Marketing Plan of Nike Essay

The world has a long, rich history of international trade among nations. Most international trade dates from the prevailing age of mercantilism. However, objecting mercantilism is the common idea of trade philosophies proposed by Adam Smith and David Ricardo. Both of them advocated free international trade. The rule of the zero-of-sum game was the core of mercantilism. One country increased the wealth must cause another one decreased from trade. Only one could be beneficial. They thought exports could bring inflows of wealth from and imports could lead outflows of wealth to other countries. It was this thought that each country encouraged exports and restricted imports. 1? The Classical Trade Theory (1) Theory of Adam Smith: Absolute Advantage Adam Smith set himself against the mercantilism. He advocated free trade and proposed the absolute advantage theory. In his theory, each country had its own advantage for producing goods which other country did not possess. It was this that stimulated countries to participate in the international trade by exerting the absolute advantage to obtain more benefits. Adam Smith made two assumptions: First, trade only existed between two countries. Second, each country produced only two products, one product must have absolute advantage, and the other product must have absolute disadvantage. Therefore, each country should concentrate on producing the product with absolute advantage, and then trade the absolute disadvantage product to the other country with the absolute advantage product. After trading, the disengaged, surplus resources and products of each country could be used completely reasonable. Thus, both countries can be beneficial from the trade, not just one. This pulled down the rule of zero-of-sum game and created the rule of n-of-sum game. Adam Smith’s absolute advantage theory successfully promoted the international trade. However, this theory did not deal with the problem that for both two products, one country had absolute advantages and the other country had absolute disadvantages. (2) Theory of David Ricardo: Comparative Advantage Fortunately, another famous economist David Ricardo succeeded and developed Adam Smith’s theory. Just like Adam Smith, David Ricardo also was an opponent of protectionism for national economies. He created his comparative advantage theory. The theory dealt with the problem that could not be dealt using Adam Smith’s theory. The economic motives and causes international trade. According to Ricardo’s theory, even if a country has no absolute advantage in any product, the disadvantaged country can still be beneficial from specializing in and exporting the product for which it has the lowest opportunity cost of production. Though the two theories were proposed hundreds of years, they still play important influences on international trade. Each trading country can improve productivity and the world economic is promoted. The two theories will contribute to world prosperity in the future. 2? The Modern Trade Theory Comparative advantage based on opportunity cost forms the basis of modern trade theory. The theory shows that after comparing, when the country decides to produce its advantage product, it needs to give up the other product that can come forth during the period. The benefit form the product it gives up is its opportunity cost. Here I take a simple example to illustrate this theory. The land for planting rice or cotton, the output of rice is 500 kilogram or 100 kilogram of cotton. If we choose to plant rice, the 100 kilogram of cotton we give up is our opportunity cost. Today, the practice of trade among nations is growing by leaps and bounds. There is hardly a person on earth who has not been influenced in some way by the growing trade among nations. The theories stimulate trade between developed and developing countries that avoid the autarky. International trade increases trading countries’ wealth and world output. That is because with trade, the resources are allocated rationally, job opportunity increase, products quality and variety increase and so on.

Problems at Perrier Essay

The case study Problems at Perrier faces issues of resistance to change and strained relationships. By the end of this short essay we will understand two things about Perrier’s troubles. There will be a clearer definition of the key elements of the resistance to change and we will have also developed a strategy for dealing with the situation. The Communication Connection One thing that can be noted is management may not agree with the changes because of the unfamiliarity and lack of knowledge based on the real issues. Managers, at least as much as any other category of employee, are likely to have within their ranks a range of opinions as to whether a proposed change is a good idea. † (Palmer, Dunford, & Akin, 2009, p. 170). When the managers look back and see that profits were large and growth developed at a rapid pace, moving forward with change is difficult. Often people need to see what is in it for them or have a clear idea of why exactly any change is needed when t hings worked fine previously. Personal Attachment Change can be taken personal and have an affect on a person’s interest in the organization. People who have stocks or retirement plans built in as part of their income might show a strong resistance to the change. That self-interest shows concern for how the change will affect them rather than focus on whether it will be good for the organization. [no notes on this page] -2- Working With Change at Perrier 3 This personal attachment can be built on many factors and opinions which people use to justify their resistance. Something that is similar to personal attachment is the fact that the employee’s and management at Perrier had different ideas as to why the change was happening. They can possible take if personally because they have different thoughts and are confused about the plans being applied. According to the Nestle CEO Peter BrabeckLetmathe, â€Å"We have come to the point where the development for the Perrier brand is endangered by the stubbornness of the CGT† (Palmer, Dunford, & Akin, 2009, p. 183). A New Strategy for Management One of the most effective forms of delivering a solid speech and plan is to have clear communication. The managers at Perrier should help educate the employees and build a chart defining the connection between the change and new strategies. People can be afraid of the unknown and being uneducated and then not being involved with the change is relevant to the â€Å"unknown. † Nestle and the management at Perrier should have began a strategic plan by developing a higher level of communication between themselves first. Once that relationship was established, a plan to rebuild the relations between anagement and the employees would have been easy to build. Becoming Involved People like to generally be involved with things when it will have an impact on them, whether it be at work or at home. Jean-Paul Franc, head of the CGT at Perrier was continuously working against Nestle. Having the employees involved could have brought new insight and ideas into the negations which might have been relevant for Jean-Paul Franc to use in making plans with Nestle. Allowing people to have the opportunity to be involved also increases their knowledge about the situation and allows them to form their no notes on this page] -3- Working With Change at Perrier 4 own opinions which will not be based just on pure resistance. If they have an understanding then their acceptance or resistance will feel justified. Leadership and motivation can also be high points for management at Perrier. Motivation through education and rewards for increasing productivity could encourage new direction. Conclusion A level of support and education needs to be built into a solid f oundation for anyone to understand why change is needed.

