Does America Want an Unmotivated Society Essay

I. Presentation Weed is the name given in the United States to the medication delivered from the hemp plant Cannabis sativa. The utilization of cannabis subsidiaries under such names as hashish, charas, bhang, and ganja is boundless all through the world. The most dynamic element of the plant subsidiary is tetrahydrocannabinol (THC). The power of this concoction is demonstrated by the way that the normal road test of weed contains under .5% THC. A few examples are impressively higher in THC content; in this manner, impacts from the medication change as indicated by its quality, which means its THC content. The blooming portions of the plant contain the best measures of THC (Goode 567). These are typically dried and smoked, yet they might be made into a beverage to some degree like tea or mixed into different cooking plans. Some way or another, pot has been utilized for certain meds yet it's anything but a substantial ground to authorize it since it has negative impacts to human bodies. In addition, maryjane is as yet illicit in many spots. Under government law an individual can be condemned to as long as one year in prison or a $5000 fine, or both, for straightforward ownership of maryjane. Consistently around 400,000 individuals are captured for ownership; around 80 percent are under age 26. Weed is being utilized as legitimate clinical treatment for a few conditions. Cautious investigations have indicated that it is powerful in rewarding extreme queasiness in disease tolerant experiencing chemotherapy. More established patients appear to react not exactly more youthful patients do and grumble progressively about symptoms, including feeling â€Å"stoned.† The reason for this current examination is to investigate whether pot ought to be authorized or not. It will likewise handle how weed will enormously influence the people that our nation needs most, similar to the workforce or the labor. II. Foundation Cannabis has been utilized for a large number of years, both as a medication and for its inebriating impacts. As tablets, pot is every now and again endorsed to calm the sickness and retching that frequently go with chemotherapy. Its non-clinical use, nonetheless, is unlawful in the United States and most different nations. The punishments for having or utilizing weed are, in numerous states, as extreme as those forced for the ownership or utilization of considerably more strong medications. Many contend that maryjane is not any more hurtful than cigarettes and alcohol and ought to be sanctioned. Most maryjane utilized in United States is smokedâ€either as cigarettes or in pipes. Its belongings fluctuate with its quality, and generally with the perspective of the client (Earleywine 149). Regularly, a feeling of prosperity is experienced. In huge nations, pot is considered as hallucinogenâ€a sedate that produces mind flights. In spite of the fact that cannabis doesn't deliver a physical reliance in the client, there is proof that it can create mental reliance. Exploration shows that pot effectsly affects the body. It can disable memory, discourse, and learning. It opens the lungs to elevated levels of tar and to more than 150 different synthetic substances. A considerable lot of these can disturb the covering of the lungs, causing aggravation and bronchitis now and again. Weed diminishes the creation of male and female sex hormones and may cause barrenness n a few people. Pregnant ladies should shun smoking pot since it can cross the placenta and influence the hatchling (Earleywine 150). A few specialists accept that the substantial utilization of weed may hurt the body’s invulnerable framework by impeding the improvement of monocytes, cells that invigorate counter acting agent creation and murder outside cells. Albeit no immediate circumstances and logical results connect between found, an individual who reliably utilizes weed might probably mishandle other, more grounded drugs. The utilization of cannabis can be perilous to an individual partaking in any action where fast reflexes and consistent discernment are vital (Goode 575). III. Conversation A. Impacts of Marijuana Numerous perceptual and enthusiastic impacts follow maryjane smoking. Tangible experience may turn out to be progressively exceptional; smells are more extravagant, surfaces feel increasingly arousing, objects are viewed as progressively wonderful, sounds are increasingly splendid, and thoughts stream all the more openly, despite the fact that they might be incoherent. The individual may encounter an enthusiastic high where the person feels blissful, quiet, and glad. The impacts of maryjane, notwithstanding, resemble those of different medications; they especially rely upon the individual and the setting. Taken in a wonderful, loosened up social circumstance, pot can be very horrendous (Earleywine 123). Additionally, individuals who are normally distrustful, dubious, or forceful may turn out to be all the more so affected by cannabis; the quiet, better-balanced clients are increasingly able to encounter an euphoric high. Besides, a great many people use weed for the adjusted states it produces. These states are somewhat simpler to control than those created by other psychedelic medications, except if the dose is exceptionally high. At low to direct measurements, fantasies are absent. Rather, the individual ordinarily reports of tranquility, expanded tangible mindfulness, changes in existence, and expanded hunger, frequently with a hankering for desserts. At higher doses, the individual may encounter thought unsettling influences, quick passionate changes, lost consideration, and a feeling of frenzy. Weed has been one of the most explored sedates throughout the entire existence of pharmacology, and there is as yet extensive difference about its present moment and long haul impacts (Belenko 34). It was made an illegal medication in the United States, and numerous states have set up cruel punishments for those indicted for ownership of even limited quantities. In the ongoing years, there has been an advance toward decriminalization of maryjane. Despite the fact that this strategy would not legitimize the medication, it would build up progressively suitable disciplines, for instance, fines rather than detainment for ownership of limited quantities for individual use (Belenko 66). The developing accord of examination on maryjane would recommend that it's anything but a protected medication. In fact, it is dicey whether any medication taken oftentimes by decision is prudent. Numerous scientists have reasoned that smoking pot is not any more risky, and maybe even less in this way, than smoking cigarettes or utilizing liquor. The issue, however, is recurrence of utilization. The writing on ceaseless clients of marijuanaâ€that is, individuals who use it a great deal and over a significant stretch of timeâ€suggests rather unequivocally that there are not kidding deficiencies in some subjective capacities, for example, memory. Likewise, heavier clients experience some unwanted character changes, issues with rest, deficiencies in psychomotor capacities, for example, driving, and changes in inspirational levels that produce indifference and an absence of taking a stab at accomplishment. At long last, there are various elements that impact the impact of a specifi c medication (Earleywine 145). There are factors related with the medication, including its immaculateness and the strategy for its virtue and the technique for its organization. Subject factors that are significant incorporate body weight, metabolic rate, regardless of whether the individual has eaten, general condition of wellbeing, and past involvement in the medication. In attempting to anticipate how any one individual will respond to a medication, these components, and numerous others, must be considered. However, there is another significant variable that assumes a significant job in sedate responses, and time after time its belongings are neglected ( Baron 119).  That variable is the user’s desire for the drug’s impact. Exploration has demonstrated that the experience many medication clients will have isn't only an aftereffect of the physiological and biochemical changes delivered by the medication, yet in addition relies upon how they think they should react, or how they see others around them reacting. These components should likewise be viewed as while assessing the purposes behind changed conditions of cognizance through medication use. a.)â â â Respiratory impacts: Since pot smoke is profoundly breathed in, held in the lungs, and contains huge numbers of indistinguishable destructive fixings from tobacco smoke, clients give indications of debilitated lung working when contrasted with nonusers. Like tobacco smoke, maryjane smoke contains cancer-causing operators, however since many pot smokers likewise tobacco, it has been difficult to segregate marijuana’s sway on lung malignant growth. Now, the proof is just interesting (Earleywine 156). b.)â â  Immune framework: Creature considers have proposed that cannabis can hose the body’s protection from sickness, yet no examinations have been done to affirm or discredit this risk in people (Earleywine 156). c.)â â â Mental impacts: While there is no proof that weed makes the cerebrum shrivel, it can prompt a persuasive condition, which analysts characterize as a psychological dulling, enthusiastic blunting, and loss of drive and objective directedness (Earleywine 156). IV. For what reason would it be advisable for it to be legitimized? Weed is being utilized as lawful clinical treatment for a few conditions. Cautious examinations have indicated that it is viable in rewarding serious queasiness in disease tolerant experiencing chemotherapy. More seasoned patients appear to react less well than more youthful patients and grumble increasingly about symptoms, including feeling â€Å"stoned.† Researchers are proceeding with investigations of marijuana’s conceivable value in diminishing weight inside the eye in glaucoma and in rewarding muscle spasticity (Goode 575). Maryjane has been utilized for a huge number of years, both as a medication and for its inebriating impacts. As tablets, maryjane is regularly recommended to diminish the queasiness and regurgitating that frequently go with chemotherapy. Its non-clinical use, notwithstanding, is unlawful in the United States and most different nations. The punishments for having or utilizing weed are, in numerous states, as serious as those forced for the ownership or utilization of significantly more powerful medications. Many contend that maryjane is not any more hurtful than cigarettes and alcohol and ought to be legitimized ( Julien 489) V. End Weed

