Cost Control and Budgeting in Millennium Seoul Hilton Case Study

Cost Control and Budgeting in Millennium Seoul Hilton - Case Study Example Among these, power or electricity was found to be a major cost contributor. Further analyses revealed that there possibilities the use of electricity can be cut to an optimum level. Reduction of the consumption of power in the hotel would sufficiently reduce operational cost and thereby increase revenue. Based on the problem identified, it is proposed that a power cost saving plan will be developed and implemented. The first step is energy audit which would identify the trend and practices in electrical consumption in all section of the hotel and equate them to the volume of users. Once the information is at hand, areas where reduction can be implemented will be identified. Automated systems will be used instead of manual operations. Electronic devices that detect the optimum level of power needed in a particular area must be installed. For instance, a sensor automatically shuts off a light when there are no more users, etc. The solution will be implemented in few selected area to test the effectiveness. The data prior to implementation and during implementation will be recorded for validation purposes. The affectivity of the systems installed will be evaluated after six months of operation by comparing the consumption rate before and after using the systems. Consumption index will be obtained by dividing power consumption against total persons (consumers and employees). A lower consumption index would mean positive result. If the system is found to be efficient it will be replicated throughout the entire hotel systems.. Table of Contents POWER CONSUMPTION TREND AS POTENTIAL REVENUE ENHANCER FOR MILLENNIUM SEOUL HILTON 1 Management Summary 1 Table of Contents 3 Introduction 4 Findings 5 Analysis/Discussion 6 Recommendations 7 Conclusion 8 Bibliography/References 9 Hilton Hospitality, Inc. 2007. Millennium Seoul Hilton hotel. [Online]. Available: http://www1.hilton.com/en_US/hi/hotel/SELHITW-Millennium-Seoul-Hilton-hotel/index.do (19 October 2007) 9 Review Procedure 10 Introduction The Millennium Seoul Hilton is a Five Star Hotel situated at the foot of Mount Namsan and 1.5 miles from the business district of Seoul City, South Korea. The hotel can be considered a complete facility for business and leisure. For business purposes it has an Executive Lounge, a business center, and 8 meeting rooms that can accommodate 500 persons. It also has high-speed Internet access. Its support amenities for leisure and relaxation include 7 restaurants and bars catering Italian, French, Chinese, and Japanese foods aside from its native Korean specialties. It also has a health club, a golf driving range, a shopping area, a sauna, 82-foot swimming pool, and a well-equipped gym. Millennium Seoul Hilton hotel caters to individuals and families seeking for relaxation and leisure. But its services primarily is aimed on executives seeking for a place to do their business and other functions, meetings, conferences, seminars, and the likes. To suit the needs of the family they have babysitting services, children's video rental, cribs, high chairs, and family package offers. For the convenience of the business costumers they have audio-visual equipment rental, communication facility rental, office space rental, photo copying service, printer, secretarial service, and video conferencing service. The hotel offers several packages for tourists and family trips. The bulk however

National Organization for Women Essay Example | Topics and Well Written Essays - 1000 words

National Organization for Women - Essay Example The amendment known as Equal Rights Amendment had been introduced by Alice Paul, and it sought to make men and women have equal rights all over the United States, as well as any other place under its jurisdiction (Wood 85). The amendment received opposition, and it is unfortunate that up to this moment, it has not been ratified. Some people believe that collective action problems played a significant role in the Equal Rights Amendment’s ratification failure. This implies that the pro-ERA lobby groups did not co-ordinate their actions well while fighting for the common cause. Women were not united in their struggle for their rights. This was demonstrated by some women leaders such as Phyllis Schlafly, the right-wing leader of Eagle Forum, a lobby group that was created to stop ERA. Women who were in this group argued that ERA was going to deny women the right to obtain support from their husbands, women were going to be sent to battles, women’s privacy rights were going to be reversed, and that homosexual marriages and abortion rights was going to be upheld. Schlafly presented a consistent and coherent message, and this defeated the dispersed efforts from pro-ERA forces (Critchlow 215). The National Organization of Women (NOW) decided not to pursue a centrally managed and hierarchically organized support program for ERA. This is because it was faced with dilemmas regarding the organizational style to use while pushing for the amendment. This dilemma was brought about by the manner in which Schlafly’s opposition was well organized. If NOW had chosen to adhere to its decentralized and participatory style of management to agitate for ratification of ERA against the properly orchestrated campaign, there was no way it was going to be successful. Its only option to counter Schlafly’s campaign was to adopt the same campaign style, and this would mean that it compromises its ideals. Therefore, NOW