media the measurement style of the effectiveness of the brand messaging is quite time consuming and lengthy process. But in the other hand in case of a social media it is instantaneous. In the social media space the customer reacts to the brands, the platforms and the applications instantaneously. In any case if that response becomes negative the social media have some chances to react to that negative response. 6. Newness: Traditional media is hardly unique in terms of the consumer per-occupation with whatever is new. Even though the huge demand of the consumer who seeks change social media keeps its pace by engaging the sheen in new so that it can attract the consumer attention from time to time. But in case of a traditional media the distribution mode hardly changes even though the content may change. 7. Exponential: even though it is very hard for any product or brand to thread the market social media has huge potential for the exponential growth in exchange of a low cost. 9. Proximity: In the social media space there is virtually no time and distance barrier exist between the consumers. It is more like creating a global and connected community by the customers. These characteristics of the social media open enormous opportunity for the social media for success and failure closely depending on the how well it measures its market dynamics. 10. Future: Now a days most of the time the consumer looks at the online advertising but in near future it will be in the huge mobile community. The advertising dollar will follow in the huge mobile community. It shows a new future for the social media space. 2http://simonmainwaring.com/blog/uncategorized/top-ten-advantages-of-social-over-traditional-media/

Powerful Characterization in The Invisible Man :: Ralph Ellison, The Invisible Man

     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Ralph Ellison manages to develop a strong philosophy through characterization in the Invisible Man. Ellison portrays the lonely narrator's quest in struggling to search for his identity and an understanding of his times. The well development of the character lays out the foundation on the philosophy of finding and understanding himself. Through a labyrinth of corruption and deceit the narrator undergoes events that manage to enrich his experience and further contribute in his search for himself.   Such scenes include the battle royal scene, the college, Trueblood's visit, and the blueprint seller.      Ã‚  Ã‚  Ã‚  Ã‚   The narrator at first never realizes his innocence. At first the timid Invisible Man is invited to attend his scholarship award ceremony. However with other Negroes he is rushed to the front of the ballroom where a stripper frightens them by dancing in nude. After staging the "battle royal" and attacking one another in response to the drunken shouts of the rich white folk, the boy is brought to give his prepared oration of gratitude to the white benefactors. An accidental remark to equality nearly ruins him, but the narrator manages to survive and is given a briefcase containing a scholarship to a Negro college. This acts a high peak in the narrator's quest since it sets him for his struggle in searching for himself.      Ã‚  Ã‚  Ã‚  Ã‚   The narrator adores the college however is thrown out before long by its president, Dr.Bledsoe, the great educator and leader of his race. Ironically the narrator had seen Dr.Bledsoe as an idol aiming to gradually impersonate him. He was expelled for permitting, Mr.Norton , one of the college founders into the slave quarters and the Golden Day bar.   After that incident the Invisible Man goes through the sense that he is losing his identity. This initiates an air of confusion as the narrator is now brought in a quarrel against himself.      Ã‚  Ã‚  Ã‚  Ã‚   In the prologue the Invisible Man quotes, "I was naà ¯ve...I was looking for myself and asking everyone except myself questions which only I could answer." The narrator is tempted to set out in the quest to search for his identity. The prologue identified the theme to the readers. It was however during Trueblood's visit that the character manages to learn about his true background and roots. It is through such people, of his true

The Difficulties of Implementing the Good Friday Agreement Essay

The Difficulties of Implementing the Good Friday Agreement The Good Friday Agreement was voted on by a relatively large turnout of 68.8% in 1998 and was rejected by a significant 29% of people in Northern Ireland. For the past six years it has proved to be difficult to implement and there are a number of reasons for this. The emphasis on issues raised in the agreement has changed over the years and some are proving to be more difficult to implement than others. A major area within the Good Friday Agreement is the setting up of an Assembly. Hard line Unionists such as the DUP refuse to accept the Assembly. They refuse to sit at a table with Sinn FÃ ©in in cross party talks while they argue that Sinn FÃ ©in still have links with the IRA. The DUP's mindset has been created by fifty two years of unionist rule. They do not wish to accept principles contained within the agreement which they feel they have already rejected in the 1974 power sharing executive. The DUP are now offering a full re-negotiation of the agreement and their slogan for the last elections was, 'It's time for a new deal.' There are deep divisions within the official unionist party. There is continual disagreement over how many concessions can be made to nationalists. David Trimble the party leader has remained committed to the agreement despite bitter criticism from fellow unionists and himself also feeling uneasy over some elements of it. He has faced leadership challenges and recent defections to the DUP by Geoffrey Donaldson, Arlene Foster and Norah Beare have reduced the number of seats held by the UUP. David Trimble must have ... ...ng to have it raised again. The flying of paramilitary flags particularly around the marching season upsets and provokes nationalists who feel threatened by such and obvious display of paramilitary strength. The agreement could now be said to be more difficult to implement than before due to the recent election results. The middle ground lost out while extremists at the opposite end of the political spectrum gained votes. The DUP have a majority of 33 seats and Sinn FÃ ©in has 27. This perhaps suggests that more moderate voters have become disillusioned and no longer believe in the capabilities of their politicians to do their job. There could be a feeling of apathy towards the peace process. However this does not mean that peace is not obtainable in Northern Irelandand with hard work and co-operation it is achievable.

