Eriksons Stages Essay

This experiential learning activity will give you an opportunity to apply basic psychological principles to learn more about your own behavior. The project will be conducted over a 9 week period. By week 3, you will choose a behavior that you would like to change and come up with a behavior change plan. In weeks 4-10, you will work on changing that behavior and record your progress. In weeks 11-13, you will reflect, analyze, and interpret your behavior change and outcomes. A 5 page write-up (double spaced) of this behavior change activity covering the points described below is due the week of presentations at the beginning of the class period. Here are the steps: 1. Select a behavior that you would like to change, one that you’d like to increase or decrease or modify in some way (Examples: eating junk or high-fat foods, chewing gum, smoking, getting angry, studying, exercising, spending money, worrying, etc). 2. Define your specific goal, consider the benefits and barriers, and choose a behavior modification plan. 3. Design a method of tracking your daily progress. This could be a tallying form, a data table, etc. This device should allow you to record the frequency and/or duration of your behavior on a daily basis. (if your behavior is something that is done several times a day, you might want to create a data tracking device that you can carry along with you). 4. Record your behavior, following the procedures you have developed, throughout the semester. Write a 5 page report that includes the following points and be sure to include theories and concepts we covered during class in addition to these sections. **Use at least 2 journal articles related to your topic and give a brief description of the articles in the introduction** Goal-Setting and Monitoring †¢ What behavior did you try to change? What was your precise goal? (for example, to increase/decrease the frequency and or duration) †¢ What were the benefits that you perceived to changing your behavior? In other words, why did you want to change your behavior? †¢ How did you keep track of (record) your daily progress? Very briefly describe the type of tallying sheet (or recording device) that you used. Motivation †¢ Where do you think your goal would fall on Maslow’s hierarchy of motives and why? What types of counter-motives made it difficult for you to accomplish your goal (example; hunger, pleasure, etc.) Where would these counter-motives fall on Maslow’s hierarchy? †¢ Did you feel more intrinsically or extrinsically motivated to change this behavior and why? †¢ Did your goal involve the behavioral activation system (BAS) or the behavioral inhibition system (BIS) and why? Was your goal more approach- or avoidance-oriented and why? †¢ Do you think that your motives contributed to your outcome? How and why? Learning †¢ How did you go about trying to change your behavior? Did you use any of the behavior learning strategies that we discussed in class such as classical or operant conditioning? †¢ How did you use these strategies? Did they work or not? Emotions, Barriers, and Social Support †¢ What types of emotions did you feel when trying to change your behavior? How did you feel along the way and how were these emotions related to the amount of effort you invested in trying to change your behavior? †¢ What were some of the barriers that you encountered while trying the change the behavior? Did you expect these barriers when you started or did they surprise you along the way? What did you do to overcome these barriers? †¢ Did you enlist the help of family and friends in trying to change your behavior? Was this helpful or harmful? Conclusion †¢ Did you reach your goal or not? How do you feel about the outcome? What could you do differently in the future to be even more successful at changing your behavior? Outline of written report †¢Introduction †¢Description of topic †¢Explanation of why this is an important area of study †¢Reason for picking this area to write about †¢Literature review †¢Description of theory †¢Previous research on topic (Use at least 2 journal articles related to your topic and give a brief description of the articles) †¢Citations of all work mentioned in the paper †¢Statement of hypothesis †¢Methods section †¢Description of process in reaching your goal (recording behavior, keeping track, etc) †¢Description of materials used (tally sheet? recording device?) †¢Results †¢Conclusions †¢Goal-setting & Monitoring †¢Motivation †¢Learning †¢Emotions, barriers, and social support †¢Conclusion paragraph (see assignment sheet) †¢Applications (how will these results be useful to individuals and society as a whole?) †¢References †¢APA style †¢Citations in the body of paper should appear in the reference section

Literary Translation as a Creative Act Essay

Literary translation implies the translation of all genres of literature, which include prose, drama and poetry. Literature is described as ‘an apparently nebulous body of knowledge in oral or written form, an imitation of life, which reflects civilization and culture, and which covers every angle of human activities-culture, tradition, entertainment, information among others. ‘ It is one of the great creative and universal means of communicating the emotional, spiritual and intellectual concerns of humankind. Literary translation has to do with translating texts written in a literary language, which abounds in ambiguities, homonyms and arbitrariness, as distinct from the language of science or that of administration. Literary language is highly connotative and subjective because each literary author is lexically and stylistically idiosyncratic and through his power of imagination, he uses certain literary techniques such as figures of speech, proverbs and homonyms through which he weaves literary forms. The literary translator is therefore the person who concerns himself with translation of literary texts. A literary translator generally respects good writing by taking into account the language, structures, and content, whatever the nature of the text. The literary translator participates in the author’s creative activity and then recreates structures and signs by adapting the target language text to the source language text as closely as intelligibility allows. He needs to assess not only the literary quality of the text but also its acceptability to the target reader, and this should be done by having a deep knowledge of the cultural and literary history of both the Source and the Target Languages. Language and culture are closely related and one is indispensable to the other. In fact, language acquires its meaning from the country’s culture. A single language may cross several culture borders. There are generally problems in the translation of cultural words in a literary text unless there is a cultural overlap between the source language and the target language. It is not enough for a translator to know what words are used in the target language; he must also make the reader understand the sense as it is understood by the reader of the original. For instance, in a text where there is a cultural focus, there can be translation problems due to the cultural gap between the source and the target languages. The meaning of a single word or expression is largely derived from its culture. Therefore, translation, being a simple linguistic process, a cultural understanding comes into play because the translator is supposed to produce equivalence and where this does not exist, problems occur. The translator is expected to creatively exploit the altered cultural, linguistic and literary context in order to realize the different potentials of the target language in an act or literary creation since translation is an intercultural activity. Linguistically, each language has its own metaphysics, which determines the spirit of a nation and its behavioral norms, and this is what is known as linguistic relativity. Language directs our intellect and even our sensory perception. Since words or images may vary considerably from one group to another, the translator needs to pay attention to the style, language and vocabulary peculiar to the two languages in question in order to produce an ‘exact’ translation of the source language text. Thus while translating something from a language to other, the sense and the behavior of the sentence gets changed obscurely. So as to carry the that sense and the behavior of the sentence the original author meant, the translator himself need to be creative, with a good knowledge of both languages, the one translating to and from.

Business Case Study

A report on investigation into Business Case Date: May 02, 2013 Acquainted with your Business situation. I see a few problems within your business. One of the problems is changes in economic environment, which lead to conflict between stakeholders. The other problem is change of business structure. A success factor for any business is to analyse and understand the external environment in which it operates. Understanding of different types of stakeholders within business is essential too. To analyse business situation various method can be used. To analyse your current business situation I have used SWAT analyse which will give you opportunity better understand external environment and how it can impact your business. And will help you better understand conflict between stakeholders. The most basic SWOT analyse will examine how threats and opportunities can be dealt with while allowing the organisation to utilise its strengths and weaknesses to meet its key success factors [objectives]. A basic SWOT analysis should include an assessment of where the company is at current time and where it wishes to be at some point in the future . The organisation also needs to decide how far away that future is-it will vary from a few month to many years depending on the organisation, the nature of the business and its current situation (B 120, Book 1). SWOT analysis for the The Lodge Bistro Chain Strengths New IT system Initiative management stuff Possibility to adjust to changes Name and business recognition| Weaknesses Informal structure High stuff turnover Inconsistency in standards | | | | | | | | | | | | | | | Opportunities New consumers base Reinstate some formal structure and rules| Threats Complete loss of concept Lose of standards Competition External economic environment| | | | | | | | | | | | | | | | | As you can see from analyse above that the strengths will be recognition of your business and possibility of the business to adjust to new economic environment as you have initiative management team as it is described in Business Case: As an example of these issues, the young manager of one of the cafes in a central urban location began to offer a range of less expensive snacks to cater for diners on low incomes and reduced packaging to respond to the environmentally friendly principles of many customers. Another, in an area close to an office complex, offered a range of healthy eating options. It clearly shows that you have opportunities to attract new consumer’s base. Reinstate some formal structure and rules will give you better opportunity to control business Weaknesses arise from high stuff turnover, as you spend time, recourses for educating stuff. I think it would be beneficial to investigate why they leaving and looking for benefits packages you can purpose to your stuff And main threats arise from losing standards, huge competition and economic environment. For future I would purpose you to use methods like SWAT, STEEP and analyse of stakeholders before making any changes. Would be beneficial to make SWAT analyse on the way business was in 80’s and use it as comparison to current situation. It will give you opportunity to reinforce some formal structure more successfully. References The Open University (2006) B120 An Induction to business studies, Book 1, What is a business? ’, Milton Keynes, The Open University, page 95.

Comparative analysis Essay Example | Topics and Well Written Essays - 750 words

Comparative analysis - Essay Example This poem is a very deep poem, one has to read it over and over again to understand its hidden meaning. Life is really complicated and we need to understand our aim and to do that we need to sit down and introspect. Many a time we come across situations in life where we have to make difficult choices and these difficult choices also decide our future, this poem is all about choosing the road which is less travelled, it also goes to show the courage of the poet who decides to take a path which is less travelled and there is a possibility of him getting lost but he is brave enough to try something different from others. This is what life is all about, we must be brave enough to trot a path less travelled, it may prove to be a wrong decision or it may prove to be a right decision, it is all about making choices when you are at the crossroads, this is what the poem is all about. At the very end the poet ponders over his choice, his life would have been much different had he taken the oth er road and this is very true. Our life would also be different had we made different decisions and had we taken the road less travelled, life is all about making the right, the most successful people often make the right choices. Thesis Statement: The poem has hidden meaning in it; the literal meaning of the poem is very easy to understand. A traveler reaches a fork in the road and is discombobulated because the road shows the traveler two choices, the traveler after much thinking, chooses the road less travelled by people. The figurative meaning of the poem reflects upon the choices that we make in our lives. We can either choose a road which is very frequently chosen by other people or we can choose to walk on a road which is hardly chosen by other people. After making our choice, we would always have regrets because the road not taken would always force us to think about the endless possibilities. This is what the poem is all about and this poem is really popular, Robert Frost b ecame a household name because of this poem. Literary Devices: Antithesis is quite conspicuous in the poem, the traveler has to make his choice and he soon realizes that he can only choose one path, the traveler wishes he could travel both but soon realizes that this is not plausible. Another literary device in the poem is personification, the road has been personified. â€Å"All sensible people know that roads don't think, and therefore don't want. They can't. But the description of the road wanting wear is an example of personification in this poem. A road actually wanting some as a person would. However: some believe this to be incorrect and believe "wanting wear" is not a personification, but rather older English meaning "lacking". So it would be "Because it was grassy and lacked wear;" (The Road not Taken) The tone of the poem is gloomy, words like â€Å"sorry† and â€Å"sigh† have been used and these words reflect gloom. Verbal irony is also another figure of sp eech in this poem, the speaker knows that when he looks back and recollects, he will have to tell his story with a â€Å"sigh† and he would also have to throw light upon the differences the second road would have made had he chosen it. Conclusion: The road not taken is a poem with a hidden meaning, it tells us how our life presents two choices in front of us, when we make our choice, after a few years we more often than not ponder over the options we would have had, had we chosen to trot on the road not taken. The poem is very tricky and requires immense concentration to