Play within a play Essays - Economy, Politics Of The United States

Prof. P History 2010 07 September 2010 The Great Depression: America, 1929-1941 This book was composed by Mc Elvaine in 1993. His philosophy of the Great Depression in the United States is a well assembling account, to a great extent sequential. In this interpretive history, the creator talks about the causes and the consequences of the most noticeably awful sorrow in American history, covering the time from 1929 to 1941. Its accentuation is on individuals and governmental issues, with representations of Hoover and Roosevelt and portrayals of occasions and clashes in and around races, gatherings and groups, Congress, laborers' associations, help programs, etc. He likewise looks at the reasons for this destructive occasion, its effect upon the American individuals, and the political, legislative, and social reactions to it. There's no genuine endeavor at financial history, there's not a solitary table of figures, yet the monetary discussions about the Depression and its causes are addressed in the initial parts. There's substantially more profundity to the social history, however that is for the most part drawn closer from the viewpoint of organizers and projects; for the perspectives on conventional Americans, McElvaine draws vigorously on the letters written to Eleanor and Franklin Roosevelt. There's likewise an (interesting to me) record of the Federal Theater Project and the other workmanship alleviation ventures. The creator plunges into famous writing and movies of the period to manufacture a story of the open's evolving esteems, from rivalry based rapacious independence in the Roaring Twenties to collaboration based financial moralism McElvaine endeavors were to put the Depression in the more extensive flows of US history, with a specific spotlight for enormous scope, long haul changes in mentalities and qualities. This occasionally appears to be over-oversimplified, yet gives his story a controlling system: the main genuine ponderousness accompanies endeavors to connect the Great Depression to current legislative issues. I don't wish to romanticize the Great Depression period as some brilliant time of collaboration and network, however I do accept there are pertinent exercises to be gained from the manner by which networks reacted to the enduring of their time, especially as we remain on the moving sands of a precipice called breakdown Little foundation is accepted by The Great Depression ? I had no issues tailing it in spite of my scrappy information on United States history ? furthermore, McElvaine's methodology makes for simple perusing. Just as making a fine presentation, it gives a premise to promote increasingly specific perusing. I totally can't help contradicting McElvaine's methodology that Franklin Roosevelt's New Deal and Keynesian financial matters didn't saved the country from complete disaster, however he additionally brings up that ...the changing blend of American qualities in the Depression-was of considerably more noteworthiness than was Roosevelt himself.(324) Roosevelt's plan would have fallen on hard of hearing and self-satisfied ears ten years sooner, and it couldn't have prevailing without an adjustment in values in the American individuals that had the option to resound with the estimations of the New Deal. I hurry to include that I do accept that it was the New Deal that at last hauled the country out of the downturn. As I would like to think the FDR organization and the New Deal spared free enterprise from the stun of its most exceedingly terrible abundances by being sober minded, and not ideologically unbending. I am not denying World War II and the starting of the military modern complex that did help and has kept on forestalling dejections and veil progressively extended, less obvious monetary and social shamefulness. The book finishes by inferring that nothing the New Deal did ever relieved the Depression (which just finished with the beginning of World War II), yet that the rising estimations of Depression-period America laid the preparation for the U.S. government we know today. However I think the creator's conclusions are uncovering, regardless of whether I don't concur with the greater part of them. The Great Depression was an incredible injury. I think it is imperative to comprehend the time as it was in those days. To put it plainly, this book is a regarded investigation of the HISTORY of the Great Depression time, with a portion of the writer's liberal feelings. The dates, realities, individuals and occasions are clarified altogether and in a manner that is anything but difficult to peruse. By and by, I think a decent life story of Franklin Roosevelt is a superior spot to begin, however this book