Using ICT to help a man to sell his business

My user is my uncle who thinks he is too old to run his business. Mr. Devakumar (the owner/user) needs money urgently and his only son lives in a foreign country therefore he has decided to sell it to someone as soon as possible. The petrol station is located in South Harrow, bessborough road near ‘Alexander Park' and ‘Netto's'. The purpose of this document is to sell his petrol station he owns. He has handed over the job of selling his business to me. This will help him to sell his business. To do this job I need to get some information such as how much profit he makes a year, or what price he wants to sell it for etc. Interview What is your business? I own a petrol station. How much do you earn a year? I earn between 20 and 30 thousand pounds a year Do you have any problems? I don't think I can run this business, I am too old now. What type of a leaflet would you like? I would prefer an A4 with one fold. What colours would you like? Red, blue, silver, black and any other colours. Just make it look good Would you like a border? Yes in silver please. Possible Solutions I can draw the pictures and colour it in myself. I will use pencil and colour pencil to do the pictures. I could also cut out pictures from the newspaper or magazines. I will handwrite the text myself. I could use a photocopy machine to get more copies of leaflet. ICT methods Microsoft word There are many features including being able to change different font styles, sizes, word art, spell check, colour, background. It is ideal to write letters. Layout of both sides cannot be seen, folds are not visible and you cannot move your text/pictures easily. Microsoft publisher Allows you to create leaflets, pictures can be moved around easily but settings need to be done. Background colours can be changed easily. Training is required and is time consuming. Microsoft PowerPoint Allows you to make slideshows and presentation. Text boxes can be put in easily. Not much can be written on a page if done so than it will be all crowded and hard to be read. It's not suitable to make leaflets. Advantages of using ICT The advantages of using ICT to produce my leaflet are that you can cut and paste any images but also text. You can resize the images and manipulate them. You can change the font, colour, shape and size any time you like. If you make a mistake when you are typing you don't need to cut it out you could just delete it and continue writing. There is also a grammar and spelling mistake checker which will underline the word/phrase that is wrong. If you save it you could change its design any time. Using ICT you can keep your document save by saving it in your required files or sending to an e-mail or computer. You could also save it on a memory stick. Conclusion I have chosen Microsoft publisher to make my leaflet because it is the easiest way to make leaflets. I also know how to use it properly. It gives many choices to make different types of leaflets graphics can be inserted easily, textboxes can be linked and the colours can be used in different ways. Objectives * I must include pictures showing different parts of the petrol station including inside and outside. * Contact information should be able to be found at the back of the leaflet. * Basic and important information should be at the back.(e.g. contact information) * Text should be written in ‘Ariel'. * Text should be big enough to be seen easily e.g. 12pt or higher. * A4 paper with one fold. * Colours used should be red, blue, black and silver. * Borders should fade. * PART 2: ANALYSE Hardware Input devices needed Keyboard-type information into word, publisher, power point or excel. Mouse- allows to control things on the screen. Objects can be moved, resized or changed. Digital cameras- allows me take pictures (e.g. of user.) Output devices needed Printer-can print out leaflets. Monitor- can see what I am creating. Storage devices needed USB-documents can be saved and carried around. Hard disc- is the main storage device in a computer. Software Microsoft Publisher- good layout and text can be linked together on other boxes. Microsoft word- good facilities to write documents (letters, reports etc) Internet- download information from internet. I will use Microsoft publisher to create my leaflet. However I will also use Adobe Photoshop to edit the graphics. Data collection & input Data Required Source Collection method Input method Error checking Picture of user Digital camera Manually take pictures then download on to computer Import into publisher Check with the user Picture of shop Digital camera Download on to computer Import into publisher Check with the user company logo Internet Download from the internet Import into publisher Check with the user Information about the company User Type in word Import into publisher Check with the user & spell check in word. Map of place. Internet Download on to computer Import into publisher Check with the user & check practically Data processing I will have 4 pages of text. I will only use one sheet of A4 sized sheet with one fold, so that there are 4 pages. I might use linked text boxes. I will format my text by justifying it; it should make my text look neater. I will use Comic Sans MC for my font to write the text and graphical font like word art for eye catching titles. I will edit my images using Photoshop, paint and Microsoft publisher. I might crop or resize my graphics to fit them in a suitable place. Data flow Outputs Card paper is strong but much more expensive. You can get it in different sizes as well. Plain A4 is cheaper compared to colour and card. It is the ideal size to make leaflets and can be folded in to preferred forms. A4 coloured paper more expensive than A4 but no ink has to be wasted on it for the background colour. But you cannot print certain colours on certain colours on certain coloured paper as it cannot be seen. Laser printer- This printer is much quieter, faster and its cost per page is much cheaper, the printouts have also better quality. They are much more expensive, bigger and the toners cost more compared to ink jet cartridges. Ink-Jet Printer- This printer is cheap to buy, the ink cartridges are cheaper and the printer is more space saving than the laser printer. Its printouts have a higher quality and are faster than dot-matrix printer but not as good as laser printers. Dot- matrix printers- Cheapest from all printers. But also the worst quality and it's very loud. I have decided to use the colour printer which is the laser printer as it makes the fastest and high quality printouts and it is the only one available in school. I have also decide to use the plain A4 paper as any colours can be printed on it, it cheap and any ideal size can found easily. Backup & Security The user should have a printout version of it and an electronic version on their computer. The user should have a back up copy so in case they loose the original version they will still have another copy of it. Nowadays they best way to save it on, is on a memory stick as it is portable but CD will do. Every time they open they file on the computer they should make a backup. To make it extra safe they should keep updating it at least once every fortnight. Another way of keeping it secure is to make a password with different characters (minimum 6 characters e.g. numbers, alphabetical letters, other characters such as /). The password could be anything personal or even something that doesn't make sense. PART 3: DESIGN User feedback on initial designs I am quite pleased the way the leaflet is presented but I would still like a few changes. I like the way colour and the borders are used. But could you try and add more detailed graphics, make sure there is a picture of me. Write why I want to sell it and important information such as contact information, words/phrases such as ‘for sale'. And make sure it always looks professional. I had also like images linking every title. Remember on the first page don't put any text going across. Subtasks * Make a draft version of leaflet using same paper but hand drawn. * Show user to check for any improvements. * Make another final design of it. * Collect map and create logo. * Produce leaflet on Microsoft publisher type details in word and insert * Show user check for any more improvements. * Make final leaflets. * Make more copies of it. Test Plans Test Expected results Actual results Changes needed Check if location map is present Map is positioned on back page Check if logo is correct Logo matches company logo Check if map is correct Map shows right location of shop. Check correct font is used.(Arial) Correct font used for suitable places Check if colours required by the user are used. (Black) Colour matches (black) Check if graphics are correct ( correct images, border fade) Graphics match as user preferred (logo, images) Check if contact information is found on the back of the leaflet. Contact information (Phone No., address) is found easily on the back of the leaflet. There shouldn't be a lot of writing squeezed together in one place. Font is big and clear. Writing is easy to be read. A4 paper with one fold should be used. A4 paper with one fold is used. PART 4: IMPLEMENT Evidence of making your leaflet * I first collected images from file and uploaded them into the software ‘Picture it'. * I used the crop tool to cut out each image. * I made text and faded it. * I put the images together. * I changed the orders of some images by right clicking the images and going to orders and choosing my preferred order, PART 5: EVALUATE Review objectives * I must include pictures showing different parts of the petrol station including inside and outside. – Done. I