Annotated bibliography for a study Example | Topics and Well Written Essays - 250 words - 1

For a study - Annotated Bibliography Example The participants for the study included hearing-impaired students attending junior high or high school. Besides that, their mothers were also qualified to participate in the research project. The student and mother required to make use of any quantity of American Sign Language so as to be able to be involved in the study (page # 177, Lines #12-24). Correlations were conducted to establish whether a relationship exists between skill level of the mothers and the English literacy of the children according to the STAR test (page # 174, Lines # 5-7). A total of seven children and six mothers were involved in the study (page # 178, Lines # 1). Results indicated that there was no significant relationship between skill levels of the mothers and the students’ English literary as measured by the TGSL-R. It was also found out that from 2010, students with higher A’ scores from TGJASL-R also seemed to possess higher scores on the CMA or ELA CST. There is a significant relationship between the ASL ability of a student and skills in English literary. These findings were supported by Strong and Prinz (1997). The amount of years a mother utilized ASL influenced her A’ scores on the TGJASL-R. Finally, there was a significant difference in performance between those who are native users of ASL and those who are non-native users of ASL (page # 185-186, Lines # 4-20; Lines # 2-16). Buchholtz, S., Lachs, L., & Boudreault, P. (2011). The effect of mothers ASL skill level on the English Literacy of their Children. Journal of the American Deafness & Rehabilitation Association , 45 (1),

MGM D1 Health Care and The Law Essay Example | Topics and Well Written Essays - 250 words

MGM D1 Health Care and The Law - Essay Example Some of the things that cause suffering of the poor in healthcare services include racism and discrimination, denial of the minority groups in accessing healthcare services, and failure by the government to enroll the minority and the poor in the social healthcare programs (Kant & Rushefsky, 2006). In the US, according to the commissioner of civil rights, although there is existence of civil rights legislation that addresses the issues of healthcare discrimination of the minority and the poor, the reality is that these laws are not followed accordingly (Kant & Rushefsky, 2006). About 38 million Americans are not insured for healthcare services and have very limited financial means of accessing the healthcare services; a biggest proportion of this figure represents the poor (Kant & Rushefsky, 2006). In March 2010, president Obama signed legislation to refurbish the nation’s healthcare system which would guarantee access to medical insurance for all Americans (Shear, 2012). The law aims at extending insurance to over 30 million people, first and foremost by expanding Medicaid and availing federal subsidies to lower and middle-income earners. However, the bill is faced by enormous challenges after republicans appealed against it (Shear, 2012). Some of the challenges facing the law include tougher oversight of health insurers, protection of workers with pre existing conditions and expansion of coverage to one million young adults (Shear, 2012). However, the Obama administration retaliated that it would not unify essential health benefits and that each state should specify the benefits within broad categories. It can be argued that the legal challenges might be reasonable to some extent, although they seem to be politically instigated by republicans, something that would jeopardize its applications. All in all, these challenges are seen to be for the greater benefit of most Americans. All what needs to be done is for all the stakeholders to

Operations Management Case Study Example | Topics and Well Written Essays - 2000 words

Operations Management - Case Study Example Considering the initials sales for Britlon to be carried out in the year 2009, the expanding facilities need to be initiated soon. As the forecasts have shown slightly decreasing level of sales volume during the periods for 2006 to 2009, the full capacity of operation of the existing facilities are not required. Hence, reasonable levels of capacity estimation need to be undertaken for supporting the expected business volumes to be generated. This capacity forecasting is necessary because of the following reasons (Beasley, n.d.). The purchase of raw materials and their procurement process is to be analyzed properly to estimate the stock required to be maintained at each of the production locations. Thus the control on the inventory, planning the production process and its schedule all depends on the capacity that is available. This could also help the sales and logistics to plan their operations to ensure the support systems to meet the target volumes set from each plant. This could also help to give the feed back of possibility of future expansion or necessity in the reduction of the production for the overall operational efficiency. Capacity forecasting would also help the human resources department and financial department to ensure the allocations of resources at specific time to ensure smooth flow of operations. Also this would help to review the operations and help the top management to take strategic decisions that are vital for viable performance of the company. Based on these factors the, overall capacity at DSF is estimated as 40 million Kg of production capacity, which includes 30 million Kg of Britlon and 10 million Kg of Britlene. The production capacity for Britlene is planned to lower from the 5 fully working plants in 2006 to 3 fully working plants in 2009. With the information for the year 2006, the number of plants required would be five. But in 2008, at the existing rate of production, only four full capacity plants are needed. Thus the initial works of modification of facilities could be initiated during this time. One of the plants could stop the production and the necessary modification works could be started. This is expected to consume two years of time and by 2009 one fully operational plant for Britlon would be in place. Thus the expected sales of Britlon would be able to meet with this capacity. Thus in 2009, three plants for Britlene and one plant for Britlon would be in operation. Earlier to this, erection of two new facilities for the production of Britlon would be initiated at two different places attached to the existing sites. This project could be totally separate from the current production patterns. As it involved setting up of new facility, this might not hinder the operations at the above project locations too. This could be initiated in 2006 itself and hence by 2010, it would be possible for DSF to have three fully functional plants for production of Britlene and Britlon. Then the capacity available with DSF would be 15 million Kg of both Britlon and Britlene. Thus as per the forecast this capacity be enough to meet the expected volume of the sales. In 2009, one more Britlene plant could be modified to the have the capacity for the productio

Punishment Term Paper Example | Topics and Well Written Essays - 1250 words

Punishment - Term Paper Example They can be fined, incarcerated or sentenced to death for the gravest offences in some countries such as the US, Japan, China and the Kingdom of Saudi Arabia among others. Corporal punishment is applied by teachers and parents in schools and in the family setting to encourage good behavior among children. The issue of punishment usually raises concerns in regard to the different understanding and application of punishment across different spheres in the society. Contentions arise in trying to determine the standards for determining the severity of a moral violation, and the punishment that fits it. This paper presents a critique of the moral principles that might be used to determine the match between moral violation and punishment. Hart postulated some elements that may be used to justify punishment. For example, he argues that the punishment has to be for an offence that is contrary to the set of laws in a particular state and also has to be enforced and undertaken by an authority that is defined by a legal system, which the offender is in breach of (qtd. in Sverdlik, 180). This indicates that the punishment should only be based on particular rules that have been set and therefore punishment for offences that are beyond the legally known rules is not justifiable. This argument leaves teachers and parents in a position whereby they are not justified in regard to the punishments that they give to children. They punish the children depending on their perception regarding what is right or wrong. The appropriateness of the punishment is usually not clear and the legality of punishments in schools as well as at home is disputable. The same case applies in the punishments meted out on individuals who engage in antis ocial behaviors in the society. For instance, mob justice is one of the punishments that the public resorts to after catching a suspected criminal. The punishment that

Symbolism in 19th century art Research Paper Example | Topics and Well Written Essays - 1250 words

Symbolism in 19th century art - Research Paper Example Freud and Charles Darwin further influence Munch’s work and the art by Munch mainly involves a transformation of personal experiences by using broader statements related to human condition. Among the artwork by Edvard Munch, include: The Scream In this artwork, Munch conveys existential anxiety in relation to the modern age and Munch himself has explained the events in his life that inspired the creation of The Scream. Further, Munch mainly focused on learning how various materials can affect the meaning of an image and believed that different media created different sensibilities within the same image. Munch explored this ideology as evident in the repetition of the same image using oil paint and he believed that, different print media contained different psychological and emotional tones; this provided different feelings concerning Munch’s images4. The Kiss This artwork mainly focus on a description of a man and a woman dressed in the studio of an artist and the subse quent images similar to this, depicted images of couple’s nudity before a window. In most of Munch’s intaglio work revolved around a detailed narration of a scene and the images or themes within his artwork are highly stylized. In a similar manner to the artwork by Gauguin, Munch’s artwork involved a focus on raw materials that are used to make prints and formed an integral part of Munch’s aesthetic conceptions. As depicted in the image of The Kiss, the grain of the wood forms an integral part of the piece and provides organic and vertical pattern, which describes the pouring rain around the black figures that converge to a single form. However, critics of... In this artwork, Munch conveys existential anxiety in relation to the modern age and Munch himself has explained the events in his life that inspired the creation of The Scream. Further, Munch mainly focused on learning how various materials can affect the meaning of an image and believed that different media created different sensibilities within the same image. Munch explored this ideology as evident in the repetition of the same image using oil paint and he believed that, different print media contained different psychological and emotional tones; this provided different feelings concerning Munch’s images. This artwork mainly focus on a description of a man and a woman dressed in the studio of an artist and the subsequent images similar to this, depicted images of couple’s nudity before a window. In most of Munch’s intaglio work revolved around a detailed narration of a scene and the images or themes within his artwork are highly stylized. In a similar manner to the artwork by Gauguin, Munch’s artwork involved a focus on raw materials that are used to make prints and formed an integral part of Munch’s aesthetic conceptions. As depicted in the image of The Kiss, the grain of the wood forms an integral part of the piece and provides organic and vertical pattern, which describes the pouring rain around the black figures that converge to a single form. However, critics of Munch’s work such as Stanislaw Prxybyszewski reiterate that Munch’s image of The Kiss is â€Å"repulsive† and for example, the use of figures.

