Fashionably Loud Essays - Fashion, Television Advertisement, Model

Fashionably Loud Fashionably LOUD! Do you choose what you wear or does the media choose it for you? I am one of the million Americans who struggle with keeping up with the new trends of the season. The media works their hardest in trying to persuade us into buying new things for home, work, and family. The media today is the largest advertisements money can buy and many large companies spend millions of dollars for a one-minute commercial on one of the major stations. Television and Magazine elaborate not only on what to wear and when to wear it but also on what others are wearing such as movie stars, models, music artists. Television, one of the major mediums of the media world, gives us the gossip on who is wearing what and what is fashionable for the season. Television shows like Entertainment Tonight, The National Inquirer TV, and Fashion TV are few of the shows that give us information on new trends for all different types of people and in all different countries. Television commercials give us the backbone we need to fall into all the schemes for selling. Designers such as Calvin Klein, Levis and many others try to catch our eye with their cool and crazy commercials. Television influences the way we shop. It accents to each and every one of our wardrobes with telling us what is hot and what is not. Teenagers, especially, give a lot of their attention to these television programs and try to be just like the models on the runway. The commercials try to target the younger generation because they will have them in the palm of their hands for the rest of their lives. Also they are easily influenced by Television with the billions of dollars spent on advertisements they have them trapped. Fashion Magazines give us a very good look at the fashion world, also. In magazines like Cosmopolitan, Marie Claire, and Vogue we see many great and very sexy advertisements that are screaming out to sell, sell, and sell. Designers such as Dolce this is cool and hip for the season. Although lets not over look the face, make-up has a very large part in the fashion world. Magazines are constantly telling us what shades are in for the season and who sell them. The Magazines and designers of the clothing world work theyre hardest to get people to buy their stuff. They highly influence people into buying clothing. Kate Spade, now the number one designer of hand bags in the world, got her fame from advertising in magazines. The handbags selling no lower than $200, has become a must in ones wardrobe coming from Vogue In conclusion the media shapes our thoughts and minds in buying products that are not a life necessity. We are always finding ourselves trying to keep up with the new trends an d new styles of the 90s. Television is one of the major networks that keep businesses going. They give a need to buy to someone who is willing to listen. Magazines are also a wonderful medium in selling clothing and other things. With their outrageous advertisements who would not fall into their trap? In conclusion, the media shapes our thoughts and minds in buying products that are not a life necessity although it makes us happy, it is worth it. We are always finding ourselves trying to keep up with the new trends and new styles of the 90s. Television and Magazine are one of the major mediums that keep businesses going and designers coming out with new and more expensive trends. The media give the need to buy to someone who is willing to listen. Social Issues

The Talented Mr. Ripley essays

The Talented Mr. Ripley essays Directors often base their films on novels; however, directors many times will alter the characters, plots, and settings of their films to appeal to an audience more than the novel. Changing the overall image of a character and accentuating different elements of a setting for a film will alter an audiences perspective of the character. This new opinion of the character in the film usually portrays the directors feelings toward a particular character, whether the feelings are positive or negative. The Talented Mr. Ripley is a wonderful example of changing a character and setting so they will come across to an audience in the same way the character appeals to the creator. A good scene for comparison is when Marge finds Dickies beloved rings among Tom Ripleys possessions. This scene shows how the drastic differences in Marges character changes the relationship of Tom and Marge in the novel and film and also changes the audiences perspective of Marge because of the different ways Pa tricia Highsmith and Anthony Minghella wrote her character. The setting of the ring scene is different in the novel and film. Marge confronts Tom with the dilemma of Dickie having taken off his rings in a large, open room in the novel; an open room for an open mind. This open room instills a feeling of receptiveness on the part of Marge. Tom has been sitting on a sofa that has just been described as fitted his shoulders like someones arm, or rather fitted it better than somebodys arm... The cozy sofa also makes the reader aware that Tom is very vulnerable at this point in the movie because he is relaxed and drowsy. Highsmith is able to change the cozy feeling quickly though because she then draws attention to Toms nervous actions when Marge informs Tom that she has found Dickies rings. Tom stands up quickly; he bumps into on of his shoes and picks it up; he holds the sho...

Managment Essay Example | Topics and Well Written Essays - 250 words

Managment - Essay Example Compared to other graduates, I believe that my superior research skills and ability to organize myself and the team to face challenges puts me at an advantage. I bring the values of honesty, accountability and an ability to meet challenges head on to the table. I am transparent in my dealings and if I am given some responsibility, I ensure that I am accountable as well. Combined with the ability to rise up to challenges, these values make me an ideal person to lead a team. Further, I can subordinate my individual goals to the needs of the team making me a team player as well. Hence, this ability to be a part of the team as well as lead a team makes me versatile and skillful at my job. I will show my value to the prospective employer by telling him about the most significant challenge that I have faced in my life so far and recounting the details of how I overcame the challenge. The challenge being mentioned is about how I led from the front when faced with an intractable problem that required out-of-the-box thinking to arrive at a