used the camera to take photographs and inserted into publisher. * There shouldn't be a lot of writing squeezed together in one place. – Done. I tried to put as much information as possible in a small paragraph. * Contact information should be able to be found at the back of the leaflet. – Changes were made as telephone number was put on first page as user preferred it that that way. * Enough information to convince the dealer to buy it. – Happy with the amount of information but not the way the information was used as it is not good enough to convince the buyer. * Basic and important information should be at the back. – Objective has been changed as the address and directions were put at the back and the basic brief details were put on the front page. User was happy with the changes. * Text should be written in ‘Ariel'. – Done by changing font to Ariel and typing using that font. * Text should be big enough to be seen easily. – Done, I used text font size 16pt. * A4 paper with one fold. – Done, A4 paper was used with one fold. User comments Overall I am pleased the way you have presented this leaflet. I still have some concerns about little things; you could have put a heading for each page of information, you only had few views from outside showing the petrol station. You could have taken images from different angles. Add more facts and statistics. You should have headings linking every page of information. But other than that I am very happy and glad that I handed over this job to you. I also like how you used the colours and different graphics. They way you presented the images was also good, tilting it and so on. Improvements * Have headings linking every page of information. * Add more pictures showing different views of the petrol station. * Add more facts and statistics in text.

Case Study – Appendicitis

I. DEFINITION/PREVALENCE Acute disease of the GI tract may be caused by the pathogen itself or by a bacterial or other toxin. Acute inflammatory disorders such as appendicitis and peritonitis result from contamination of damaged or normally sterile tissue by a client’s own endogenous or resident bacteria (Lemone and Burke, 2008, page 766). Appendicitis is the inflammation of the vermiform (wormlike) appendix; the appendix is a small fingerlike appendage about 10 cm (4 in) long, attached to the cecum just below the ileocecal valve, which is the beginning of the large intestine.It is usually located in the right iliac region, at an area designated as McBurney’s point. McBurney’s point, located midway between the umbilicus and the anterior iliac crest in the right lower quadrant. It is the usual site for localized pain and rebound tenderness due to appendicitis during later stages of appendicitis. The function of the appendix is not fully understood, although it reg ularly fills and empties digested food. Some scientists have recently proposed that the appendix may harbor and protect  bacteria  that are beneficial in the function of the human colon.Appendicitis  is the most common cause of acute inflammation in the right lower quadrant of the abdominal cavity. The lower quadrant pain is usually accompanied by a low-grade fever, nausea, and often vomiting. Loss of appetite is common. In up to 50% of presenting cases, local tenderness is elicited at Mc Burney’s point applied located at halfway between the umbilicus and the anterior spine of the Ilium. Rebound tenderness (ex. Production or intensification of pain when pressure is released) may be present.The extent of tenderness and muscle spasm and the existence of the constipation or diarrhea depend not so much on the severity of the appendiceal infection as on the location of the appendix. If the appendix curls around behind the cecum, pain and tenderness may be felt in the lumbar region. Rovsing’s sign may be elicited by palpating the left lower quadrant. If the appendix has ruptured, the pain become more diffuse, abdominal distention develops as a result of paralytic ileus, and the patient’s condition worsens.The disease is more prevalent in countries in which people consume a diet low in fiber and high in refined carbohydrates. It is the most common reason for emergency abdominal surgery, affecting 10% of the population. Although appendicitis affects a person at any age, the peak incidence is between the ages of 20 and 30 years old in which the vast majority of clients are most common in adolescents and young and slightly more common in males than females. About 7% of the population will have appendicitis at some time in their lives (Lemone and Burke, 2008 page 766).The major complication of appendicitis is perforation of the appendix, which can 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 generally occurs 24 hours after the onset of pain symptoms include a fever of 37. 