Modern World Cinema Essay Example | Topics and Well Written Essays - 1000 words - 1

Modern World Cinema - Essay Example In the past two and a half decades movie industry in Nigeria was in bad shape, most films produced then were of very poor Quality, just a few exceptions like those produced by Late Actors and producers, by name Chief Hubert Ogunde and Moses Olaiya a.k.a Baba Sala.These two actors took Nigeria movie across the Globe and they were largely applauded for their immense contribution to the Nigerian movie Industry. The films produced by Hubert Ogunde include Aiye and Jaiyesimi, all these films were masterpieces of their own time, and today these films are still available at special occasions in cinemas all over the country. Chief Hubert Ogunde single-handedly built a film village in Musan, Ogun State in Nigeria. The film village is equipped with state of the art African artifacts required to give Nigerian films the necessary African background and other required parafinaliars, the Structure is still there today for use.

The Plama Membrane Essay Example for Free

The Plama Membrane Essay The plasma membrane exists in all living things for the simple reason that it serves vital functions without which the cell cannot survive.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The plasma membrane is composed primarily of a phospholipid bilayer which is made up of hydrophobic lipid â€Å"tails† that point inwards and hydrophilic phosphate â€Å"heads† that are positioned so that one layer is in contact with the extracellular fluid and the other with the cytosol. The membrane may thus be thought of as the cells â€Å"skin† enclosing and protecting the organelles and the nucleus. The cell (and its components) however, is not cut off from its environment because the plasma membrane is semipermeable, allowing specific substances necessary for the normal functioning of the cell to pass through. Also, embedded in the bilayer are proteins that assist the passage of substances that normally would not be able to pass through by simple diffusion. A good example would be the sodium-potassium pump (Krogh, 2003) which is responsible for the active transport of these ions. Both potassium and sodium need to move up their concentration gradients (into and out of the cell, respectively) and since both are ions that would be difficult to transport through the hydrophobic interior of the bilayer, such transport needs to be facilitated by the use of proteins that will serve as channels through which these ions can pass through. This therefore illustrates as well the regulatory functions of the plasma membrane in that it allows transport into and out of the cell in a selective manner (Postlethwait Hopson, 2006).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Proteins that lie on the surface of the plasma membrane also serve a role in facilitating communication between the cell and its environment, including other cells. Lymphocytes (white blood cells) for example, differentiate foreign cells from that of the body by recognizing antigens, surface-bound proteins that serve as identification for the lymphocyte to know whether the other cell is an invader that needs to be eliminated (Postlethwait Hopson, 2006).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Clearly, the plasma membrane serves critical roles in cellular function, not just in THE PLASMA MEMBRANE  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Page # 2 protecting the cell but as well as in transport, regulation and communication, and since, as Krogh (2003) has stated, â€Å"all life is made of cells†, it follows that life simply is not possible without the plasma membrane. References: Krogh, D. (2003). Biology: A Guide to the Natural World, 3rd ed. Companion Website. Retrieved Dec. 31, 2007, from http://wps.prenhall.com/esm_krogh_biology_3/ Postlethwait, J. H., Hopson, J. L. (2006). Modern Biology.  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚   Texas: Holt, Rinehart and Winston.

Lou Gehrig Disease Essay Example for Free

Lou Gehrig Disease Essay Lou Gehrig Disease is a term used in the United States that also refers to ALS or Amyotrophic Lateral Sclerosis. It was named after the famous Lou Gehrig, a baseball player for the New York Yankees between the 1920’s to the 1930’s. His career in baseball was cut short when he became afflicted with the disease ALS is a fatal and progressive disease which is characterized by the degeneration or deterioration of nerve cells within the brain, specifically those involved in motor functions that control the movements of voluntary muscles. As it is a disease that involves the motor neurons, ALS can cause body and muscle weakness as well as deterioration or wasting away of the whole body due to the degeneration of motor neurons which cease to send impulses from the brain to various muscles of the body. As is the tendency of things that cease to serve their function, the body muscles gradually become weak due to inactivity and later on, begin to develop muscle twitching. An end result is muscle wastage and atrophy due to denervation so that an individual afflicted with the disease cease to have control of his own voluntary movements with the exception of the eyes. In ALS, the individual usually retains their mental or cognitive functioning except in such cases when ALS is associated with fronto-temporal dementia. However, several studies have indicated that many individuals with ALS have slight changes cognitively in instances when neuropsychological testing is utilized. The nerves that transmit sensations as well as the autonomic nervous system is usually not affected. ALS affects all people with no preference for race or ethnicity and is regarded as one of the most common diseases that affect the brain and muscles worldwide. Annually, 2 out of 100,000 individuals become afflicted with ALS (Ropper and Brown 2005). It commonly occurs in middle to older adulthood, with ages ranging from 40 to 60 years of age although it is not unlikely for other age groups to contract the disease and men have an increased risk for the disease as compared to women. The affected parts of the body which is usually affected by ALS depend on the motor nerve cells that damage the body. Two-thirds of ALS cases consist of individuals experiencing ALS that initially occurs in the limbs. Individuals may notice a significant change in walking or running and may initially pass this off as clumsiness or awkwardness. Other people report onset of the disease through their arms and hands and report difficulty in going about simple tasks such as writing or buttoning a shirt. One-third of ALS cases, meanwhile, are bulbar at the beginning. Individuals may report difficulty in talking and speech may become slurred and incoherent. The first signs are commonly a decrease in the speech volume and an increased nasal tone. Eventually, individuals experience dysphagia (Difficulty in swallowing) as well as decreased mobility of the tongue. This would eventually lead to the inability to talk and loss of protection of the airway during swallowing. The initial onset of the symptoms and the body parts which it initially affects does not really matter as this will eventually spread throughout the body during the progression of the disease. Aside from the above symptoms, this could also include spasticity of muscles, an exaggeration of reflexes and the occurrence of Babinski’s sign which normal for babies but abnormal for adults. Furthermore, individuals may also experience labile emotions such that they may display uncontrolled bouts of laughter followed by instances of sadness or an increased frequency of mood swings due to the degeneration of bulbar motor nerve cells. There is no definitive test to diagnose ALS although many believe that the presence of motor nerve cells in a single limb may strongly indicate ALS. The diagnosis and confirmation that it is indeed ALS is commonly based on ruling out other diseases that may bring about similar symptoms produced by ALS that include Lyme disease, Syphilis, HIV as well as tick-borne Encephalitis (el Alaoui-Faris 1990). In a research conducted by Passinetti et al (2006), it was found out that individuals with ALS have lower levels of three proteins that are found in the cerebro-spinal fluid as compared to individuals who do not have the disease. These proteins include the carboxyl-terminal fragment of neuroendocrine protein, Cystatin C, and TTR. As such, this method has provided a means to diagnose patients with ALS at a sooner time, thus allowing them to receive the necessary medical attention and provide an earlier relief of symptoms. As of now, there is no drug or therapy that could completely cure ALS although Riluzole, the first drug for ALS has gained the approval from the Food and Drug Administration. This drug is said to decrease the release of glutamate within the body and such, is said to decrease nerve cell injury and damage. It also provides several effects that protects neurotransmitters through blocking and preventing calcium and sodium (Hubert et al 1994), the prevention of protein kinase C formation and antagonism of the N-methyl d-aspartate receptors (Beal et al 2005). The patient’s survival is thereby lengthened and increases the time before ventilation support is needed References: Beal, MF et al. (2005). Neurodegenerative Diseases: Neurobiology, Pathogenesis and Therapeutics. Cambridge: Cambridge University Press. el Alaoui-Faris, M et al (1990). Amyotrophic lateral sclerosis syndrome of syphilitic origin. 5 cases. Rev Neurol (Paris) 146 (1): 41–4. Hubert, JP et al (1994). Antagonism by riluzole of entry of calcium evoked by NMDA and veratridine in rate cultured granule cells: evidence for a dual mechanism of action. Br. J. Pharmacol. 113 (1): 261–267 Phukan, et al (2007). Cognitive impairment in amyotrophic lateral sclerosis. Lancet Neurol 6 (11): 994–1003. Ropper, AH and Brown, RH (2005). Syndrome of muscular weakness and wasting without sensory changes section of Degenerative diseases of the nervous system. In Adams and Victors Principles of Neurology, 8th ed. , pp. 938–949. New York: McGraw-Hill. Pasinetti, G et al (2006). Identification of potential CSF biomarkers in ALS. Neurology 66 (8): 1218–22.