Frostbite Chapter 12

Twelve I WAS OUT OF BED in a flash. We found the entire lodge abuzz with the news. People clustered in small groups in the halls. Family members sought each other out. Some conversations were conducted in terrified whispers; some were loud and easy to overhear. I stopped a few people, trying to get the story straight. Everyone had a different version of what had happened, though, and some wouldn't even pause to talk. They hurried past, either seeking out loved ones or preparing to leave the resort, convinced there might be a safer place elsewhere. Frustrated with the differing stories, I finally- reluctantly- knew I had to seek out one of the two sources who would give me solid information. My mother or Dimitri. It was like flipping a coin. I wasn't really thrilled with either one of them right now. I debated momentarily and finally decided on my mother, seeing as how she wasn't getting it on with Tasha Ozera. The door to my mother's room was ajar, and as Lissa and I entered, I saw that a sort of makeshift headquarters had been established here. Lots of guardians were milling around, moving in and out, and discussing strategy. A few gave us odd looks, but no one stopped or questioned us. Lissa and I slid onto a small sofa to listen to a conversation my mother was having. She stood with a group of guardians, one of whom was Dimitri. So much for avoiding him. His brown eyes glanced at me briefly and I averted my gaze. I didn't want to deal with my troubled feelings for him right now. Lissa and I soon discerned the details. Eight Moroi had been killed along with their five guardians. Three Moroi were missing, either dead or turned Strigoi. The attack hadn't really happened near here; it had been somewhere in northern California. Nonetheless, a tragedy like this couldn't help but reverberate within the Moroi world, and for some, two states away was far too close. People were terrified, and I soon learned what in particular made this attack so notable. â€Å"There had to be more than last time,† said my mother. â€Å"More?† exclaimed one of the other guardians. â€Å"That last group was unheard of. I still can't believe nine Strigoi managed to work together- you expect me to believe they managed to get more organized still?† â€Å"Yes,† snapped my mother. â€Å"Any evidence of humans?† someone else asked. My mother hesitated, then: â€Å"Yes. More broken wards. And the way it was all conducted†¦it's identical to the Badica attack.† Her voice was hard, but there was a kind of weariness in it, too. It wasn't physical exhaustion, though. It was mental, I realized. Strain and hurt over what they were talking about. I always thought of my mother as some sort of unfeeling killing machine, but this was clearly hard for her. It was a hard, ugly matter to discuss- but at the same time, she was tackling it without hesitation. It was her duty. A lump formed in my throat that I quickly swallowed down. Humans. Identical to the Badica attack. Ever since that massacre, we'd extensively analyzed the oddity of such a large group of Strigoi teaming up and recruiting humans. We'd spoken in vague terms about â€Å"if something like this ever happens again †¦Ã¢â‚¬  But no one had seriously talked about this group- the Badica killers- doing it again. One time was a fluke- maybe a bunch of Strigoi had happened to gather and impulsively decided to go on a raid. It was horrible, but we could write that off. But now†¦now it looked as though that group of Strigoi hadn't been a random occurrence. They'd united with purpose, utilized humans strategically, and had attacked again. We now had what could be a pattern: Strigoi actively seeking out large groups of prey. Serial killings. We could no longer trust the protective magic of the wards. We couldn't even trust sunlight. Humans could move around in the day, scouting and sabotaging. The light was no longer safe. I remembered what I'd said to Dimitri at the Badica house: This changes everything, doesn't it? My mother flipped through some papers on a clipboard. â€Å"They don't have forensic details yet, but the same number of Strigoi couldn't have done this. None of the Drozdovs or their staff escaped. With five guardians, seven Strigoi would have been preoccupied- at least temporarily- for some to escape. We're looking at nine or ten, maybe.† â€Å"Janine's right,† said Dimitri. â€Å"And if you look at the venue†¦it's too big. Seven couldn't have covered it.† The Drozdovs were one of the twelve royal families. They were large and prosperous, not like Lissa's dying clan. They had plenty of family members to go around, but obviously, an attack like this was still horrible. Furthermore, something about them tickled my brain. There was something I should remember †¦ something I should know about the Drozdovs. While part of my mind puzzled that out, I watched my mother with fascination. I'd listened to her tell her stories. I'd seen and felt her fight. But really, truly, I'd never seen her in action in a real-life crisis. She showed every bit of that hard control she did around me, but here, I could see how necessary it was. A situation like this created panic. Even among the guardians, I could sense those who were so keyed up that they wanted to do something drastic. My mother was a voice of reason, a reminder that they had to stay focused and fully assess the situation. Her composure calmed everybody; her strong manner inspired them. This, I realized, was how a leader behaved. Dimitri was just as collected as she was, but he deferred to her to run things. I had to remind myself sometimes that he was young as far as guardians went. They discussed the attack more, how the Drozdovs had been having a belated Christmas party in a banquet hall when they were attacked. â€Å"First Badicas, now Drozdovs,† muttered one guardian. â€Å"They're going after royals.† â€Å"They're going after Moroi,† said Dimitri flatly. â€Å"Royal. Non-royal. It doesn't matter.† Royal. Non-royal. I suddenly knew why the Drozdovs were important. My spontaneous instincts wanted me to jump up and ask a question right now, but I knew better. This was the real deal. This was no time for irrational behavior. I wanted to be as strong as my mother and Dimitri, so I waited for the discussion to end. When the group started to break up, I leapt up off the sofa and pushed my way toward my mother. â€Å"Rose,† she said, surprised. Like in Stan's class, she hadn't noticed me in the room. â€Å"What are you doing here?† It was such a stupid question, I didn't try to answer it. What did she think I was doing here? This was one of the biggest things to happen to the Moroi. I pointed to her clipboard. â€Å"Who else was killed?† Irritation wrinkled her forehead. â€Å"Drozdovs.† â€Å"But who else?† â€Å"Rose, we don't have time- â€Å" â€Å"They had staff, right? Dimitri said non-royals. Who were they?† Again, I saw the weariness in her. She took these deaths hard. â€Å"I don't know all the names.† Flipping through a few pages, she turned the clipboard toward me. â€Å"There.† I scanned the list. My heart sank. â€Å"Okay,† I told her. â€Å"Thanks.† Lissa and I left them to go about their business. I wished I could have helped, but the guardians ran smoothly and efficiently on their own; they had no need for novices underfoot. â€Å"What was that about?† asked Lissa, once we were heading back to the main part of the lodge. â€Å"The Drozdovs' staff,† I said. â€Å"Mia's mom worked for them†¦.† Lissa gasped. â€Å"And?† I sighed. â€Å"And her name was on the list.† â€Å"Oh God.† Lissa stopped walking. She stared off into space, blinking back tears. â€Å"Oh God,† she repeated. I moved in front of her and placed my hands on her shoulders. She was shaking. â€Å"It's okay,† I said. Her fear came to me in waves, but it was a numbed fear. Shock. â€Å"This is going to be okay.† â€Å"You heard them,† she said. â€Å"There's a band of Strigoi organizing and attacking us! How many? Are they coming here?† â€Å"No,† I said firmly. I had no evidence of that, of course. â€Å"We're safe here.† â€Å"Poor Mia †¦Ã¢â‚¬  There was nothing I could say to that. I thought Mia was an absolute bitch, but I wouldn't wish this on anyone, not even my worst enemy- which, technically, she was. Immediately, I corrected that thought. Mia wasn't my worst enemy. I couldn't bear to leave Lissa's side for the rest of the day. I knew there were no Strigoi lurking in the lodge, but my protective instincts ran too strong. Guardians protected their Moroi. Like usual, I also worried about her being anxious and upset, so I did my best to diffuse those feelings. The other guardians provided reassurance for Moroi too. They didn't walk side by side with the Moroi, but they reinforced lodge security and stayed in constant communication with guardians at the scene of the attack. Information flowed in all day about the grisly specifics, as well as speculation about where the band of Strigoi was. Little of this was shared with novices, of course. While the guardians did what they did best, the Moroi also did what they- unfortunately- did best: talk. With so many royals and other important Moroi at the lodge, a meeting was organized that night to discuss what had happened and what might be done in the future. Nothing official would be decided here; the Moroi had a queen and a governing council elsewhere for those types of decisions. Everyone knew, though, that opinions gathered here would make their way up the chain of command. Our future safety could very well depend on what was discussed in this meeting. It was held in an enormous banquet hall inside the lodge, one with a podium and plenty of seating. Despite the businesslike atmosphere, you could tell this room had been designed for things other than meetings about massacres and defense. The carpet had the texture of velvet and showed an ornate floral design in shades of silver and black. The chairs were made of black polished wood and had high backs, clearly intended for fancy dining. Paintings of long-dead Moroi royalty hung on the walls. I stared briefly at one of a queen whose name I didn't know. She wore an old-fashioned dress- too heavy on lace for my tastes- and had pale hair like Lissa's. Some guy I didn't know was in charge of moderating and stood at the podium. Most of the royals on hand gathered at the front of the room. Everyone else, including students, took seats wherever they could. Christian and Mason had found Lissa and me by that point, and we all started to sit in the back when Lissa suddenly shook her head. â€Å"I'm going to sit in the front.† The three of us stared at her. I was too dumbfounded to probe her mind. â€Å"Look.† She pointed. â€Å"The royals are sitting up there, sitting by family.† It was true. Members of the same clans had clustered near each other: Badicas, Ivashkovs, Zekloses, etc. Tasha sat there as well, but she was by herself. Christian was the only other Ozera there. â€Å"I need to be up there,† said Lissa. â€Å"No one expects you to be there,† I told her. â€Å"I have to represent the Dragomirs.† Christian scoffed. â€Å"It's all a bunch of royal bullshit.† Her face set into a determined expression. â€Å"I need to be up there.† I opened myself up to Lissa's feelings and liked what I found. She'd spent most of the day quiet and afraid, much as she had when we'd found out about Mia's mom. That fear was within her still, but it was overpowered by a steady confidence and determination. She recognized that she was one of the ruling Moroi, and as much as the idea of roving bands of Strigoi scared her, she wanted to do her part. â€Å"You should do it,† I said softly. I also liked the idea of her defying Christian. Lissa met my eyes and smiled. She knew what I had sensed. A moment later, she turned to Christian. â€Å"You should join your aunt.† Christian opened his mouth to protest. If not for the horribleness of the situation, seeing Lissa order him around would have been funny. He was always stubborn and difficult; those who tried to push him didn't succeed. Watching his face, I saw the same realization I'd had about Lissa come over him. He liked seeing her strong too. He pressed his lips together in a grimace. â€Å"Okay.† He caught her hand, and the two of them walked off toward the front. Mason and I sat down. Just before things started, Dimitri sat down on the other side of me, hair tied behind his neck and the leather coat draping around him as he settled in the chair. I glanced at him in surprise but said nothing. There were few guardians at this gathering; most were too busy doing damage control. It would figure. There I was, stuck between both of my men. The meeting kicked off shortly thereafter. Everyone was eager to talk about how they thought the Moroi should be saved, but really, two theories got the most attention. â€Å"The answer's all around us,† said one royal, once he'd been given leave to speak. He stood by his chair and looked around the room. â€Å"Here. In places like this lodge. And St. Vladimir's. We send our children to safe places, places where they have safety in numbers and can be easily guarded. And look how many of us made it here, children and adults alike. Why don't we live this way all the time?† â€Å"Plenty of us already do,† someone shouted back. The man waved that off. â€Å"A couple of families here and there. Or a town with a large Moroi population. But those Moroi are still decentralized. Most don't pool their resources- their guardians, their magic. If we could emulate this model†¦Ã¢â‚¬  He spread his hands out. â€Å"†¦ we'd never have to worry about Strigoi again.† â€Å"And Moroi could never interact with the rest of the world again,† I muttered. â€Å"Well, until humans discovered secret vampire cities sprouting up in the wilderness. Then we'd have lots of interactions.† The other theory about how to protect the Moroi involved fewer logistical problems but had greater personal impact- particularly for me. â€Å"The problem is simply that we don't have enough guardians.† This plan's advocate was some woman from the Szelsky clan. â€Å"And so, the answer is simple: get more. The Drozdovs had five guardians, and that wasn't enough. Only six to protect over a dozen Moroi! That's unacceptable. It's no wonder these kinds of things keep happening.† â€Å"Where do you propose getting more guardians from?† asked the man who'd been in favor of Moroi banding together. â€Å"They're kind of a limited resource.† She pointed to where I and a few other novices sat. â€Å"We've got plenty already. I've watched them train. They're deadly. Why are we waiting until they turn eighteen? If we accelerated the training program and focused more on combat training than bookwork, we could turn out new guardians when they're sixteen.† Dimitri made a sound low in his throat that didn't seem happy. Leaning forward, he placed his elbows on his knees and rested his chin in his hands, eyes narrowed in thought. â€Å"Not only that, we have plenty of potential guardians going to waste. Where are all the dhampir women? Our races are intertwined. The Moroi are doing their part to help the dhampirs survive. Why aren't these women doing theirs? Why aren't they here?† A long, sultry laugh came as an answer. All eyes turned toward Tasha Ozera. Whereas many of the other royals had dressed up, she was easy and casual. She wore her usual jeans, a white tank top that showed a bit of midriff, and a blue, lacy knit cardigan that came to her knees. Glancing at the moderator, she asked, â€Å"May I?† He nodded. The Szelsky woman sat down; Tasha stood up. Unlike the other speakers, she strode right up to the podium, so she could be clearly seen by everyone. Her glossy black hair was pulled back into a ponytail, completely exposing her scars in a way I suspected was intentional. Her face was bold and defiant. Beautiful. â€Å"Those women aren't here, Monica, because they're too busy raising their children- you know, the ones you want to start sending out to the fronts as soon as they can walk. And please don't insult us all by acting like the Moroi do a huge favor to the dhampirs by helping them reproduce. Maybe it's different in your family, but for the rest of us, sex is fun. The Moroi doing it with dhampirs aren't really making that big of a sacrifice.† Dimitri had straightened up now, his expression no longer angry. Probably he was excited that his new girlfriend had mentioned sex. Irritation shot through me, and I hoped that if I had a homicidal look on my face, people would assume it was for Strigoi and not the woman currently addressing us. Beyond Dimitri, I suddenly noticed Mia sitting by herself, farther down the row. I hadn't realized she was here. She was slumped in her seat. Her eyes were red-rimmed, her face paler than usual. A funny ache burned in my chest, one I'd never expected her to bring about. â€Å"And the reason we're waiting for these guardians to turn eighteen is so that we can allow them to enjoy some pretense of a life before forcing them to spend the rest of their days in constant danger. They need those extra years to develop mentally as well as physically. Pull them out before they're ready, treat them like they're parts on an assembly line- and you're just creating Strigoi fodder.† A few people gasped at Tasha's callous choice of words, but she succeeded in getting everyone's attention. â€Å"You create more fodder still if you try making the other dhampir women become guardians. You can't force them into that life if they don't want it. This entire plan of yours to get more guardians relies on throwing children and the unwilling into harm's way, just so you can- barely- stay one step ahead of the enemy. I would have said it's the stupidest plan I've ever heard, if I hadn't already had to listen to his.† She pointed at the first speaker, the one who had wanted Moroi compounds. Embarrassment clouded his features. â€Å"Enlighten us then, Natasha,† he said. â€Å"Tell us what you think we should do, seeing as you have so much experience with Strigoi.† A thin smile played on Tasha's lips, but she didn't rise to the insult. â€Å"What do I think?† She strode closer to the stage's front, gazing at us as she answered his question. â€Å"I think we should stop coming up with plans that involve us relying on someone or something to protect us. You think there are too few guardians? That's not the problem. The problem is there are too many Strigoi. And we've let them multiply and become more powerful because we do nothing about them except have stupid arguments like this. We run and hide behind the dhampirs and let the Strigoi go unchecked. It's our fault. We are the reason those Drozdovs died. You want an army? Well, here we are. Dhampirs aren't the only ones who can learn to fight. The question, Monica, isn't where the dhampir women are in this fight. The question is: Where are we?† Tasha was shouting by now, and the exertion turned her cheeks pink. Her eyes shone with her impassioned feelings, and when combined with the rest of her pretty features- and even with the scar- she made a striking figure. Most people couldn't take their eyes off her. Lissa watched Tasha with wonder, inspired by her words. Mason looked hypnotized. Dimitri looked impressed. And farther past him †¦ Farther past him was Mia. Mia no longer hunched in her chair. She was sitting up straight, straight as a stick, her eyes as wide as they could go. She stared at Tasha as though she alone held all the answers to life. Monica Szelsky looked less awed, and she fixed her gaze on Tasha. â€Å"Surely you aren't suggesting the Moroi fight alongside the guardians when the Strigoi come?† Tasha regarded her levelly. â€Å"No. I'm suggesting the Moroi and the guardians go fight the Strigoi before they come.† A guy in his twenties who looked like a Ralph Lauren spokesmodel shot up. I would have wagered money he was royal. No one else could have afforded blond highlights that perfect. He untied an expensive sweater from around his waist and draped it over the back of his chair. â€Å"Oh,† he said in a mocking voice, speaking out of turn. â€Å"So, you're going to just give us clubs and stakes and send us off to do battle?† Tasha shrugged. â€Å"If that's what it takes, Andrew, then sure.† A sly smile crossed her pretty lips. â€Å"But there are other weapons we can learn to use, too. Ones the guardians can't.† The look on his face showed how insane he thought that idea was. He rolled his eyes. â€Å"Oh yeah? Like what?† Her smile turned into a full-fledged grin. â€Å"Like this.† She waved her hand, and the sweater he'd placed on the back of his chair burst into flames. He yelped in surprise and knocked it to the floor, stamping it out with his feet. There was a brief, collective intake of breath throughout the room. And then †¦ chaos broke out.