Why the End of Break Isnt So Bad

Why the End of Break Isnt So Bad It was nice being able to travel, sit on the couch, hang out with your dog, and grab food from your kitchen cabinet whenever you wanted. But now you’re back at school, and if you’re finding it hard to get into the swing of things again, you’re not alone. A lot of people struggle with end-of-break-bummers, and I promise it’ll get easier soon. “I was totally in the zone last semester. There’s no way I can get back in it!” There is too a way! I was once talking with someone whose name and face I have now completely forgotten, but they told me that it takes two weeks to develop a habit. Maybe that someone was a TED Talk or a random person from high school. I don’t know. It doesn’t matter. What does matter is that you may be may be having a hard time now, but in two weeks, things might be a whole lot easier.   Starting up again is always the hardest part, because you have to have the energy to do it all again. If you’re back at school already, though, that first step is done. Now you just have to keep goingâ€"and you can, since you’ve done it before. It’s hard now, but you’ll be able to adjust soon enough.   “But homework stinks, and I’m not going to do it!” Homework does stink. But it’s a huge part of school, and since you signed up to go here, you might as well play along. There’s light at the end of the tunnel; the last day of the semester is just 16 weeks away at most, and then you get another break. And don’t forget that theres also some light at the start of the tunnel, too. If you’re just beginning classes right now, then you’re walking into one of the most glorious weeks of the semesterâ€"syllabus week. Getting used to classes can be tough, but the workload is usually not so bad those first few days. If you’re not about to begin a new semester (if you’re coming back from fall or winter break, for instance), then … hang in there. “I still don’t want to go back to school!” No one does (except Harry Potterâ€"why didn’t any of us submit our Hogwarts applications on time?). But the great thing about school is that you are surrounded by people who on the same schedule at you. Reach out to your fellow classmates. You can all share the burden of getting back to work; what better way to make friends? Schoolwork itself is hard (because it’s work) but try to remember all the things that you like about school. And before you say there are none, think more, dang it! There must be something about it you like. Here are some things that college offers: FriendsSquirrelsBeing around people your ageCampus resources like gyms, theaters, and cultural centersInteresting classesFun local stores and restaurantsA truly picturesque campus (mind that construction!) If you’re still having a hard time with the idea of going back to school, think about why. Is it because you don’t like what you’re studying? Is it because youre not digging the atmosphere on your campus? If a few weeks go by and you still find yourself unmotivated and upset, then maybe it’s time to reevaluate your situation this semester. Do whats right for you, and remember that there are always, always people there to help you (more people than you even know!). You’ve just come back from a great break, but remember that you had to work for it. You’ll be enjoying another break before you know it, and in the meantime, you’ll get back into school-mode. I bet that once you start learning cool things, you’ll appreciate your classes and start liking school again. (And if all else fails, maybe we can still get into Hogwarts.) Kate Class of 2020 I’m a senior here at the university, majoring in English and Math and minoring in Spanish. I’ve lived in Illinois all my life, sharing a room with my sister and many crickets. As the youngest in my family, I’m lucky enough to have my older siblings’ advice and perspective as I make my way through college!

A Personal Experience Using One Of These Terms, And How I...

In this written assignment unit 4, I will define 3 terms, give examples of each, describe a personal experience using one of these terms, and how I responded. I will also write about children, and violence in the media. Different situations or behaviors sometimes need a response or do they? These are the questions that I will attempt to answer in this written assignment. According to (Stangor, 2010), these terms are about how we feel, and react to the people in our presence. Fundamental Attribution Error- To define this term in my own words, I will say that this term means to think about things in the wrong way. The thinking is that there are two main reasons for the behavior that we are receiving. These reasons include, internal reasons and external reasons. Internally speaking, it is what makes people perform actions that can be attributed to our personalities. We act the way we do, because that is the way we are. Externally speaking, we behave the way that we do, because of the predicaments that we are in. It is the mixture of internal and external reasons that explains our behavior. The fundamental attribution error, is when internal reasons are blow out of proportion, when you are trying to comprehend why people do what they do. Example of Fundamental Attribution Error- An example of the fundamental attribution error would be if a lady came into a store you owned, and she approached you with an attitude. The fundamental attribution error by definition, causes us toShow MoreRelatedEthical Dilemmas in Workplace1634 Words   |  7 PagesEthical Dilemmas in Workplace Personal values may conflict with ethical decision making if those personal values are different than the organizational norms of the business or institution. 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Psychology - 1413 Words

------------------------------------------------- ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- ------------------------------------------------- Childhood to Adolescence Development ------------------------------------------------- Monica Rodriguez-Sosa ------------------------------------------------- University of Houston – Downtown Introduction As we age and grow in life, we constantly change in many different aspects. It is natural for humans to develop†¦show more content†¦212). Another example of emotional development is having empathy. Apprehending another person’s emotional state and then matching that to ones emotions is considered empathy. The last example is moral emotions which is defined as emotional states that are linked to their culture’s definitions of right and wrong (Boyd Bee, 2009, p. 213). These emotions include guilt, shame, and pride. Middle Childhood Second, Boyd and Bee (2009) explain that between the ages of six and twelve, children grow two to three inches and add six pounds each year (p. 246). Because of growth, muscle also grows so children have the ability to bike ride better. A second example of growth is the brain development that occurs between ages 10 and 12 in which the frontal lobes improve dramatically. This causes children to develop a particular kind of concentration called selective attention, which is the ability to focus cognitive activity on the important elements of a problem or situation (Boyd Bee, 2009, p. 245). The last example of physical growth is excessive weight gain issues. 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Digital Telecommunications and Network Free Essays