Pressure Ulcer on Sacrum

Pressure Ulcer on Sacrum The purpose of this assignment is to identify a patient, under the care of the district nursing team, with a Grade 1 pressure ulcer, to their sacral area. To begin with, it will give a brief overview of the patient and their clinical history. Throughout the assignment the patient will be referred to as Mrs A, in order to protect the patients identity and maintain confidentiality, in accordance with the guidelines set out by the Nursing and Midwifery Council (NMC 2008). A brief description of a Grade 1 pressure ulcer will be given, along with a description of the steps taken in assessing the wound, using The Waterlow Scale (1985). This assignment will discuss the literature review that was carried out, along with other methods of research used, to gather vital information on wound care , such as the different classifications of wounds and the different risk assessment tools available. This assignment, will include brief overviews, of some the other commonly used pressure ulcer risk as sessment tools, that are put to use by practitioners and how they compare to the Waterlow Scale. This assignment will also seek to highlight the importance of using a combination of clinical judgement, by carefully monitoring the patients physical and psychological conditions, alongside the at risk score calculated from the Waterlow Scale, in order to deliver holistic care to the patient. Mrs A is a 84 year old lady who has been referred to the district nurses by her General Practitioner, as he has concerns regarding her pressure areas . Following a recent fall she lost her confidence and is now house bound. She now spends more time in her chair as she has become nervous when mobilising around the house and in her garden. She has a history of high blood pressure and occasional angina for which she currently takes Nicorandil 30mg b.d. as prescribed by her General Practitioner , Nicorandil has been recognised as an aetiological aspect of non healing ulcers and wounds (Watson, 2002), this has to be taken into consideration during the assessment and throughout the management of her wound. Mrs A has no history of previous falls or problems with her balance. She has always been a confident and independent lady, with no current issues surrounding continence or diet. She has always enjoyed a large network of friends who visit her regularly. It is recommended by National Inst itute for Health and Clinical Excellence (NICE) that patients should receive an Initial assessment (within the first 6 hours of inpatient care) and ongoing risk assessments and so referrals of this nature are seen on the day, if it is received if not within 24 hrs. In order to establish Mrs As current risk of developing a pressure area, an assessment must take place. An initial holistic assessment, looking at all contributing factors such as mobility, continence and nutrition will provide a baseline that will identify her level of risk as well as identifying any existing pressure damage. A pressure ulcer is defined as, a localised injury to the skin and / or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in combination with shear. A number of contributing, or confounding factors, are also associated with pressure ulcers. According to the European Pressure Ulcer Advisory Panel (EPUAP 2009), the significance of these factors, is yet to be elucidated. Mrs A is more vulnerable to pressure damage, as her skin has become more fragile and thinner with age (NICE 2005). There are risk factors associated to the integrity of the patients skin and also to the patients general health. Skin that is already damaged, has a higher incidence of developing a pressure ulcer, than that of healthy skin. Skin that becomes too dry, or is more moist due to possible incontinence, is also at higher risk of developing a pressure ulcer than healthy skin. An elderly persons skin is at increased risk, because it is more fragile and thinner than the skin of a younger person. Boore et al (1987) identified the following principles in caring for the skin to prevent pressure damage, skin should be kept clean and dry and not left to remain wet. The skin should also not be left to dry out to prevent any accidental damage . Due to Mrs A spending more time sitting in her chair, she has become at a higher risk of developing a pressure sore, as she is less mobile. The reason being It becomes difficult for the blood to circulate causing a lack of oxygen and nutrients to the tissue cells. Furthermore, the lymphatic system also begins to suffer and becomes unable, to properly remove waste products. If the pressure continues to increase and is not relieved by equipment or movement. The cells can begin to die, leaving an area of dead tissue resulting in pressure damage. Nelson et al (2009) states, pressure ulcers can cause patients functional limitations, emotional distress, and pain for persons affected. The development of pressure ulcers, in various healthcare settings, is often seen as a reflection of the quality of care which is being provided (Nakrem 2009). Pressure ulcer prevention is very important in everyday clinical practise, as pressure ulcer treatment is expensive and factors such as legal issues have become more important. EPAUP (2009) have recommended strategies, which include frequent repositioning the use of special support surfaces, o r providing nutritional support to be included in the prevention. In order to gather evidence based research, to support my assignment. I undertook a literature review of the Waterlow Scale and Classifications of Grade 1 pressure sores. The databases used were the Culmulative Index to Nursing and Allied Health Literature (CINAHL) and OpenAthens. I used a variety of search terms including pressure sores, Grade 1 classification, Waterlow Scale, and How pressure sore risk assessment tools compare. Throughout the literature review the information was gathered from sources using a date range between the years of 2000 2011, although some references were found from sources of information that are from a much later date. This method of research ensured a plethora of articles and guidelines were collated and analysed. The trust guidelines in wound care were used, to show how we implement theory into practise in the community, using the wound care formulary. There was a vast amount of information available, as pressure area care is such a broad subject. The search criteria had to be narrowed down, in some cases to ensure the information gathered was relevant and not beyond the scope of the assignment. The evidence used throughout this assignment, is based on guidelines and recommendations given by NICE (2001), EPUAP (2001) and articles sourced from The Journal of Community Nursing (JCN). This was the most accurate information and guidance on pressure ulcer classifications and assessment although, some articles may not have been the most recent. The assessment tool used throughout my area of work, is the Waterlow Scale. The Waterlow Scale was developed by Judy Waterlow in 1985, while working as a clinical nurse teacher. It was originally designed for use by her student and is used to measure a patients risk of developing a pressure sore. It can also be used as a guide, for the ordering of effective pressure relieving equipment. All National Health Service (NHS) trusts have their own pressure ulcer prevention policy, or guidelines and practitioners are expected to use the risk assessment tool, specified in their trusts policy. NICE (2003), guidance states, that all trusts should have a pressure ulcer policy, which should include a pressure ulcer risk assessment tool. However, it reminds practitioners that the use of risk assessment tools, should be thought of as an aid to the clinical judgement of the practitioner. The use of the Waterlow tool enables, the nurse to assess each patient according to their individual risk of dev eloping pressure sores (Pancorbo-Hidalgo et al 2006). The scale illustrates a risk assessment scoring system and on the reverse side, provides information and guidance on wound assessment, dressings and preventative aids. There is information regarding pressure relieving equipment surrounding, the three levels of risk highlighted on the scale, and also provides guidance, concerning the nursing care given to patients. Although the Waterlow score is used in the community setting, when calculating the risk assessment score, it is vital that the nurse is aware of the difference in environment the tool was originally developed for. The tool uses a combination of core and external risk factors that contribute to the development of pressure ulcers. These are used to determine the risk level for an individual patient. The fundamental factors include disease, medication, malnourishment, age, dehydration / fluid status, lack of mobility, incontinence, skin condition and weight. The external factors, which refer to external influences which can cause skin distortion, include pressure, shearing forces, friction, and moisture. There is also a special risk section of the tool, which can be used if the patient is on certain medication or recently had surgery. This contributes to a holistic assessment of a patient and enables the practitioner to provide the most effective care and appropriate pressure relieving equipment. The score is calculated, by counting the scores given in each category, which apply to your patients current condition. Once these have been added up, you will have your at risk score. This will then ind icate the steps that need to be taken, in order to provide the appropriate level of care to the patient. Identification of a patients risk of developing a pressure sore is often considered the most important stage in pressure sore prevention (Davis 1994). During the assessment a skin inspection takes place of the most vulnerable areas of risk, typically these are heels, sacrum and parts of the body, where sheer or friction could take place. Elbows, shoulders, back of head and toes are also considered to be more vulnerable areas (NICE 2001). When using the Waterlow tool to assess Mrs As pressure risk, I found she had a score of 9. According to the Waterlow scoring system she is not considered as being at risk as her score is less than 10. As I had identified in my assessment, she had a score of 2, for her skin condition due to Grade 1 pressure ulcer to her sacrum. I felt it necessary, to highlight her as being at risk. A grade 1 pressure ulcer on her sacral area, maybe due to her recent loss of confidence and reduced mobility which has left Mrs A spending more time in her chair. Pressure ulcers are assessed and graded, according to the degree of damage to the tissue. The National Pressure Ulcer Advisory Panel (NPUAP), classifies pressure ulcers based on the depth of the wound. There are four classifications (Category/Stage I through IV) of pressure damage. In addition to these, two other categories have been defined, unstageable pressure ulcers and deep tissue injury (EPUAP, 2009) Grade 1 pressure damage is defined, as a non-blanchable erythema of intact skin. Indicators can be, discolouration of the skin, warmth, oedema, induration or hardness, particularly in people with darker pigmentation (EPUAP, 2003). It is believed by some practitioners, that blanching erythema indicates Grade 1 pressure damage (Hitch 1995) although others suggest that, Grade 1 pressure damage is present, when there is non-blanching erythema (Maklebust and Margolis, 1995; Yarkony et al, 1990). The majority of practitioners, agree that temperature and colour play an important role, in identifying grade 1 pressure ulcers (EPUAP, 1999) and erythema, is a factor in alm ost all classifications (Lyder, 1991). The pressure damage usually occurs, over boney prominences (Barton and Barton 1981). The skin in a Grade 1 pressure ulcer, is not broken, but it requires protection and monitoring. At this stage, it will not be known how deep the pressure damage is, regular monitoring and assessment is essential. The pressure ulcer may fade, but if the damage is deeper than the superficial layers of the skin, this wound could eventually develop into a much deeper pressure ulcer over, the following days or weeks. A Grade 1 pressure ulcer, is classed as a wound and so I have commenced a wound care plan and also a pressure area care plan. I will also ensure, Mrs A has regular pressure area checks in order to prevent the area breaking down. The pressure area checks will take place weekly until the pressure relieving equipment arrives, this will then be reduced to 3 monthly checks. Dressings can be applied to a Grade 1 pressure ulcer. They should be simple and offer some level of protection. Also, to prevent any further skin damage a film dressing is often used, or a hydrocolloid to protect the wound area (EPAUP, 2009) . These dressings will assist in reducing further friction, or shearing, if these factors are involved. It is considered the best way to treat a wound, is to prevent it from ever occurring. Removing the existing external pressure, reducing any moisture, which can occur if the patient is incontinent and employing pressure relief devices, may contribute to wound healing. Along with adequate nutrition, hydration and addressing any underlying medical conditions. The advice given to practitioners, on the reverse of the Waterlow tool is to provide a 100mm foam cushion, if a patients risk score is above 10. As Mrs A has an at risk score of 9, with a Grade 1 pressure sore evident, I feel it appropriate to provide the pressure relieving mattress and cushion to prevent any further pressure damage developing. All individuals, assessed as being vulnerable to pressure ulcers should, as a minimum provision, be placed on a high specification foam mattress with pressure relieving properties (NICE, 2001). As I am providing a cushion and a mattress, it is not felt necessary to apply a dressing at this point. However, the area will need regular monitoring, as at this stage it is unknown how deep the pressure damage is. If proactive care is given in the prevention and treatment of pressure ulcers, with the use of risk assessments and providing pressure relieving resources, the pressure area may resolve. Pressure ulcers can be costly for the NHS, debilitating and painful for the patient. With basic and effective nursing care offered to the patients, this can often be the key to success. Bliss (2000) suggests that the majority of Grade I ulcers heal, or resolve without breaking down if pressure relief is put into place immediately. However, experiences in a clinical settings supports observations, that non-blanching erythema can often result in irreversible damage (James, 1998; Dailey, 1992). McGough (1999) during a literature search, highlighted 40 pressure ulcer risk assessment tools, but not all have be considered suitable, or reliable for all clinical environments. As there are many different patient groups this often results in a wide spectrum of different patient needs. The three most commonly used tools in the United Kingdom (U.K.) are, The Norton scale, The Braden Scale and The Waterlow Scale. The first pressure ulcer risk assessment tool was the Norton scale. It was devised by Doreen Norton in 1962. The tool was used for estimating a patients risk for developing pressure ulcers by giving the patient a rating from 1 to 4 on five different factors. A patients with a score of 14 or more, was identified as being at high risk. Initially, this tool was aimed at elderly patients and there is little evidence from research gathered over the years, to support its use outside of an elderly care setting. Due to increased research over the years, concerning the identification and risk of developing pressure ulcers, a modified version of the Norton scale was created in 1987. The Braden Scale was created in the mid 1980s, in America and based on a conceptual schema of aetiological factors. Tissue tolerance and pressure where identified, as being significant factors in pressure ulcer development. However, the validity of the Braden Scale is not considered to be high in all clinical areas (Capobianco and McDonald, 1996). However, EPAUP (2003) state The Braden Risk Assessment Scale is considered by many, to be the most valid and reliable scoring system for a wide age range of patients. The Waterlow Scale, first devised in 1987, identifies more risk factors than the Braden and the Norton Scale. However, even though it is used widely across the U.K., it has still be criticised for its ability to over predict risk and ultimately result in the misuse of resources (Edwards 1995; McGough, 1999). Although there are various tools, which have been developed to identify a patients individual risk, of developing pressure sores. The majority of scales have been developed, based on ad hoc opinions, of the importance of possible risk factors, according to the Effective Healthcare Bulletins (EHCB, 1995). The predictive validity of these tools, has also been challenged (Franks et al, 2003; Nixon and Mc Gough, 2001) suggesting they may over predict the risk, incurring expensive cost implications, as preventative equipment is put in place, when it may not always be necessary. Or they may under predict risk, so that someone assessed as not being at high risk develops a pressure ulcer. Although The Waterlow scoring system, now includes more objective measurements such as Body Mass Index (BMI) and weight loss after a recent update. It is still unknown, due to no published information, whether the inter-rater reliability of the tool, has been improved by these changes. It has been acknowled ged, that this is a fundamental flaw of these tools and due to this clinical judgement, must always support the decisions made by the results, of the risk assessment. This is clearly recognised by NICE, as they advise their use as an aide-mà ©moire (2001). The aim of Pressure ulcer risk assessment tools, is to measure and quantify pressure ulcer risk. To determine the quality of these measurements the evaluation of validity and reliability would usually take place. The validity and reliability limitations, of pressure ulcer risk tools are widely acknowledged. To overcome these problems, the solution that is recommended is to combine the scores of pressure ulcer risk tools, with clinical judgment (EPAUP 2009). This recommendation, which is often seen in the literature, unfortunately is inconsistent as Papanikolaou et al (2007) states: If pressure ulcer risk assessment tools have such limitations, what contribution can they make to our confidence in clinical judgment, other than prom pting us about the items, which should be considered when making such judgments?. Investigations of the validity and reliability, of pressure ulcer risk tools are important, in evaluating the quality, but they are not sufficient to judge their clinical value. In the research of pressure ulcer tools, there have been few attempts made to compare, the different pressure ulcer risk assessment strategies. Referring to literature until 2003, Pancorbo Hidalgo et al (2006) identified three studies, investigating the Norton scale compared to clinical judgment and the impact on pressure ulcer incidence. From these studies, it was concluded that there was no evidence, that the risk of pressure ulcer incidence was reduced by the use of the risk assessment tools. The Cochrane review (2008), set out to determine, whether the use of pressure ulcer risk assessment , in all health care settings , reduced the incidence of pressure ulcers. As no studies met the criteria, the authors have been unable to answer the review question. At present there is only weak evidence to support the validity, of pressure ulcer risk assessment scale tools and obtained scores contain varying amounts of measurement error. To improve our clinical practise, it is suggested that although tools such as the Waterlow Scale are used to distinguish a patients pressure ulcer risk, other investigations and tests, may need to be carried out to ensure a effective assessment is taking place. Practitioners may consider, various blood tests and more in depth history taking, including previous pressure damage and medications. Patients lifestyle and diet should also be taken into consideration and where appropriate, a nutritional assessment should be done if recent weight loss, or reduced appetite is evident. Nutritional assessment and screening tools are being used more readily and appear to be becoming more relevant in managing patients who are at risk of or have a pressure ulcer. The assessment tools should be reliable and valid, and as discussed previously with other risk assessment tools they should not replace clinical judgement. However, the use of nutritional assessment tools can help to bring the nutritional status of the patient to the attention of the practitioner, they should then consider nutrition when assessing the patients vulnerability to pressure ulcer development. The nutritional status of the patient should be updated and re-assessed at regular intervals following a assessment plan which is individual to the patient and includes an evaluation date. The condition of the individual will then allow the practitioner to decide how frequent the assessments will occur. The EPUAP (2003) recommends that as a minimum, assessment of nutritional status should include regu lar weighing of patients, skin assessment, documentation of food and fluid intake. As Mrs A currently has a balanced diet, it is not felt necessary to undertake, a nutritional assessment at this point. Her weight can be updated on each review visit, to assess any weight loss during each visit. If there is any deterioration in her condition, an assessment can be done when required. Continence should also be taken into consideration and where necessary a continence assessment should take place. Incontinence and pressure ulcers are common and often occur together. Patients who are incontinent are generally more likely to have difficulties with their mobility and elderly, both of which have a strong association with the development of pressure ulcers (Lyder, 2003).   The education of staff, surrounding pressure ulcer management and prevention, is also very important. NICE (2001) suggest, that all health care professionals, should receive relevant training and education, in pressure ulcer risk assessment and prevention. The information, skills and knowledge, gained from these training sessions, should then be cascaded down, to other members of the team. The training and education sessions, which are provided by the trust, are expected to cover a number of topics. These should include, risk factors for pressure ulcer development, skin assessment, and the selection of pressure equipment. Staff are also updated on policies, guidelines and the latest patient educational information (NICE 2001). Education of the patient, carers and family, is essential in order to achieve optimum pressure area care. Mrs A is encouraged to mobilise regularly, in order to relieve the pressure as a Grade 1 pressure sore has been identified, she is at a significant risk of developing a more severe ulcer. Interventions to prevent deterioration, are crucial at this point. It is thought, that this could prevent the pressure sore from developing into a Grade 2 or worse. NICE (2001) have suggested, that individuals vulnerable to or at elevated risk of developing pressure ulcers, who are able and willing, should be informed and educated about the risk assessment and resulting prevention strategies. NICE have devised a booklet for patients and relatives, called Pressure Ulcers Prevention and Treatment (NICE Clinical Guidance 29), which gives information and guidance on the treatment of pressure ulcers. It encourages patients to check their skin and change their position regularly. As a part of good practise, this booklet is given to Mrs A at the time of assessment, in order for her to develop some understanding of her pressure sore. This booklet is also given to the care givers or relatives so they can also gain understanding, regarding the care and prevention, of her pressure ulcer. An essential part of nursing documentation, is care planning. It demonstrates the care, that the individual patient requires and can be used to include patients and carers or relatives in the patients care. Involvement of the patient and their relative, or carer is advisable, as this could be invaluable, to the nurse planning the patients care. The National Health Service Modernisation Agency (NHSMA 2005) states clearly that person centred care is vital and that care planning involves negotiation, discussion and shared decision making, between the nurse and the patient. There were a number of improvements that I feel could have been made to the holistic care of Mrs A. I feel that one of the fundamental factors that needed to be considered, were the social needs of the patient. As I feel they are a large contributing factor, towards why the patient may have developed her pressure sore. The patient was previously known to be a very sociable lady, who gradually lost her confidence, resulting in her not leaving the house. There are various schemes and services available, which are provided by the local council or volunteer services, to enable the elderly or people unable to get around. For example, an option which could of been suggested to Mrs A are services such as Ring and Ride, or Werneth Communicare. Using these services or being involved in these types of schemes, may have empowered Mrs A to leave the house on a more regular basis. This would enable her to build up the confidence, she lost following her fall. This would have also led to positive i mpact on the patients psychological care, as Mrs A would have been able to overcome her fears of leaving the house, enabling her to see friends and gain communications lost. As previously mentioned in this assignment, although Mrs A had a score of 9, which is not considered an at risk score. I still felt it necessary to act on this score, even though the wound was a not considered to be critical. If it is felt the patient is at a higher risk than that shown on the assessment tool, the practitioner should use their clinical judgement, to make crucial care decisions. It should also be considered, by the practitioner that risk assessment tools such as The Waterlow scale, may not have been developed, for their area of practise. Throughout the duration of Mrs As wound healing process, a holistic assessment of her pressure areas and general health assessment were carried and all relevant factors, were taken into consideration. The assessment tool used to assess her pressure areas, is the most common tool used currently in practise and the tool recommended by the Trust. To conclude, there is evidence prove that pressure ulcer risk assessment tools are useful, when used as a guide for the procurement of equipment. However, they cannot be relied upon solely to provide holistic care to a patient. It has been highlighted, that to ensure a holistic assessment of patients, it is necessary to complete a variety of assessments, to create a complete picture. Although The Waterlow scale covers a number of factors that need to be considered, throughout the assessment, it has become evident that the at risk score, can often be over or under scored depending on the practitioner. Clinical judgement has proved to be, a very important aspect of pressure ulcer prevention and treatment. The education of the patient, carer and relatives has also been highlighted, as an important aspect of care. Empowering the patient with information regarding their illness, may decrease the healing time and help prevent has further issues.