Case Study of Patient presenting with flu-like illness 2500 words Essay

Case Study of Patient presenting with flu-like illness 2500 words - Essay Example Patient satisfaction evaluated using typical patient questionnaires is said to be higher after advanced nurse consultations for flu-like illnesses and minor illnesses. It is from such data that it is discovered that advanced nurses give longer consultations and necessary information as compared to general practitioners. However, some patients who have ever visited a nurse practitioner for insignificant illness care have recorded a preference to seeing practitioners next time, regardless of the fact that they were satisfied with the consultants with the advanced nurse. Patients may not anticipate their general practitioner to create time and listen to hem but they may have much confidence that an advanced nurse would do so (Moulton, 2007). The aim of this evaluation is to determine how the consultation process is carried out by an advanced nurse, inclusive of the methods used in the context of general practice. The method used Subjects were interviewed before and up to one week follow ing their consultation with an advanced nurse. Constant comparative methods and semi-structured interviews were utilized to explore the matter from the patients’ point of view. ... Therefore, a specified 1-year practice-based training program was initiated. It was comprised of the Higher Professional Education Masters Degree in Advanced Nursing Practice (MANP), inclusive of training on managing common complaints. As the program went on, the advanced nurses were employed, educated, and facilitated with general practices. Common complaints associated with the flu-like illness was compiled for which the participants seek he nurses’ medical attention. According to Keenan, J, 1999, such common problems will always result in minor health issues. The role of the advanced nurse in this study was to assess symptoms like physical examinations, and diagnose or make decisions where appropriate. However, the advanced nurses were not permitted to prescribe any medications, meaning that the general practitioners were frequently available for consultations and validations on referrals and prescriptions. The process required that patients who had appointments for the stu dy be assessed for inclusion. Patients aged over 18 years and had come for the first consultation were welcomed to take part in the study if they requested for an appointment on a day when the advanced nurse was around and had time availed to him or her in the schedule. There was random choice of patients to be allocated in either the reference group or the intervention group. Assignments were given at random by an independent individual and he codes generated. In each project, a research assistant gave an explanation of the research to the patients as they came in and informed consent was achieved. Collection of data and the analysis Before the consultation in the general practice same day consultancy room, the first interview was performed, and the

Compare and contrast the importance of using primary and secondary Essay

Compare and contrast the importance of using primary and secondary methods when conducting market research. Are secondary methods more advantageous when analysing results for a new product - Essay Example Significantly, each business venture at least has an organization it looks up to in terms of strategies; it also has a vision that acts as a guiding principle. Entrepreneurs conduct market research so that they can reduce the risks associated with their business, indentify more opportunities and predict current and potentially future problems. Such information will aid in making decision on whether to execute the new product or shelve for another time. The research also enables individuals to establish benchmarks that will assist the business not to collapse when they encounter uncertainties along the way. Methods of data collection when carrying out market research influence the end result. While both primary and secondary methods hugely contribute to informed data, one overrides the other one. This paper will focus on establishing the comparison and contrast of primary and secondary methods of market research. It will also determine whether secondary methods are more advantageous when analysis the market situation of a new product. Primary research methods refer to the original research carried out by the owner of the business or by a contracted company (Sumathi & Saravanavel, 2003, p. 154). The main aim of this research is to answer a specific objective. Before going into the field, a set of objectives and research questions are outlined. In addition, a clear hypothesis may be set so that at least the data obtained will measure it. With primary method, information compilation is done from scratch since it bases on what the respondents give. Despite the fact that the information provided by the respondents play a critical role, the researcher must have a set of expectation. In essence, the desired goal and the vision of the business inform the whole idea of market research. Primary research could lead to quantitative or qualitative data. This depends on the format

American History Assignment Example | Topics and Well Written Essays - 250 words - 1

American History - Assignment Example The Spanish also had knowledge of metals such as iron and bronze which allowed them superior weaponry and armor/shields. But the Indians had the advantage of knowing how to live off the land, and its topography, more so than the Spanish. They had natural superior knowledge of the topography and survival on smaller amounts of supplies than the Spanish. If the Indians could have gotten the Spanish out of their comfort zone, they could have resisted Spanish encroachment much more easily. Part B. It was a good point that the Incan Indians were susceptible to European diseases such as small pox and measles. Many Indians were wiped out because of Spanish disease. The Spanish weapons were far superior (more high tech) than those of the Indians, which was a huge advantage. Although the Indians had more numbers of people, the Spanish nullified that with their superior technology and weaponry. Also not mentioned was the Spanish desire to convert and conquer native Indians and convert them to C hristianity. That was a wave of conversion which the Indians were powerless to survive, as the Spanish did so all over the world. Part C. This answer is almost unintelligible.

Consumer Protection Essay Example | Topics and Well Written Essays - 500 words

Consumer Protection - Essay Example When various competitors reach an agreement to limit the competition between them, the outcome is often an increase in prices. For that reason, price fixing is a huge concern of the Federal Trade Commission. An outright agreement between competitors to settle at particular prices is in most cases illegal regardless of whether the prices are fixed at a minimum, maximum or in a particular range. Illegal fixing of prices takes place when two or more competitors create an agreement that raises, lowers or stabilizes the price of any product or service without any form of reasonable explanation. Schemes to fix prices are in most cases developed confidentially and may be difficult to expose, but the agreements can be unearthed from circumstantial evidence. For instance, if directly connected competitors have an array mysterious identical contract terms or behaviors in regard to prices along with other factors, illegal pricing may definitely be the reason (Ftc.gov, 2014). When the competitors are also invited to coordinate the prices of goods and services, concerns are raised. This also happens when a particular competitor makes a public announcement that it is willing to put an end to a price war when there was prior announcement from a different competitor to do the same with the terms being so particular to the point that the competitors may consider it as an invite to set prices jointly (Ftc.gov, 2014). However, not all the likenesses in prices or adjustments in prices that take place simultaneously are associated with price fixing as in contrast, they are often the outcome of normal market conditions. For instance, the price of commodities like wheat is the same since the products are virtually the same and the prices charged by the farmers increase or decrease at the same time without the farmers necessarily agreeing among themselves. It the supply of the wheat declines as a result of a drought, the prices associated with all the

Factortame Essay Example | Topics and Well Written Essays - 1500 words

Factortame - Essay Example 101). This decision seriously threatened the livelihood of Factortame Limited, whose Spanish directors had re-registered 53 Spanish-registered boats as British boats, and also purchased 42 British-registered boats, for a fleet of almost 100 fishing boats to use in UK waters. When the Merchant Shipping Act 1988 was passed, Factortame sought to have a British court overturn it, because it violated the Common Fisheries Policy, and legal principle held that Community law held sway over national law. This had been set as precedent by the ECJ in Costa v. ENEL in 1964 (Drewry, p. 101), but that did not stop the Court of Appeal and the House of Lords make Factortame seek remedy in the ECJ before starting the process on British soil. The Factortame received far more publicity than did Costa, and it brought home to the British public a fact that had been clear to the British legal community for some time: that, in many ways, British sovereignty had been changed as soon as the British government acc eded to membership in the EC (Oliver p. 2). Over time, the British courts have moved to make this change a reality through case law. In the instance of Factortame, the court invalidated provisions that were contradictory to European law, and precedents over time have altered the doctrine of implied repeal. Other changes have included an alteration in the common law presumption of compliance between British statutes and international law, as well as a change in the way that the common law of remedies works, so that it dovetails with European requirements (Oliver, p. 1). Much press has been given to the ways that the European Union has allegedly attempted to rob its member countries of their individuality by instituting regulations in a number of silly ways. According to an editorial in the New York Times, a large urban mythology about this has grown up: The European Union has long tried to dispel myths that its zealous bureaucrats are trying to impinge on national cultures in their bid to harmonize standards in the world's biggest trading bloc. Such myths have included that cucumbers sold in the European Union must not arch more than 10 millimeters for every 10 millimeters of length; that it is against health rules to feed swans stale bread; and that Brussels had decided that shellfish must be given rest breaks and stress-relieving showers during boat journeys over 50 kilometers long." (European Union). Since the Factortame case came well after the Costa case, which was the groundbreaking precedent in establishing the supremacy of European law over national law, it is interesting that it was this case that attracted such attention in the public arena. As Gavin Drewry points out, the case of Factortame was much less of an earthquake in legal circles than it was in public opinion, because relevant precedent had been set almost fifteen years before, and the legal community was accustomed to seeing British statutes get set aside when they came into conflict with European law. The timing of Factortame was what made the case such a significant event in the public arena: it occurred during Prime Minister Thatcher's Conservative

