Dark Water Essay Example | Topics and Well Written Essays - 2250 words

Dark Water - Essay Example In Japanese horror it relies more on folklore and psychological themes that make the plot very different from western movies. The popularity of these horror movies even got up to the point where the American movie industry does remakes of them. The movie that was credited at starting the wave of popularity of this genre is The Ring, also directed by Nakata. The difference in Japanese horror is the unique way that folklore and technology is integrated into the movie. Moving in and getting acquainted with the neighbors The movie Dark Water is about a mother and daughter who move to a run down apartment complex who starts having paranormal encounters upon. The mother had just gotten divorced and was going through a difficult moment in her life. The movie itself, like others in its genre is full of references to Japanese folklore. One such reference is the spirit of the dead child that comes back and haunts the living. In Japanese folklore it is very popular for a spirit of a child who d ies to come back and haunt the living in order to exact revenge in very violent ways. The child is Mitsuko, who dies the previous year from drowning due to the neglect of her mother who was not able to fetch her from school, she goes home alone and plunges into the water tank of their apartment and dies. This theme figures heavily Japanese folklore. ... In the end she dies protecting her daughter from Mitsuko. This is related to the vengeful fetus stories that also figures in Japanese folklore. Here the spirit of an aborted fetus comes back to haunt the mother. The only way to stop this is through a ritual or proper burial. Another way to appease these spirits is through self sacrifice of the mother which happened to Yoshimi. Another theme that has been incorporated here from Japanese folklore is that of the â€Å"monster mother† or the mother who treats her child badly. There are many reasons for this and one reason that comes up is usually the absence of a father, such as the case of Yoshimi and her daughter whom she neglects and treats badly in the movie. One of the reasons for her neglecting her child is quest to look for a job to provide for both of them. Another is the mental anguish the divorce proceedings are causing her. These two combine for a very volatile personality and make for a mother that is both loving and m enacing at the same time. Yoshimi tries her best to nurture her daughter but the pressures of her current situation bear down on her and make her very unstable. As opposed to the father who is very stoic in his appearances in the movie. Yet another theme that comes from Japanese folklore is the Kappa which is a mischievous spirit in Japanese folklore who inhabits water. It is a humanoid that is the size of a child that lures people into bodies of water. The Kappa is usually blamed for drowning in rivers and also raping women who frequent rivers or bodies of water. The child in the movie is not a Kappa per se but her appearance in one of the scenes is inspired by the Kappa whose color ranges from green to yellow. The fact that she is

The Middle Ground Method of Argumentation Coursework

The Middle Ground Method of Argumentation - Coursework Example The topic in the essay could have been approached in a middle ground argument approach. This would have involved considering both the advantages and disadvantages of mandatory drug testing and settling on middle ground where no side gets it all but each side gets something (Anonymous). This would have necessitated a change of the claim from mandatory drug testing having adverse effects to there being a confidentiality mechanism for the results of drug tests (Anonymous). This middle ground solution would have taken care of stigmatization which is one of the disadvantages of mandatory drug testing and it will allow for testing in favor of the group in support. Additional sources will be needed so as to assist in research of the confidentiality method that can be used to make the middle ground solution a success. Proper application of this middle ground solution would be a success as far as mandatory drug testing is

Nursing Process Essay Example for Free

Nursing Process Essay The client is a 70 year old, Caucasian male who is a retired siding salesman from Riverside, IA, who has an extensive history with Paralysis agitans (Parkinson’s disease). The client was first admitted to the long term care facility in December 2012. The client explained that he came to be at this facility after â€Å"already being in two places like this†. He was removed/discharged from the last long-term care facility for being what he called â€Å"disruptive†. The client described the staff at the last facility as not very kind to the residents. There was an incident where the drugs that were prescribed to the client made him hallucinate and he became unruly with the staff and was restrained and taken to the hospital for evaluation. He was then transferred to this long term care facility. Wanting to gather the client’s health history, an interview was scheduled. In starting the interview with the client, he was asked if he would be comfortable with being asked some questions and was informed that he did not have to answer any questions that he was uncomfortable with. Due to the client’s paralysis agitans and his muscle weakness he is primarily in a wheelchair. The client was asked if there was anything that he needed before starting and if he would prefer the door be closed or the curtain be drawn for privacy, he stated that wasn’t necessary. It was observed that the client had tremors in his right hand and arm. A few minutes after sitting down, the client asked for help moving his hand that was resting on the bed to the arm of his wheelchair; in doing this it seemed to help calm the tremors. When speaking with the client, he is of sound mind and has a sense of humor. This indicates that the client’s paralysis agitans has not affected the area in the right hemisphere of the brain that controls personality. The client noted that he was in respectable physical health until 1996. He then explained that in the spring of 1996, while he was running he suffered from a TIA (Transient Ischemic Attack). The client sought out professional answers from 5 specialists and was diagnosed with Paralysis agitans. The client conveyed this was a concern he had because his father also had Paralysis agitans. The client describes that the Paralysis agitans has  progressively become worse over the past 18 years. It was observed that his speech was slow and monotonous. The client spoke in a