Economics Term Paper Example | Topics and Well Written Essays - 1500 words

Economics - Term Paper Example 2.2 Economy of North America†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦... 7 The topic covers opportunities for allocation of capital as a scare resource that has to be allocated in many ways. Others see prospects in monopolistic environment, while others perceived the pure and natural monopoly more advantageous for their particular intention. Economies of countries differ because of economies of scale. This results to differences in GDP of poor and rich countries. We also see that aggregate demand is affected by price levels that either lowers or raises income and eventually influences balance of trade. Also, we have come at a conclusion that capital is the backbone of any business, but there are several decisions needed before a business could be established. Economics is a social science that studies production, distribution and consumption of goods and services. By extension economics also studies economic system, human welfare the creation and distribution of wealth, and the scarcity and alternative uses of resource. Under this definition, this study looks at the different market structure in a monopoly environment, examines the economy of selected countries, and studies the capital structure of business in order to understand the process of distribution of wealth. A monopolistic competition is a form of an imperfect competition which results from the differentiation of products by sellers. Dean, J. (p. 51) describes monopolistic competition as a situation where there are many sellers and no one can claim of control of major part of the common commodity. For example, McDonalds cannot claim a monopoly of hamburger sandwich as many others are selling the same product. McDonald differentiates its product thru advertising and promotion. Chart below shows a monopolistic competition which shows that on a short run basis, profit margin is comfortable for

How to make it illegal for employers not to offer bike racks and Essay

How to make it illegal for employers not to offer bike racks and showers - Essay Example This research will begin with the presentation of the current state of workplace cycling campaign. The major benefit to employers is that healthy employees take fewer sick leaves and are more productive at the workplace. The health of employees is improved because cycling is a form of physical exercise which lowers blood pressure of people, improves weight control and improves the condition of the heart and lungs. Cycling employees are also very alert and they experience lower stress levels. Employees also arrive at work on or in time because cyclists are freed from traffic jams. Staff cycling also lowers direct costs of employers. Employees also travel cheaply using shared bicycles at the workplace; hence savings are made on bus fares, taxi costs and care to hire expenses. The organization also benefits from cheaper parking costs, this is because the cost of parking one car can adequately meet parking costs for more than 10 bicycles. Encouraging cycling also reduces company car expe nses because giving a bicycle and incentives make employees forego company car. Cycling also builds a greener corporate image; this is because companies encouraging staff cycling reduce effects of road congestion and associated air pollution. Employees also benefit from cycling in various ways. Staff cycling lowers the cost of employee travel; this is because the buying price of a bicycle is much less than the buying price of a car, cycling saves car parking fees, and employees incur fewer petrol bills and bus passes.