chose to stick to its accustomed methods, and this led to ERA’s defeat. The ratification process was also made difficult by some external factors. For instance, the Supreme Court’s decision on the abortion case, Roe v. Wade on 22 Jan 1973, as well as the countrywide appreciation for Senator Sam Ervin as the chairman of the Senate Watergate hearings that commenced in May, made it difficult for the proponents of ERA. Social conservatives and fundamentalists were angered by the decriminalization of abortion, and to make it worse, ERA was linked with upholding of the abortion rights (Wood 86). Therefore, they campaigned against ERA as a way of retaliating the Supreme Court’s ruling. On the other hand, Senator Ervin had exemplary performed his duty as the chairman of the Senate Watergate hearings; thus, he was viewed as a savior to the United States Constitution. His portfolio, as the Senate opposing leader to ERA, played a significant role in influencing the southern states to refuse to ratify ERA. It is worth noting that Schlafly also made use of Senator Ervin’s influence to propel her campaigns. She included Senator Ervin’s wife in her campaigns in order to make her campaigns have a national appeal bearing in mind that Senator Ervin was highly regarded (Critchlow 220). NOW and pro-ERA lobby groups had difficulties handling the pressures that was being exerted by the opposition groups. This is attributed to the fact that several opposition groups kept springing, and their number

An Epic Tragedy of History Essay Example for Free

An Epic Tragedy of History Essay Both Native American literature and film have been inspired by the oral tradition of passing down stories and cultural folkways, through the spoken word. The personal journey of chronicling these stories in literature and film is very allegorical in that the personal journeys that these writers also parallel their struggle with a literal journey. As such, these stories become full of symbolism for the types of cultural artifacts that cannot be assimilated into mainstream culture; not in the English language, not in the Christian religion, and not in the reservations that hindered spirituality. There is a theme in all of the texts and in the film that depicts the struggle of trying to determine where the individual and the culture fit into the wider world that knows little of their existence. Other texts provide specific insight into how conversion of Native Americans into Christianity was essential for those of European descent to explain this mysterious group. It becomes apparent that the oral tradition sustained these groups for centuries until the loss of land led to the loss of more freedoms, especially that of having the right to shape ideas about the world without the influence of others. The film and the Native American writers reviewed all seek to exert their power and use words and motion pictures to explain all the literary and historical meaning of the stories told to them, predating all these modes of communication. Scott Momady in his book, The Way to Rainy Mountain describes the story of the creation of the Kwuda, which was passed down in the oral tradition. What is interesting is that he notes that the names of the tribe did change and there was a sense of this tribe being divided. â€Å"Later still they took the name Gaigwu, a name which can be taken to indicate something of which two halves differ from each other in appearance† (17). It is not only the way that this group of people came into existence but also the diversity and difference within this particular tribe that is extremely important. When Native Americans were forced onto reservations, it was of the utmost importance for the rest of the world not to see all Native Americans as the same, as they were varied with the many tribes and also within tribes. These oral stories become even more important to dictate into print or film to show how Native Americans viewed the world, themselves, and most importantly to realistically illustrate their heritage with the hopes of changing how many whites viewed them. The allegorical and symbolic divide that came to move all of these authors to write stories that bridged the gap in their own respective lives, also helped to create a film as well. The movie Dreamkeeper, directed by Steve Barron, shows how a family divided will struggle to keep tradition alive despite the death or disappearance of an important figure. In this film the pressing issues between the grandfather, grandson, and absent father serves as a metaphor for the intrusion on the culture of the family’s tribe versus the tradition of passing down lineage and heritage. The metaphor is that the grandfather is rooted in the past, the grandson is heading into an uncertain future, and the father is the only link to the present. These cultural threats are more than just the loss of land or the loss of a father, it is the changing of times into a future that is being mapped out by another group entirely, that being white Americans. These maps, so to speak, or the oral tradition that has mapped out the history of entire tribes and families has been written about by other prominent Native Americans in their journey and tragedy of trying to fill this divide between past and present all the while wondering what the future will hold. These types of worries were normally settled by spiritual means, but loss of land meant loss of the ability for Native Americans to go on their spiritual quests. Charles Alexander Eastman in his passage from â€Å"The Soul of an Indian† writes about the mystical