low and discreet volume. A lack of facial expressions was also noticed. The client can walk with the assistance of a walker but is generally in a wheelchair. Name of Drug Dosage Route Time Related to Carbidopa-Levo 25 100 tab Orally TID Paralysis agitans Comtan 200 mg tablet Orally TID Paralysis agitans Seroquel XR 50 mg tablet Orally In the afternoon Nonorganic psychosis He is prescribed 3 tablets to be taken orally 3 times a day Carbidopa-Levodopa 25-100 (25 mg of Carbidopa and 100 mg of Levodopa) for paralysis agitans. He is also prescribed 200 mg of Comtan to be taken orally 3 times a day for paralysis agitans. These drugs raise the level of dopamine in the brain. A side effect of having elevated levels of dopamine in the brain is psychosis. The client is also given 50 mg of Seroquel XR orally in the afternoon to alleviate his nonorganic psychosis. It is documented in the client’s chart that there are symptoms of sleep apnea. When asked, the client stated that he was unaware of having that condition. The client does not use a continuous positive airway pressure (CPAP) machine  while sleeping at night. When talking more in depth about sleep patterns and concerns the client stated that he gets approximately 8 hours a sleep a night, this is without any help from sleep aids. When speaking of his bedtime rituals he said that he does have two beers, back to back, at night right before bedtime, while watching television. He does not have difficulty falling asleep but did claim that he sometimes has a hard time staying asleep at night. When questioned about taking occasional naps throughout the day he stated â€Å"depends on if I’ve been up all night†. The client then explained that it is the noise level at the long term care facility that keeps him awake. When inquiring about the client’s family he stated that he has been married for 48 years and has two children, a son who is 44 years old and a daughter that is 39 years old. The client also has seven grandchildren. When asked what he likes to do in his spare time he replied that he loves spending time with his wife and children. He stated that before coming to this long term care facility he enjoyed playing card and gambling. He now plays computer games for fun, when his wife is there to help him. The client explained that he has a â€Å"little bit† of high blood pressure and it was noted in his chart that he is given an 81MG Aspirin daily for atrial fibrillation. Aspirin 81 mg Orally o.d. A-fib Acetaminophen 325 mg Orally Every 6 hour Pain He has no history of heart surgeries or surgeries of any kind. The client reported that he has never had rheumatic fever. When asked about blood clots, the client responded that he believes that his TIA in 1996 was a result of arterial emboli. The client claims that sometimes he has numbness in his legs and his hamstrings tighten up and it can be painful. He stated that he will ask for his prescribed 650 MG of acetaminophen for the pain. When speaking about everyday stresses with the client, he stated that he doesn’t have a lot of stress but gets irritated when that staff turn on the lights every morning at 6:30 am. When asked if there was anything that he does when he notices that he is stressed, the client mentioned that when he was younger he would travel to Vedic City in Iowa and practice with the Maharishi meditating. He says that meditating has been very helpful in his adult life. The client also mentioned that he liked to follow the Maharishi lifestyle and eat only organic foods but it is not possible to follow that when residing at a long term care facility. Other things that he does to distress are look at his pictures that he has on his shelf in his room. The one that helps him the most is a black and white picture of him in a small airplane with his flight instructor standing on the wing. The client use to pilot planes when he was younger. When the client was asked if he was religious and he explained that he is Methodist but hasn’t been to church in about 5 years. He did state that he does pray occasionally. The client stated that is not afraid of dying but he is afraid of falling. He then joked that maybe it’s not so much the falling but maybe it’s the landing. When assessing the client’s vitals it was noted that he has slightly elevated blood pressure of 129/84 and could be cause for concern of pre-hypertension. Metoprolol tartrate 25 mg Orally BID Hypertension It is noted in his chart that the client is given a 25 mg tablet of metoprolol tartrate orally twice a day for hypertension. His respirations were within normal range at 18 respirations per minute. SaO2 was at 86%. The client’s temperature was taken orally and was 97.6  °F. The client is 6 feet and 1 inch tall and weighs 257 lbs. The client has a BMI of 33.9. The client received a vaccination for influenza on 10/16/13. The clients chart states that he requires assistance with many daily activities. He is dependent on help with dressing, and bathing. When asked, the client stated that it is challenging to get dressed and undressed due to the stiffness in his arms and legs. The client is on a regular diet and states that he  doesn’t have any difficulty swallowing foods and doesn’t require help with feeding. When asked about appetite he said that sometimes he doesn’t have much of an appetite but he believes that is due to the medications that he is taking. The client explains that he is not aware of having any food allergies. He also stated that after eating he does not experience sensations of nausea/vomiting, but does encounter heartburn/indigestion occasionally, which he takes 30 ml an antacid suspension. He is also given one multivitamin orally daily for supplement. Antacid Suspension 30 ml Orally Every 6 hours Supplement heartburn Multivitamin 1 tablet Orally o.d. Supplement When the client was asked about dentures he stated that he does not have dentures even though dentures were noted in his chart. He states he needs aid in transferring from bed to a chair and with toileting. When asked about the character of his stools he explained that both consistency and color were normal. The client also stated that he does not need the help of laxatives. Noted in the client’s chart he is given a 100 mg capsule of Docusate sodium orally 2 times a day to help with constipation. Docusate sodium 100 mg capsule Orally BID Constipation The client does not have any history of kidney or bladder disease. He claims that the frequency, amount and color of his urine are normal. He also claims that he does not have any difficulty voiding and there is no pain or burning while urinating. According to the CNA, the client is able to stand,  holding the hand rails, while urinating. It is noted in the clients care plan that he is urinary incontinent which is related to impaired mobility and PRN straight catheter needed for intermittent retention secondary to BPH. The client is given one 0.4 mg of Tamsulosin HCL orally a day for BPH (benign prostatic hyperplasia). Tamsulosin HCL 0.4 mh Orally o.d. BPH The client needs assistance with bathing as well. The client also has a DNR order. Parkinson’s disease (paralysis agitans) is a progressive disorder of the nervous system that affects ones mobility. According to Hubert and VanMeter, Parkinson’s disease is a â€Å"dysfunction of the extrapyramidal motor system that occurs because of progressive degenerative changes in the basal nuclei, principally in the substantia nigra.