Nursing Informatic Job Roles Coursework Example | Topics and Well Written Essays - 1250 words

Nursing Informatic Job Roles - Coursework Example This integration is meant to enhance communication, management and expansion of knowledge, information, wisdom and data within the nursing practice (Bickford, 2009). Nursing informatics development can partly be attributed to the developments in the computer world whose applications have pervaded the whole medical field continuum. Computer application in knowledge management is currently applicable in clinical practice, nursing research and nursing education (Anderson et al., 2012). The recognition of the importance of NI led to the development of certification of nurses specializing in NI from 2005. The NI nurses have led to better patient outcomes through the application of their expertise in information technologies, structures and processes. This has helped other medical providers and nursing and medical practitioners in creating evidence-based practice and a clear record of practice that facilitates research, decision-making and policy development (Anderson et al., 2012). This p aper critically reviews three nursing informatics job advertisements to determine whether the job descriptions are in line with the NI scope of operation, functional area definition and standards of practice. It is an analytical review aimed at determining whether the jobs have the right designation, which should take consideration of all elements of the nursing informatics field. ... ob Requirement Summaries Descriptive Details Job One Job Two Job Three Job Title -Nurse Informatics -Nursing Informaticist -Clinical Informatics Supervisor Academic Qualifications -Bachelors degree (BSN). -Information system courses. -Bachelors degree (BSN). -Bachelors degree (BSN). -NI Certification by â€Å"American Nursing Credentialing Centre† (ANCC). Competencies & skills. -Computer skills. -Customer service skills. -Communication skills. - (missing). -Knowledge on computer applications and documentation. - Experience -1 year teaching or administrative role. -2 years in a clinical role with systems application. -5 years clinical nursing experience. -3-4 years’ experience in clinical nursing. -2 years’ experience in nursing staff education. -5 years’ experience in acute care set up. -Healthcare information systems’ knowledge. -Experience in NI. Job Type -Full time -Full time -Regular/Full time Other Requirements -RN Licensure -RN licensure -RN l icensure -Membership in relevant nursing body. Job Descriptions Job One Create liaison with the medical staff, nursing practitioners, house staff and other care sectors in order to plan, design, develop, implement, maintain and evaluate electronic medical records and systems. Analyze structural processes and clinical operations in a manner that facilitates development of decision-making structures relating to clinical systems. Determine clinical processes that deserve computerization using clinical practice experience and knowledge. Ensure compliance of information systems with regulations and standards of practice. Assist with data analysis, quality assessment and design workflow and CKI. Job Two Change work culture related to technology implementation. Provide technological support in clinical information system.

Japanese Internment Essay Example | Topics and Well Written Essays - 1000 words - 2

Japanese Internment - Essay Example The article provides valuable perceptions and insights about what the Japanese went through during the internment(Flamiano,2000, pp.22). The United States entered into World War II after the Japanese Navy attacked Pearl Harbour in 1941. According to Dolores the anti Japanese criteria, then gripped the home front. She states that president Franklin signed an executive order which authorized the war department to exclude any group of people from the military areas for the duration of the war. A hundred and ten thousand Japanese immigrants and Americans from the west coast were evacuated at that time. Their lives were disrupted since they had to stop living their normal lives and move to other areas. The Japanese Americans were falsely accused of sending signals to their countries. Dolores states that three priests were arrested and the reporters gave a false report. Dolores explains that the Japanese continued to follow their traditions while still in America. She quotes a California governor saying that it would be impossible to tell whether the Japanese are loyal or not. She states that they faced racism in America w hereby all Asian immigrants were considered aliens in the United States. Internment photography begun in the 1970s as scholarly analysis with a strong focus being on the Manzanar photographs of Asel Adams and Dorothea Lange. Many scholars, however, neglected the magazine photography in order to study the ones in museums or the government archives. Dolores states that Adam’s work that contained eight photographs shared a vision that the camp was tough to live in for people of Manzarin An example, as Dolores explains, was a photo of Collier that portrayed opportunities for people who were ready to work. In 1980 and 2004, Elena Tajima and Sylvia Danovitch noticed that the internment photographs excluded the harshness or inconvenience of the camp’s living conditions. An example is Colliers’s photo of two women with checkered curtains at their

Solving problem of elctrodynamic Assignment Example | Topics and Well Written Essays - 1500 words

Solving problem of elctrodynamic - Assignment Example As before, the procedure for determining the Greens function is to split. The region of interest in to two parts (one on each side of the observation point), and separate solutions of the Laplace equation that satisfy the boundary conditions of every region, and then join the two solutions at the source point such that their values match up but the first derivative (in whichever dimension we chose sides) has a finite discontinuity. The solution in the first region must be admissible down to which excludes the in term and the negative powers of p. However, these terms may be included in the solutions for region in second place. In individually regions, the solution must vanish at which excludes the cos terms Henceforth when the electromagnetic disturbance has reached the origin, the particle has traveled as far as the electromagnetic disturbance did, but in the opposite direction, so it is now twice as far from the origin as it was when the disturbance we are just now feeling was generated. The electric fields do not depend on the unprimed variables and come out of the integrals, which was the point of the Taylor sequences expansion. After a little manipulation, we recognize the integrals that are left as the dipole moment and quadrupole moments d) If, instead of the semi-classical charge density used above, the electron in the 2p state was described by a circular Bohr orbit of radius , rotating with the transition frequency w0, what would the predicted power be? Express your answer in the same units as in part b and evaluate the ratio of the powers numerically. b) We now want to calculate the ï ¬ elds from the potentials. This is mostly straight forward, albeit tedious, algebra. We need to remember that the dipole moment is evaluated at the retarded time, so that there is an implicit time dependence in p (t0) a) Starting with the Proca Lagrangian density (12.91) and following the same procedure as for the electro

Tragic Hero Macbeth Essay Example for Free

Tragic Hero Macbeth Essay 1. In the Shakespearean tragedy, â€Å"The Tragedy of Macbeth†, Macbeth himself did not come from noble stature, but instead he followed into the line of kingship, and had presented himself with outstanding qualities; such as strong abilities out on the battlefield. 2. The hamartia presented in Macbeth resulted in Macbeth’s own murder against his good king Duncan, in order to gain power, fame, and fortune for his own pleasure. Macbeth himself had a hubris or pride and passion that he allowed to take over his decisions, leading to his tragic downfall. 3. Macbeth’s downfall itself was led by his own freewill, overridden by his own arrogant confidence. Proof he had taken done this to himself is said so by Macbeth, â€Å"I am in blood stepped in so far that, should I wade no more, returning were as tedious as to go o’er.† (Act III, Scene 4, Line 136-138). 4. As the audience, pity was expressed dearly through Macbeth’s possible and yet great human potential, â€Å"I have lived long enough†¦and that which should accompany old age, as honor, love, obedience, troops of friends, I must not look to have.† (Act V, Scene 3, Line 22-26). 5. The first signs of awareness are when Macbeth puts together the real predictions granted to him by the three apparitions, â€Å"Let every soldier hew him down a bough and bear it before him.† (Act V, Scene 4, Line 4-7). He is then lead to accepting his fate or anagnorisis, right before Macbeth is slain by Macduff, â€Å"I will not yield, to kiss the ground before young Malcolm’s feet†¦I throw my warlike shield. Lay on, Macduff.† (Act V, Scene 8, Line 27-24). Part Two: By using Aristotle’s definition of a tragic hero, I would conclude that Macbeth is indeed a tragic hero. Macbeth’s tragic flaw mostly described as his passion, where he would contemplate over and over with his very own reasoning, in which passion overrules all of his humanly common senses; this causes an imbalance between human reason and passion thus leading to tragic consequences or rather the hero’s tragic death.