7 degree Celsius or 100 degree Fahrenheit or greater, a toxic appearance and continued abdominal pain or tenderness. II. TYPES/CLASSIFICATIONAppendicitis can be classified as simple, gangrenous, 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 evidence of gross perforation and contamination of the peritoneal cavity (LeMone & Burke, 2008 page 766). Peritonitis can be primary or secondary. Primary peritonitis is an acute bacterial infection that is not associated with perforated viscus, or organ.Bacterial infection is the usual cause and may be associated wi th an infection by the same organism somewhere else in the body, which reaches the peritoneum via the vascular system. Tuberculosis peritonitis, which originates from tuberculosis elsewhere in the body, is a type 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 also result from severe chemical reactions to: pancreatic enzymes, digestive juices, or biles released into the peritoneal cavity (Gould & Dyer, 2011). III. DEMOGRAPHIC PROFILE Patient’s name is Mr. Ruptured Acute Appendicitis, 24 years old, male, residing at 820 General Kalentong, Daang Bakal, Mandaluyong City. He is the second child among 3 siblings, a Roman Catholic, single, a 3rd year college Information Technology student. IV. FAMILY MEDICAL HISTORY (Family Genogram)COD: TB COD: TB A: 83 -S, -D A: 83 -S, -D Not 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 patient patient LEGEND: LEGEND: male male married married deceased male deceased male S- smoker D- drinker COD- cause of death S- smoker D- drinker COD- cause of death female female deceased female deceased female V. PAST MEDICAL HISTORY He was first hospitalized last 2006 due to dengue at the same hospital: Mandaluyong City Medical Center (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 patient experienced abdominal pain all over abdomen. He consulted at ER MCMC si gned 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 days prior to consultation, the patient still experienced abdominal pain.He consulted at Emergency Room and was opted for surgical intervention – EXPLORATORY LAPAROTOMY APPENDECTOMY under the service of Dr. Abram Del Valle, M. D. VII. GORDON’S PHYSICAL ASSESSMENT i. Health Maintenance – Perception Pattern Before admission: The patient used to smoke cigarette 3 sticks per day. And he also drinks alcohol daily specifically beer of more than 2 bottles per session. He was not using drugs and he has no allergies at all. During time 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 we ek. He was also 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. Elimination Pattern Before admission: The patient’s normal bowel 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 urine output of 480 cc per shift. iv. Activity and Exercise Before admission: The patient could do his activities independently without a ssistance.He usually goes to gym 2-3 times a week. During time of care: The patient’s 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 coherent, has normal speech, with mild 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 described 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 patient’s support system is his mother 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 said 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 didn’t have his testicular exam. ix. Coping – Stress Tolerance/Self – Perception/Self – Concept Pattern The patient’s 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 poor 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 able to find a job suited for him. x. Value – Belief Pattern Our patient is a Roman Catholic and he always goes to church every Sunday together with his family. VIII. GROWTH AND DEVELOPMENT DEVELOPMENTAL TASK| THEORIST| STATUS| Intimacy 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 IT student. | Genital * Emergence of sexual interests and development of relationships with potential sexual partners (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 u p 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. | Early 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 didn’t expected that something like that will happen to them (referring to his girlfriend). He was really 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, that’s 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 * Vital 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| 120/80| 120/80| 120/80| 120/80| 120/80| 110/80| Sequence: BY SYSTEMS NORMAL FINDINGS| BOOK FINDINGS| PATIENT FINDINGS| SIGNIFICANCE| I. NEUROLOCIGAL SYSTEM Alert and coherent; with normal body temperature of 36. 3 °C – 37. 