A network is defined by Noergaard (2005) as a collection of two or more connected devices that can send or receive data. He further adds that the relationship between these connected devices in a network determines the total architecture. The purpose of this report is to understand the networked applications architectures. We will write a custom essay sample on Digital Telecommunications and Network or any similar topic only for you Order Now Two networking architectures are covered here; the client/server architecture and peer-to-peer architecture. The report first gives an outline of these two architectures and their advantages and disadvantages. It is seen that the industry divides its products on the concept of client-server model or peer-to-peer model. Some applications perform better with the former model while others perform better with the later model (Klemt 2005), 1992). Based on the understanding of this report, two separate scenarios for a basic networking application will be analysed. The idea will be to judge the type of networking architecture to be used for each scenario. Finally based on the entire analysis, a conclusion will be drawn as to which resource has to be used in what situation. Part 1: Review of Client/Server and P2P application architecture Client/Server architecture Client-network computing is one of the most basic paradigms of distributed computing, and this architecture is based on the paradigm as described by Jalote (2005). This architecture has a minimum of three components – a client, a server and a network that connects these two systems. This is a two level architecture where a client requests a service and the server provides it (Singh 2005). The server is usually accessed through a remote procedure called RPC, request of which is defined by their signature. The processing of the request is internal to the server and is transparent to the client. The client and server may be on different or same systems Advantages of client/server architecture Client server architecture using RPCs has been used for over a decade for system wide exchange computing (Singh 2005). The main reason for this is the high level of reliability this architecture provides. It is also found that the cost of the entire system over a period of time is less than that used by other architectures. In addition, the architecture also enhances safety since any of its components can be removed without a major impact on the other system. This architecture leads to a better distribution of resources through the system. This architecture also leads to increased productivity because the front and back end distribution of processes is optimised (Jalote, 2005). Disadvantages of client/server architecture The main disadvantage of the client/server architecture is that there are multiple databases in the client/server environment, making the management and synchronizing of the data shared between them difficult. This also leads to a difficulty in software distribution and configuration management program, as the system is distributed. The cost of maintenance may also increase because of the different networks being inter-networked. P2P architecture Peer-to-peer or P2P architecture is another way of managing distributed applications. In this method, the individual nodes have similar and comparable roles, unlike the client/server systems. In this architecture, the nodes are given roles such that both can act as client and server. This type of connection requires at least two computers connected to each other (Reid, 2004). In order to function correctly each node of the system should know the address of at least another node. Each node can directly contact the other node of the system for using its resources, without going trough the server (Heathcote Langfield, 2004) Advantages of P2P Architecture This type of communication exists since the time of old IBM PCs. The primary advantage of a P2P network is that it is fault tolerant and there is no single location for the fault. This means that the system works well even when several of its components are missing (Verma, 2004). Also the combination of processing power of multiple nodes in a network greatly increases the efficiency of the system in terms of combined processing power and storage when compared with a central server. P2P systems are hence extremely autonomous and can secure anonymity. They can be generally deployed in an ad hoc system without requiring central management or control. Finally, unlike the client/server systems there is no need for a separate network operating system (Reid, 2004). Disadvantages of P2P Architecture The manageability of peer-to-peer systems is much harder, due to the extremely distributed nature of the system. Security is also not centrally controlled and the users need to remember different passwords for accessing the resources located on different nodes on the network (Porter, 2006). Facilities such as backup are the responsibilities of the individual user unlike the client/server systems where the server can schedule them. This system works best for lesser number of systems in a network, usually under 10 (Reid, 2004). Part 2: The architecture of Mr. Robertson’s home network Network Architecture The architecture which I would suggest for Mr. Robertson’s home would be a peer—to-peer network. There is no necessity for a client/server model in this case. Also no type of hub system is required, since the application is very simple Justification As is already explained in the section above, a peer-to peer network is used for ease of applications without extra overload. The system works best for systems which having less than 10 systems. As Mr. Robertson’s system uses only two computers, the system is ideal for this purpose. In addition to this, the home network does not require the additional overhead of a server so a pure peer-to-peer system, one without any server (Subramanian Goodman, 2005), can be used. The application mainly used is the file sharing which can be easily done. Also for using the internet, there is no necessity for the system to have simultaneous connections as is already mentioned in the example. While, to most intents and purposes, a printer application requires the use of a server so as to manage the print request being sent from multiple systems, this is clearly not the case here. The network should merely have the capability to receive print jobs from both the systems a simultaneous operational capability is not really required, as the application would not be too critical. In the worst case, the print job could be cancelled and given again. Finally, the use of a client server system would in addition to setting a server, also need additional components and software like an operating system, which is not required in this case, as there is no need for tasks like allocation resources, backups etc. Also, Mr Robertson gets the advantage of removing any of the two systems from the network at anytime, and the second component would work just as well, as neither of the system is a server. Components for the home network In addition to the 2 computers and printers purchased by Mr. Robertson, he needs very few components to get his system up an running. He would need the cable modem, a twisted cable pair, media converter for running the internet through cable, a splitter and a print sharer. There is no necessity for a hub for such a system, which is necessary only if there are more than two computers on a network. The splitter would divide the internet connection to the two systems which will the function of the print sharer also. A wireless NIC or a wired one can be used to share the network. Only single numbers of components, except the connecting cables, are needed because there are only two computers. Topology of the home network The figure above shows the basic topology of the network. As explained above, there is no need for a hub for just 2 systems. The printer can be connected either via a print sharer or the software can be used to do that by accessing the network. Here, each computer can access the network printer. In addition, the cable connection that comes can be split into two using a splitter. This type of networking requires basic minimum of components and can be used for connecting systems on a home network. This system is extendable to more than two systems. The only difference would be that in that case, a hub would be used between the two systems instead of just a cable. Also the cable type, which is twisted in this case, might be changed for more than two computer systems, because of load factors. In this case also, there will not be any necessity for a server, as the printer tasks will be shared, but not scheduled or managed by an external system. Part 3: The architecture of the LAN of BC Inc. Network Architecture For the company’s LAN, a client server system is a must. There are only 16 systems, on the LAN would more than fulfil the application necessity. There are multiple applications needed for this system. There is the printer service which is multiple in numbers and locations. In addition, there is the obvious necessity for an email and web server for the business applications. All this necessitates are need for the use of a client/server model. Justification In many of the situations given above the peer-to-peer network fails to have any use. First and foremost is the number of systems. The P2P system is only suitable if the number of systems is less than 10, as mentioned earlier. Also it is not just the number of system that is a problem, since it is not a very huge network. Office applications as a rule need more features and functionality than a home based server, and so the load on the network contributed by each system is also a lot. In addition to this there is he additional necessity for security and backups as compared to the home networks. People usually prefer manual backups on their home networks, but almost all the companies insist on having scheduled backups for the protection of data. In addition, the systems also need to have security updates with a controlled installation, which is not necessary for a home network, whose security necessities extend maximum to having a basic firewall. As in earlier case, due to data sensitivity, companies prefer to have all of these controlled rather than leaving it to the discretion of the office employees. There is an obvious burden due to the higher cost of installation and maintenance of the system. But this is more than compensated by the quality of security and safety levels given by such a system. Also since, there are only 16 employees in the system, it is logical to have the email server as the same as the network server. This is also true for the web server applications. However, here there is an assumption being taken. It is assumed that the company business is a small size, based on the number of people working there. This may very well not be the case. In addition to this, the web sever installation might be mandatory on an external system, because of security reasons. For instance, the company might not want its intranet lined with its webserver to provide more security. This case might necessitate the need for a separate web server, though for this report, a single sever is being considered for now. Physical Components In addition to the computer systems and printers, the company needs many additional systems to make a network. First and the most important of this is the server system, which needs be high ended, with high processing power and speed. This is that the system can easily act as a intranet server, a mail server, and also the web server. In addition to this a router is essential for connecting to the internet via the DSL modem. Also there are multiple numbers of cables, based on the systems connected to the network. Since the system is connected via the Ethernet here, the internet being a DSL based one; the corresponding cables are also required. The printer is connected to the server, which takes care of the scheduling the print jobs. The other servers, as mentioned earlier are situated on the main server itself. The figure above shows the scheme of the connection diagram. The above diagram is a very simplistic way of representation of the office network. As mentioned above, the server would be common from email and web applications, and also take care of the intra networking scheme. In addition, the various printers and DSL modem would be added to this server only. The server would need a network operating system and the main security firewalls and the protection schemes like the antivirus would be installed here. Ethernet would be the mode of interconnection in the network. The system can be extended when a new web server is required, which is separate from the present server. There can be another server attached to the present one which would take care of the business related websites etc. The connection would be restricted so that only the purchase related or feedback related information is passed to the main server, which would then direct this information to the necessary client system. Conclusion In the report mentioned above, there were two types of networking architecture which were analysed. One was the client server architecture, which is one of the oldest networking schemes available. The system finds its use in complex networks having many systems, and necessity for multi-file sharing applications, common or shared database and also security. All these are provided by this system, which the case seen by the company example is being taken here. The operations are very complex with multi-printers and their multiple locations, the necessary for common access to the internet, and also the need for servers for websites and emails. Also the network needed security and will be needed managed access permission for files stored on the network. The restricted type of entry for a network is possible only for a client and server type of architecture, which is what was proposed for this case. The company being an accounting firm would also need internal data restrictions and security issues, which can only be tacked by this architecture. In contrast, the home networking system is a very simple operation, which needs to have a mere connection to the internet and the use of a printer. There are no constraints of security or access restrictions on this systems and the main application need is a basic file share operation. For such a system a basic, peer-to-peer architecture is sufficient. There is no need for hubs also as there are only two systems. The network does not need any server based system which is too much of overkill here. Hence, using these two examples, the two types of networking architectures are explained here. How to cite Digital Telecommunications and Network, Papers