quest undertaken by Native Americans in his native Sioux tribe that required several nights away from camp in meditation. He also writes of the divide of the Native American, a common theme in all the reviewed works. â€Å"The red man is divided into two parts,-the spiritual mind and the physical mind. The first is pure spirit, concerned only with the essence of things, and it was this he sought to strengthen by spiritual prayer† (767). Because of this loss of land, essentially the loss of spirit or at least the ways in which spiritual rituals were conducted came to an end. Also, the fear of the future was replaced by Christian ideals to help Americans of European descent understand how these natives fir into their Bible. In this way the Native Americans, already concerned with loss of identity were split even further in a divide that led them to an uncertain and uncharacteristic future. It was only through the oral tradition of preserving identity that Native Americans could attempt to achieve a personal wholeness while the many tribes and family members within tribes became scattered and disillusioned. It is through the personal journeys of the writers that it becomes apparent how the loss of land impacted not only an entire civilization, but individuals, who lost identity and did whatever was necessary to try to discover, rediscover, and preserve all that was left. Gertrude Bonnin, in passages from â€Å"Impressions of an Indian Childhood† talks about living what could be considered a double life. Gertrude sometimes refers to herself as her Sioux name, Zitkala-Sa, which means Red Bird. She was born on a reservation to a Sioux mother and her white father was absent in her life. She struggled between the old ways that her mother tried to teach her in the oral tradition and the ways that people conducted themselves outside of the reservation. She became torn and decided that the reservation life was not for her and the American way of treating Native Americans was not appealing either. So she began compiling all the information she could gather from what was relayed to her by her mother in the oral tradition and then wrote these stories in English. She abhorred the fact that the language of her ancestors had disappeared and she was just as concerned as Eastman was about the loss of spirituality for all Native Americans under the conversion to Christianity. Bonnin writes, â€Å"I prefer to their dogma my excursions into the natural gardens where the voice of the Great Spirit is heard in the twittering of birds, the rippling of mighty waters, and the sweet breathing of flowers† (939-940). It becomes clear that for the spirituality of Native Americans to thrive, then land uninterrupted by industrialization was needed in order for this group to be who they had always been before they were removed to reservations. So taking their land was not a simple geographic issue, this also took these peoples’ essence and spirituality from them. It is therefore important for these texts and films to exist as reminder of what was lost, not just space, but a place in history for people who had to rely on a few to pass on as many of the stories given to them in the oral tradition and put it in print or in film. All three written pieces reviewed and the film help to show the importance of the land that was taken from the Native Americans, as well as the influence of the oral tradition of passing down stories and spiritual pathways to each ensuing generation. The film and the written works display both a metaphorical divide in the ways of the respective authors and tribes and the bigger community, showing that differences need to be acknowledged as well as the common goal of this group to gather their cultural artifacts that would have disappeared into an assimilated America. Also, the allegorical journey that all these contributors took to discover their part in history is akin to an epic and a tragedy. Scholars, as well, have looked at the impact of the spiritual strivings of Native Americans and the ultimate need for tribes to achieve a new identity in a foreign land to them, a land that was once their own. It was the need for Christian legitimacy on the part of European settlers that led to a need for Native Americans to be stripped of their spiritual roots and forced to resign to religious conversion. The mission of these Christians â€Å"absorbed Native Americans into a Christian world view that made them comprehensible to Euro-Americans, who were otherwise faced with a population whose mysterious origins threatened to call into question the explanatory value of the Bible† (Wyss, 162). So as Euro-Americans sought to explain the discrepancies with Native Americans and their absence from the Bible, Native Americans had to wrestle with their own identities that were being challenged by these settlers for purposes other than just the acquisition of land. What then became an issue was the questioning of creation on the part of settlers and the â€Å"lost tribe theory† (162) that proposed that Native Americans were part of a tribe that was not thoroughly explained in the Bible. All the while many Native Americans asserted their own creation myths while other Natives tried to assert superiority over whites with the reasoning that if Natives were a part of Israel’s lost tribes then, therefore, they were closer descendants of Jacob. This hierarchy of Biblical place did play an important role on the identity of Natives during their assimilation into Euro-American culture, though the oral tradition certainly did support a different idea for