Management of Diabetic Foot Ulcers

Management of Diabetic Foot Ulcers Diabetic foot disorders are the rated as the number one cause of hospitalisation for diabetic mellitus patients in the United States and abroad. Among these disorders are, foot infection, ulcerations, cellulitis and gangrene. It is estimated that a 100 people per week lose a digit, foot or a lower limb due to diabetes mellitus8. Diabetic foot disorders and its long term complications account for direct medical budget of hundreds of millions of dollars annually, including lengthy hospital stay of patients and lengthened periods of disability. In the UK, diabetes cost the NHS over  £5 million pounds per annum and the cost of diabetic foot complications including amputations was  £252 million in 2003. Figures show that 1 in 10 foot ulcers result in the amputation of a foot or a leg. The most distinguishing foot complication of diabetes is the ulcer, which is of course a major risk factor for amputation. Mortality rates after amputation are as high as 50 percent in diabetic patients. Although the primary pathogenesis is neuropathy, immunopathy and vasculopathy (ischemia), diabetic foot ulcer is attributed to a number of other risk factors. Early detection of these risk factors as well as the foot ulcers themselves is crucial in the general management of diabetic foot ulcers and amputation prevention. Therefore, immediate and aggressive treatment of all diabetic foot ulcers can prevent worsening of the complication and the need for amputation. The objective of treatment as a result should be prompt intervention to allow good healing of the ulcer and once healed, to prevent its recurrence. However, the optimum care for foot ulcers rest upon the treatment teams understanding of the pathophysiology associated with diabetic foot ulcers, familiarity with current methods of treatment and the concept that the multidisciplinary team approach is the gold standard in preventing limb amputation. And above all, prevention of foot lesions should be ranked highest amongst all priorities. EPIDERMIOLOGY There is no concrete data illustrating the true picture of the incidence and prevalence of diabetic foot ulcers. However, majority of the information gathered about its aetiology is based upon national hospital discharge survey (NHDS) data, which does not include a vast number of patients with ulcerations treated on the outpatient basis. Cross-sectional and population-based studies help to approximate the distribution and frequency of diabetic foot ulcers, while prospective cohort studies and retrospective case-control studies are instrumental in detecting associated risk factors for the foot lesions. According to Reiber et als epidemiological review, chronic ulcers represented 2.7% of all diabetes related admissions and 46% of all admissions due to any ulcer condition. The 1983-1990 NHDS survey also revealed that the highest ulcer rates were found in individuals aged 45-64 years, with male preponderance over the female. The average length of stay (LOS) for diabetes pat ients discharged with ulcers was 59% more than in patients without ulcers, around 14 and 8 days, respectively. Numerous population-based studies record a yearly incidence of diabetic foot ulcers in the magnitude of 2% 3% in both type 1 diabetes mellitus (IDDM) and type 2 diabetes mellitus (NIDDM) patients, while the prevalence ranges between 4% and 10%. These studies also suggest a widespread trend for higher prevalence of ulcerations with increasing age and duration of diabetes. Once ulcerations have occurred, recurrence rate can get to 50% in 2 years and 70% in 5 years. Despite the fact that mortality linked with diabetic foot ulcerations has not been recorded, 70% to 80% of amputations of the lower extremity can be lead by foot ulcers. Amputation is one of the most common sequels in persons with diabetes mellitus now exceeds 100,000 per year in the United States and amputations involving the leg, foot or toe(s) are not uncommon. Approximately 15% of patients with diabetic foot u lceration will require amputations due to uncontrolled infection, gangrene or failure of the ulcers to heal. Unfortunately, there is a 3-year survival rate of 50% after the amputation of a lower limb, while the 5-year survival rate is approximately 40%. Subsequently, less than half of the patients who end up with lower extremity amputation (LEA) of one limb go on to develop a severe contralateral ulcer within a space of 2 years, thereby putting the future of the other limb at risk as well. AETIOLOGY/PATHOPHYSIOLOGY Several factors have been implicated in association with diabetic foot ulcers. These factors include the intrinsic complications of diabetes mellitus in affiliation with some extrinsic factors and together predispose the diabetic patient to the risk of developing foot lesions. The trilogy of peripheral neuropathy, peripheral arterial disease (ischemia) and susceptibility to infection (immunopathy) are the main predisposing factors for lesions on the foot. The impact of peripheral neuropathy may not be easily detectable, with little or no signs and symptoms. Notwithstanding, its pathology advances fast and the end stage of tissue necrosis quickly reached. Distal sensory neuropathy can be seen in 20% to 50% of patients with type 2 diabetes. This decreases the protective sensation in the feet, leading to abnormal spreading of foot pressure and shear stresses with subsequent callus formation. This in turn diminishes the patients ability to perceive minor trauma to the foot and this is de monstrable by vibration perception threshold (VPT) and insensitivity to a 10g monofilament, which conveys a 7-fold and 18-fold risk of foot ulceration respectively. Distal motor neuropathy precedes atrophy of the intrinsic and extrinsic musculature of the foot, with accompanying deformities of the toes and metatarsals heads on the plantar aspects of both feet and consequent bunions on the 1st and 5th metatarsal-phalangeal joints. However, these irregularities of the feet cause an increase in the foot pressures, particularly around the bony prominences, thus resulting in more calluses forming. These calluses then go on to further increase the local subcutaneous pressure, ultimately resulting into haemorrhage beneath the callus, a lesion known as the pre-ulcer is then formed. With progressive pressure mounting on the pre-ulcer, the overriding skin breaks down to produce an ulcer. In addition, distal autonomic neuropathy could as well spark a plantar ulcer directly by reducing sweating in the feet with consequent drying and cracking of the skin28.Peripheral arterial disease and impaired cutaneous circulation are also important risk factors for both ulcerations and LEA. Peripheral arterial ischemia sometimes produces ischemic ulcers, but these are rare occurrences i.e. (1% 2% incidence) than neuropathic ulcers (65%) or combined neuroischaemic ulcers (25%) 28. Transcutaneous oxygen tension (Tc pO2) levels less than 30mmHg and absence of peripheral pulses or past history of vascular surgery are strong separate predictors of ulceration. Diabetic foot infections often set in and complicate already settled foot