The Relational Database Model

Question: Describe the motivation, theory and technology behind . Compare and contrast this with the standard Relational Database Model that has been discussed during the topic. In doing so, discuss the benefits and drawbacks of both approaches and when it is appropriate to use each approach. Answer: has been the NOSQL which is a database system that is able to highly optimize the data for the retrieval and for handling all the appending operations. This is mainly to work for the record storage and the key value stores in reduced time flexibility which is compared to the full SQL systems. (Nance et al., 2013). These have been applied with the use that requires a huge quantity of the data where the same attributes could be used for the capture on the single machine. It is important when the data can be structured easily without any use of the NoSQL. There have been production system which evaluates the underlying techniques of NoSQL, with the query possibility, concurrency control, partitioning and the replication of the different opportunities. The Relational Database Model discussed has been SQL. SQL stands for the Structured Query Language which lets you properly access and handle the manipulation of the database with the ANSI standard. The execution of the queries against the database with the retrieval of the data, to insert, update, delete, and create new database records. This will help in handling the creation of new tables in the database which can be stored easily through the procedures in the database through the proper views and the permissions on the tables, procedures and the views. (Padhy et al., 2011). For the Relational Database Management System, there have been opportunities of the relational model which directs to store the data with the different fields or the records in the row or the column form. Benefits and drawbacks of both approaches NoSQL has no schema where the data structure is not through the explicit schema where a particular database knows about it. The client can store the data which adheres to the predefined structure. This is mainly for the built in of a large storage which is generally used by the websites like Google and Amazon. They also allow the horizontal scaling where there have been additional machine to the cluster without any downtime. (Cattell, 2011). SQL (Structured Query Language) has been designed for the management of the data which is related to handling the data definition language and the different functions. There have been occurrence of the same row multiple times with the employed queries in the LIMIT cause. The SQL language includes the different clauses, expressions, predicates, queries and the statements for a proper flow of the program. (Mohan, 2013). When it is appropriate to use each approach. NoSQL does not need the querying technology that has been used in the RDBMS for SQL. It has a better capacity for the compression of the data as it generally make use of the sparse rows. This is not mainly for the ACID transaction and is not considered to be the open source as well as it does not give the adequate controlled access. (McCreary et al., 2013). The SQL is users for describing the desired data for the planning, optimization and proper performance of all the physical operations which are important for the retrieval of data. This includes the JOIN option with the specification of the rules for the joining of tables. Reference Nance, C., Losser, T., Iype, R. and Harmon, G., 2013, March. Nosql vs rdbms-why there is room for both. InProceedings of the Southern Association for Information Systems Conference(pp. 111-116). Padhy, R.P., Patra, M.R. and Satapathy, S.C., 2011. RDBMS to NoSQL: Reviewing some next-generation non-relational databases.International Journal of Advanced Engineering Science and Technologies,11(1), pp.15-30. Cattell, R., 2011. Scalable SQL and NoSQL data stores.ACM SIGMOD Record,39(4), pp.12-27. Mohan, C., 2013, March. History repeats itself: sensible and NonsenSQL aspects of the NoSQL hoopla. InProceedings of the 16th International Conference on Extending Database Technology(pp. 11-16). ACM. McCreary, D. and Kelly, A., 2013. Making sense of NoSQL.Greenwich, Conn.: Manning Publications.