the origins of each tribe. Even those Native Americans that did subscribe to a Christian ideal were â€Å"defined by a constant deferral of home, or the constant movement, both geographical and cultural, of a fragmented people† (165). It seems then that the roots of all Native Americans, who were fragmented and spread across the nation, was entrenched in the oral tradition of creation stories and spirituality. However, the many Native American stories that were told and passed down led to they idea the Euro-Americans had as Natives being savage and mythical, making their stories, even true encounters appear to be false. This led to the Natives â€Å"invisibility in the annals of encounter: constructed as tellers of myth and as peoples of myth, they are denied a place in the national story and a voice in recounting it† (Bellin, 99). This created the powerlessness found in Natives attempting to assert their place in the new America that was founded on laws, both the divine and those conceived by Europeans. The fact that Natives had stories, spirituality, and kinship was not enough to place them in a position of asserting their power in any way that seemed rational to Euro-Americans. As well the illiteracy of Native Americans certainly did not assist this group in gaining any type of recognition for having much to offer the Europeans in their stories. â€Å"the oral nature of much Indian narrative has been taken to explain both the Indians’ irrelevance to history-for what could illiterates offer? -and their inability to remember and record it† (102). As well, Native Americans stories were not just told, they were animated through acting, making the stories more meaningful to the Native audience but meaningless to a person outside of a tribe. It is fair to say that the identity of Native Americans was not only in their oral tradition, but in the ways in which stories were acted out. This is something that is lost even if a story is recounted by a Native to as close to the original message as possible. Much is also lost in translation further undermining any attempts that Natives could make when forced on reservations, where their land and language was taken along with the ties of spirituality that sustained them. It also makes the spiritual identity of Native Americans more complicated when they are not only placed in an Anthropological category of uncivilized, the literary category of completely mythical, and finally over romanticized by scholars, who do not understand the deep meaning behind Native American spirituality and ritual. These rites and rituals are meant to cement a community of people together and individual identity can be created within these rituals. Instead, many times, these acts and stories are perceived as more universal and therefore there is the mistaken implication that Native American spirituality can be lumped into a religion that can be used by all. This has placed and continues to place the sense of community outside of the purposes intended and sadly many people use information gleaned from Native spirituality for profit or for writing scholarly articles that do not take into account the private lives of a single Native, but instead combine individuals into a whole. With a fragmented sense of history and culture, it is right to note that there has been and continues to be fragmentation in the Native American communities, but for an individual, a sense of self requires both community identity and a complex set of cultural artifacts to make that individual whole and not a watered down, assimilated version of the Euro-Americans. To be more clear, the text versions of Native Americans stories involving spirituality and rituals many times do not take into account the personal nature of these events. It is not only a matter of entire communities of Native American feeling the need to forge and reclaim their converted or dismissed identities as a whole, but the essence of the individual in a tribe, separate from others that must do the same. â€Å"Nicknames, shadows, and shamanic [sic] visions are tribal stories that are heard and remembered as survivance [sic]. These personal identities and stories are not the same as those translated in the literature† (Grim, 44). This lack of voice to individual Native Americans and stereotyping of all communities and persons being inherently the same in their spirituality and other social activities makes more important the voices, such as the Native authors and filmmakers reviewed all the more important. These artists have shown how gender, tribe, place, and, politics, to name just a few social forces can affect an individual struggling for acceptance within him or herself and in the larger world. All these factors must be considered when looking at film and literature, separating the individual from the group while at the same time seeing the struggle for those individuals as being the best representation available for a group without a strong voice. In conclusion, the film and the literary works of Native Americans highlight the voice of a specific individual, attempting to speak for their community. Taken with scholarly research, it can be seen the effect of colonialism and religious conversion on the vulnerable Native American population. Their history has many gaps in that the myths and traditions were many times dismissed and the absence from the Christian Bible made their existence confusing and unsettling to the settlers. The voices that have been stifled serve to help save the history of the mainstream at their expense, and this powerlessness and