ulcers. Although, infections play an integral part in the pathway to lower limb amputation, there is inconclusive data with regards to the position of susceptibility to infection in causing ulceration. Even though, most ulcers are caused by minor foot trauma, and in some cases the patient takes no notice of because of the sensory neuropathy. These minor injuries (i.e. extrinsic factors which include; wearing ill-fitting/brand new shoes, hot soaks occupational hazards and to a lesser extent self-induced trauma by cutting toe nails or calluses) constitute the leading cause of acute precipitant of diabetic foot ulcers. In addition, there are also a number of intrinsic factors which could predispose diabetics to developing foot ulcers and they include; longstanding diabetes, past history of ulcers or amputation, age, weight, retinopathy, nephropathy and structural deformities of the foot (i.e. Charcot foot) have al l been associated as risk factors for ulcerations. However, bad biomechanical function arising from the complications of diabetes generally leads to foot injuries in most diabetic patient. ASSESSMENT OF DIABETIC FOOT ULCERS A detailed and well organised evaluation of the lower extremities is crucial when commencing the treatment of a diabetic foot ulcer. Before carrying out the physical examination of the limbs, it is noteworthy to perform a quick inspection of the patients shoes for good fit, foreign objects and the wear and tear patterns. The clinical evaluation must include an appropriate assessment of the ulcers aetiology, its extent and depth, presence and severity of both local and systemic infection and peripheral vascular status. A comprehensive assessment of the patients general health and glycaemic control, extent of peripheral neuropathy, a careful, yet detailed dermatologic and musculoskeletal examination should also be included in the evaluation. These assessments determine the ulcers healing rate, potential progression to LEA, and the likelihood of reoccurrence. Therefore, they should be accomplished urgently in the ambulatory or hospital setting and require a multidisciplinary team approach, with possible consults to the infectious disease specialist, podiatry, vascular and orthopaedic surgeons. Bilateral lower limb pulses must be examined. When pulses are diminished or not palpable, Doppler segmental pressures to the toes or TcpO2 measurement are indicated and the vascular experts should be brought on broad. The neurological evaluation should assess the patients sensorium and deep tendon reflexes. The ankle and knee reflexes are tested with the aid of a simple neurological hammer, while the important aspects in the evaluation of the sensorium are: reduced sensation to pain, light touch, hot/cold and vibratory sensation. Pain sensation is easily assessed with a disposable needle. A piece of cotton ball, lambs wool or 10-g monofilament can be used to evaluate the light touch and a 128-Hz or 512-Hz tuning fork or biothesiometer are approved for vibratory evaluation. Cold perception is also assessed by submerging the metal arm of a neurological hammer into cold water and then placing it against the patients skin. Anatomical deformities such as hammertoes, previous foot amputation, or Charcot joints often produce high pressure areas which result in ulceration. The musculoskeletal evaluation cannot be done by visual inspection of structural findings alone, it must also include testing for muscle strength, weakness, atrophy and contracture. Assessment of joint range of movement and gait evaluation with computerised plantar pressure analysis will also be of great value in appreciating the abnormal dysfunction contributing to ulceration. Examination of the skin of both feet is also carried out with detailed attention to the quality and integrity of the skin around the interdigital areas. Changes in the colour of the skin often associated with spotted rashes and heel fissures are suggestive of a significant level of ischemia. Toenail changes and presence of subungual drainage are pointers to a proximal source of infection. Clinical assessment of the ulcer should include a detailed description of its appearance as well as the measurement of the ulcers diameter with a wound measuring guide. Outlines of the ulcer on a translucent film or plastic sheet can also promote this process. This must be documented and retraced at subsequent visits to assess the treatment process. The depth and extent of the wound should be carefully explored with a blunt sterile probe. Special care must be taken to probe for hidden sinus tracts and subcutaneous abscesses or to identify tendon, bone or muscle or joint involvement. Ulcer depth is a significant predictor of healing rate, possibility of concurrent osteomyelitis and the chances for amputation. The presence of infection is a huge cause of the need for hospitalization. Therefore, a general assessment with physical examination, laboratory investigations and radiographic studies is important in classifying infection as absent, mild, moderate or severe. This classification acts as a guide to determine or select the initial antibiotic therapy and to decide when to hospitalise the patient. Clinical signs of infection such as purulent discharge, odour, cellulitis, fever and leucocytosis must be documented. However, Leucocytosis and fever might not always be noticeable even in the presence of acute osteomyelitis. Approximately 54% of patients with diabetic foot infections had normal white blood cell count and no fever44. Bacteria cultures of anaerobes and aerobes (both gram positive and gram negative) should be obtained from the base of the ulcer, bone or blood or from all three depending on the clinical setting. This helps in clarifying the true hidden pathogens and may facilitate the decision to adjust initial antibiotic therapy. Physical examination of signs of infection in the patient centers on the presence or absence of systemic responses such as fever, tachycardia, sweats or hypotension and the appearance of the wound and adjacent tissues. Early signs of infection are evident by increased amount of exudates from the wound, base of the ulcer changes from pink granulation to yellowish- grey tissue, tenderness and induration around the ulcer. Infection should be considered severe when the patient present with systemic toxicity, signs of fascilitis or a rim of erythema around the ulcer greater than 2cm in diameter. Laboratory investigation to confirm the presence of infection should include white blood cell count and differential which could show leucocytosis or a shift to the left or both, erythrocyte sedimentation rate (ESR) which when elevated above 40mm/hr is a strong indicator of osteomyelitis28. In addition, glucose, bicarbonates and creatinine levels are tested to rule out possible hyperglycaemia, metabolic acidosis or azotemia from dehydration which strongly suggest the presence of a severe infection. Radiological evaluation should be obtained promptly to ascertain the presence of fractures, foreign objects or signs of osteomyelitis. Plain x-rays have a low sensitivity, thus they should be interpreted with caution as changes in the foot caused