6 °C| * Fever (usually >38 °C although hypo thermia 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 increased pressure of fluid on the nerves, especially in enclosed areas, and by the local irritation of nerves by chemical mediators such as bradykinins (Gould, et al. 2011). | II. RESPIRATORY Normal respiration with a rate of 12-20 breaths per minute| * Tachypnea; shallow respirations| * RR: 23 bpm w/ shallow respiration| Acute pain usually initiates physiologic stress response with increased respiratory rate (Gould & Dyer, 2011). | III. INTEGUMENTARYPink or brown and in uniform color, no edema, no lesions, moistSkin temperature is normally warmIntact skinWhen pinched, skin springs back to previous state| * Dry lips and mucous membranes * Swollen tongue * Poor skin turgor| * Dry lips and mucous membranes * Skin turgor:3-5 seconds * Presence of surgical incision at lower longitudinal midline of the abdomen * Sk in is warm to touch and is reddened| Dry mucous membrane and poor skin turgor are signs of dehydration (Gulanick, et al. 1994). Redness may indicate inflammation (Weber & Kelly, 2007). Redness and warmth are caused by increased blood flow into the damaged area (Gould & Dyer, 2011). | IV. CARDIOVASCULAR Normal pulse rate of 60-100 bpm| * Tachycardia * Diaphoresis * Pallor * Hypotension * Tissue edema| * Pulse 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 primary focus in the life of an individual (Gould & Dyer, 2011). | VI. GENITO-URINARY Normal urine output of 30cc/hrColor: Amber, transparent, clear| * Decreased urinary output * Dark color urine| * Dark color urine * Urine output: 480 mL/shift * Specific gravity: 1. 30| Decreasing output of concentrated urine with increasing 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 reported by the clientNo rebound tenderness is presentAbdomen is non-tender and soft.There is no guarding| * Loss of appetite * Nausea & vomiting(usually projectile) * Constipation of recent onset * Diarrhea(occasional) * Sudden, severe, generalized abdominal pain * Abdominal 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 inflammat ory process & the psoas muscle) * Obturator Sign (the internal rotation of the right leg with the leg flexed to 90 degrees at the hip and knee and a resultant tightening of the internal obturator muscle may ause abdominal discomfort) * Rovsing’s 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 quadrants * Absence of flatus/stool * Presence of surgical incision| Signs indicating the onset of peritonitis include a rigid â€Å"board-like† abdomen (Gould & Dyer, 2011).Pain 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 inflam mation persists, nerve conduction is impaired, and peristalsis decreases, leading to obstruction of the intestines (paralytic ileus) (Gould & Dyer, 2011). | X. DIAGNOSTIC 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 focal mass lesion seen. CD measures 3. 9mm. Gallbladder is normal in size and wall thickness. There are multiple tiny echogenic shadowing foci seen within the gallbladder lumen. Pancreas & spleen are normal in size & echopattern. No focal mass lesion seen. Both kidneys are normal in size & echopattern. Right kidney measures 10. 1Ãâ€"4. 2Ãâ€"5. 46cm with cortical thickness of 1. 7cm while the left kidney measures 10. 5Ãâ€"4. 8Ãâ€"4. 1cm with thickness of 19cm. No evident caliectasis, lithiasis, seen bilaterally.Urinary bladder is unf illed. Impression:Tiny cholecystolithiasesNormal liver, pancreas, spleen, kidneys by UTZUnfilled urinary bladderNot dilated biliary tree | Abdominal ultrasound is the most effective 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/LWBC: 3. 8-11. 0 K/mm3Hemoglobin: 135-180g/LHematocrit: 0. 45-0. 52DifferentialNeutrophils: 0. 50-0. 81Lymphocytes: 0. 14-0. 44Monocytes:0. 02-0. 06Eosinophils: 0. 01-0. 05Basophils:0. 00-0. 01| WBC Count: 12. 6 K/mm3RBC: 4. 1 M/uL (normal)Hematocrit: 0. 45 (normal)Hemoglobin: 153g/L (normal)Differential Count:Neutrophils 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: NegativeKet ones: NegativeRBCs: RareWBCs: 3-4Casts: Occasional hyaline| 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 cloudy 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 o f the large intestine are the cecum, colon, rectum, and anal canal. The opening 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 open end of the cecum merges with a long tube called colon, which is divided into ascending, transverse, descending colon are retroperitoneal; the transverse 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) flexure.The colon continues across the abdomen to the left side as the transverse colon. It curves beneath 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 arranged 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 anal sphincter of smooth muscle (involuntary) and an external anal sphincter of the skeletal muscle (voluntary). Normally these sphincters keep the anus c losed 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 foreign 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 mucosa 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 congestion 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 adjacent