absence from history can only be reconstructed in the best way possible. Though even stories passed down in the oral tradition are lacking in the gestures and actions of the storytellers, which is the essence of oral storytelling. Works Cited Joshua David Bellin, The Demon of the Continent: Indians and the Shaping of American Literature, Philadelphia: University of Pennsylvania Press, 2001. Gertrude Bonnin, â€Å"Impressions of an Indian Childhood† in The Heath Anthology of American Literature Vol. 2. Ed. Paul Lauter, Lexington: D. C. Heath and Company, 1994. Dreamkeeper, Dir by Steve Barron, Hallmark Entertainment Productions, 2003. Charles Alexander Eastman, â€Å"The Soul of an Indian† in The Heath Anthology of American Literature Vol. 2. Ed. Paul Lauter, Lexington: D. C. Heath and Company, 1994. John A. Grim, â€Å"Cultural Identity, Authenticity, and Community Survival: The Politics of Recognition in Native American Religions† in Lee Irwin Native American Spirituality: A Critical Reader, Lincoln: University of Nebraska Press, 2000. Scott N. Momaday, The Way to Rainy Mountain, Albuquerque: University of New Mexico, 1969. Hilary E. Wyss, Writing Indians: Literacy, Christianity, and Native Community in Early America, Boston: University of Massachusetts Press, 2000.

The condition known as delirium

The condition known as delirium Introduction This assignment will examine the condition known as delirium and will focus on a clinical case study (please see appendix 1. for the full overview of the clinical case study) of a gentleman called Halim* who has presented in the emergency department with his two daughters. This assignment will be separated into two distinct parts; the first part of this assignment will provide a clinical overview of delirium and will explore what the condition is, the common features, clinical causes and interventions available to manage and treat the condition. This will provide the reader with an understanding of the components that constitute the condition of delirium. The second part of the assignment will then focus on placing the acquired knowledge of delirium on to the clinical case study of Halim so that a more detailed clinical exploration can be completed; with focus being placed on the role of the practitioner and their interventions in addressing the key issues. *To protect and respect client confidentiality all names have been changed and any identifiable data censored for the purpose of this assignment. Delirium Clinical Overview Delirium, also sometimes referred to as an acute confusional state, is a common clinical condition that presents with individuals experiencing disturbances in consciousness, cognitive function and perception, which has an acute onset and fluctuating course (NICE, 2010). The important clinical characteristic of a delirium is that the onset is quite rapid; it may present and develop within a very short period of time, usually over the course of a few hours or days (Brown Boyle, 2002). It is not uncommon for an individual to present to hospital settings with symptoms of delirium and it is important to acknowledge that individuals who already are hospital inpatients or in a care setting may also develop delirium; it is a condition that traverses the inpatient and community settings. Literature suggests that there are two types of delirium; hypoactive delirium is characterised by individuals experiencing withdrawal, lethargy, introversion and sleepiness whereas people with hyperactive delirium have heightened arousal, restlessness, agitation and aggression (NICE, 2010). There is also a third variation where individuals may experience a mixture of both hyper and hypoactive symptoms which can make diagnosis very difficult. It is suggested that delirium can often be mistaken for dementia, worsening of pre-existing cognitive problems and old age; however delirium is a clinical syndrome that differs from these other conditions as it is the sudden and acute onset that tends to vary throughout the course of the day that identifies it as delirium rather than any other disorder (Meagher, 2001). It is reported frequently within the literature (Wong et al., 2010; NICE, 2010; Meagher, 2001; Brown Boyle, 2002; Cole, 2004 and Siddiqi House, 2006) that patients with delirium experience a reduced ability to focus and concentrate; perceptual disturbances which includes delusions, paranoia and hallucinations; fluctuations in presentation; difficulty in following conversation or direction; rambling or changing topic; disorganised thinking and disturbances in consciousness. In addition to these clinical symptoms there also may be mood disturbances and changes in neurological presentation with individuals experiencing changes in muscle tone, tremor and involuntary jerking (Map of Medicine, 2011). Delirium occurs due to underlying physical pathology (American Psychiatric Association, 2000) and although symptoms may present as symptoms of mental illness the condition itself has originated usually from some kind of underlying infection, disease or event that has impacted on the individuals physical health status (Wong et al., 2010). Examples of possible causes for delirium include; hypovolaemic shock, cardiac failure, myocardial infarction, head trauma, seizure, metabolic disorders such as liver or renal failure, fluid and electrolyte imbalance, infection, malignancy, dehydration, post operative state, pain, constipation or urinary retention. In addition to these common causes delirium may also be induced by individuals experiencing complications from drug interactions and withdrawal; and