†(UMMC, 2012) The substantia nigra is the primary area of the brain that is affected by Parkinson’s disease (PD). (UMMC, 2012) The substantia nigra is comprised of a specific set of neurons that send chemical signals, called dopamine. Dopamine then travels to the striatum, responsible for balance, control of movements, and walking, by means of long fibers called axons. (Okun, 2013) These regular body movements are controlled by the activity of dopamine on these axons. With PD the neurons in the substantia nigra break down and die causing the loss of dopamine, which in turn causes the nerve cells in the striatum to trigger excessively. The excessive firing of neurons makes it impossible for one to control their movements, a sign of Parkinson’s disease. (Okun, 2013) According to the Parkinson’s disease Foundation (2014): As many as one million Americans live with Parkinsons disease, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrigs disease. Also approximately 60,000 Americans are diagnosed with Parkinsons disease each year, and this number does not reflect the thousands of cases that go undetected. An estimated  seven to 10 million people worldwide are living with Parkinsons disease. Incidence of Parkinson’s increases with age, but an estimated four percent of people with PD are diagnosed before the age of 50 and men are one and a half times more likely to have Parkinsons than women. (p 1) Since PD is a progressively degenerative disease the signs and symptoms change over time and vary from person to person. A widely used clinical rating scale is the Hoehn and Yahr scale (HY); this helps to identify signs and symptoms in the various stages of Parkinson’s disease. (MGH, 2005) Early stages, like HY’s stage one, of Parkinson’s disease the symptoms are usually mild and appear unilateral. There may be changes in facial expressions, posture and locomotion; these symptoms are usually untimely and bothersome but not disabling. As the disease progresses, into stage two of the HY scale, it may begin to affect ambulation and be noticeable bilaterally with minimal disability. (MGH, 2005) As symptoms worsen, as in stage three of the HY scale, there is considerable slowing of body movements, early impairment of equilibrium with walking and standing and generalized dysfunction that is moderately severe. The Hoehn and Yahr scale’s stage four explains that signs and symptoms are severe but the person can still walk to a limited extent. (MGH, 2005) Rigidity and bradykinesia become factors in mobility. In stage five the person is unable to walk or stand so is bedridden or confined to a wheelchair. This stage is referred to as the â€Å"cachectic stage †. Constant nursing care is required in stage five (Costa and Quelhas, 2009). There are many complications that are associated with PD; one can be difficulty swallowing (dysphagia), likely due to the loss of control of muscles in the throat. (UMMC, 2012) Drooling can occur since saliva may accrue in the mouth due to dysphagia. Difficulty swallowing can also lead to malnourishment, but also poses a risk for aspiration pneumonia (Leopold and Kagel, 1997). Constipation can be another complication as to the slowing of the digestive tract. Parkinson’s disease can also cause urinary retention and urinary incontinence. Dementia and difficulty thinking comes in later stages of PD. (University of Maryland Medical Center, 2012) Depression is very common in patients with Parkinsons. The disease process itself causes changes in chemicals in the brain that affect mood and well-being. Anxiety is also very common and may be present along with depression (University of Maryland Medical Center, 2012). Sleep problems  and sleeping disorders are also associated with PD, with this comes fatigue. Some patients may experience feeling light headed when standing due to the drop in blood pressure (orthostatic hypotension). Pain can also be another symptom related to Parkinson’s disease (Okun, 2013). There is not yet a cure for Parkinson’s disease but there are treatments that can help alleviate the symptoms. The most commonly used is drug therapy. Medications can help with difficulty with movement, walking and controlling tremors by increasing the brains amount of dopamine. (University of Maryland Medical Center, 2012) The most common and most effective Parkinson’s disease drug is Levodopa. This is a natural chemical that passes into your brain and is converted to dopamine (Okun, 2013). There is also surgical procedures available, deep brain stimulation. With this procedure the surgeon implants electrodes into a specific location in the patient’s brain. A gen erator is implanted in the patient’s chest, which is attached to the electrodes. This generator sends electrical impulses to the patient’s brain, which may lessen the symptoms of Parkinson’s disease. (University of Maryland Medical Center, 2012) Other ways that help control the effects of PD is a healthy diet. Constipation is a complication associated with PD, so a diet that is balanced with whole grains, fruits and vegetables helps to manage this complication. Balance, coordination, flexibility and muscle strength deteriorate with PD so, exercise is encouraged. Exercise also helps with decreasing anxiety and depression. The client exhibits many of the discussed signs and symptoms of Parkinson’s disease. The client experiences resting tremors, bradykinesia, mask like face (hypomimic), slowed speech and is in a wheelchair. He scores very poorly according to the Hoehn and Yahr scale. The client is on medications to help diminish the signs and symptoms of Parkinson’s disease. Impaired physical mobility level 3, related to bradykinesia, ak inesia, neuromuscular impairment motor weakness, pain and tremors. (Berman Snyder, 2012) Evidenced by lack of decisive movement within physical environment, including movement in bed, transfers, and ambulation. Limited