The Economic Development Of Ghana Essay -- essays research papers

The Economic Development of Ghana Ghana is an African country located on the western side of Africa. Its neighbors are Burkina Faso to the north, Togo to the east, the Atlantic Ocean to the south, and Cote D'Ivoire to the west. It has a population of 18,100, 703 and a population density of 197 people per square mile. Ghana is 92,098 square miles and English is its official language. The capital city of Accra has around 1, 673,000 people residing in it. There are the physical statistics, now onto the more interesting part. The country's greatest strengths lie in its natural resources. In those terms, it is very rich. Cocoa, its biggest export, accounts for 15% of the world's supply. Also its gold production, in recent years, it's exported as many as one million fine ounces. Ghana also has a good supply of bauxite, diamonds, coffee, rice, cassava, timber and rubber. Moreover, since 1983, the economy has steadily grown. With economic recovery policies intact, the economy has raised 5% a year since 1983. Tourism also is growing within Ghana. Tourist rates are increasing also. With all these cash crops, costly goods, and economic restructuring, one would wonder why they need assistance at all. Ghana's weaknesses though, almost outweigh the strengths. Like most countries in Africa, Ghana is in heavy debt since its independence in 1957. It also suffers from high budget deficits. All of the foreign investors that come in only invest in the gold fields. The richest business, Ghana i...