included in this is prescribed medications, illicit drugs and alcohol (Map of Medicine, 2010). Delirium is a very serious condition and it cannot be underestimated as the mortality rate for individuals is very high even after discharge from hospital for up to 12 months (McCusker et al., 2002), other complications from delirium also include patients having to stay longer in hospital which means they are exposed longer to hospital acquired infections, persistent cognitive deficits and an increased risk of the individual being discharged into residential care rather than return to living independently are also factors (Wong et al., 2010). With the symptoms of delirium presenting as the onset of an acute mental illness it is possible for debate to arise as to which clinical team should be responsible for the management of the patient; additionally; in light of the evidence presented; it would be easy for the individual with delirium to be overlooked or not be investigated for the reasons behind the onset of the condition which is probably why the mortality rate is so high; underlying physical conditions that are not assessed, treated or managed will continue to affect the health status of the individual. Statistically more than half of delirium cases go unrecognised by health professionals (Inouye et al., 1998). Prevention of delirium is more effective than treating it once it has developed (Brown Boyle, 2002) therefore it is important for healthcare professionals to be aware of the risk factors, symptoms and causes of delirium for individuals under their care either in hospital or in the community. If delirium has already developed then it is the responsibility of the healthcare team to manage the condition quickly and efficiently to reduce further problems and difficulties for the individual; recognizing the mortality rates associated with a diagnosis of delirium should facilitate efficiency. To assist with obtaining a clearer clinical perspective of delirium and the impact it has on an individual a clinical case study shall now be explored. Halim Clinical Exploration Halim was admitted to the emergency department and when the clinical history was obtained from his daughters it was identified that there had been a rapid change in his cognitive status which had been observed within a 24 hour period as his daughter had not been alerted to any concerns when she had spoken to him the previous evening. In light of the evidence it is possible for practitioners at this point to consider that Halim has developed an acute syndrome such as delirium and the next stage is to explore this further. On completion of the basic observations it was evident that there are physical abnormalities present. From visual observation of the patient it is clear he has altered mental status, dry skin and cracked lips. From clinical measurement of heart rate, blood pressure, temperature and oxygen saturation levels, there is further evidence of physical abnormalities that may contribute to changes in cognitive function to such an acute degree. Obtaining clinical history often involves information being sought from third parties to support clinical findings particularly if the patient is impaired cognitively. Halims daughters were able to give an account of a gentleman who had experienced marital problems and divorce due to alcohol misuse and evidence remains that he continues to consume alcohol regularly. In addition to this there is a history reported of Halim neglecting his diet to the extent his daughters provide food for him when they visit, he also engages in health limiting behaviours by smoking and consuming high levels of caffeine on a daily basis. The history obtained from Halims daughters identifies a gentleman who is successfully self- employed, he has hobbies and interests although his social network has reduced and although he engages in health limiting behaviours such as smoking, drinking alcohol and neglecting his dietary needs; he has remained independent within his own home. The evidence suggests there has been an acute change and with this information and the clinical evidence indicating Halim is experiencing tachycardia, high temperature, hypotension and dehydration the clinical evidence provides a strong indication that he is experiencing symptoms of delirium. Further investigations are required to gain a greater understanding of what physical changes have occurred so that underlying causes are treated, however the practitioner should take some time to explain to the family members what tests are being completed and what the medical team are treating Halim for. The family must be very distressed by the changes to their father and by communicating the outcomes of the assessment and responding to any questions they may have will be beneficial as it is reported that the experience of delirium is frightening for both the patient and their carers and the value of reassurance cannot be underestimated (Mohta et al., 2003; Jacobson Schreibman, 1997). Managing Halim in terms of obtaining his consent to agree to treatment and investigations may be difficult because of the level of cognitive change and because his understanding and judgement may be impaired because of the delirium; therefore it is important that the practitioner and family are familiar with legal frameworks and hospital policies that are in place to ensure the rights of all parties are being protected. An example of this would be practitioners being familiar with the hospitals delirium policy, being well versed in patients rights and by having knowledge