range of motion (ROM). Decreased muscle stamina, strength and control. Limitation in independent, purposeful physical movement of the body and impairment unilaterally on the right side. Due to the muscular and neuromuscular weakness related to Parkinson’s disease, evidenced by it being difficult for the patient to ambulate. The client has a defect of extrapyramidal tract, in the basal ganglia, with loss of the neurotransmitter dopamine. (Berman Snyder, 2012) Classic triad of symptoms: tremor, rigidity, bradykinesia (Jarvis, 2012). Tremors associated with paralysis agitans make it difficult maneuver. Tremors cease with voluntary movement and during sleep (VanMeter and Hubert, 2014). Immobility is an expected human response to Parkinson’s disease. The client’s immobility puts him at risk for thrombophlebitis, skin breakdown, pneumonia and depression. Immobility impedes circulation and diminishes the supply of nutrients to specific areas. As a result, skin breakdown and formation of pressure (decubitus) ulcer can occur (Berman and Snyder, 2012). Immobility also promotes clot formation. Self-care deficits related to neuromuscular impairment, immobility, decreased strength, and loss of muscle control and lack of coordination, ridgity and tremors. Self-care deficits, dressing, hygiene and toileting, evidenced by tremors and motor disturbance. The client lacks the ability to cleanse his body, comb his hair, brush his teeth and do skin care. . The client is also unable to dress himself satisfactory. He does not have the capability to fasten his clothes. The patient is assisted with ADL’s. Patient is incapable to bathe, dress or brush teeth without aid. Patient occasionally needs assistance with feeding. Assistance is also required with toileting. Aid is needed with ADL’s because of the lack of coordination and for safety. This nursing diagnosis is important because it ensures hygiene, improves quality of life, and promotes dignity, self-worth, independence and freedom. Risk for falls related to decreased mobility, a nd unsteady gait secondary to sedentary lifestyle and Parkinson’s disease. Patient uses a wheelchair and ambulates with a walker. Patients gait is impaired due to Parkinson’s disease. Festination, or a propulsive gait (short, shuffled steps with increasing acceleration), occurs as postural reflexes are impaired, leading to falls (VanMeter and Hubert, 2014). Falls also result in psychological implications for the patient with a decrease in self-confidence and a fear of further falls. This contributes to a decrease in mobility and culminates in a significant reduction in quality of life (Jarvis, 2012). Impaired bowel elimination/constipation related to medication, physical disability and decreased activity. Evidenced by the client not passing stools daily. Medications prescribed to patient for Parkinson’s disease attribute to constipation. The patients experience with immobility is also a  contributing factor for constipation. This nursing diagnosis is important because it allows nursing staff to monitor the patient’s bowel movements and avoid fecal impaction. Imbalanced nutrition less than body requirements related to tremors, slowing the process of eating, difficulty chewing and swallowing. Evidenced by the client occasionally needing assistance with eating. Pressure sores develop more quickly in patients with a nutritional deficit. Proper nutrition also provides needed energy for participating in an exercise or a rehabilitative program. The goal is to optimize the client’s nutritional status. Impaired verbal communication related to decreased speech volume, decreased ability to speak, stiff facial muscles, delayed speech, and inability to move facial muscles. Evidenced by lack of expression on the client’s face, client’s hindered speech. Loss of dopamine can affect the facial muscles, making them stiff and slow and resulting in a characteristic lack of expression. Speech impairment is referred to as dysarthria and is often characterized as weak, slow, or uncoordinated speaking that can affect volume and pitch. Difficulty speaking and writing because of tremors, hypophonia, and â€Å"freeze† incidents. This is an expected consequence of Parkinson’s disease. Nursing Care Plan- Alteration in impaired physical mobility- Parkinson’s disease Related to: Goals Intervention Bradykinsia Client will use a walker to go to breakfast in the mornings and not need assistance with transfers. Client will be able to perform all active ROM by 3 months Examine current mobility and observation of an increase in damage. Do exercise program to increase muscle strength. Perform passive or active assistive ROM exercises and muscle stretching exercises to all appendages. To promote increased venous return, prevent stiffness, and maintain muscle strength and endurance. Without movement, the collagen tissues at the joint become ankylosed (permanently immobile) (Berman Synder, 2012) Akinesia Client will gain power of voluntary movements. Joint contractures will not occur. Assess the possibility of deep brain stimulation. Refer to physical therapy. When the muscle fibers are not able to shorten and lengthen, eventually a contracture forms, limiting joint mobility (Berman Synder, 2012) Tremors Client’s tremors will decrease. Encourage deep breathing, imagery techniques and meditation. Encourage holding an object in hand Suggest holding the arm of the chair. Stimulating the brain by concentrating on breathing may cease tremors. (www.theparkinsonhub.com) Pain Client will not experience pain 4 on a scale of 0-10 Before activity observe for and, if possible, treat pain. Assess patients willingness or ability to explore a range of techniques aimed at controlling pain. Administer pain medication per physician orders. Encourage/assist to reposition frequently to position of comfort. Pain limits mobility and is often exacerbated by movement. (www.ptnow.org) Nursing Care Plan- Alteration in Skin Integrity, Impaired: Risk for Pressure Sores; Pressure Ulcers, Bed Sores; Decubitus Care Related to: Goal Interventions Rationale Neuromuscular impairment Client will be free of any pressure ulcers for length of long term stay. Monitor site of skin impairment at least once a day for color changes, redness, swelling, warmth, pain or any other signs of infection. Pay special attention to high risk areas and ask client questions to determine whether he is experiencing loss of sensation. Apply barrier cream to peri area/ buttocks as needed. Use ROHO cushion on wheelchair. Checking skin once a day will ensure that skin stays intact. (Jarvis, 2012) Immobility Client will be able to express s/s of impaired skin. Teach skin and