by Charcot foot could mirror those osteomyelitis when seen on a plain x-ray. However, a normal plain x-ray of the foot does not rule out osteomyelitis, a repeat should be requested 2 weeks later to exclude occult osteomyelitis. As indicated, other imaging modalities can aid in the diagnosis of osteomyelitis such as CT scans, magnetic resonance scan (MRI) or leukocyte scans and each having their own strengths and limitations. TREATMENT Management of the foot ulcer is mostly determined by its severity, vascularity and the presence of infection1. Recognition of its root cause will serve as a guide during the course of treatment. However, a multidisciplinary team consisting of specialist from podiatry, orthopaedic surgery, vascular surgery, the infectious disease service and diabetic education service should be involved in the management. The multidisciplinary team approach is due to the complicated nature of the disease itself as well as managing the various comorbidities associated with foot ulcers. In addition, the approach has been demonstrated in clinical trials to produce significant outcomes in terms of improvement and reduce the incidence of major amputations. The wound should be immediately relieved of all pressures, elevated and rested at first presentation. Effective local wound care must be carried out and ill- fitting footwear should be discarded and replaced with appropriate surgical or relief shoes for protection. And in cases where total nonweightbearing with crutches is impossible, a pressure felt padding or foam can be used in the surgical shoes. However, the total contact cast (TCC) is considered gold standard to protect neuropathic ulceration during ambulation due to its ability to eliminate high pressure areas under the foot. Adequate alternatives to the TCC are the Scotchcast Boot or removable walking braces. Treatment of hyperglycaemia, ketoacidosis, renal insufficiency and other comorbidities that may coincide in the ulcerated patient should be treated simultaneously with the foot lesion. Consultations to internal medicine, endocrinology and cardiology are generally frequent when managing acutely infected patient who need to be hospitalised. Such consultations are usually sought early in course of treatment to ensure good metabolic control. Diabetic foot infections are usually polymicrobial and as such initial antibiotic therapy should be broad-spectrum after obtaining good aerobics and anaerobic culture samples. Antibiotic therapy should be later modified according to the culture and sensitivity test and the patients clinical response to the initial therapy. Surgical debridement and drainage or local partial amputations are crucial adjuncts to antibiotic therapy. Underlying osteomyelitis usually present in moderate to severe infections and often requires aggressive bony resection of infected bone and joints accompanied by cultured -directed antibiotics for 4 6 weeks. Foot ulcer patients with underlying ischemia should undergo revascularization with angioplasty or vascular bypass procedure if its anatomically possible. Even with severe distal arterial obstruction, revascularization to return pulsation to the foot is a major part of the limb-salvage strategy and may be accomplished in such patients. However, where revascularization is not feasible or in cases of advanced infection or extensive necrosis, amputation at some level may be required. Wound care is also necessary after surgical or sharp debridement of all callus and necrotic tissue58. Practically, a warm, moist environment conducive for wound healing should be maintained.This can be arranged using saline wet/dry dressings or special dressings such as semipermeable films, hydrogels, calcium alginates and hydrocolloids. Tissue-engineering dermis is a more recent class of biologic dressing and has been tested to be more effective than saline dressings. There is little evidence to support the role of topical enzymes and should be avoided. Although the role of topical growth factors in the healing rate of ulcers is beneficial, however, they are expensive and should be limited to patients whose ulcers cease to improve after 4-6 weeks of adequate therapy. PREVENTION OF RECURRENCE AND AMPUTATION Prevention is regarded as a major aspect in avoiding ulcer relapse and diabetic lower limb amputation. Recurrence rate with diabetic foot ulcers and LEA are as high as 50% -70% over three years. Comprehensive intervention programs tailored to individual patients can lower these rates and can be accomplished with a multidisciplinary team approach. Control of both macrovascular and microvascular risk factors is also of great importance. Patient education and re-education plays a primary, yet active role in this program and involves instruction in foot hygiene, the need for daily inspection, proper footwear and the necessity of prompt treatment of new lesions. In addition, regular and frequent visit to a diabetic foot care program is crucial. The feet must be thoroughly inspected at every visit and should include debridement of calluses and ingrown toenails. This provides an excellent opportunity to back up self care behaviour as well as allowing early detection of new or imminent foot problems. Appropriate therapeutic footwear with pressure-relieving insoles and high toe box which protect the high risk foot are an essential element of the prevention program and have been associated with significant reductions in ulcer development. Subsequently, patients with major structural deformities may benefit from reconstructive surgery to prevent recurrent foot ulcers. Surgery may be especially suitable in patients who cannot be accommodated in therapeutic footwear. And because patients with healed ulcers are at risk for future ulceration, these preventive measures must be integrated into a long life strategy and treatment program. CONCLUSION Diabetic foot ulcerations, infections, gangrene and lower extremity amputations (LEA) are major causes of disability to patients with diabetes mellitus. And these often results in extensive periods of hospitalisation, substantial morbidity and mortality. Although not all such lesions can be prevented, it is certainly possible to reduce their incidence by proper management and prevention programs. A multidisciplinary team approach to diabetic foot disorders has been regularly proven to be the best method in achieving favorable rates of limb salvage in this high risk population. Foot care programs accentuating preventive management can reduce the incidence of foot ulceration through modification of self care practices, appropriate evaluation of risk factors and formulation of treatment protocols directed at patient education/re-education, early intervention, limb preservation and prevention of new lesions. The joint team of medical, surgical, rehabilitative and footwear specialist shou ld impart effective and coordinated services for acutely infected or ischemic inpatients as well as management for the outgoing patients. In general, the incidence and morbidity of diabetic limb amputations can be reduced if the above principles are embraced and integrated into everyday patient management protocol.