omentum temporarily walls off the inflamed area by adhering to the appendiceal surface. In some cases, the inflammation and pain subside temporarily but then recur. Localized infection or peritonitis develops around the appendix and may spread along the peritoneal membranes.Increas ing 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 DIAGRAM 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 Abdominal pain Abdominal pain Increased pressure within the lumen of appendix Increased pressure within the lumen of appendix Compression of blood vessels Compression of blood v essels * Fever * Obturator Sign * Psoas Sign * Rovsing’s Sign * Rebound tenderness * Fever * Obturator Sign * Psoas Sign * Rovsing’s 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 Proliferation of localized peritonitis around the appendix and peritoneal membranes Proliferation of localized peritonitis around the appendix and peritoneal me mbranes Increased pressure inside the appendix Increased pressure inside the appendix * Sudden, severe, generalized abdominal pain * Abdominal distention & rigid â€Å"boardlike† abdomen * Absence of bowel sounds/(-) flatus/(-) BM (July 24, 2012) * Sudden, severe, generalized abdominal pain * Abdominal distention & rigid â€Å"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 * Tachycardia * Hypotension * Vomiting Generalized peritonitis Generalized peritonitis XIV. NURSING PROCESSProblem #1: ABDOMINAL PAIN – July 24, 2012 * Subjective Cues: * â€Å"Nurse wait lang, ang sakit kasi parang nagcacramps,† patient verbalized while having a conversation with him. How does it feel like: Abdominal cramping Precipitating factor: â€Å"Kapag nililinisan pero kadalasan bigla-bigla na lang sumasakit† (â€Å"Whenever wound cleaning is performed but oftentimes it just suddenly happened†) Relieving factor: Pain reliever (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: â€Å"Paiba-iba din eh.Minsan sobrang tagal mga 2-3 minutes, minsan naman mga ilang Segundo lang† (â€Å"It differs, sometimes it’s 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. * Objective Cues: * Facial grimace * Guarding of the incision site * Rigid (board-like) abdomen * Abd ominal distention * Location of pain: Surgical site * RR: 25 bpm * Nursing Diagnosis Acute Pain related 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 invol vement of the parietal peritoneum (Gould & Dyer, 2011). * Goal/NOC: Pain Control Outcomes Short Term: After 30 minutes of nursing intervention the patient will report a decrease in pain from pain scale of 8/10 to 4-5/10. Long Term:After 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 client’s 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 and 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-Fowler’s 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, promotes relaxation, and may enhance 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). * Encouraged early ambulation. Promotes normalization of organ function; stimulates peristalsis and passing of flatus, reducing 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). Dependent: * Administered analgesic as prescribed (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 early intestinal peristalsis and gastric irritation/vomiting (Doenges et al. 2006). * Evaluation Short Term: Goal partially met. After 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. Long Term: Goal met. After 8 hours of nursing intervention the patient displayed control of pain as evidence by deep breathing exercise 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: â€Å"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 activity 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 Short Term: After 8 hours of nursing intervention the client wil l report/experience flatus and will understand and demonstrate the need for early ambulation following abdominal surgery. Long Term: After 2 days of nursing intervention the client will report/experience either 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 (intake) and output every hour or 2 hours. Intake and output records provide valuable 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 moving from side to side o r 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 the  pH, or reversibly reduce or block 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 didn’t 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. After 3 days of nursing intervention the patient reported of a flatus fo r 3 times.Problem #3: RISK FOR DEHYDRATION – July 24, 2012 * Subjective Cue: * â€Å"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 value: 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 imbalance (Doenges, et al. , 2008). * Goal/NOC: Knowledge: Treatment Regimen; Hydration; Oral Hygiene; Tissue Integrity: Skin & Mucous Membranes Outcomes Short Term: After 30 minute s 