wound assessment and ways to monitor for s/s of infection, complications and healing. Use prophylactic antipressure devices as appropriate Early assessment and interventions may help complications from developing. To prevent tissue breakdown. (Jarvis, 2012) Nursing Care Plan- Self Care Deficits Related to: Goal Intervention Rationale Immobility Client will assist with bathing, grooming, dressing, oral care and eating daily. Assist client with bathing, grooming, dressing, oral care and eating daily. Use high back wheelchair. The effectiveness of the bowel or bladder program will be enhanced if the natural and personal patterns of the patient are respected. Loss of muscle control and lack of coordination Client will improve muscle control and coordination in all extremities for the length of long term stay. Client will walk to dining room and in hallways- 5 mins a day 5 days a week. Use consistent routines and allow adequate time for patient to complete tasks. Assist client with ambulation. This helps patient organize and carry out self-care skills. Tremors Client will be able to assist with dressing. Provide appropriate assistive devices for dressing as assessed by nurse and occupational therapist. Encourage use of clothing one size larger. Teach and support the client during the clients activities Apply extensions on breaks with ball grips The use of a button hook or of loop and pile closures on clothes may make it possible for a patient to continue independence in this self-care activity. Ensures easier dressing and comfort. Grips will be easier to grasp with tremors. Neuromuscular impairment Client will be clean, dressed, well groomed daily to promote dignity and psychosocial well-being. Assist with shower as needed. Assist with daily hygiene, grooming, dressing, oral care, and eating as needed. This promotes dignity and psychosocial well-being. Nursing Care Plan- Falls, risk for Related to: Goal Intervention Rationale Decreased muscle tone Client will express an understanding of the factors involved in possible injury. Educate the client about what makes them at risk for falls. Bed should be in lowest position. Provide assistance to transfer as needed. Reinforce the need for call light. If the client is educated and shows an understanding of the factors involved with falls, they are less likely to fall. Prevent fall. Nursing Care Plan- Impaired Bowel elimination/constipation Related to: Goal Intervention Rationale Inactivity, immobility Client will have soft formed stool every other day that are passed without difficulty. Encourage physical activity and regular exercise. Adjust toileting times to meet client’s needs. Report changes in skin integrity forum during daily care Ambulation and/or abdominal exercises strengthen abdominal muscles that facilitate defecation. low-fiber diet Evaluate usual dietary habits, eating habits, eating schedule, and liquid intake. Initiate supplemental high-protein feedings as appropriate. Change in mealtime, type of food, disruption of usual schedule, and anxiety can lead to constipation. Proper nutrition is required to maintain adequate energy level. Diminished muscle tone Encourage isometric abdominal and gluteal exercise Apply skin moisturizers/barrier creams as needed To strengthen muscles needed for evacuation unless contraindicated. (http://www.gutsense.org) Medications Encourage liquid intake of 2000 to 3000 ml per day To optimize hydration status and prevent hardening of stool (VanMeter Hubert, 2014) My thinking about my resident has definitely changed since the initial day when I conducted a health history assessment on him. I knew that first day that I was going to appreciate getting to know this resident because of how smoothly the conversation flowed. This resident had some amazing stories to tell. I absolutely adore that fact that he and his wife have been married for 48 years. I enjoyed listening to him remember what life was like before being diagnosed with Parkinson’s disease, it appeared to lighten his spirit. I feel very fortunate to have been given the opportunity to care for such a genuine soul. My whole clinical experience was a positive one. I realized that if I lacked the knowledge about a particular task to ask for help. I liked the fact that clinicals was hands on and that I gained experience in a long term health care facility. Another thing that this clinical rotation  taught me was that it takes an exceptional type of person to go into geriatric nursing. Probably the number one thing that I’m going to take away from this clinical experience is the total importance of dignity. I too will be old someday and I applied the golden rule to this experience. I treated others as I want to someday, and hopefully, will be treated. What a fantastic learning experience. References: Berman, A., Snyder, S. (2012). Kozier Erbs Fundamentals of Nursing: Concepts, Process, and Practice. Upper Saddle River: Pearson Education. Coleman, J., (September 1, 2013) Meditation Mitigating Parkinsons Symptoms. Retrieved from http://www.theparkinsonhub.com/your-quality-of-life/article/meditationmitigating-parkinsons-symptoms.html Costa, M. Quelhas, R. (2009). Anxiety, Depression, and Quality of Life in Parkinson’s Disease. The Journal of Neuropsychiatry and Clinical Neurosciences 2009; 21:413-419. Jarvis, C. (2012). Physical Examination Health Assessment. St. Louis: Elsevier Kegelmeyer, D., (July 1, 2013) Functional Limitation Reporting (FLR) Under Medicare: Tests and Measures for High-Volume Conditions. Retrieved from http://www.ptnow.org/FunctionalLimitationReporting/TestsMeasures/Default.aspx Leopold N., Kagel M. (1997). Pharyngo-esophageal dysphagia in Parkinson’s disease. Dysphagia 1997; 12:11–18 Massachusetts General Hospital (MGH) (May, 2005) Hoe hn and Yahr Staging of Parkinsons Disease, Unified Parkinson Disease Rating Scale (UPDRS), and Schwab and England Activities of Daily Living. Massachusetts General Hospital. Retrieved March 2, 2014, from http://neurosurgery.mgh.harvard.edu/functional/pdstages.htm#HoehnandYahr Okun, M. (2013). Parkinsons Treatment: 10 Secrets to a Happier Life. CreateSpace Independent Publishing Michael S. Okun M.D. Parkinson’s disease Foundation (2014, March) Understanding Parkinson’s. Parkinson’s Disease Foundation. Retrieved March 2, 2014, from http://www.pdf.org/en/understanding_pd University of Maryland Medical Center (2012, September) Parkinson’s disease. University of Maryland Medical Center. Retrieved March 2, 2014, from http://umm.edu/health/medical/reports/articles/parkinsons-disease#ixzz2upFLCggw VanMeter, K. C., Hubert, R. J. (2014). Goulds Pathophysiology for the Health Professions. St. Louis: Elsevier.