about legislation such as the Mental Capacity Act (The Stationary Office, 2005). As stated previously the experience of delirium may be frightening for Halim and therefore the practitioner should endeavour to implement nursing and care strategies that reduce distress, improve orientation, address physical health status and ultimately minimise the duration and impact of the delirium. Examples of the interventions that can be implemented include; working with the multi disciplinary team to treat the underlying cause of the delirium. This may include providing pain control, regulation of bowel and bladder function, ensuring adequate diet and fluid intake is promoted and recorded. Another intervention that is reported to be effective in supporting patients with delirium is for care staff to provide a safe and therapeutic environment. This would mean that Halim is offered reassurance and support, all activities are carefully explained; and for Halim this may mean that a Farsi speaking interpreter is found to facilitate communication between him and the medical team as he reverts to the language of his birth when speaking with the clinicians. In expanding the opportunity to communicate with Halim, this may increase his comprehension of what the medical team are trying to achieve and reassure him that the procedures being carried out; like attempting to obtain a urine screen. Due to the life threatening nature of Delirium it is essential for all physical screens and assessments to be carried out to ensure early identification of the reason for the onset of the condition, if the therapeutic interventions are unable to be implemented due to Halim remaining agitated and acutely confused then as a last resort medication may be considered in an attempt to reduce his level of arousal enough to ensure clinical procedures and care can be delivered. Psychotropic medication can be prescribed in delirium in an attempt to reduce the levels of distress and agitation and for Halim it may be beneficial to ease his levels of arousal enough so that medical interventions can take place; it is important to note however that psychotropic medications have side effects that include; extra pyramidal side effects, mobility impairment, sedation and cardiac interaction therefore they must be used with extreme caution and Halim should be monitored closely. Conclusion Halim has presented to the emergency department with a delirium and the impact of this on his health and welfare should not be underestimated by practitioners. With mortality rates in delirium being worthy to note it is essential that care pathways are developed to ensure the physical health and mental wellbeing of patients like Halim are met concurrently. Clinical, environmental and behavioural interventions are acknowledged to reduce the impact, intensity and duration of the condition; therefore practitioners should work intensively to ensure a delirium presentation is treated efficiently and effectively to ensure mortality rates are reduced and recovery is facilitated as quickly as possible.

Prosthetics :: essays research papers

Introduction Prosthetics is the branch of surgery dealing with mechanical devices used to reproduce the form and function of missing body parts. Prosthetics is the replacement of faulty or amputated body parts with artificial body parts. Artificial limbs have been in use since at least 300 BC. In AD 1509 German knight, GÃ ¶tz von Berlichingen, called GÃ ¶tz of the Iron Hand, wore an artificial hand with jointed fingers. Early in the 19th century a German prosthesist built a hand with fingers that could be flexed or extended and that could hold light objects, such as a pen or a hat. Before World War I (1914-1918), wood was considered the best substance for making artificial legs, but later an aluminum alloy called Duraluminum, and more recently fiber materials, have made artificial limbs both lightweight and strong. In recent years, the manufacture of prosthetic devices has developed into a science. Artificial limbs with functioning joints can simulate natural motion. Hip joint prostheses can pr ovide virtually normal mobility for people with damaged hip joints. History Artificial limbs, in one form or other, have been in use from ancient times. In 1885, a specimen was discovered in a tomb at Capua, Italy, along with other relics dating from 300BC. The celebrated artificial hand built in 1509 for the German knight Gotz von Berlichingen, who was called Gotz of the Iron Hand, weighed about 1.4 kg (3 lb.) and had articulated fingers so constructed as to be able to grasp a sword or lance. The hand is in the NÃ ¼rnberg Museum and is still in working order. Early in the 19th century a German prosthesist built a hand with fingers that could be flexed or extended without assistance and yet could still close to hold light objects, such as a pen, a handkerchief, or a hat. In 1851, a French prosthesist invented an artificial arm fitted with a wooden hand and attached to a leather socket that fitted the stump firmly. The fingers were half-closed, the thumb pivoted on a pin and could press firmly against the fingertips by a concealed, strong rubber band; the gr asp of the thumb could be operated by a mechanism attached to the opposite shoulder. The same inventor devised a leg that reproduced a natural gait and lengthened the stride. Technology Before World War I, wood was universally considered the best substance for making artificial legs. Prosthetic devices made of leather reinforced with metal bands tended to lose their shape and were therefore unsatisfactory.