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 Term:After 3 days of nursing intervention the patient will be able to maintain adequate fluid balance as evidenced by moist mucous membrane, good skin turgor, stable vital signs, and individually adequate urine output. * NIC: Fluid Management; Fluid Monitoring; Vital Signs Monitoring Independent: * Monitored BP & Pulse. Variations help identify fluctuating intravascular volumes, or changes in vital signs associated with immune 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 output of concentrated urine with increasing s pecific gravity suggests dehydration/need for increased fluids (Doenges, et al. , 2006). * Auscultated bowel sounds. Noted passing of flatus, bowel movement. Indicators of return 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). * Stressed 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 hand 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 painful cracking of the lips and mouth (Doenges, et al. , 2006). Dependent: * Maintaine d 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 Multiple 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, â€Å"So kaya pala hindi pa ako pwede kumain ngaun para maiwasan mairritate ang tiyan ko. † Long Term: Goal met. After 3 days of nursing intervention th e 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: â€Å"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. 3 °C * 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 Infection) Outcomes Short Term: After 30 minutes of nursi ng 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 of  nursing intervention  the  patient will be free of sign and symptom r/t infection. * NIC: Incision Site Care; 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. Practiced aseptic wound care. Reduces risk for infection (Doenges, et al. , 2006). * Encouraged adequate nutr itional 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. Therapeutic 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 Term:Goal met. After 30 minutes of nursing intervention the patient was able to have an understanding about infection control as evidenced by verbalizing, â€Å"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 s a pakiramdam. † Long Term: Goal met. After 3 days of  nursing intervention  the  patient 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: â€Å"Hirap talaga ako gumalaw, maglakadlakad, o kahit man lang umupo dahil sa mga nakakabit na ito sa akin,† as verbalized by the patient. â€Å"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 pat ient will be able to have a clear understanding with the use of identified techniques to enhance activity tolerance 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 i mmobility may heighten restlessness and irritability.The Cardiovascular SystemDiversional activity aids in refocusing attention and enhances coping with actual 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 sch edule. Client’s 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 Term:Goal 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, â€Å"Medyo natotolerate ko na rin yung mga activities kahit pautay-utay muna. Hindi ko lang talaga muna kaya maglakad p ero pagnaalis na siguro yung catheter baka kayanin ko na. † XV. BIBLIOGRAPHY * Cosgrove DO, Meire HB, Lim A, & Eckersley RJ. (2008). Grainger & Allisonn's Diagnostic Radiology: A Textbook of Medical Imaging (5th edition). 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). Nurse’s Pocket Guide Diagnoses, Prioritized Interventions, and Rationales (11th Edition). F. A. Davis Company, Philadelphia * Gabriely I, Leu, J. P. , Barky, N. (2008). Clinical problem-solving, back to basics. New England Journal of Medicine * Gould, B. ; Dyer, R. (2011). Pathophysiology for the Health Professions (4th Edition). Saunders Elsevier Inc. * Gulanick, M. Klopp, A. , Galanes, S. , Gradishar, D. ; Puzas, M. (1994). Nursing Care Plans Nursing Diagnosis and Intervention (3rd Edition). Mosby-Year Book, Inc. * LeMone P. ; Burke, K. (2007). Principles of Medical-Surgical Nursing: Critical Thinking in Client Care (4th Edition). Pearson International Edition * LeMone P. ; Burke, K. (2008). Principles of Medical-Surgical Nursing: Critical Thinking in Client Care (5th Edition). Pearson International Edition * Mosby’s Pocket Dictionary of Medicine, Nursing ; Allied Heath (4th Edition) 2002, Mosby Inc. Palma G. ; Oseda A. (2009). G;A Notes Clinical Pocket Guide for Medical and Allied Health Professionals (2nd edition). G;A Notes Publishing Co. , Philippines * Sabol, V. K. ; Carlson, K. K. (2007). Diarrhea: Applying research to bedside practice. AACN Advanced Critical Care * Tortora G. ; Derrickson B. (2006). Principles of Anatomy and Physiology 11th edition. Biological Sciences Textbooks, Inc. * Weber J. ; Kelley J. (2007). Health Assessment in Nursing (3rd Edition). Lippincott Williams ; Wilkins