Rolex Company Analysis

Rolex Company Analysis This report is about the research on a premium product brand on the market. The premium product out team agrees to choose is the Rolex Company product. Rolex Company was the companies that manufactures a high quality hand watch and sells the product to an upper high value to the consumer, Rolex Company also provide technical repair service especially for its product user at different places or facilities due to its different region and its global market or business operations. The objective of Rolex Company is to provide the high and luxury hand watch with innovative technology and design which also promote its brand to a kind of collection item which symbolize as prestige, luxury and high quality. The Vision and mission of Rolex Company was to always put the customer at the first place and make sure that their customer are satisfied with their product and services. Objective Provide the high and luxury hand watch with innovative technology and design and promote its brand to a kind of collection item which symbolize as prestige, luxury and high quality. Vision Mission Statement Always put the customer at the first place. Ensure that their customers are satisfied with their product and services. 2.0.0 Company Summary Rolex is the worlds well known brand in luxury watches. In addition to that, Rolex was included in the luxury watch list of the worlds top brands. It is only brand that able to produce 2000 watches per day and able to earn 3 billion per day. lts brand name , exclusiveness and unique style attract people from all strata of society. 2.1 Background Hans Wilsdorf and his brother-in-law Alfred Davis founded Wilsdorf Davis and signed as WD in the year of 1905 in London, England. Later the name Rolex trademark was registered in 1908 and opened a office in La-Chaux_de-Fond, Switzerland, which was the worlds center for most high quality watch making. The name Rolex in phrase of French were horlogerie exquise which mean exquisite horology. In 1919, the companys headquarters was moved to Geneva, Switzerland, because taxes and export duties in the United Kingdom were driving up costs. The company was first established in Geneva as the Rolex Watch Company. Later, the name changes toÂÂ  Montez Rolex, SAÂÂ  and finally just Rolex, SA. To add on, Rolex was the first company to produce fully waterproof watch (1926), auto-winding watch (1932). 2.2 Company Location Rolex Company split its product and services into two different sections one was the normal direct selling and the other was the service facilities. Until now, The Rolex main headquarter is on Geneva of Switzerland by Rue Francois-Dussaud. In Malaysia are only on Kelantan, Perak, Pulau Pinang, Sabah, Sarawak, and Selangor which the center for direct selling. But there was only one Rolex service center at Malaysia which in Jalan Sultan Ismail at Menara Dion 3.0 Product and services People satisfy their wants and needs with products and services. A product can be provided to a market to satisfy a need or want. Besides that, product include services, which are benefits or activities provided for sale that virtually intangible. Examples include insurance, airline, banking, home repair services and so on. 3.1 Product Description A product is anything that is capable of satisfying customer needs. (David Jobbs) The product was a physical product and took the form of a hand watch. The previous Special edition hand watch manufacture by Rolex Company hand watch model Submarine have evoke a feeling to the customer like a sea because of its blue design on the watch. Rolex Company took the symbol of a crown and places it on its company name to be its brand or logo (figure 1.1) 3.2 Competitive Comparison The Swiss luxury watch making industry is a profitable market. However, new entrants find it difficult to enter the market due to the numerous barriers. In addition to that, there were still many top brands of luxury watches in the market to come up with different styles of watches. Here are some of the top brands and competitors of luxury watches which are famous. Cartier Cartier is a company of the first worldwide luxury watchmaking group and Richemont Compagnie Financiere Group. Cartier enjoys the fame for selling only the first rate quality of jewellery and accessories. Tag Heuer Tag Heuer name has its distinct reputation and status in the world of luxury watches. Furthermore, many Hollywood stars also like to wear Tag Heuer watches. Blancpain Blancpain was founded in 1735 by Jehan Blancpain and is one of the luxury watches in the market. Famous businessmen and celebrities prefer Blancpain watches because Blancopain watches show the exclusiveness and individuality of their personality. 3.3 Supply Demand Details Due to concentrated on its quality and its image, Rolex company supply cannot exceed demand because using the certificate high quality material and qualified craftsmanship to produce each watch will very time taking and some model even required some special technology to produce the model. Refer to the market, this product was considered as inelastic product because increase in price lead to fewer customer to purchase the product. 3.4 Technology needs Rolex has a few series of its watches. There are Automatic Movement, Classic watches, Quartz Movements, Water resistant cases, Collection, Certified Chronometers and Ceramic bezels. Ceramic bezels-The bezel of a watch will exacerbate when exposed to sunlight. Regarding to this issue, Rolex have been motivated to create a unique bezel with a Cerachrom disc. It is essentially scratch-proof and its colour remains unaffected by ultraviolet ray. They are available on the Daytona models, Sea Dweller-Deepsea, Submariner and GMT Master ll. Water-resistant cases- The watch can be survived withstand pressure to a depth of 100m. Classic watches- The classic watches assembled with scrupulous attention to detail and crafted from the first-rate raw materials. 