Kelloggs The Market Leader Of Cereals Marketing Essay

Kelloggs The Market Leader Of Cereals Marketing Essay The purpose of this report is that to let the readers know the challenges and competition in Cereal and Snacks of UK and rest of the world. This report is sculptured on Kelloggs the market leader of cereal and breakfast industry of UK. This report consists of detail company analysis using SWOT* analysis, PESTEL** analysis and using Marketing 4 ps*** and Porter Five Forces to highlight the industry. The objective of the report is to outline the marketing plan of Kelloggs and then critically evaluate the plan making the recommendations. Further then this report is going to highlight effects of technology on Kelloggs operations and how Kelloggs is benefiting from new media i.e Internet. The end of the report some focus is upon the Kelloggs Sustainability plan and recommendations for further improvements. Marketing is the management process of Identifying, anticipating and satisfying customer needs and requirements profitably. Chartered Institute of Marketing So the main functions of marketing is to Identify and Anticipate what are the needs and wants of the customer and analysing what the competitors are providing at the moment and what further new and better product and service the Organisation can provide. The Main aim here is to know and understand the customer so well that product or service fits accordingly to customer requirements and sells itself. Secondly the important aim of marketing is to satisfy the customer. So the companies provide the combination of products and services to satisfy the needs and wants of the customers. Kotler describes marketing as the process by which companies create value for customers and build strong relationships in order to capture value from customers in return. To do this successfully, firms need to embrace a culture of market orientation and put the customer at the forefront of everything they do. Communication of the marketing strategy and plan across the organisation plays a vital part in making this happen. Philips kotler There is misconception among the people that marketing is all about advertising and selling i.e. Telling and selling, although they are important but they are only the tip the marketing iceberg. Selling and telling occurs after the product is complete and ready to launch to market, in contrast marketing starts long before the company has a product. Marketing is all about assessing the needs of consumers, measure their extend intensity and estimate whether there is a profit opportunity exist. Marketing is of such importance that is continues from the product development to market withdrawal, and its main function during this period is to acquire new customers and keep the current customers locked in by improving product appeal and performance and giving customer a good after sales service with constant product updates. According to the Marketing guru Peter Drucker, The Aim of marketing is to make selling unnecessary this is done by understanding the customers so well that the product and service sells itself. Marketing is a five step process; Understanding the Marketplace and Customer needs and wants Design Customer-Driven Strategy Construct a Marketing Programme that delivers superior value. Build Profitable relationship and customer delight Capture Value from customer in return. Kotler one of the famous Marketing author describes marketing as a Process by which companies create value to the customers and build a strong relation in order to capture value from customers in return in the form of Current and future sales, market share and profits. Companies should provide good quality service and superior products to customers to satisfy them and in return win customer loyalty and future sales. To create value for the customer the company should have a Customer-driven marketing strategy and the customer driven strategy looks upon two basic questions, What customers will we serve and how can we serve these customers best. The company must first decide who it will serve, for this company divides the market into segments and selects the segment it will go for. After selecting the target customer then company decides how they are going to differentiate and position itself in the marketplace. One important role of marketing is that to lock the customer with continuou s good quality service and to provide innovative products at regular intervals and once the customer is locked in, and then most important step is to build a profitable customer relationship. Kelloggs About Kelloggs: Kelloggs is a prominent player in the world of Breakfast and produces more than three out of 10 packets eaten in UK. Kelloggs has 42% of UK market share, this makes Kelloggs a market leader and in 2009 it was Britains biggest grocery selling brand with sales of  £550 million and global sales of nearly 12 billion. Kelloggs products are manufactured in 18 countries and marketed in more than 180 countries and it employs around 32000 employees. The Company Products including cookies, crackers, toaster pastries, cereal bars, fruit-flavored snacks, frozen waffles and veggie foods. Kelloggs markets its products under a variety of brands include Rice Krispies, Special K and Nutri-Grain. Vision and Mission Kellogg Companys Vision and Mission statements define our focus upon sustainable growth, our broadened definition of social responsibility and the true strength of our company our people and our brands. Our Vision encompasses the full spectrum of our stakeholders including shareowners, employees, customers, consumers and communities.   Our Mission articulates where we are as a company today and where we wish to be in the future. Our Vision and Mission do not stand alone.   They are integrated with our focused strategy and operating principles as well as the foundations of our business: our K Values, people and commitment to social responsibility. http://www.kelloggcompany.com Kelloggs Marketing Plan and Strategies The cereal giant Kelloggs being the Market leader in the world of breakfast has plans to further increase its market share with the help of new innovative products and new marketing campaigns. Kelloggs chief marketing officer Mark Baynes said in an marketing Magazine We are aiming to create a team inspired, equipped and enabled to drive stronger returns in this increasingly complex consumer landscape. As per Mark Baynes the company marketing plan is to drive stronger returns in the complex business environment as last year Kelloggs reported six per cent drop in the earnings in the third quarter, which is because of increasing competition in the cereal industry, General mills, Nestle being the biggest competitor of Kelloggs followed by Quaker Oats. So the main Marketing and Business plan of Kelloggs is to Leadership in product innovation Strengthening the companys seven largest market segments Continuing to reduce the Cost and increasing the effectiveness and efficiency of the business processes Investing in new product research and brand building activities Thinking ethically and environmentally. SWOT ANALYSIS The SWOT analysis is an analysis of the companys current position in the light of its strengths, weakness, opportunity and threats. Kelloggs Strengths: Kelloggs biggest strength comes from its 42% market share and being market leader Brand is fully recognised by the customers and the retailers. Providing Quality innovative products with the support of proper marketing campaigns and sound distribution channels. High product demand gives Kelloggs main shelf space in the shops and Retailer like ASDA, TESCO etc. Kelloggs have products targeting childrens, teenagers, adult and even the elders. This gives Kelloggs reputation of proving products for everyone. Social Responsibility: Kelloggs welcomes social responsibility and notes the environment, advocating healthy lifestyles, and promoting diversity as its main responsibilities. Kelloggs Weakness: Slow erosion in Global market share as competitors like Nestle and Wheatabix are providing new and economic valued products. Kelloggs has many demographically different customers which mean many different focuses. This may cause a conflict when it comes to public opinion Kelloggs Opportunities: Kelloggs can slowly diversify and still remain into their core business. This could further increase their profitability and market growth. There can further increase their market share and growth by using better pricing strategy. Major opportunity for Kelloggs is to provide health and more organic products as customers are looking for healthier life-style. Kelloggs Threats: Retailers like ASDA, Tesco are so powerful that they have created their own brand of cereals and corn flakes. Providing cheaper and better quality alternative products. The world economy is suffering, so customers prefer economical n cheap products. Kelloggs charging premium prices can hinder in its growth. Competition in the market is increasing day by day as many companies like Quarters , Nestle wheata bix and other brands are coming with new and healthy breakfast products, this increases pressure on kelloggs to provide even better products with reasonable price. PEST ANALYSIS Political: Social health Conscious†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦fast paced Life style†¦Ã¢â‚¬ ¦ obesity Kelloggs 4 Ps: The main objective of marketing plan is to create a strategy and goals that ultimately satisfy customer needs. The main part of marketing plan consists of its marketing mix, to satisfy customers the company is to provide quality products with suitable distribution channels i.e Place with competitive and reasonable Price with appropriate Promotion. Products: Product is anything that is offered to the market for the attention, acquisition, use and consumption that satisfy the wants and needs of the customer. Kelloggs being the market leader in product innovation by launching new cereals and snacks

Distinguishing the Arts and Crafts in Books

Distinguishing the Arts and Crafts in Books OVERVIEW OF THE TOPIC This dissertation examines the craft of the book and its distinction between Art and Craft. Is it considered an art form†¦ a fine art if you will, or simply a traditional craft? The intended, original purpose of the book, was to be used as a means of recording information, but soon developed to become a piece of literature used for education or to contain novels of drama, fantasy, crime and other assorted genres, eventually developing further into aesthetically pleasing objects of art. In this digital era our daily lives have become disengaged from touch and so the craft of the book is taken for granted, with no thought taken into how books are made, whether it is by means of machine or by hand. REASONS FOR INVESTIGATION The tactile nature and this production method of books†¦ the traditional handmade method to be more precise is what drew me to this subject. I myself am an obsessive bookbinder, producing handcrafted books on a daily basis; there is a concrete sense of satisfaction felt in transforming sheets of paper or other media into a book. I am fascinated with this traditional craft and the aesthetic qualities the book possess, with the use of fine quality materials used and the traditional techniques and methods. However, more recently, there are now other uses for the traditionally bound book, one being the function as an artists medium, an art object known today as Artists Books. Having just recently discovered this art form, I feel more investigation is needed to distinguish what sets it apart from the traditionally crafted book. Is this genre of book art considered an art or craft? KEY AIMS AND OBJECTIVES There will be a number of key aims and objectives to this exploration of the craft of the book. However the primary objective of this study will be to determine the art and craft aspects of this handmade production of books, determining their distinctions. William Morris, a well-known figure in the Arts Crafts movement, will be a vital key thinker in studying the traditional craft aspect of the book. Morris, going back to the traditional methods of the 15th century, produces books â€Å"†¦with the hope of producing some which would have a definite claim to beauty†¦Ã¢â‚¬ [1] At the other end of the scale, Johanna Drucker, a scholarly writer in the book arts, will be a vital key thinker in exploring the art aspect of the book, more specifically the subject of Artists Books. Her book, The Century of Artists Books explores the Artists Book and its development in form and concept. She comments that Artists Books â€Å"†¦did not exist in their current form before the 20th century†.[2] That being the case, there is a possible transformation of the book from a traditional craft, to an expressive art form, which will be explored in the coming chapters, along with further exploration to discover the of moment of liberation for the book designer and the Artists Book. STRUCTURE The first chapter examines the historical significance of the book and its perceived appearance as a work of art. It will begin by reviewing the history of the book as a container of information, as a means of recording the past, touching on the various methods, techniques and technologies that were paramount in the craft of book production. Key thinkers involved will be Lucien Febvre and Henri-Jean Martin, in particular their highly credited book, The Coming of the Book. Along with other key thinkers in this field of study, they will assist in examining the development of the book and print culture, exploring the historical importance and emergence of the codex book that we are familiar with today. The first chapter will also consider the work of William Morris, a leader in the Arts Crafts Movement, and his interest in the craft of the book and the traditional methods of book production he used. Morriss greatest achievement, the influential Kelmscott Press, will set the scene to explore the growth of the private press of the twentieth century. Does the private press of today meet the standards of early traditional book production? Can the handmade qualities of the private press be compared to the machine made? As David Pye comments on his theories in workmanship, the effects of the finish and the aspects of the handmade, â€Å"Some materials promise far more than others but only the workman can bring out what they promise†.[3] The second chapter however, will be concerned with the book in relation to art, or to be more specific†¦ the Artists Book. Here the referencing of Johanna Drucker, a key thinker and scholarly writer on the subject, will be useful as it will introduce the early forms of the Artists Book, focusing more on the development of the book as an object of art. As well as a select few artists that were paramount in the development of the Artists Book, the work of William Blake, Ed Ruscha and Dieter Roth will be explored along with the relationship between text and image, artist and author. The third and final chapter offers a study of Fine Bindings being produced today, focusing on the work of Shepherds Bookbinders of London as great examples of contemporary bindings. The books in particular are a set of hand crafted, limited edition Ian Fleming novels†¦ the James Bond series to be more precise. They are of high quality craftsmanship, although with aesthetic qualities that would consider them to be works of art. Compared to their paperback counterparts, the study of these books will aid in understanding whether the handcrafted books of today are considered art or craft. The study will review numerous definitions of art and craft, which I shall discuss in the conclusion. Will a definitive distinction between art and craft be achieved? Will the craft of the book fit into either one of these categories, or even its own category yet to be named? The answers to these questions and more will be discovered in the coming chapters of this investigation. Sources [1] Ruari McLean, Modern Book Design: from William Morris to the present day, Faber Faber, London, 1958, p.11 [2] Johanna Drucker, The Century of Artists Books, Granary Books, New York, 2004, p.1 [3] David Pye, The Nature Art of Workmanship, University Press, Cambridge, 1968, p.2

The Fifty - First Dragon Essay -- essays research papers

â€Å"The Fifty - First Dragon†   Ã‚  Ã‚  Ã‚  Ã‚  Settings: The first setting is in a knight school where Gawaine is taught how to be a knight. It also takes place in the forest where he beheads all the dragons and is almost fooled into being eaten.   Ã‚  Ã‚  Ã‚  Ã‚  Plot: This story is about a student becoming a knight with no spirit at all named Gawaine le Coeur-Hardy. He was considered the least promising of all the pupils. The headmaster of the school thought he make better of Gawaine. He discussed about Gawaine with the Professor of Pleasaunce about how to make him more enthusiastic about training as a knight. Then they thought about training him as a dragon slayer. They knew that slaying dragons was dangerous but they knew they could find someway to trick him. The headmaster said that after Gawaine’ s training he would give him a magic word. He trained for a few months using papier-mà ¢chà © and wooden dragons using a battle-ax as a weapon. Gawaine felt that it was going to be a lot harder to behead a dragon later on. When a dragon ate the lettuce patch, they skipped his test and gave him his diploma, his battle-ax, and his magic. The magic word was Rumplesnitz. The headmaster said that if he says this word befo re slaying a dragon, he would be perfectly safe. When he goes to slaughter his first dragon, the dragon rushes towards him quickly, but he has enough time to say the magic word and he beheads the dragon. He goes out slaughtering many dr...