Fast Break Essay -- essays research papers

Fast Break   Ã‚  Ã‚  Ã‚  Ã‚  The most exciting play in basketball is the fast break. This poem outlines every detail of the fast break and does a great job using the words to create a fantastic visual for the reader. The title of the poem, â€Å"Fast Break,† is actually what the whole poem is describing. The visual that is created is one of the reasons this poem is so appealing. My love for the game of basketball, more specifically at the collegiate level is another reason why this poem catches my attention. The author, Edward Hirsch, is probably the speaker and also a coach or fan of the team that is playing. I would say that he was a player, but all five players of the team are outlined in the poem and it’s not written in the third person. The author might also be mistaken as the head coach of the team; however the poem is in memory of the late Dennis Turner, whom I believe to be the Head Coach. A fast break lasts approximately five seconds on the court and the poem outlines e very motion of both the offense and defense. The author puts the fast break in slow motion for the reader so that they can understand and re-live the play in their imagination.   Ã‚  Ã‚  Ã‚  Ã‚  Each stanza of the poem explains each step of how a fast break is preformed. The first three stanzas begin the fast break which usually starts off from a missed shot by the other team and a defensive rebound. The tall and thin center grabs the rebound and recognizes to immediately get the ba...

North vs. South Living

Have you ever wandered weather you wanted to live in the north or the south? There are a lot of differences between the northern and southern states, but there are also some highly important similarities. People in the north are generally used to crowded places, because they have a lot of people in a smaller area. In the south people feel that they have more room to stretch and relax, but weather it’s on a city street or 45 acres of grassy land their usually laughing happily with their friends. The difference in the population causes people to have different activity's they enjoy. Its common for people in the south to enjoy a relaxing day on the front porch with a cup of sweet tea, whereas people in the north would enjoy a busy night out on the town. Wherever you decide to enjoy your free time you can guarantee that you'll find a McDonald's or another popular fast food restaurant to keep your hunger satisfied. Before they go out though, they have to remember, since the temperature is lower in the north they need to wear heaver suits, and jackets. In the south, weather is hot enough to wear shorts, flip flops, and sun tan lotion. No matter where you are though, you can be sure to find a Walmart where cloths can be bought, and other items that prepare you for the weather. In the south there is a lot more room, so people can have farms. Farms are a major way for the south states to make money. In the north there are tons of buildings built feet apart from each other. People use these buildings to house their businesses. Big business is the one of the main ways the north makes money, but weather people are in an office or a field preparing crops they are working hard to make money. The north is an exiting place at night, because that is when it is lit up with the dazzling lights of the many restaurants and night clubs. While the people in the north are dressed in their best and off to a good time people in the south are sleeping soundly. The south is a place where the early bird gets the worm. People down south cant wait to get up early for church, or maybe a good game of golf with old friends. Southern people tend to take it a lot slower during the day, because they don’t have to fight to get to work on time like the city people. People like different activities, but that does not mean they aren't having fun. Weather they like dancing the night away, or hitting a few golf balls down the drive they are still enjoying their day. Not only do people in the city have to fight the dense population, also there is a matter of weather. In the north it is much colder due to distance from the equator. People in the north are usually seen in pants and long sleeve shirts year round. Southern people only have to worry about cold weather for winter, which usually only last about 3 months. Other than winter southern people can happily wear shorts and T-shirts. During the summer southern people even have to put on sun screen so they don’t get sun burns. Even though cloths are made for different climates they are usually made by the same people. Many name brand cloths such as, Hollister, Abercrombie, and forever 21 are sold in the north and south. There are many differences between the north and south, and some very important similarities. They have a difference of population, ways to earn money, entertainment interests, and even weather. In the south and in the north you'll be sure to find people enjoying their life's, and buying name brand cloths with money they make from hard work. This will never change.