4.0 Market Analysis Market analysis is to understand its evolving threats and opportunities and determine the attractiveness of a market. 4.1 Target Market Segment Strategy Rolex Company using the differentiated Segment by dividing the target market to three group that is normal model, female model, and the special model. These targets also targeting upper high or high social class population because are affordable compare to the lower class. 4.1.1 Industrial Participants / Key Player 1.Rolex 2.Cartier 3.Breitling 4.IWC 5.FranckMuller 6.Blancpain 7.Corum 8.GIRARD-PERREGAUX 9. Audemars Piguet 10. Hublot 4.2 SWOT Analysis Rolex: Strength Brand awareness involves the ability of consumers to remember to the brand name or recognition brand. In the purchase decision, it can play a vital role because people usually like to buy familiar brands. Brand awareness has been calculated by a variety of brands and is available at Annex lV: Brand Awareness. This result shows that Rolex has 97% for awareness. The Rolex brand value is quite high and the name is known around the world. Weakness The strategy has been defined so well but it is hard for the company to change its strategy even how innovative the strategy are. The weakness is that could remain some segments that hard to be achieved on the market. For instance, if the fashion goes to GPS watches, Rolex is hard to changes the strategy because Even they try to change their product to GPS watches, people assume that Rolex to be classic watches. In this case, Rolex would be hard to get a market share of GPS watches Opportunity Rolex brand name is very valuable. It seems that I can be diversified in related fields. Rolex should take the opportunity to open jewelry line over the world. Rolex has the ability to produce jewelry with its technical. Threats The threat of Rolex is youth does not recognize the name of Rolex. Normally, the most mid age people recognize the name of Rolex because most of the segments were set only for mid age people or middle upper social people. Market Need Now days Customers are very concern and picky about on quality on a product especially luxury or premium product or services. To this situation, Rolex Company is very caution on its every product so that will not disappoint the customer and remain the good name of its Company. Other than that, Rolex Company also cautious on its design for every product example what meaning or message want to tell the wearer, or how attractiveness on the customer and probably create a new function technology. 5.0 implementation and strategies 5.1 Marketing strategy The marketing goals of the company are increase awareness of your products and services and increase sales by 150% for next few months. Besides that, the company could use the 5Ps of marketing to achieve its goal. There are product, price, promotion, place and people. After that, the company will test ideas by doing research. The company could done its research through personal interview, survey, e-mail and telephone. 5.2 Pricing Strategy In a nutshell, the Rolex Company could work on value-based pricing structure. Rolex Company will determine the price or value that their consumers willing to buy it. 5.3 Promotion Strategy There are a few ways to promote the company and its products such as advertising, sales promotion and public relation. Those ways able to present information make it clearly to consumers. Furthermore, those ways also able to increase demand and differentiate the products. The company could use advertising as their main components of promotion. Advertising able to spread and present information to people from all strata. The company uses the informative advertising to introducing the new product. Moreover, its objective are telling the market about the new product and building company image. 5.4 Distribution Patterns The company initial focus will be in the China Guang Dong market. There are huge populations and demand strong in China. Such a case, the interest for particular brands is stronger than others in some areas. Omega and Longines got the top two positions in most Chinese provinces. Besides that, the people who live in Guang Dong have preference for Rolex. 5.5 Marketing Program The company could hold the program that retain existing customers and customer retention program. So that, this program able to encourage consumers loyalty and build a strong connection with consumers. This program will uses those social networking to communicate with existing customer and keep updating the information to consumers. 6.0 Web Plan Summary Nowadays, Internet has played an important role in the business. Websites became a dynamic marketing tool for sales. Websites have the ability to build the connection with customers, connection with market partner and connection with the world around us. 6.1 Website Marketing Strategy The use of E-business in Rolex Company. There are intranet, extranets and internet in E-business. Rolex Company creates intranets to help employees able to communicate and to access the information found in the company computers. Furthermore, company should set up the extranet with their supplier to enable information exchange, payments, transactions and orders. The E-commerce able to provide buyers access to comparative information, competitors, products and information about company. Besides that, company could create a marketspaces to offer buyers their products and services online. By using E-marketing, company can communicate about, sell product and services and promote their product over the internet. Company could create or design an attractive website to attract consumer. Creating a website is one thing; getting people to visit the site is another (Marketing an Introduction sixth edition 2003 p99). The important key is to create a good and enough value to get consumers to come to the site , stick around the site and come back again.