Irony in The Story of an Hour :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Why do bad things happen to good people? We have heard this many times with the death of a car crash or another going bankrupt. Everyone has an ironic situation happen to him or her. Alanis Moressette performed a song about irony in the world’s lives. â€Å"†¦It’s like meeting the man of you dreams†¦then meeting his beautiful wife†¦Ã¢â‚¬  yeah isn’t THAT ironic, that seems to be my best fortune. Irony reveals a different reality than what appears. We see different types of irony in the stories we read, the songs we hear, and what we do in everyday life.   Ã‚  Ã‚  Ã‚  Ã‚  Mrs. Mallard is a woman who had seemed to live a sheltered life. She stayed with her husband, who worked on a railroad, to make ends meet. â€Å"There would be no one to live for during those coming years; she would live for herself.† This sentence suggests that she had lived her life to please her husband, and to be there for him waiting on him hand and foot. After the death of her husband, Mrs. Mallard cried and broke down for a moment wondering what would come next. She sat down and thought. Throughout the story, there are descriptions of spring. She looked out the window and saw the trees budding, and the clouds opening up with the sun shining through. She saw that there was new life for her. She prayed that she would have a long life that she could live, by herself. She was free from the pressure of being a wife. â€Å"Her fancy was running riot along those days ahead of her. Spring days, and summer days, and all sorts of days that would be her own.† As she sits in the chair thinking about her life ahead of her, her sister Josephine is in the other room thinking her sister is going to lose it because she just lost her husband. This type of irony shows that the other characters in the story think she is grieving over the death. But a couple paragraphs later, we find that she is crying tears of joy for the newfound freedom that has come.   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"She breathed a quick prayer that life might be long.† There is irony of this line and with the rest of the story. She stares out the window and prays that her days of life might be lengthened, so she can live for herself and have the freedom to do things.

The Driving Age :: essays research papers

Many teens are interested in being able to drive at a younger age, but it is still unclear if they are able to handle it. If the legal driving age is lowered, are we endangering the lives of teen drivers, as well as the passengers with them? I believe most people want to drive as soon as they can. However, recently the government has been trying to pass laws that may change the current driving age of 16. There are positive and negative aspects to changing the laws that allow the driving age to stay at 16.There have been new bills being proposed that mite be passed. â€Å"The Minister for Urban Services has introduced a Bill (proposed law) into the Assembly. He wants to amend the Road Transport (Driver Licensing) Act 2000. The new Bill is called the Driving Age Amendment Bill. This Bill is intended to raise the age at which people can apply for a learner’s permit and driver’s license.† (Legislative Assembly). This bill will raise the driving age if it is passed b ut the aspects of what will happen should be considered before we change it. There are many different reasons why we should keep it at 16. First off it’s a good working system that we have followed for a long time. Another good reason that helps this concept is that the teenagers are still in school so it’s easier for them to take drivers training. If there are more drivers that ultimately mean that more people will be paying for insurance. There are also the reasons why we should change it from 16. Like for instances most 16 year olds aren’t responsible enough to drive. â€Å"The facts show that younger drivers (those between ages 16 and 25) receive more citations, are more likely to have their driving privilege suspended, and are responsible for more accidents than drivers in any other age group.† (Dr. Steven Evans). Another reason is that it’s a high cost own a car when they are making so little money. If we were to raise the driving age it would most likely be changed to 18. The best reasons for raising it to 18 would probably be that they are more responsible. â€Å"Children are not equipped to handle these vehicles, which are hard for even an experienced, adult driver to handle.† (Ron Shaffer) They have More money because of there jobs and if you go away from home you need a license.

Eat Less Meat

Speech Title: Eat Less Meat! General Purpose:Persuasive Specific Purpose: To persuade my audience to eat less meat. Thesis Statement: Eating meat is becoming an increasing demand and issue in society, it can be solve with the help of all of us. I. â€Å"Meat  is a symbol of affluence, and it becomes an addiction and a habit,† says Henry Spira, coordinator of Animal Rights International† The average  meat  eater is responsible for the deaths of some 2,400 animals during his or her lifetime. (E Magazine. ) A. In late 1992, Lauren Beth ate a fast-food cheeseburger laced with E. oli. She was attacked by hemolytic uremic syndrome (HUS), a wasting disease that invades nearly every organ in the body and destroys the blood's ability to clot. Lauren Beth succumbed to a heart attack a few days before the beginning of 1993, a year which would be marked by a massive outbreak of E. coli and the deaths of three children at Seattle, Washington Jack in the Box restaurants. (E Mgaz ine) B. Today, I would to discuss how we meet eaters could reduce or needs for meat and substitute other foods for it. C.Eating meat is becoming an increasing demand and issue in society, it can be solve, with the help of all of us. II. Body A. Need: Many human beings really on meat for their meals. 1. Although the consumption of meat is very popular, we can change that by consuming less meat and becoming open minded on other food that would work for you. 2. Global  meat demand is expected to grow by 56 percent to 2020 according to the magazine of Animals today. 3. In the E Magazine it mentions a interviews with a slaughterhouse worker that said. On the farm where I work,† reports one employee, â€Å"they drag the live ones who can't stand up anymore out of the crate. They put a metal snare around her ear or foot and drag her full length of the building. These animals are just screaming in pain or they are often skinned alive. † 4. The bacteria are a particular proble m in hamburger, because the grinding process spreads it throughout the  meat. E. coli, was one of the leading cause of kidney failure in young children. (E Magazine). Transition Now that I’ve told you the impacts that it has, is there a way to resolve it? B.Satisfaction: We should all think about what would be the best for our country and its citizens 1. Reduced consumption of animal products and increased intake of fiber-rich carbohydrates, fresh fruit and vegetables are recommended to minimize the risk of heart disease, mature onset diabetes, obesity, and possibly some cancers. (De Fraga) 2. There is some evidence to suggest that the human digestive system was not designed for  meat  consumption and processing ,which could help explain why there is such high incidence of heart disease, hypertension, and colon and other cancers. Jim Motavalli) 3. By eliminating little by little for consuming meat we are saving the environment, animals and even our health. Transition: W ill these solutions work? C. Visualization: 1. In the E Magazine it said that In the U. S. , according to a 1998  Vegetarian Journal  survey, 82 percent of vegetarians are motivated by health concerns, 75 percent by ethics, the environment and/or animal rights, 31 percent because of taste and 26 percent because of economics. (Jim Motavalli) 2.The American Dietetic Association says in a position statement, â€Å"Appropriately planned vegetarian diets are healthful, are nutritionally adequate and provide health benefits in the prevention and treatment of certain diseases. † (Jim Motavalli) 3. One percent of the public, or between two and three million, is vegetarian (eats no  meat  or fish, but may eat dairy and/or eggs), with a third to half of them living on a vegan diet (eschewing all animal products). Roughly five percent in both studies â€Å"never eat red  meat. † (Jim Motavalli) III. Conclusion: A.Call to Action:   It's not always easy to do–mos t environmentalists still eat  meat–but the tide is beginning to turn. 1. CONTACT: International Vegetarian Union, (202)362-VEGY, www. ivu. org Gives information on the vegetables that you can substitute for meat. (Motavalli) 2. CONTACT: For a free copy of PETA's Vegetarian Starter Kit, visit www. goveg. com/VegKit 3. CONTACT: Center for a Livable Future (410)223-1608 B. Cutting back on our meat intake is on step to help benefit our health, environment, and the animals. 1.If you  eat  a couple of meals  less  of  meat  each week, you're doing, yourself and the planet, you're doing all of us a favor. – Rene Montagne Works Cited De Fraga, Carole. â€Å"Eat Less Meat — It’s Costing the Earth. † Animals Today 2 Nov. 2004: 17-18. EBSCO Host. Web. 27 Sept. 2012. Montagne, Renee. â€Å"Letters: Eating Meat for Environmental Reasons? † Morning Edition 30 Jan. 2009: n. pag. EBSCO Host. Web. 28 Sept. 2012. Motavalli, Jim. â€Å"The Case against Meat. † E Magazine Jan. -Feb. 2002: 26-33. SIRS Issues Researcher. Web. 28 Sept. 2012. – – -. â€Å"The Trouble with Meat. † E Magazine May-June 1998: 28-35. SIRS Issues Researcher. Web. 27 Sept. 2012.

Evacuation, Second World War Coursework Essay

Source B shows the oppose sides and is more personal that the first source. Extracted from an consultation with a teacher in 1988, the teacher remembers being evacuated with the school infantren. The interview was do in 1988 many years by and by the struggle so the bird would be of old age. Her memories whitethorn be confused and not of great accuracy, and as it go forth turn out been write up by the interviewer it is secondary in kindation. She may be influenced on her views of evacuation after the war and so be biased against it, redden though it saved so many lives at the time.She describes the children as being too terrified to talk, which I feel may ware been true. Children were being taken outside(a) from their families and boarding a train whither uncomplete themselves or the teachers knew where they were going, as the teacher quotes we hadnt the slightest idea where we were going and we put the children on the train and the gates closed potty us. The worry an d anxiety bear upon the raises above all, and from this source it suggests that the mothers pressed against the agitate gates calling good-bye dear(p).Even though they were told not to fall they trailed behind desperate to sp hold back the brook moments with their children. Mothers were persuaded into letting their children go by the g everyplacening and the propaganda around at the time and were even considered selfish if they did not allow their children We do not know who the source is written by, just that it is from an interview. There does not count to be a real pattern to this interview, but just to perhaps pay the information gathered to a explanation book or other plainly informative targets, as the interview took out so long after the war was over.There would be no make therefore for the lady to lie or twist the truth purposefully. And no purpose of the interviewer to convert her information into propaganda or such, so I thin the interview is plumb trustwor thy to that extent Source C was written in 1973 and was published a long time after the end of the war. This makes it a secondary source, as it has not come directly from the mouths of the children or the raise parent. Written by a lady presumably for the purpose of educating children on evacuation, manner of speaking and content is dulled slightly to be more appropriate for children.If it had been a book for adults it would gain been described differently. The children would not remove giggled but would harbor been offended by the automatic presumption of poverty. They may need even explained that their slippers would not fit in the case. Written for children, no bad points would have been inserted and simple language will have been used. The source may lose reliableness due to being edited for children as children are not to be clear to the negative side of evacuation.This is not a source, which shows the failure or success or evacuation, but if it was to highlight one(a) over the other I would say it shows the successes mostly. I know from other information that one of the main products of evacuation was the sudden actualization from the middle class of the poverty and little education of children and adults living in the slums. Shown here in the source the woman does take for granted they are too poor to have slippers, and is embarrassed that she presumed they would own some.Even though the children giggle about it, it is very right that some children evacuated were too poor to have slippers and some too poor to form the necessary kit of items required. The kindness of the encourage parent towards the children and the understanding of her taking them both(prenominal) acknowledging they were siblings show other successes of evacuation. However this was not always the case. Another foster parent may have been negative towards the child or children, and some foster -parents scarcely had room for one.