Malnutrition Universal Screening Tool Essay -- Health, Diseases

This assignment will discuss a trust adapted version of the Malnutrition Universal Screening Tool (MUST). It will demonstrate an understanding of theoretical knowledge used to develop the assessment tool. The assignment will focus on three components within the tool; discussing the reliability and validity when used in a clinical environment. A reflection of my own experience using the tool will be included and linked to aspects of reliability. Any issues with reliability will be identified and suggestions given on how they can be corrected to aid future use. MUST is a five-step screening tool designed for healthcare professionals to identify adult patients who at risk of, or are malnourished. It includes guidelines on how to develop an effective treatment plan. The Malnutrition Advisory Group (MAG) in 2000 adapted and extended their community screening tool to include care homes and hospitals, in response to national concerns. (Department of Health, 2001). In 2003 MUST was designed by MAG and the British Association for Parenteral and Enteral Nutrition (BAPEN). It was piloted across many care settings, to target patients who may be at risk of malnutrition. I have chosen this tool as it is widely used in healthcare; however malnutrition is often unrecognised and mismanaged. According BAPEN some three million people in the UK are at risk or are malnourished. Malnutrition can affect a patient physically, mentally and can also increase recovery time (Zellipour, & Stratton, 2005). This assignment will help me understand the theory and rationale behind the development of the MUST. The first component of the MUST involves measuring the patient’s height and weight to establish their Body Mass Index (BMI). BMI is the’ relationship b... ...n or ulna length as-well-as the type of measuring device used to weight the patient for example chair or hoist scale. This would enable the assessment to be carried out each time using the same measurement and equipment, which would make the test fair and more reliable (Medical Education Division, 2007). This assignment has discussed the theory and development of a trust adapted version of the MUST. A rationale of my choice has been included and linked to specific learning objectives. A discussion regarding the three components of this tool has been included; these have been linked to validity and reliability. Finally a reflection of my experiences using the MUST in a medical care of the elderly ward has been included with regards to aspects of reliability and theories about how these can be overcome to aid future use-age in a clinical setting.

Behind the scenes of how coffee influences a girl, times three

Believe it or not, a good coffee can determine a girl's mood. We wake up in a bad mood until the coffee is in our hands. The first sip of coffee taken influences how girls will act throughout the day. A bad coffee results to a bad-tempered girl and a good one resulting in a more positive way. Girls will be pleasant to be around to say the least. Peoples moods play a huge role In how someone day will go. As well as Impacting the one's surrounding the girl. Needless to say, coffee controls a girls actions. Initially, a portion of caffeine motivates a girl to do many things.Some being; working hard, staying focused, and being able to multicast. The three to five hour span of stimulating the central nervous system, keeping someone focused is very helpful for the time being. One downfall to drinking coffee is the â€Å"caffeine crash. † Girls' look past the negatives, drinking it anyway to get things done in a timely fashion. An equally important reason as to why coffee is such an influential substance in a girls life when it comes to motivating is how it affects their grades. It alps many study and prepare wisely for a test.Motivation is an essential to a girls daily life. Coffee happens to be the key to success In most females eyes. Yet coffee may affect how girls act motivationally speaking and their attitudes towards the universe, the â€Å"look† of having coffee has a significance to girls. Society revolves around the word cool† In this generation. That being said, someone with a coffee In their hand walking down the school hallway or vigorously crossing the city street on the way to work. One feels superior to another that holds reams of power. A sensation of confidence rushes through your body.The one cup of coffee a girl drinks has more meaning than just loading up on caffeine to get a person through the day. It symbolizes confidence and power. On another hand, it can take a turn for the worse. â€Å"Addiction is characterized by the rep eated, compulsive seeking or use of a substance. † A physical dependence on something is what they would call an adaptation to a substance. Not always does the substance have to be something dangerous or Illegal. Coffee for example is not a harmful Item, but the consumption f coffee can advance to worse problems.Too much leads to heart palpitations and the Jitters. Feeling not so powerful or confident and more Like a zombie that TLD get enough sleep. The way people drink coffee can be crucial. Some girls drink It to be What they don't understand is that not receiving the correct amount of nutrients can slow down your metabolism, causing you to actually gain weight. Substituting coffee in for meals can progress into worse diseases. Taking care of your body is important. In today's life outer beauty means a lot more than it should to people.Causing girls to put themselves at risk in many ways. In conclusion, that drink made from coffee grounds has multiple significance's in a gi rls' role. Not only by controlling ones mood, to compel a persons actions and determination, or even indicate a sense of confidence while holding a cup of coffee. Coffee has its positive and negative influences on girls. Some females using coffee as an excuse to be thin or look superior to the world. Maintaining coffee supplements throughout the day is very important. Once you have had it, you can never go without.