Delinquent Daughters Summary Essays - Sex Crimes,

"Delinquent Daughters Summary" Delinquent Daughters by Mary E. Odem touches on many topics involving women residing in the U.S. from 1885 to 1920. Not only does the book raise issues about women as a whole, but also it breaks the women into a more realistic view. Women's age, race, religion, ethnicity and immigrant status, social class, and complex of morals are all used as means of classifying women for analyzing their sexual behavior. To start with there is the issue of statutory rape and what the legal age limit shall be set at. Not only are the middle class women groups seen as organizing ways to protect women they are also seen in terms of protecting only white girls through the passage of their laws. This is seen by the African American women having to form their own organizations in order to insure the morality of the young African American females, and by being denied real help when requesting help against the white male to protect the decency of their young females and help in response to lynching. The classes of girls being evaluated were also seen. For instance, reasoning was given as to why working class girls became sexually active. Like for marriage or rebellion. The female being looked at as helpless and taken advantage of was not shown in an exaggerated light. There were women who made the choice to become involved in sexual situations.

VANDERBILT Surname Meaning and Origin

VANDERBILT Surname Meaning and Origin The Vanderbilt surname has two very different accepted origins: a topographic surname for someone living near a low hill, from the Middle Low German bulte, meaning mound or low hill.originally Van de Bylt, from Die Byltye, a nickname given to ship-carpenters in Holland. From the Dutch byltye, meaning a little hatchet or bill. Surname Origin: Dutch, North German Alternate Surname Spellings: VANDERBILDT, VAN DER BILT, VANDERBUILT   Where in the World is the VANDERBILT Surname Found? While it originated in the Netherlands, the Vanderbilt surname is now most prevalent in the United States, according to surname distribution data from Forebears. However, it is also somewhat common in Chile and Columbia. The name was more common in the United States during the 1880s than it is now, especially in the states of New York and New Jersey. The Vanderbilt surname is now most common based on percentage in the U.S. states of Alaska, Arkansas, New Jersey, Illinois, and Connecticut, according to  WorldNames PublicProfiler.   Famous People with the Last Name VANDERBILT Cornelius Vanderbilt -  head of the prominent American Vanderbilt family; became the wealthiest man in America in the mid-19th century through his shipping and railroad empiresAmy Vanderbilt - American authority on etiquetteGloria Vanderbilt -  American artist, author, actress, and heiress, well known for her line of designer blue jeans from the 1970s and 80s.George Washington Vanderbilt, II - member of the prominent Vanderbilt family who commissioned the construction of Biltmore between 1889 and 1895; the estates name derived from Bildt, the origin of his Vanderbilt ancestors in Holland. The Famous VANDERBILT Family The prominent American Vanderbilt empire began with Cornelius Commodore Vanderbilt, born in Staten Island in 1794. His 3rd-great grandfather, Jan Aertszoon (1620–1705), a Dutch farmer from the village of De Bilt in Utrecht, Netherlands, was the immigrant ancestor, arriving in the Dutch Colony of New Netherland as an indentured servant in 1650. When he was sixteen, Cornelius, the fourth of nine children, convinced his parents to lend him $100 to purchase a sailboat so that he could start his own passenger and freight service between Staten Island and New York City, a service that eventually became known as the famous Staten Island Ferry.  Young Cornelius then signed on as an apprentice on a variety of ships in order to master all aspects of the seagoing industry. By the age of 50, his shipping empire had afforded him millionaire status. He then turned to buying up  small railroads and turning them into profitable ventures. At the time of his death in 1877, Cornelius Vanderbilt was worth  $105 million. Anderson Cooper, son of Gloria Laura Vanderbilt, is currently the only known prominent, active descendant of the famous Vanderbilt family.   Genealogy Resources for the Surname VANDERBILT Vanderbilt Family Genealogy: My Fascination with All Things VanderbiltTaneya Koonce, who fell in love with the Vanderbilt family after visiting the Biltmore estate for the first time, has built a comprehensive family tree of the Vanderbilt family, and also links to other Vanderbilt resources. Finding Your Roots: Anderson Coopers Interactive Family TreeThe PBS genealogy show, Finding Your Roots, traces the lesser-known heritage of Vanderbilt descendant Anderson Cooper- that of his father, Wyatt Emory Cooper.   Most Common Dutch Surnames and their MeaningsDe Jong, Jansen, De Vries... Are you one of the millions of  individuals of  Dutch ancestry sporting one of these top common last names from the Netherlands?   Vanderbilt Family Crest - Its Not What You ThinkContrary to what you may hear, there is no such thing as a Vanderbilt family crest or coat of arms for the Vanderbilt surname.  Coats of arms are granted to individuals, not families, and may rightfully be used only by the uninterrupted male line descendants of the person to whom the coat of arms was originally granted. FamilySearch - VANDERBILT GenealogyExplore over 400,000 historical records and lineage-linked family trees posted for the Vanderbilt surname and its variations on the free FamilySearch website, hosted by the Church of Jesus Christ of Latter-day Saints. VANDERBILT Surname Family Mailing ListsRootsWeb hosts several free mailing lists for researchers of the Vanderbilt surname. DistantCousin.com - VANDERBILT Genealogy Family HistoryExplore free databases and genealogy links for the last name Vanderbilt. The Vanderbilt Genealogy and Family Tree PageBrowse genealogy records and links to genealogical and historical records for individuals with the popular last name Vanderbilt from the website of Genealogy Today.- References: Surname Meanings Origins Cottle, Basil.  Penguin Dictionary of Surnames. Baltimore, MD: Penguin Books, 1967. Dorward, David.  Scottish Surnames. Collins Celtic (Pocket edition), 1998. Fucilla, Joseph.  Our Italian Surnames. Genealogical Publishing Company, 2003. Hanks, Patrick and Flavia Hodges.  A Dictionary of Surnames. Oxford University Press, 1989. Hanks, Patrick.  Dictionary of American Family Names. Oxford University Press, 2003. Reaney, P.H.  A Dictionary of English Surnames. Oxford University Press, 1997. Smith, Elsdon C.  American Surnames. Genealogical Publishing Company, 1997. Back toGlossary of Surname Meanings Origins