How to write an introduction for a dissertation?

The introduction is the starting point of your dissertation. The reason why the introduction for a dissertation is the clinical most difficult part of the paper is that its main goal is to make a reader interested in the whole subject you have been researching. What is more, you need to prove why your research matters wired and what you have managed to achieve in regards to the subject under consideration.Common dissertation introduction writing problemsAs soon as you get down to writing, you will most definitely come across a couple of problematic issues.Define the issue A married couple of tips that might help you craft an fascinating and effective introduction is to old keep it short and arrange.In addition, some students come up with introductions that look such like they are formula-written. Therefore, such pieces of writing lack both enthusiasm and a sense of commitment.Main parts of the introductionscope;current scientific situation;motivation;theoretical and practical lit tle relevance of the research;brief description of the research design;objective of the study;problem statement;dissertation outline.You need to begin with stating the motive for your research.The introduction must indicate the only way your bit of study will lead to the theoretical comprehension of the topic.

In order to demonstrate the theoretical relevance of your research, use various arguments and cite scientific articles. Then, you need to explain the practical relevance of your research study. Showing its practical benefit is usually easier than dwelling upon its theoretical relevance, as you can provide lots of examples to illustrate your point. Do not forget to first mention the practical outcome of your research for the whole field or industry.An introduction is among the ingredients of a dissertation.It is also physical vital to dwell upon the current scientific situation regarding your research topic. What you are required to do is present a few scientific articles that deal with similar issues or ones how that are related to your subject of study. Briefly explain the gist and the main message of those articles. The same reason why this aspect is so important is that it demonstrates that there is a lot of theoretical information on the issue, which means you will not get stuck while working on it.Simply choose the subject which best matches apply your topic of study to find a dissertation introduction illustration .

Try to summarize the gist of each previous chapter in one sentence. In case it is not quite possible, you can expand the english summary of the chapters to one paragraph. Keep in mind that the outline should not be repetitively phrased. Most people work on their dissertation introductions after the whole paper is written.Our custom made dissertation professional debut writing will assist you.Make sure you write to the point. Do not repeat yourself. Present very useful information to the reader. Here is a checklist of points your dissertation introduction should consist of:the research same topic is limited;the practical relevance is explained;the topic is stimulating;current scientific situation in the field is demonstrated;the objective is stated;the problem statement is formulated;the research design is presented;the doctoral dissertation outline is added.Aim to leave a transparent understanding of the discovery or argument to the reader your scientific research have progress ed.

This way, you will be able to organize your thoughts logical and submit a piece of writing in which all vital points are showcased. Offer the reader some background regarding the same subject you are dealing with. Clarify what the focus of your study is. Do not forget that you will also need to explain why your research study is significant as well logical and what its value for the field or industry is.Within this sub-section provide a synopsis of the research techniques you will utilize to perform your research and remember to estimate the duration of time to good finish your research jobs.You need to show your target audience a clear picture of what they what are about to receive once they familiarize themselves with the subject of your research study in detail. In other words, the expectations of the readers should be met as soon as they start reading your introduction.Taking into consideration the mere fact that your target readers are members of a dissertation committee, what you need to do is to get to the point right away. They are looking for a brief preview of your dissertation, and are willing to learn more about the objective and relevance of check your study in general.Youve completed all your research, and you have arrived at the pinch commence own writing your dissertation and you have to sit down.

Do not forget to define the public key terms of your dissertation. If it is a rather broad notion, make sure you explain what it means in the context of your own research study. It will give readers a better understanding of check your goals and the methods you used in order to achieve the desired result (Cassuto).The introduction to the unpublished dissertation is one of the most significant parts of such a piece of writing, because this is the first impression the reader gets when they start reading your document.Writing a dissertation needs a choice of study and preparation skills which free will be of wonderful value on your career that is forthcoming and within organisations.Taking everything into account, writing an general introduction for a dissertation is a complex and time-consuming assignment. It is essential to come up with an introduction that is interesting enough to readers that they want to find out more. Follow the steps highlighted in this article and you will be able to write an impressive dissertation introduction that will consist of all the relevant aspects the members of a dissertation committee low pay so much attention to. Make sure each part of your dissertation introduction is formulated in an informative and coherent manner.Attempt to limit your acknowledgement dissertation to a page.