Master Engravers of Fifteenth Century Germany Essay -- Master of the P

When thinking of early artistic prints, perhaps one of the few things that come to mind would be playing cards. In modernity, playing cards are not really considered â€Å"artistic† items. However, during the earliest days of print, playing cards were the original media made by the printing process. Even before the printing press, Europe had a love of cards and, whether they were actually intended to be used for play or for show, the people wanted to get their hands on them. Because of the wide spread popularity of cards, it is no surprise that this early print media featured elements that are visually present in other printed media, even to this day. Through the influence of printmakers’ works on each other, these men honed their craft and helped develop printing as a proper art form. The Master of the Playing Cards and the Master E.S. of 1466 were both major engravers in Germany during the fifteenth century. Distinct subject matter, technique, and prevalence in their field has marked them as â€Å"Masters† of their art – a label which has outlived any other identifying information about them. This paper discusses the introduction of printing into Europe and the development of the technique under the influence of these two Masters. The Master of the Playing Cards introduced new subject matter and techniques in his cards, which through his pupil, the Master E.S. of 1466, who replicated and altered these learned skills, went on to spread into other areas of printed medium and marked a path of influence for all who would come after them. Markedly one of the most important developments in the history of visual media was that of the printing press. Brought about by German goldsmith, Johannes Gutenberg, in the mid-fifteenth ... .... "Manuscript Sources for the Playing-Card Master's Number Cards." The Art Bulletin 64, no. 4 (1982): 587-600. http://www.jstor.org/stable/3050270 (accessed April 13, 2014). Wright, Harold J.L.. "Some Masters of Engraving: Lecture II: German and Netherlands Engravers (Fifteenth and Sixteenth Century)." Journal of the Royal Society of the Arts 85, no. 4529 (1939): 1079-1095. http://www.jstor.org/stable/41359422 . (accessed May 9, 2014). Wynne, Marjorie G., and A. Hyatt Mayor. "The Art of the Playing Card." The Yale University Library Gazette 47, no. 3 (1973): 137-184. http://www.jstor.org/stable/40859489 (accessed April 14, 2014). van Buren, Anne H. , and Sheila Edmunds. "Playing Cards and Manuscripts: Some Widely Disseminated Fifteenth-Century Model Sheets." The Art Bulletin 56, no. 1 (1974): 12-30. http://www.jstor.org/stable/3049193 (accessed April 13, 2014).

Is Death of a Salesman A Modern Tragedy? Essay

In â€Å"Death of a Salesman†, the main character Willy Loman is epitome of a tragic hero as he is surrounded by various elements of tragedy. These Elements strip him of his dignity as he struggles to clinch his rightful position in the world. Arthur Miller uses corrupted society, a bad view of success, and delusional dreams, to create a path to Willy’s downfall. Willy’s destruction is calamitous, and did not have to happen. He had many opportunities to live a good life that he just failed to grasp, and he would get lost in a moment of joy. The intercity of this tragedy comes from the actual viewing of these failed attempts in finding happiness and a good life. One of the main forces that destroyed Willy Loman, is Willy Loman himself. Despite all other elements of tragedy in the story, Willy ultimately destroys himself, as his tragic flow slowly kills his existence. Willy enormously cogitates the concept that connections, and linked pasts can provide him with the future, as he as a salesman desires. Willy’s perception of what he could be, or should be, contradicts what he actually is. He sees himself as a success. However, we see Willy as a tired old salesman with a vintage view of society. Willy’s entire identity is tied up with an image of what a salesman should be. One of the most important causes of Willy’s suffering is the great villain of most modern writing in the realist vein – Society. Willy Loman is constantly trying to find the key to progressing into a genuine success, but the society prohibits his discovery. He suffers from the obsession of how he is observed by other people, and he blames his lack of victory, and a diversity of shallow personal traits like his weight: â€Å"I’m fat†¦.a salesman I know, as I was going to see a buyer, I heard him say something about walrus.† The fact that people do not take him seriously: â€Å"I know it, when I walk in, they seem to laugh at me.† His wardrobe: â€Å"I know I got to overcome it. I am not dressing to advantage maybe. The control of the amount of talking he does: â€Å"I don’t k now why – I can’t stop my self – I talk too much. A man ought to come in a few words. One thing about Charley, he is a man of a few words, and they respect him. † He uses all those excuses to explain his failure. In all reality, much of his failure results from his inability to recognise he world for what it really is – the professional world no longer dependant on contacts, or smooth talking, but focuses on specially skilled knowledgeable citizens. Willy Loman is a dreamer caught in a society ruled by machinery, rivalry, and the standard of getting ahead at any cost. In Willy’s early years as a salesman, success could be achieved by personality, kindness, and honesty alone. In a later years of his career, a salesman’s success comes to all those who are equipped with training and specialty. This is what Willy claims. Because Willy does not recognise these changes in terms of success, and it is at loss for those qualities, he is doomed to a failure in a world that demands such qualities. For his customers he struggles to be jovial yet dignifi ed salesman. For his sons he tries to be the firm, yet indulgent and protective father. For his wife, he wishes to be ever dependable breadwinner. He feels that in order to make success, he must be responsive to the demands of others, and make a good impression. He longs to be not just liked, but well liked, and he thinks this is a key to success in America. He longs to be like Ben, his brother, who has a life story that consists of: â€Å"I walked into the jungle, I was seventeen. When I walked out I was twenty-one. And by God, I was rich.† Willy looks up to Ben a lot, but this might be another one of his illusions, which he has created in his head. We never find that out. One of the saddest aspects of this play is even as we know Willy’s view of success is twisted, and distorted. Willy feels betrayed because he can not achieve the goals society has set for him. We see that especially in his younger years. Willy has never been able to achieve these goals and become successful. Linda tells us this as she reveals: â€Å"I don’t say he is a great man. Willy has never made a lot of money. His name was never in the papers. He is not the finest character that ever lived†¦Ã¢â‚¬ ¦.A small man can just be as exhausted as a great man. Willy simply does not realise that personality and friendship are not enough to become who he dreams. This is evident as he is fired by his boss, and receives the information with disbelief: â€Å"I was just fired†¦.Imagine that†¦.I named him. Willy convinces Biff that anyone confident enough, gorgeous, and born leader, such as Biff himself has the right to set the rules in life. Willy is convinced th at he is famous because of his career. He talks of going to New England on a summer trip and explains to his boys that: â€Å"they know me up and down in new England. I have friends. I can park my car in any street in New England, and the cops protect it like their own.† When he refers to his yet to come funeral, he proudly insists: â€Å"That funeral will be massive. They’ll come from Maine, Massachusetts, Vermont, New Hampshire. All the old timers with the strange licence plates – that boy will be struck. He has never realised – I am known.† The truth is that nobody showed up for his funeral, but his family and two friends. Willy even gets caught in a delusion of forming his own business one day: â€Å"Someday, I’ll have my own business, and I’ll never have to leave home any more.† For a disillusioned salesman in his sixties who can hardly complete simple tasks such as driving the mile down the road, this dream is on a brink of impossible. Willy refuses to realise that his sons are not all he has envisaged. Even as Biff tries to tell his father that he has failed miserably at an interview with Bill Oliver, Willy refuses to believe him, and even conjures up on imaginary lunch date to finalise Biff’s â€Å"success.† Eventually it is Biff who develops a keen understanding of his father, and urges Willy to drop the dreams which are holding him back, and threatening to destroy his life as he cries: â€Å"Willy you take that phoney dream, and burn it before something happens!† Willy is broken by what is false within him. He has been betrayed by the dreams that he invented for himself, but can not achieve. Every dream he has ever made for himself seems to have been pulled out from underneath him, leaving him floored and desperate. He longs for something to hold on to in life. He longs for something to make his life worth living. Willy spends much of his life dreaming, and though he brings much of his terror on himself by his dreams, a piercing sympathy rips through one’s heart as he completely lets go of life. After his death, Charley attempts to justify Willy’s constant and unrealistic dreaming by remarking â€Å"Nobody dast blame this man. You don’t understand: Willy was a salesman. A salesman is got to dream, boy. It comes with the territory† In the end, Willy’s tragedy lies as much in the bringing down of his dreams as in the bringing down of the man. In some curious way, his dreams just might have been the best part of the man. Willy’s other son, Happy, determines to make his fathers dreams come true one way or the other as he boldly states that â€Å"I’m gonna show you and everybody else that Willy Loman did not die in vain. He had a good dream. It’s the only dream you can have – to come out number-one man. He fought it out here, and this is where I’m gonna win it for him†. There is a bit of truth to this statement: Willy Loman did not die in vain – not completely anyway. Even though Willy was truly ready to lay down his own life, his death is seen as a triumphant revenge upon the dreams that have broken him. On his funeral, those who loved Willy, take a moment to pay a tribute to him. Biff proclaims the mistakenness of Willy’s ambitions. Having learned from his fathers sacrifice, he decides to head west again. Happy, as feeling in duty to his father, will stay behind in the hope of licking the system on its own terms. Charley rhapsodises the meaning and value that survives the defeat; and Linda utters the simple human grief of one who, without thought, loved. Linda is traumatized by Willy’s death. His suicide has baffled her; She cannot understand why he ended his own life. Just as Willy, she has struggled in life as she continuously attempted to keep the family together with what little money Willy brought home. She spends much time and effort adding up bills, encouraging Willy to ask for a â€Å"well-deserved† raise, and overall making ends meet. She has finally managed to pay off the house payments as the play draws to a close. â€Å"Help me, Willy, I can’t cry. It seems to me that you’re just on another trip. I keep expecting you. Willy, dear, I can’t cry. Why did you do it? I search and search and I can’t understand it, Willy. I made the last payment on the house today. Today, dear. And there’ll be nobody home. We’re free and clear. We’re free. We’re free†¦ We’re free†¦Ã¢â‚¬ . It seems that Linda, like the reader, understands that Willy’s disintegration did not have to happen. She realizes that the downfall has been tragic, just as Willy’s life. She knows that the joy and the promise of the right way of life were there for Willy, and she knows that he just missed it. But, despite the grieving done by his family, Willy finally achieves one of his numerous dreams as he is remembered, loved, and a guide for people. Though Willy’s life was a life of frustrated hopes and unfulfilled dreams, it is why we revere this tragedy in the highest. Tragedy is the most accurately balanced portrayal of the human being in his struggle for happiness, and that is why tragedies truly portray us. And that is why tragedy must not be diminished: It is the most perfect means we have of showing us who and what we are. As we watch Willy struggle for himself throughout this tragedy, we come to understand what we must strive to become.