Constitution and Bill of Rights Essay Example | Topics and Well Written Essays - 1750 words

Constitution and Bill of Rights - Essay Example What may be less obvious is that this same system of governance was also put in place so that the people were given the power to rule themselves in a distinctly indirect manner. Representative government based on elected officials have their place in the American system of government both as a rejection of the status quo of the patently unfair system of monarchical rule based on primogeniture and as a rejection of direct involvement of the majority of the citizenry. In essence, America’s form of democratic principles carries within it the promise of a rejection of the potential for a mad king such as George III to attain power simply through birthright as well as the admittance that the bulk of the electorate are equally unprepared for the grave responsibilities of directly controlling the business of running the country. In addition, the framers of the Constitution also quite deliberately place obstacles in the path of minority opinion always mandating rule (McKay 52). By creating a system of checks and balances involving endowing the three branches of government with their own specific powers and lack thereof, the government of the United States po ssesses both the advantage of not putting too much power in the hands of a single individual, but it also has the effect of often grinding down the process of instituting change to a near-halt. Article I of the United Constitution provides for the basic design of the legislative branch of the US Government, the Congress. The Constitution clearly delineates in no vague terms that the Congress has the power to spend and tax so as to â€Å"provide for the common defense and general welfare† of the country. In addition, Article I of the Constitution also endow the Congress the power to born money, regulate commerce with foreign nations and amongst states, as well as the sole power to declare war and support the

Illegal action of a nurse Research Paper Example | Topics and Well Written Essays - 1250 words

Illegal action of a nurse - Research Paper Example Thus, nurses play an important role in the safety of the patient. In this article, medication errors by nurses will be discussed with reference to a case scenario in an old age nursing home. Ms X is a registered nurse in the State of Georgia working in a renowned Long-term care nursing home. On a busy day, the nursing manager noticed that she did not sign the MARs sheet even after administering the drugs to a patient. This was against the rule that all nurses must sign the medication chart soon after administering medication to patient. When confronted Ms.X argued that she had to do so to save time in the busy ward. She had planned to sign the charts after delivering medications to all the patients. However, the manager tells her that "no sign means not given the medication." Thus, there is a medication error and this is an illegal action by the nurse. Medication error may be defined as "any preventable medication-related event that adversely affects a patient in a nursing home and is related to professional practice, or healthcare products, procedures, and systems, including prescribing, prescription order communications, product labeling, packaging and nomenclature, compounding, dispensing, distribution, administration, education, monitoring and use" (Greene et al, 2005). Like any other safety issues, medication errors occur due to system failures or human errors. Factors associated with medication errors include using wrong name, abbreviation or dosage form of the drug, wrong calculation of drug dosage, atypical dosage, deficiencies in training, poor perception of risk of medication error and undue time pressure. The most commonly reported medication errors are omission errors, improper dosage and unauthorized drug errors (ICN, 2009). Medication errors by nurses can be prevented by following the "five rights" of giving medication. They are "right drug,