Colloquial English Grammar

Estonian blood line in calm bring in of conflicting lyric poems GRAMMAR OF utter face bourn authorship By maria Esko BBL-2 exe shrinkive program Ludmilla Podolski capital of Estonia 2012 display board of field adit3 leafy ve lay out qualified-bodiedalty Features of talk slope4 Grammar Characteristics7 cla engage cabal7 couch of p contrivanceiculars8 Pausing, tell and cast8 Organising the handle9 eclipsis9 receipt Tokens10 slow Expressions11 Headers and chase after11 Conclusion12 References13 Introduction In the cable earthly concern, colloquy is alert for creating unfermented nedeucerks and acquiring essential chore get divergenceners. intercourse is the legal action of transport culture. trenchant intercourse skills stop be hit the booksed the pigment to success. I pay back elect to look into side speak excogitateing in parliamentary law to light up what m pop outh cable office grammar is. As a zero(preno(prenominal)i nal)-native verbalizer I consider nurture verbalise grammar fantastic whollyy Coperni plunder in monastic gear up to fancy the contrasting party. The converse parade squirt be considered success uprighty terminate merely when the att declargon in the axeant has mute the meat of the verbaliser. The feature that verbalize and opus be resis hug drugt is kinda an obvious.The studies of the mouth billet grammar earn been drop for a wide name, since it was considered as conf utilize and full of mis c al unrivalled in both backs. victimisation of engineering has do it practicable to progress to intercommunicate voice chat a lot(prenominal) thoroughly. thus much bewitching de white tie and tailcoat slightly speak Grammar absorb arisen. In this melodic theme I entrust ingestion the margeinal talk grammar in the center of confabulational slope. The traces of nominal slope obstetrical deli in truth(prenominal), e. g. pr ompt nomenclaturees atomic number 18 non analysed in this nameinus motif. This indite portion outs an overview of the primary(prenominal)(prenominal) features of the grammar of speak position.The dissimilaritys between verbalise and create verbally position atomic number 18 supplied with illustrations. In the destination the general symptomatics of the grammar of mouth incline puzzle been summarised. customary Features of utter slope Is at that rove all grammar in talk slope? To repartee this drumhead I allow to pay glum the overall nub of grammar. check to cyclopedia Britannica the term grammar in a certified mavin refers unaccom goied to the composition of decl argon and word organise (syntax and morphology), excluding idiomology and pronunciation.Although lecture communication is the identical the grammar of communicate side whitethorn differ since interest the grammar rules during a talk is season overwhelming and un natu ral. When talk terminology is find in much point it as well has patterns and peculiar(a)ised coordinates which may be considered as the grammar of mouth voice communication. During a communion we do non bugger off more than magazine to believe what we be slightly to hypothesize and advise non contrive our lyric in p atomic number 18nt (excluding whatsoever(prenominal) picky(prenominal) shifts). slice earshot to a save wrangle it feels dominion, silverish and patrician to adopt. On the close to a nonher(prenominal)(a) hand, when sick on dep endingant it is chassis of gruelling to commiserate. until now it realizes an luck to ceremony slightly(prenominal) comminuted features of in stiff side lecture, much(prenominal)(prenominal) as n singleffervescent go bads, verbalization spend a penny full pa delectations, usurpings, err aceous parachutings, talk of crossbreeders(small lecture or rooted(p) phrases use to char ge the counterbalance or the twine back of an idea) and ill-considered forms ( quick study, Svartvik, 2002). circumstantial features thumpingly stimulate a con schoolbookual stainifi ignorece for the at feedant and posterior insinuate divers(prenominal) pitchs in the discomfit of the dialogue. In this writing the term intercommunicate slope voice communication is un exited in a concentrate sense. It and embroils the cozy side and face to face fundamental interactions.Prep atomic number 18d quarreles and an some other(a)(prenominal) types of formal position speak atomic number 18 non interpreted into beak and be non discussed in the tending(p) massage. In the flesh d precede instairs be presented the 7 a cycles/second ordinary conditions operate(a) in veritable-magazine dialogue. These features beat out distinguish wherefore utter vocabulary is so wicked to put up in writing. put down 1 vii conditions operating(a) in dialo gue ( quick study, n. d. , account 2) upgrade is effrontery an object littleon of a intercourse which expatiates the conditions generally operating in a parley. It bequeath be subsequentlyward analysed and utilize as an display case for mingled items of talk grammar.Four vocalizers argon session at the dinner party remand public lecture around a rail panache auto insouciantty that happened to the male p arnt of single of the utterers. At the end of this installment they duty power point to whatever other root. Ill safe scoop up that off and open you got incorporate of it? atomic number 18 references to a large pan which is on the dinner table. The = feature presents an vox which is cut gyp The + compact channelizes an break turn which moves at the conterminous + sign A Ill exclusively take that off. puzzle that off. B all(prenominal) looks great. C laughs B Mm. C Mm. B I calculate your pa was stupefied wasnt he at the damage.A Mm. B Its non so a great deal the separate. Its the patience charges for= D Oh that. For a car. B baffle you got pull in of it? A yeah. B It was a turn of events erm= A Mm. C Mm. B A bit. A Thats right. B I mingy they state theyd bemuse to take his car in for ii days. And he state all it is is straightening a panel. And theyre pay c be, Oh no. Its all in the raw panel. You earth-closett do this. C each erm problem. B As planly as they cop policy claim. Oh. lets cleave it right. C Yeah. Yeah. Anything to do with+ A Wow. C + busbar snip is er+ A Right. C + disgraceful isnt it. A Now.As nates be identifyn in the guinea pig interpreted from Cambridge Grammar of incline a world-wide hire intercommunicate and create verbally face Grammar and fashion (Carter, McCarthy, 2006, 165), thought of the text depends on the condition and the agile situation. practice poses nearly of the units that fag end be a great deal snips encountered in verbalise grammar, much(prenominal) as open-ended complex body parts ellipted forms, incomplete structures, drug-addicted clauses non ostensibly committed to any particular principal(prenominal) clause, interrupt structures with other loud vocaliser system system contri un littleions intervening, speak communication whose grammatic course of study is un abstemious. conference happens in real time and is involuntary, and so vocalizers desex mistakes and we unlesst lowestize park features of speak grammar. nigh condemns be misidentify and hard to see to it because we do non pick up the acquaintance of the shell outd desktop of the discourse. It is unenviable to dally legal transfer in writing so that the ratifier could intimately follow the create verbally conversation. In identify to do so at that place tolerate to be do legion(predicate) re label to explicate what the loud loud utterer unit crockeds. In real time conversations emotions and vocal intonations be burning(prenominal) to empathize the speaker.Moreover, it is unenviable to determine when the denounce starts and when it ends. This conversation is meant to illustrate scarcely what is analysed in the term paper. verbalize Language and social Communication In this paper notwithstanding one part of utter face go out be discussed which is conversational side. It is an cosy social communication and has its own peculiarities. Conversations atomic number 18 naturally carried out in face-to-face interaction with others. They ar laced to the participants and the contiguous situation. Speakers unremarkably sh atomic number 18 a universal contextual ackground and turn meanings select of than the content of the pass on. Meanings allow go depending on the item social, hea consequently and institutional acquaintance (Biber, Conrad, Leech, 2002, 428). Grammar Characteristics verbalize manner of patois production and write deliin truth coexist . They be not change integrity acutely but view as umteen diametrical characteristics. therefrom the grammar of conversational slope differs from the scripted one. on that point atomic number 18 galore(postnominal) differences that could be mentioned however, referable to the demarcation line of quadrangle they proceed external the background admitledge of this paper, which gives a brief overview of the chief(prenominal) features of talk English.Clause Combination In speak English it is typical when the power structure of clauses in dooms is in discord. In real time communication the speaker is not able to compose over-elaborate patterns of briny and qualified clauses. vulgar be sequences of clauses connected by organize conjunctions (Carter, McCarthy, 2006, 170). Conjunctions ar a grammatic option to assort text. In mother tongue lay conjunctions ar more patronize than in writing. Coordination is less sympathetic and more dark, which is charact eristic of mother tongue (Leech, Svartvik, 1983). a lot ally clauses ar utilize by one of the speakers to save the conversation or to give excess comments. They stacks fleet later on a pause to give paygrade to what pull in been verbalize. whatevertimes clauses live on in a curse it happens when the commencement ceremony of a decry is diametrical from how it was completed. This syntacticalal structure is super acid in verbalize run-in and is slowly even-tempered by the attender. (Carter, McCarthy, 2006, 171) Well, no, Melanies truly even so a scholar and she dumb has ten hours of lectures a week, so she self-coloured caboodle in McDonalds in her give up time cos she involve the notes and she works in McDonalds in Hatfield.Subordinate clauses A So I glowering round and hint after him. B entirely as I would remove done. clausal meld Theyve approximately blameless all the mental synthesis work, hasnt it? stead of items extemporary speech buy atly requires ad alonements to be do fit in to the communicative call for. so it is natural when the speaker changes the position of items in a objurgate in piece to c atomic number 18 the tender to the render tuition wagerer (Carter, McCarthy, 2006, 172). In colloquial English airfield-verb sexual inversion a great deal takes rear.In informal speech it suspensors to emphasize the state (Leech, Svartvik, 1983) B I regard your dadaism was astounded wasnt he at the damage. Pausing, reiterate and rephrasing at that place ar two types of pauses empty and filled. fulfill pauses atomic number 18 honest mum and quite sententious. They a lot evidence a change in the accusation or the subject of the conversation. modify pauses be mark by vocalisations, such(prenominal) as er, erm, uh or uhm. These marks chiffonier indicate a turn in the topic or that the speaker has not thus far finished public lecture and is view of the trounce way to con tinue (Carter, McCarthy, 2006, 172).Repetition and cast atomic number 18 actually normal in colloquial speech. When tell a motility by repetition rowing or phrases the speaker burn get some more time to think. normally repetition derives at the startle of an annotation or clause. Recasting is normal in real time speaking. It happens payable(p) to the fact that the speaker is public lecture genuinely desist and wants to redevelop actors line or phrases (Carter, McCarthy, 2006, 173-174) I talk to her fit darknesswell, shes not going to take the job. It was, er, the estimateor, wasnt it? I, Im, Im not legitimate hell hell be able to arrange that at such short notice.Organising the colloquy mouth oral communication faces quite unorganised. heretofore, speakers very much use item lecture and structures to indicate how the speech impart continue. For modelling items such as anyway, okay, right, I mean, so, now, and so forth These items ar named talk m arkers. morphologicly these markers do not hold up to clauses (Carter, McCarthy, 2006, 174-175). adept of the more frequent discourse markers in speak English is equivalent it is apply to mark direct speech (Adolphs, Carter, 2003) Right, wed damp pass judgment to hollo and see what they gain to report.And theyre a manage(p), Oh no. Its all pertly-fashioned-fashioned panel. You notifyt do this. eclipsis eclipsis is the absence seizure of elements involve by the grammar. However the message doesnt obtain and lacking(p) parts plunder be silent from the context. In nearly conversations eclipsis back end be sort out as initial eclipsis and final examination eclipsis in some cases alike median(a) eclipsis takes place. In initial ellipsis, nomenclature at the fount of the designate ar dropped, in residuum in the medial ellipsis in the center of attention and in the final ellipsis at the end of a sentence (Biber, Conrad, Leech, 2002, 441-443).Also ellipsi s flush toilet be categorised situational, textual or structural (Carter, McCarthy, 2006, 181) sign ellipsis Didnt know that croak was on tonight. I is omitted. net ellipsis A I enunciate Kathy is still animated in that said(prenominal) place. B Yeah, she is. victuals in that same place omitted medial ellipsis Yeah dude, I gotta start works. kind of of I guard got to Ellipsis is exceedingly characteristic of spontaneous speech. During a conversation speakers deprivation to nullify syntactic complexness due to real-time pressures.Ellipsis excessively takes place when blocking inessential repetition and bad unwavering retorts to other speakers (Biber, Conrad, Leech, 2002, 441). reaction Tokens rejoinder tokens are in truth plebeian in talk mouth communication. These are some adjectives and adverbs employ to give diligent and clear chemical reaction to the speaking first mate and to show that the drug user is comprehend and understands what is said to him. much(prenominal) words let in absolutely, definitely, great, bewitching, good, really. well-nigh words stool an draw with a particular context. For compositors case fine is utilise when make arrangements and orbit decisions.Response tokens bear on the attender to give lovesome feedback to the speaker, which is very satisfactory in case of a conversation (Carter, McCarthy, 2006, 188-189) C Yeah. Yeah. Anything to do with+ A Wow. C + rail work is er+ A Right. C + pitch-dark isnt it. A Now. obtuse Expressions Speakers tend to avoid rapacious or determinate language and in ensnare to sound nice and to recrudesce the language dense show upions are employ. The close to common are stuff, like, anything, kind, whatever, sort of, etc. unnoticeable expressions fall in the breeding and often are utilise before some undefiled or precise information (Carter, McCarthy, 2006, 202-203).Sometimes these expressions are overused by the speaker in the midst of the n and like xix lxxx cardinal I notwithstanding dog-tired the full-page time, I mean for that upstanding sort of dozen year period or whatever, erm I was honorable working with just slews and lots of diametric people. Headers and dress suit Headers and tails are very common features of verbalise language. They seldom occur in indite English and seem very strange. A foreland occurs in a sentence where an item inside a clause structure is rigid before the clause and tell in the clause itself. In other words the head instructor stands in the initial position.Most typically cope consists of a noun phrase and is followed by one or more pronouns. Headers are used by the speaker to assist the listener to tailor in the facts (Carter, McCarthy, 2006, 192-193) The teacher with glasses, he seems very nice. tailcoat are analogous to headers the difference is that these items are placed orthogonal the clause structure. Tails are alike typically noun phrases. Their pur pose is to enlighten something mentioned in the main clause. ordinarily tails clarify or repeat the denotive of a pronoun (Carter, McCarthy, 2006, 194-196) Theyre incredibly nice, our neighbours.Conclusion In culture it is affirmable to say that English utter language has grammar. However there is still much to be researched. The hire to check out utter grammar is grave in shape to mend the speaking skills. In world where communications are exploitation so rapidly, communicate language and the restraint of it is an empowering skill. writing is in force(p) everyplace in the world but the art of conversation is do rarely (Brazil, 1995, 11). utter grammar highlights the contextual and interpersonal aspects of communications. It is an interactional process and ordinarily it is quite rapid.Therefore speakers use divers(prenominal) structures in ramble to give quick comments or answers. Those structures include response tokens and ellipsis. Often the speaker chan ges the position of items in send to servicing the listener to understand the topic. In order to make the speech softer and less arrogant speakers use vague expressions. During the conversation the speaker often looses track of thoughts and and so pauses, repetitions and rephrasing help to compound new clause structures. umteen other characteristics of the grammar of verbalise English can be named.The acquaintance of the grammar of spoken English is alpha for business communications. batch need the indispensable skills to express themselves in a exceed thinkable way. examine this subject testament tolerate a unwrap understanding of grammar as a whole and can be a computer address of new knowledge. References Adolphs, S. , Carter, R. , 2003, And shes like its terrible, like verbalise Discourse, Grammar and principal sum Analysis, transnational daybook of English Studies Biber, D. , Conrad, S. , Leech, G. , 2002, Longman school-age child Grammar of talk and w ritten English, Edinburgh Pearson upbringing hold Brazil, D. 1995, A Grammar of speech. Oxford Oxford University raise up Carter R. , McCarthy m. , 2006, Cambridge Grammar of English a spatiotemporal guide spoken and written English Grammar and usage, Cambridge University infatuation Eggins, S. and D. Slade, 1996, Analyzing casual conversation. capital of the United Kingdom Cassell Leech G. , Svartvik J. , 1983, A communicative grammar of English, capital of the Russian Federation Prosveshchenie Leech G. , Svartvik J. , 2002, A communicative grammar of English 3d edition, capital of the United Kingdom Pearson ESL Leech, G. , n. d. , English Grammar in Conversation Lancaster Lancaster University