ARAB-ISRAELI WARS Essays - ArabIsraeli Conflict, Western Asia

ARAB-ISRAELI WARS Essays - ArabIsraeli Conflict, Western Asia ARAB-ISRAELI WARS Since the United Nations partition of PALESTINE in 1947 and the establishment of the modern state of ISRAEL in 1948, there have been four major Arab-Israeli wars (1947-49, 1956, 1967, and 1973) and numerous intermittent battles. Although Egypt and Israel signed a peace treaty in 1979, hostility between Israel and the rest of its Arab neighbors, complicated by the demands of Palestinian Arabs, continued into the 1980s. THE FIRST PALESTINE WAR (1947-49) The first war began as a civil conflict between Palestinian Jews and Arabs following the United Nations recommendation of Nov. 29, 1947, to partition Palestine, then still under British mandate, into an Arab state and a Jewish state. Fighting quickly spread as Arab guerrillas attacked Jewish settlements and communication links to prevent implementation of the UN plan. Jewish forces prevented seizure of most settlements, but Arab guerrillas, supported by the Transjordanian Arab Legion under the command of British officers, besieged Jerusalem. By April, Haganah, the principal Jewish military group, seized the offensive, scoring victories against the Arab Liberation Army in northern Palestine, Jaffa, and Jerusalem. British military forces withdrew to Haifa; although officially neutral, some commanders assisted one side or the other. After the British had departed and the state of Israel had been established on May 15, 1948, under the premiership of David BEN-GURION, the Palestine Arab forces and foreign volunteers were joined by regular armies of Transjordan (now the kingdom of JORDAN), IRAQ, LEBANON, and SYRIA, with token support from SAUDI ARABIA. Efforts by the UN to halt the fighting were unsuccessful until June 11, when a 4-week truce was declared. When the Arab states refused to renew the truce, ten more days of fighting erupted. In that time Israel greatly extended the area under its control and broke the siege of Jerusalem. Fighting on a smaller scale continued during the second UN truce beginning in mid-July, and Israel acquired more territory, especially in Galilee and the Negev. By January 1949, when the last battles ended, Israel had extended its frontiers by about 5,000 sq km (1,930 sq mi) beyond the 15,500 sq km (4,983 sq mi) allocated to the Jewish state in the UN partition resolution. It had also secured its independence. During 1949, armistice agreements were signed under UN auspices between Israel and Egypt, Jordan, Syria, and Lebanon. The armistice frontiers were unofficial boundaries until 1967. SUEZ-SINAI WAR (1956) Border conflicts between Israel and the Arabs continued despite provisions in the 1949 armistice agreements for peace negotiations. Hundreds of thousands of Palestinian Arabs who had left Israeli-held territory during the first war concentrated in refugee camps along Israel's frontiers and became a major source of friction when they infiltrated back to their homes or attacked Israeli border settlements. A major tension point was the Egyptian-controlled GAZA STRIP, which was used by Arab guerrillas for raids into southern Israel. Egypt's blockade of Israeli shipping in the Suez Canal and Gulf of Aqaba intensified the hostilities. These escalating tensions converged with the SUEZ CRISIS caused by the nationalization of the Suez Canal by Egyptian president Gamal NASSER. Great Britain and France strenuously objected to Nasser's policies, and a joint military campaign was planned against Egypt with the understanding that Israel would take the initiative by seizing the Sinai Peninsula. The war began on Oct. 29, 1956, after an announcement that the armies of Egypt, Syria, and Jordan were to be integrated under the Egyptian commander in chief. Israel's Operation Kadesh, commanded by Moshe DAYAN, lasted less than a week; its forces reached the eastern bank of the Suez Canal in about 100 hours, seizing the Gaza Strip and nearly all the Sinai Peninsula. The Sinai operations were supplemented by an Anglo-French invasion of Egypt on November 5, giving the allies control of the northern sector of the Suez Canal. The war was halted by a UN General Assembly resolution calling for an immediate ceasefire and withdrawal of all occupying forces from Egyptian territory. The General Assembly also established a United Nations Emergency Force (UNEF) to replace the allied troops on the Egyptian side of the borders in Suez, Sinai, and Gaza. By December 22 the last British and French troops had left Egypt. Israel, however, delayed withdrawal, insisting that it receive security guarantees against further Egyptian attack. After several additional UN resolutions calling for withdrawal and after pressure from the United States, Israel's forces left in March 1957. SIX-DAY WAR (1967) Relations between Israel and Egypt remained fairly stable in the following decade. The Suez Canal remained closed to Israeli shipping, the Arab boycott of Israel was maintained, and periodic border clashes occurred between Israel, Syria, and Jordan. However,