The Human Papilloma Virus and Cervical Cancer in Ghana

The Human Papilloma Virus and Cervical Cancer in Ghana CONTENTS INTRODUCTION HUMAN PAPILLOMA VIRUS Causes Risk factors Prevention Vaccination Screening CERVICAL CANCER Signs and symptoms INTRODUCTION Sexually Transmitted Infections (STIs) are infections that one can acquire from having sexual contact with an infected person. There are over 20 STIs which have been identified including HIV/AIDS, chlamydia, pelvic inflammatory disease, trichomoniasis, syphilis, gonorrhoea, HPV and genital herpes1. According to WHO, more than a million people acquire a sexually transmitted infection a day2. STIs require treatment but there are some such as HIV/AIDS which are incurable and deadly but can be managed to prolong life. Majority of STIs are asymptomatic2 but the infection can still be passed on to partners3. If there are symptoms, they include bumps, sores or warts near the mouth, penis, vagina, or anus, swelling near the penis, skin rash, painful urinations, weight loss, night sweats, aches, pains, fever, chills, jaundice, vaginal or penal discharge and severe itching near genitals4. Infections are spread predominantly, as suggested by its name, through sexual contact, including vaginal, oral, anal sex or even genital touching3. Some ways of protecting one’s self against STIs are; Abstinence from sexual activities Condom usage during sex Limiting the number of sexual partners one has. The more the number of partners one has, the higher the chances of catching an STI. Practicing monogamy. This means a couple should have sex with only each other Careful choice of sex partners. Dont have sex with someone whom you suspect may have an STI. Getting checked for STIs so that the infection is not passed on to others Knowing the signs and symptoms of STIs and looking for them in one’s self and their sex partners. Learning more about STIs to better protect one’s self.4 STIs are classified under bacterial, viral, and parasitic/fungal infections. For the purpose of this paper, the viral group shall be taken into consideration. In general, viral infections involve many different parts of the body at the same time5. Viral infections include; Human Papilloma Virus (HPV): The human papilloma virus (HPV) is the most common viral infection. There are about 40 types of HPV that are transmitted sexually through oral, anal or vaginal sex. Genital Herpes: Genital Herpes is caused by the Herpes Simplex Virus. It is in the same family of viruses that cause cold sores around the mouth. Hepatitis B Virus: Hepatitis B or Hep B, affects the liver. It is not to be mistaken with Hepatitis A or C, which are other forms of liver disease. Hepatitis B is easily transmitted not only through sexual activities, but by sharing items like razors, needles and toothbrushes. Human Immunodeficiency Virus (HIV): Human Immunodeficiency virus or HIV/AIDS attacks the body’s immune system, leaving infected individuals unable to fight off other illness. It is transmitted through sexual activities, but also spread by sharing items like razors, needles and toothbrushes. Cervical cancer occurs when there is an abnormal proliferation of cervical cells. These cells gradually develop pre-cancerous changes before turning into cancers. It is one of the most common cancers in women across the world. When pre-cancerous cell changes are detected early, using a method called the pap test, they can be successfully treated to prevent cancers from developing6. Cervical cancers are classified into squamous cell carcinoma and adenocarcinoma. The focus of this paper is to describe the relationship between one of the viral STIs, the Human Papilloma Virus, and cervical cancer in Ghana. HUMAN PAPILLOMA VIRUS Human papilloma viruses, commonly referred to as HPVs, are aetiological agents of cervical intraepithelial neoplasia and cervical cancer7. In humans, HPV is the most common sexually transmitted virus. It affects about 50% of sexually active people at some point in their lives8. Often, being infected is asymptomatic and the infection may go away without medical treatment. HPV is spread through contact with infected genital skin, mucous membranes and body fluids, and can be transmitted through vaginal, anal and oral intercourse. HPV lives in the epithelial cells of the body hence it usually affects the surface of the skin, vagina, vulva, anus, cervix, penis head, mouth and throat. Over 100 HPV types have been identified and each is referred to by a number9. HPV can be classified into a high-risk or low-risk strains. Not all of the sexually transmitted types cause serious health problems. High-risk HPV strains are known to cause about 70% of cervical cancers8. These are majorly types 16 and 18, but they also include types 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68, 73, and 82. Low-risk HPV strains rarely cause cancers but instead cause warts on skin surfaces. Of the total number of virus types found, about 60 cause warts on hands and feet (A papilloma is a benign tumour derived from epithelium ­). There are about 40 types of HPV that are transmitted through sex. CAUSES HPV infection is caused when the virus enters your body through a cut or abrasion in the epidermis of the skin. The virus is transferred primarily by skin-to-skin contact. Genital HPV infections are contracted through sexual intercourse, anal sex and other skin-to-skin contact in the genital region. Some HPV infections that result in oral or upper respiratory lesions are contracted through oral sex. It is possible for a mother with an HPV infection to pass on the virus to her infant during delivery. This exposure may cause HPV infection in the babys genitals or upper respiratory system3. RISK FACTORS The following are some risk factors inherent in HPV: Prevalence of genital HPV is directly related to the number of lifetime sexual partners, recent changes in sexual partners, marital status, age at which one first had sex, illiteracy, oral contraceptive use, alcoholism, hormonal and dietary factors and immune suppression,(domfeh et al) Age at first sexual intercourse: the age of a person at the time which they first had sex could be an indicator for the number of sexual partners they have in their lifetime. Number of sexual partners. The greater the number of sexual partners one has, the more likely they are to contract a genital HPV infection. Having sex with a partner who has had multiple sex partners also increases the risk. Weakened immune systems. People who have weakened immune systems are at greater risk of HPV infections. Immune systems can be weakened by HIV/AIDS or by immune system-suppressing drugs used after organ transplants. PREVENTION The best way to prevent getting an HPV infection is to avoid direct contact with the virus, which is transmitted by skin-to-skin contact. It is difficult to avoid skin-to-contact with our loved ones in our relationships. Also, in most cases of HPV infection, there are no visible signs for us to know in order to avoid direct skin contact with infected individuals. Correct and consistent condom use is associated with reduced HPV transmission between sexual partners but areas not covered by condoms can still pass on the virus when they come into contact partner’s skin. Regular pap tests, which can detect precancerous changes in the cervix that may lead to cancer are recommended. SCREENING AND VACCINATION CERVICAL CANCER Most cases of cervical cancer are caused by two specific varieties of genital HPV: Types 16 and 18. Once HPV enters an epithelial cell, the virus begins to make the proteins it encodes. Two of the proteins made by high-risk HPVs (E6 and E7) interfere with cell functions that normally prevent excessive growth, helping the cell to grow in an uncontrolled manner and to avoid cell death. Often, infected cells are recognized by the immune system and eliminated. Sometimes, however, the infected cells are not destroyed, and a persistent infection results. As the persistently infected cells continue to grow, they may develop mutations in cellular genes that promote even more abnormal cell growth, leading to the formation of an area of precancerous cells and, eventually, a cancerous tumour. Other factors may increase the risk that an infection with a high-risk HPV type will persist and possibly progress into cancer. These include: Smoking or chewing tobacco (for increased risk of oropharyngeal cancer) Having a weakened immune system Increased parity (for increased risk of cervical cancer) Long-term oral contraceptive use (for increased risk of cervical cancer) Poor oral hygiene (for increased risk of oropharyngeal cancer) Chronic inflammation10 It can take 15 to 20 years for cervical cancer to develop in women with normal immune systems. It takes only about 5 to 10 years in women with weakened immune systems, such as those with untreated HIV infection 9 IN GHANA In Ghana, cervical cancer constitutes about 57.8% of all gynaecological cancers. It is the second most common cancer in women with an estimated incidence of 26.4 per 100,000. It is also the second most common cancer in women aged 15 to 44 years in Ghana. Every year, 3,038 women are diagnosed with cervical cancer and 2,006 die from it in Ghana (Edwin, 2010; Nkyekyer, 2000; WHO, 2010) The Pap smear and VIA have been observed to have challenges with regards to sensitivity and specificity even though the Pap smear is the gold standard for screening in Ghana. A study conducted at the Ridge Hospital in 2013, 201 women were sampled to be used to determine the prevalence of HPV and the associated risk factors. 1

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 Parkinson’s disease, which is more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease. Also approximately 60,000 Americans are diagnosed with Parkinson’s 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 Parkinson’s 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 Parkinson’s 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 Parkinson’s. 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 patient’s 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 client’s 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 & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice. Upper Saddle River: Pearson Education. Coleman, J., (September 1, 2013) Meditation & Mitigating Parkinson’s Symptoms. Retrieved from http://www.theparkinsonhub.com/your-quality-of-life/article/meditation–mitigating-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 H ospital (MGH) (May, 2005) Hoehn and Yahr Staging of Parkinson’s 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). Parkinson’s 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). Gould’s Pathophysiology for the Health Professions. St. Louis: Elsevier.