Care Of Patients Health And Social Care Essay

In this assignment, I shall choose a longanimous role from my arrangement, this go forth be backed with a dominion for my chosen patient. This depart bothhow do reference of the here and nowance epidemiological information, in s tage of appearance this I will show an discretion of the aetiology of common long backlashary conditions. I will exemplify the nurse pretense employ and bodily, psychological and social judgement of my selected patient. In relation to the idea this will besides include the involve help of patient being discussed. I have selected a patient from a S asideh London Healthcargon Trust. In prep are to keep confidentiality unidentifiedms have been used to protect the patient s separateity. The ( NMC ) emphasises that we as comforts, must(prenominal)iness esteem populate s rights to confidentiality accord ( 2008 ) .Mr B is 51-year- experienced self-aggrandizing male. He domesticates as a bricklayer on a edifice site. He has deuce boie s whom are bestrided 21and 25. He is confused from his married woman who is the biological distaff parent to his both boies, and now has a new spouse. His avocations are reading, socializing, and disbursement preen with his boies. Mr B is a really sweet gentleman who enjoys his livelihood, and makes the most start of it.Mr B admitted to gorging on downpour occasionaly. Mr B became certified on deluge drink, and was diagnosed with waterspout colorful indisposition in 2006. After go toing umpteen brook groups, which overhaulight-emitting diode him a great trade, he became vacuous and free of heady dep abateence. Sadly, his genus Dendranthema grandifloruom upset her conflict to cancerous neoplastic indisposition his Dendranthema grandifloruom. Intelligibly, Mr B fix this difficult to cover with, and thence sour to alcohol as a lintel mechanism.EpidemiologyI purport that alcoholic coloured dis lighten ( ALD ) is going progressively common in acute infirm ary scenes, this may be payable to the huge addition in orgy imbibing. Harmonizing to ( NHS Clinical Knowledge Summaries, intoxicating abuse in England is prevailing, 33 % of which are flirt sop ups, and 16 % of adult females, which may comport damaging affects to their health. ( EBP ) . I opine my chosen subject will tending both my here aft(prenominal) practise and my own(prenominal) apprehension of ( ALD ) .( ALD ) is risqueer(prenominal)ly common in England. Approximately 90-100 % of muckle who drink the exceeded recommended resound have alcoholic fat person colorful indisposition ( home(a) Health function Choices 2009 ) . These statistics single-handedly are loftyschoolly high, which because means that Mr B is extensive bet on of roll uping ( ALD ) . It is known that each maculation oft 1 in 5 population who drink, will wear out colored-colored cirrhosis ( NHS Choices 2009 ) . Immediately this places Mr B at an unmeasur able-bodied sham of roll uping coloured cirrhosis, as he was generally admitted to infirmary with excessive ingestion of inebriant.It has been found that work take ins are to a greater extent likely die from colorful-colored disease, this may be be try their alcoholic drink con affectionption is much greater than adult females. However, this demonst reckons that Mr B s hazard of mortality is going peculiarly refering.The mortality rate of alcoholic liver-colored disease has move by over two-thirds ( 69 % ) in the past 30 old ages, which makes inebriant one of the most common cause of decease, unneurotic with high cable force per unit area, and smoke. This is a significantly high addition in the figure of deceases connect to alcoholic liver disease. Subsequently, this contributes to m all brokers associating to Mr B s alcoholic liver disease, it is unequivocal that his mentality is highly hapless deadeningonizing to these statistics. recount has been found that in that respect is a high pre valence in underdeveloped liver cirrhosis in pile age 40 or over. Further more(prenominal), as Mr B is over the age of 40, which indefinitely shows he is a high hazard of developing liver cirrhosis.As at that place is a high prevalence of grownups who consume intoxicant in ( U.K ) , every bit much 90 % ( reader ) . This altogether does non brave eitherbody in good position, allow entirely Mr B as he has a history of intoxicant abuse. thither appears to be a immense spread in recognition of the day-to-day benchmark, and if pile neb thither alcohol units ( subject field Statistics 2006 ) . Mr B s deficiency of instruction demonstrates that is otiose to construe how much he is counsel to imbibe, which may cop led to his unjustified imbibing.1 in 16 people are admitted to hospital with intoxicant associate unwellnesss ( ref2 ) It is known that greater intoxicant consumed, the higher(prenominal) hazard of unwellness, such as oesophageal cancerous neoplastic disease, whic h increases significantly one era the intoxicant consumption exceeds more than 3 drinks per 24 hours ( elegant/Health developing Agency 2005 ) . Mr B s old consumption of intoxicant indicates that may be a affirmable hazard to oesophageal malignant neoplastic disease. This presents a secondary hazard to him as he already has ( ALD ) .Q.1 AssessmentAny interposition and caution given must be given with the patient s ain demands and penchants should be taken into history. A patient with an acute unwellness should be make cognizant that they have the right to do informed determinations about the concern that receive, together with their health care professionals. However, if a patient does non hold the mental capacity to do determinations themselves ( Department of Health 2001 ) .Nursing is to toss away wellness, mending, growing and development, and to forestall disease, unwellness, hurt, and disablement. When a individual becomes sick or handicapped, nursing is guaranting th at a individual s hurt and distress is kept to a lower limit, and alter people to grok and to cover with their unwellness or disablement, its intervention and do. When decease is foreseeable, the rule of nursing is to imprimatur that the best quality of flavor is maintained until its terminal ( 2003 ) .An appraisal is a methodical, purposeful and synergistic procedure that strengthens every characteristic of nursing vigilance ( paradise & A Maguire 1996 ) . This is where a both nurse and patient indentify the patient s demands and anxiousnesss, whereby distinguish attention is given. ropemaker-Logan-Tierney a priori key out specifically for nursing is widely used in praxis throughout the linked Kingdom, it is besides used in m each nursing schools, which demonstrates the relation between theory and pattern in nursing ( roper et al 2000 ) .Although all 12 Activities of day-to-day life ( ADL ) are every bit of aftermath when measuring a patient, I shall but do referenc e of a hardly a(prenominal) due to the limited sum of words.Mr B ObsInitially B s outer ventilation was absolutely within frequent scope. However, as his view deteriorated his external respiration was compromised. It was inevitable that he required O therapy, to assist armed service his external respiration. In monastic order for his lungs to have sufficient sum of O ( o2 ) , it was of significance he was sit vertical. His respiratory rate was 35 breaths per minute. The profundity was hapless, which was apparent due the fact of the start out he used to take a breath in and out. Royal Marsden CHECK It is cardinal that patients observations are obtained on the initial appraisal or at the jog of their admittance, which will assist place any important alterations their observations. ( Nice 2007 ) .Elimination is some other activity of day-to-day life, which I tangle was compromised. Mr B had a urine catheter, to help him with go throughing piss, and so we could detect his e nd product about. Fluid balance is particular when a patient is precipitously ailing, it is of import that this is observed ( ref ) . Mr B was able to travel to the lavatory independently on admittance to infirmary. As he became acutely ailing, this became more of a battle, and he was inefficient to make this himself. I felt up his haughtiness was compromised due to his illness/condition deterioration.However, I managed to keep this to the best of my ability, esteeming his self-respect throughout my clip caring for him. The Nursing and midwifery Council ( NMC ) emphasises that we as healthcare professional must handle people who we care for as persons and esteem their self-respect ( 2008 ) .This meant that he was uneffective to extinguish independently, which accordingly diminished his independency. In order for Mr B to recover his mobility, we had to chiefly handle his ( ALD ) , so he could so reconstruct this. Harmonizing to ( NMC ) It is small that we go for people in o ur attention, guaranting they care for themselves, in order to heighten and keep their wellness ( 2008 ) .I felt that Mr B s mobility was some other ( ADL ) which was doing a immense concern. As Mr B was in the acute stage of his ( ALD ) he became brain upset, which caused his mobility to diminish ( ref ) . His reduced mobility was retentivity a knock on essence on his independency, doing him to go farther imbibe and withdrawn.Mr B s forcible wellbeing was doing a immense concern. His hepatic heading overturn induced by the harm to his liver, which depleted his mobility. Hepatic brain disorder is a neuropsychiatric, whereby the liver has been harm due to inordinate imbibing. In hepatic encephalopathy ammonium hydroxide is non being reborn into carbamide, which should usually be excreted by the kidneys, accordingly it so enters the placementic circulation ( Zimmaro & A Sawchuk, 2004 ) . reader med n surgConsequently to Mr B retentiveness alcoholic liver disease, he had oesophageal varices. This is whereby a composite of Byzantine venas at the wanting(p) terminal of the gorge, are enlarged and fruitless as a consequence of the entry high blood pressure. If left untreated Mr B may be able-bodied to an oesophageal or stomachic variceal rupture, which may do hypovolemic daze ( ref ) . HBAs Mr B has portal high blood pressure, this means he is a high hazard of a gastrointestinal bleed ( GI Bleed ) . A ( GI ) bleed is where portal high blood pressure occurs when there is an impedimenta in the intra- or extrahepatic circulation ( reviewer ) .psychologicallyI face that Mr B s physical demands were been depleted due to his chronic condition/illness. On admittance to infirmary, Mr B was highly malnourished, dehydrated and presented with self-neglect, which was provoked by his overly imbibing. Harmonizing to Maslow ( 1943 ) , these are all basic physiological demands.Mr B had late lost his Dendranthema grandifloruom to malignant neoplastic disease, which led to imbibing intoxicant overly. He felt he neer grieved decently, or intercommunicate to anyone about his loss. I feel that this was a important contributing factor to his backsliding. reader bereaves ) . Prior to his mourning he had been clean and free of intoxicant. Attending a support groups for alkies, such as alcoholic nameless may hold prevented his backsliding * ( REF ) . Consequently, this may hold helped him to get by with the loss of his Dendranthema grandifloruom, and assist beef up his ability to get the best(p) of his alcoholic dependence.Mr B feels that he is socially excluded from society as he has been unavailing to work due to his illness/condition. As a nurse, it is cardinal that I help in back uping him, so he feels included in society, which may be make so by reffering him to an occupational healer. ( OT ) consumeWhilst measuring Mr B, he give away that when he was turning up his pa consumed intoxicant overly. He feels that this had a immense imp act on him, act uponing him embrace his pa behaviour. It is known that if a people have parents who misuses intoxicant, so they have greater