Ireland Conflict :: essays research papers fc

Conservation of the Amazon Rain Forests The rainforests are essential for life on earth, and destroying them could result in an ecological imbalance and the loss of many valuable resources; therefore measures must be established to protect the world’s rainforests. The rainforests are a major factor in the stability of the environment, especially in the greenhouse effect and the help to fight pollution. The Amazon Rain forest is the largest tropical rain forest of the world. It covers about 2 million square miles and about two-thirds of the forest is in Brazil. The rain forest lies in parts of Bolivia, Peru, Ecuador, Columbia, and Venezuela. The rainforest receives about 50 to 175 inches and the average temperature is about 80 degrees. The Amazon rain forest contains a huge variety of plants and animals than any other place in the world. A statistic shows that a two and half acre area contains about 280 or more species of animals and trees. The growth of resources has made the rain forest decrease in size over the years. Only six percent of the rain forests are being protected today. Human activities are out of control and the forests are depleting rapidly. The rain forests are the homes to a variety of animals. These animals such as monkeys, gorillas, and leopards are a big source of food, which the native villagers heavily depend on. Many villagers depend on certain animals for me dicine. The two major factors that are destroying the rain forests are logging and poaching, logging being the greater of the two. â€Å"The further aspects of man’s impact on the vegetation of the rain forests must be mentioned: (1)the commercial exploitation of trees for lumber, (2)the continued exploitation of wood for fuel, including charcoal, and (3)the introduction of exotic trees for production of raw materials.†(Bennett 230) Logging itself, does not have to be so destructive. The multiple clearances of land are what is so destructive. The forest has the ability to replenish itself if given the proper time to. The problem is that as soon as the new trees reach a suitable size they are cut again. Some areas of the rain forest have been cleared three times in thirty years. Logging has grown extensively, and there is a spread of it into the last intact forests. One of these is the Amazon River Basin. The Basin is being logged from every side.

The Trial And Death of Joan of Arc :: St Joan of Arcs Heresy Trial and Death

On May 16, 1920, Pope Benedict XV conducted a ceremony at St. Peter’s Basilica in Rome to canonize Joan of Arc, often referred to as the Maid of Orleans. This ceremony was the final step in a process that was begun in 1849 by the Bishop of Orleans, Felix Dupanloup, over 400 years after St. Joan’s was tried, convicted and executed in the name of the Church. A study of her heroic deeds and an intensive review of her life, virtues and the trial transcripts that condemned her to be burned at the stake, resulted first in her beatification in 1909, and finally her canonization 11 years later in 1920 (Pernoud 245). Amazingly, two years after that, the woman who had been condemned, put to death, and then canonized as a saint by the Catholic Church, was declared the patroness of France (McBride 82). Jeanne d’Arc was born around January 6, 1412, in the village of Domremy in France (Thurston). At the time of her birth, France and England had been engaged in the longest war in history, which has come to be known as the Hundred Years' War. These two countries were fighting over whose right it was to rule. The English had occupied much of northern France, and the primary issue became the survival of France as an independent state rather than as part of an Anglo-French empire ruled by the English monarchy. The French were determined to drive the English out and crown Charles VII as their king (Reither 227-229).   Ã‚  Ã‚  Ã‚  Ã‚  Joan was a simple peasant girl who was raised in a Catholic home as the youngest of five children (Thurston). Her mother was very religious and had a big influence on Joan's life. Joan never learned to read or write, but was skilled in spinning and sewing. She was also always very strong and healthy (Michelet 8). At the age of thirteen, Joan began to have holy visions and hear the voices of saints she identified as St. Margaret, St. Catherine, and St. Michael (Thurston). Her voices convinced her to vow to remain a virgin (Lucie-Smith). When Joan was seventeen years old, the voices revealed her divine mission. Joan was told that she had been chosen to lead the French army into battle against the English, to drive them from French soil. The voices instructed her to go to see Robert Baudricourt, the Captain of Vaucouleurs, who would arrange for her to be taken to see the king (Michelet 12).

Economies of Scale

Detroit and some of its surrounding areas as Windsor and Ontario, represent a huge factor in the economy of the United States by being one of the major cities where trade takes place. General Motors, Ford and Chrysler also known as Americas ‘Big Three’ automobile companies are located in this city. The concept of External Scale Economies can help us explain why these three major companies are located in this area. Scales economies are important for a country because they represent a growth in its economy. Companies are able to produce more products or services at a lower cost of input. External scale economies are based on the size of an entire industry within a specific geographic area. †1 These companies bulk in one specific area in this case Detroit, causing a decrease in the cost of the inputs by sharing some of these with the other surrounding companies, â€Å"this way the output of the industry within the area is larger†2 But how did Detroit turned out to be the spot for these major companies? Detroit’s location gave it the advantage to start growing as a transportation hub in the very beginning.At the end of 19th century Detroit had shipping, shipbuilding and manufacturing industries, but what gave Detroit the main advantage for the businesses to settle there were the natural resources that it owned which eventually led automobile industries to be interested in this place for what meant for them: the external factors which provided a reduction in the firm’s cost. Some of these factors were coal, iron, and copper mining, Detroit was also easily accessible by water and by land; and it was near the nation’s leading, well-established production centers. One of Detroit’s strength was certainly the external factors mentioned above; it guided important industries towards its direction becoming what is now known as a global symbol. The agglomeration of these three big automobile companies has allowed the achi evement of an external scale economy therefore a benefit for the United States’ economy. Notes 1. Thomas A. Pugel, â€Å"Chapter 6 Scale Economies, Imperfect Competition, and Trade†, International Economics, 15th Edition: Page 94 2. Ibid 3. Thomas J. Sugrue, Motor city: The story of Detroit. http://www. gilderlehrman. org/history-by-era/politics-reform/essays/motor-city-story-detroit