Time Saving 101 Topics to Avoid Reading

Time Saving 101 Topics to Avoid Reading I read a lot of blogs, newsletters, magazines, and websites. As a fast reader and research guru, I can hardly resist to let some resource pass me First and foremost, give yourself credit for knowing what you need and what you dont. Not everyone is an expert and not every piece of expert advice is worth reading. Topics I will immediately discard: 1) Writers block. This is so dang personal that nobody can tell someone else what to do. I happen to be one who believes in either writing through writers block or taking a nap to wake up and start writing refreshed. I dont believe in it much, and I definitely dont want to hear about someone elses. 2) Self-editing. There are so many ways to self-edit, so many angles, so many levels. There isnt one right way. If you understand good writing and appreciate proper grammar, then figure it out. 3) The best way to market. Marketing depends on your extrovert level, your wallet, your tech savvy, your social media appreciation, your genre, your platform, your region, your experience in other arenas. The best way is to analyze your strengths, and the strengths of a handful of successful people you trust and admire, and just do it. 4) Outlining or pantser. I delete those instantly. Each writer has to test both ways and figure it out. 5) Religion or politics. Enough said. 6) Finding time to write. This isnt a secret. You make time, or you dont. You prioritize, or you dont. So many of these topics are the result of someone needing filler so they write about an evergreen subject. Some writers talk about these subjects because they are avoiding their more serious writing. Some want to sound experienced when they are not. Fact is, they are not unique topics. They are washing machine items, constantly spinning around in the tub. How do I know to discard them without reading them? I read the email subject lines, first lines in the first paragraph, and/or titles. Yes, I practice what we hear preached all the timeletting the opening hook dictate whether I read further or not. When I have 300-500 emails per day, I need some sort of gleaning mechanism, and why not that which we teachopening with a bang, or at least with enough meat to suck me in. And if the writer still wants to pick such a mundane topic, then they need to show me they have a new twist that will totally wow me.

Zappos Company Case Study Example | Topics and Well Written Essays - 250 words

Zappos Company - Case Study Example ution is one of the factors that can affect the revenue levels since it defines the number of customers that can be served over a specified period (Michelli, 2012). For example, the institution focuses on online purchases as the main source of revenue. Evidently, this is one of the success strategies of the firm since many people in the United States, United Kingdom and other European countries have resorted to buying via the internet (Gray and Vander, 2012). However, the capacity of the firm may not be well exploited since some customers may be left out of the equation. Thus, this paper highlights the importance of capacity to an institution as well as the approaches to be used to improve the situation. Notably, the company has many employees that serve the customers via the internet, but the capacity can be used to improve the revenue generated. Illustratively, a segment of the market may not have access to the internet at all times, and they may need a physical market for the products. In such a situation, the customers have to visit the shops so that they can make their informed purchases. Principally, this may increase the revenues collected by the firm. Additionally, some individuals choose to procure products after ascertaining the exact quality of materials used. In such a situation, the clients will feel the products and may as well fit in the clothes, shoes and other apparels. Resultantly, the customers can make additional purchases. Furthermore, prevalence of physical stores in different parts of the market increases the chances of the employees to make sales. A diverse niche market offers the firm an added advantage as the approach encourages impulse buying. Accordingly, studies about consumer behavior cite that some people create a need for a product after seeing it (Lussier, 2012). Thus, the company can improve its capacity through introduction of additional shops in more locations. Lastly, the amount of time used to place orders should be reduced

The film one flew over the Cuckoo's Nest Essay Example | Topics and Well Written Essays - 250 words

The film one flew over the Cuckoo's Nest - Essay Example During the first electro-shock therapy he was told the procedure would not be painful, but was not given a choice with regards to the therapy. Eventually he was lobotomized again without consent because he was a danger. The film makes one ask if it is wrong to forcibly give medication and electro-shock therapy with a keen understanding in the end that it is wrong. It is wrong on a basic level in that it violates human rights. Society believes there are inalienable and fundamental rights that cannot be overstepped because they are either natural or legal rights. In philosophy there is also the concept of human rights, which are considered universal and egalitarian. Forcing medications or electro-shock therapy on patients goes against these rights even if the patients may need help because the patient is not given a voice in the matter. It cannot be denied that some individuals may not understand what is being asked, but there are laws to protect an individual who is unable to speak for themselves. In this instance a guardian, not the mental institution staff, with their best interests in mind would be given the choice in determining medication. By forcing a person to undergo treatment without consen t, it becomes an abuse of power and control rather than actually helping the individual to overcome any issues they