hazard of spare-time activity these traits ( ref ) . hitch steps will assist ease Mr B in act uponing his kids from following his drinking civilization.Socio-economic background may hold immense deduction in the effect of the effects of inordinate ingestion of intoxicant. I feel that this may be a immense barrier for Mr B to hold on the constructs of the damaging effects of intoxicant abuse. As a health care it is vituperative that I simplify the possible long term wellness effects of inordinate intoxicant comsumption. ( Ref )Q3.Required attentionAt present, there is no national service exercise ( NSF ) for liver disease patients. The primary attention trusts view in liver patients, is that they are non a immense precedence. Specialists stressed that liver patients are being left out on National Health aid ( NHS ) financess, which means that they will be at greater hazard ( REFFFBBC ) . However, there is National Institute Clinical ( prissy ) Guidelines in topographic point in order to assist supply quality attention to those enduring with ( ALD ) .Shaw et al indentified an assessment nib for patients enduring with intoxicant climb-down, which establishes the hardness of their backdown, and what capture intervention is required ( 1981 ) . The assessment asshole used is the Clinical Institute insularism Assessment for Alcohol Withdrawal ( CIWA-A ) , which is scored Mild-20.4, check out 24.2, and Severe 29.In regard to the appraisal tool, Mr B had a assortment of the characteristic backdown symptoms, which were shudders, sudating, hallucinating, and agitation, which meant he scored 20 & gt .Nonetheless, this presented a important hazard, if left untreated may take to complications.Mr B was treated as per communications communications communications protocol, which is Librium is benzodiazepine minor tra nquilizers drug, which is used for short- flux anxiousness, and should non be used long-run ( bnf 2010 ) .Harmonizing ( NICE ) guidelines the protocol intervention for anxiousness is 10 mgs Three generation daily ( TDS ) , and may increased if necessary to 60-100 mgs daily in divided doses. The dosing government is a restore dosage, get downing on twenty-four hours one at 20-30milligrams ( MGS ) four times daily, twenty-four hours two 20-30mgs three times day-to-day, twenty-four hours two 20-30mgs twice daily, and twenty-four hours four 20-30mgs one at bedtime. There is besides a symptoms triggered dose as required ( PRN ) , this depends on the badness of the symptoms.Benzodiazepine acts on receptors in the cardinal awkward organization ( CNS ) to originate the achievement of gamma-aminobutyric acid ( gamma aminobutyric acid ) , which is a neurotransmitter. ( GABA ) receptors have at least two benzodiazepine receptors, which are named BZ and BZ2, when stimulated they enhance t he restrictive action by the ( GABA ) ( Alan et al. 2004 )As Mr B s brain disorder was impacting his degree of consciousness, it was significantly of import that we carried out his neurological observations. Neurological observations is whereby an appraisal and military rank of an person s unity and interpret of an person s nervous system ( Rowley & A Fielding 1991 ) .CHECK WEB His status has meant that he is temporarily paralyzed, doing his musculuss to weaken, decreasing his physical strength. As a consequence he may potentially necessitate physical therapy. ( ref )Education can beAn probe that may be through with(p) to discourage if there is any hinderance in the portal venous system is an angiography, which establishes the cause and site of opponent. It is besides critical that Mr B has an endoscopy, which will uncover gastro-oesophageal varices. It is of import that Mr B s haemoglobin is closely monitored, this will bespeak if there is any signifier of bleed or obstructo r ( Miller et al 2006 ) . PHARMAscitess is another clinical manifestation of hepatic cirrhosis. It is where serous nomadic is repeatedly produced in the peritoneal cavity.. This is when an aggregation of placid in the abdominal pit enters quicker than it can be returned to the circulation by the capillaries and lymphatics. If this is left untreated, the accretion of fluid will compromise Mr B s critical variety meats, doing it hard for them to map.One of the mechanisms of ascites is hypoalbuminemia, whereby the liver is unable to synthesise albumen.It is of import this fluid is drained from the abdominal pit. There are two interventions which are used to run out this extra fluid. One is, an anti-diuretic called spriolactone, which is a loop water pill. Ref bnfThis is done so by the interpolation of an ascitic drain. refAnderson et al defines that the disposal of total blood or any of its constituents into the blood stream, to rectify or handle any clinical abnormalcies ( 1994 ) . Mr B was given military personnel Albumin Solution ( HAS ) transfusion to govern is hypoalbuminemia. Harmonizing to the ( BNF ) 20-25 % of concentrated solution of ( HAS ) may be used to obtain a diuresis in hypoalbuminaemic, it is of import whilst a patient receives this blood plasma replacement, their unstable balance is closely monitored ( 2010 ) . FBC REFPatients with alcohol-related liver disease are often malnourished, which accordingly has disadvantageous effects in their endurance ( Mendenhall et al.1984 )KEISER MODELAs intoxicant abuse is going a immense load on the national wellness service ( 2000 ) . NICE guidelines stated that when such patients present themselves to hospital, it is of import that they are referred to the seize health care professional, which will guarantee they receive equal support ( 2010 ) . On admittance Mr B was referred to the intoxicant specializer nurse ( ANS ) , who deal with the intervention, after attention, and followup.Mr become nutri tionally depleted as a consequence of his intoxicant liver diease, it was indispensable that was introduced some signifier of nutrition. ( Lechtenberg & A Warner ) states that Nutritional support must be offered, and see implementing a nasogastric tubing eating ( NG ) ( 1992 ) .KIASER MODELThe Kaiser theoretical account is to assist guarantee that there is a strategic and systemic attack towards those with ( LTC s ) . It focuses in instance direction on the most vulnerable people with ( LTC s ) .Mr B degree of attention is disease specific direction, which is ( flat 2 ) , this encompasses tracts and protocols. As mentioned earlier in the assignment there is presently no ( NSF ) for people with alcoholic liver disease. However, there are ( NICE ) guidelines to help in supplying attention for people with ( ALD ) . Mr B was populating independently precedent to his admittance, with no input from multidisciplinary squad ( MDT ) .Planing the emission on Mr B meant I had to direct at the wider facets of his illness/condition.I feel that the execution of social services would be highly benifical to Mr B.A referral to a liver nurse specializerI feel that Mr B would profit from a support group such as alkies anon. , which may assist diminish his time to come admittances to infirmary.The Alcohol Needs Assessment interrogation Project ( ANARP Department of Health, 2005 ) identifies three classs of alcohol-use upsets.The clinical grounds reappraisal showed that benzodiazepines were more impressive than placebo for the bar of craze tremens and intoxicant backdown seizures26.The mean cost for handling patients with AAW crossways all trusts in England and Wales was estimated to be ?219 per in-patient day181. vivid intoxicant backdownhypertext pitch protocol //www.patient.co.uk/doctor/Alcohol-Related-Problems.htmbarr A. Drink a societal history London 1998? ? ? ? ? ? ? ? ? reforford j. inordinate appetencies psychological position of dependences 2nd chance variab le chichester wiley 2001hypertext enthrall protocol //www.nhs.uk/Conditions/Physiotherapy/Pages/How-does-it-work.aspxYou must back up people in caring for themselves to better and keep their wellnessShaw JM, Kolesar GS, Sellers EM, Kaplan HL, Sandor P. Development of optimum intervention tactical maneuver for intoxicant backdown, I appraisal and effectuality of supportive attention. J Clin Psychopharmacol. 1981 8382-389.British Medical Association and Royal pharmaceutic Society of Great Britain. British National Formulary. 58 erectile dysfunction. London United kingdom BMJ Group and RPS Publishing 2009.DO NOT REF BELOWhypertext transmit protocol //books.google.co.uk/books? id=q4qMwXJm4iwC & A pg=PR13 & A dq=Roper+N+etal+ ( 1996 ) +The+elements+of+nursing+a+model+for & A hl=en & A ei=BPYDTfPxJoyU4gbfwsWTCg & A sa=X & A oi=book_result & A ct=result & A resnum=1 & A ved=0CDMQ6AEwAA v=onepage & A q & A f=falseFatty liver disease is reversible. If you stop imbibing intox icant for two hebdomads, your liver should return to normal. alcoholic liver disease is widespread in England.It is estimated that90-100 % of loaded down(p) drinkers have alcoholic juicy liver diseaseoneA in fourA drinkers with fatty liver disease will develop alcoholic hepatitisone in five drinkers with fatty liver disease will develop cirrhosisA heavy drinker is person who on a regular basis exceeds the recommended hebdomadal bound for intoxicant ingestion. This isA 3-4A units of intoxicant a twenty-four hours for work forces, andA 2-3A units for adult females.Womans are more likely to develop alcoholic liver disease, but work forces are more likely to decease from it, perchance because work forces tend to be heavier drinkers.In 2008, there were 4,764 deceases in England and Wales due to alcoholic liver disease. Three-fourthss ofA these were work forces.Death ratesA linked to alcoholic liver disease have arise by over two-thirds ( 69 % ) A in the lastA 30 old ages. This makes alcohol one of the most common causes of decease, along with smoke and high blood force per unit area.Fatty liver disease and hepatitis can develop at any age. Cirrhosis normally develops in people aged 40 or over.A However, instances of cirrhosis have been reported in people of all ages, including adolescents.NHS Clinical Knowledge Summaries, intoxicant abuse. hypertext transfer protocol //www.cks.nhs.uk/patient_information_leaflet/Alcohol_misuseApedhypertext transfer protocol //www.statistics.gov.uk/CCI/nugget.asp? ID=1027 & A Pos=1 & A ColRank=2 & A Rank=1000Roper N etal ( 1996 ) The elements of nursing a theoretical account forhypertext transfer protocol //www.nmc-uk.org/Nurses-and-midwives/The-code/The-code-in-full/hypertext transfer protocol //www.nice.org.uk/nicemedia/live/12995/48989/48989.pdfhypertext transfer protocol //www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103161.pdfhypertext transfer protocol //news.bbc.co.uk/1/hi/health/266097 7.stmHeaven C.M. & A Maguire P. ( 1996 ) pedagogy hospice nurses to arousepatient concerns. Journal of advance Nursing 23, 280A286.International Council of Nursing ( 2007 ) www.ICN.ch/definition.Anderson, K.N. , Anderson, L.E. & A Glanze, W.D. ( explosive detection systems ) ( 1994 ) Mosby s medical, Nursing, and confederate Health Dictionary, 4th edition. Mosby, St Louis, MO.Galbraith, A, Bullock, S, Manias, E, Hunt, B & A Richards, A92004 ) Fundamentalss of Pharmacology, Second Edition, Essex, Pearson Education Limitedhypertext transfer protocol //www.nice.org.uk/nicemedia/live/11810/35950/35950.pdfhypertext transfer protocol //www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_103653.pdfhypertext transfer protocol //www.rcn.org.uk/__data/assets/pdf_file/0008/78569/001998.pdfhypertext transfer protocol //qjmed.oxfordjournals.org/content/93/5/291.fullMendenhall CL, Anderson S, Garcia PP et Al. short-term and long-run endurance in patients with alco holic hepatitis treated with oxandrolone and Pediapred. New England Journal of Medicine. 1984 311 ( 23 ) 1464-1470.Lechtenberg R, Worner TM. Entire ethanol ingestion as a ictus hazard factor in alkies. Acta Neurologica Scandinavica. 1992 85 ( 2 ) 90-94