Behind the Sun

Behind the Sun (Abril Despedacado) was a thought-provoking and captivating work of art by Walter Salles, Sergio Machado and Karim Ainouz; who collaboratively derived the story from an Albanian book (Broken April by Ismail Kadare). Behind the Sun was set in 1910 in the Northeast region of Brazil. The movie unfolds with this line, â€Å"This is the story of me, my brother, and a shirt in the wind†¦ † The line was narrated by a charming young boy, Pacu (com/english-4-b-calpac/">Ravi Ramos Lacerda). He comes from a family of peasants, who grows sugarcane for a living.Pacu's oldest brother had just been murdered at the beginning of the movie. The setting was miserable, to say the least. The opening of the movie only matched this misery in the setting by showing a gory sight of a blood-stained shirt. The shirt belonged to Pacu's oldest brother, who was then the latest victim in their family's feud with the Ferreiras family. The two families had been warring over land and territ orial issues. Tradition dictates that the Breves family should avenge the death of their family member, but not long before the stain has turned from red to yellow.â€Å"When the blood on the shirt turns yellow, someone will die,† Pacu narrated further. The surviving eldest son of the Breves family, Tonio (Rodrigo Santaro), did what he had to do, according to their tradition — he killed the eldest son of the Ferreiras family. Tonio felt that the vicious cycle of killing and revenge, disguising as a noble tradition, had to end; but he felt powerless to end it, so he allowed it to continue by killing the eldest son in the other family. As a result, he was next in line to be killed.But the charming and much too adorable boy, Pacu, had a way of keeping Tonio alive. Pacu died for Tonio. He knew at a tender age that sacrifice, an act of love, was the key to end the vicious cycle that their family was caught in. In relation to Brazilian notions of ethnicity, the deep set often mysterious-looking eyes of the Breves brothers were captivating. Ironically, the softness of their looks couldn't match with the ferocious tradition they keep. The film is a story about a strong family bond, so strong in fact, that one had to be prepared to die in revenge of the other.Moreover, one was willing to die to let the other live and move on. The photography and sequence of shots in the movie are absolute astounding and even poetic in nature. It seemed that every beat of its music matched with every frame in the screen with grace and much respect to art. Their clothing was not far from imaginable, the family bonding was very plausible, considering how tight family bonding was (still is) in Brazil. If it were a movie set in this time and age, it wouldn’t have been plausible, with all the killings.But it was in 1910, when a lot of things, like respect for life, have yet to be discovered. Certainly, the work of art from the sounds to the overall direction and cinematog raphy helped in establishing the depth and heaviness of the movie. Truth be told, Hollywood cannot create movie that is as profound as this without resorting to much gimmickry. What Behind the Sun producers did that Hollywood won’t dare to try is to simply tell a tragic story in the most poetic way possible. It was a wonderful movie, overall. It was heavy in the mind, and it certainly will not be easy to forget.

How Attitude Roles in Decision Making Essay

Before I can talk about the play role between attitude and buying decision process, let’s look at the definition of attitude first. Attitude is a relationship link between feeling and believes or a consumer’s thoughts and the response action. We can say that attitude is something that is in the people’s mind and the thought of a consumer’s openness towards the information received by each individual. The information received can be both positive and negative. As we can all see that attitude comprise of consumer’s thought which has an effect on the feeling and that feeling will express through the consumer’s acting. Now let’s see what it is means by decision making process. It is a process of choosing one or another way from all of the alternatives that a consumer has considered with. Normally, the final decision making would be the best and the most suitable alternative which helps consumer reaches their objective. Attitude is the important internal factor that shapes an individual choice. In addition, there are three factors that will lead to consumer’s behavior, which are predisposing factors, enabling factors and reinforcing factors. Predisposing factors comprise of knowledge, beliefs, values, cultures and, of course, attitude, which I will focus on. Moreover, attitude can be form by many ways. It may be through the learning process, the ability to distinguish the differences (which one is good or bad), imitate from others and experienced for each individual. These three factors influence a consumer’s behavior and it also effect the decision making of that particular consumer. For example, consumer has experienced that the expensive things always come together with the better quality products. And he believed in what is actually has happened to him in the past, called the cognitive component. So whenever he recognized the problem, like he want to buy a new bag (an opportunity recognition) and try to search for all the alternatives he is willing to buy or interested in, you will find out that all the alternatives are all the brand name bags with the high price. In another situation, a consumer may imitate an attitude of â€Å"being fat means ugly† from friends and society around her. So it may leads to the decision making by she is starting to recognize the problem by thinking that she is too fat and will classify herself as ugly person, called an affective component. Then what she will try to do next is the information search, both internal and external, about how she can reduce her weight and so on. So you can see that an attitude of a consumer, even though it comes from your society around you, can influence an individual’s decision making process easily. The function of attitudes may also role in the decision making process because it helps consumes to cope with their environments. One of the five functional theories of attitudes is social-adjustment function, which is a function occur when a society make an adjustment about something and it leads an individual consumer to develop the attitude toward it. For example, nowadays people are more concerned about the environmental in our society

The Dark Side of the Roaring Twenties - 1310 Words

The Roaring Twenties, most of the things we hear about the twenties are of good, happy times and of advances in technology and medicine. When we picture the twenties, we picture people dancing, listening to jazz and driving Model Ts. Also, in the twenties, the pretty was quite prosperous. But, there was a dark side to the Roaring Twenties. Those years there were some troubling trends and events, which many forget when thinking of that decade; prohibition, organized crime, nativism and the return of the Ku Klux Klan. Ironically, the twenties are often thought of as a time with careless drinking, when actually, it was illegal in that decade to sell or consume alcohol. On January 16th, 1920, the Eighteenth Amendment went into effect. A ban†¦show more content†¦People then began to find the cost of prohibition too high and most did not see drinking, at least in moderation, as sinful. Prohibition finally ended in 1933 with the Twenty-first Amendment. Another issue that arose in t he twenties was nativism. During the late nineteenth and early twentieth centuries, immigrants were welcomed into the United States because the country was growing and industrializing. Due to this, laborers were needed. Also, the United States was always proud of being a refuge for people fleeing hardship or mistreatment in their own countries, or looking for new opportunities for themselves and their children. Before 1890, most of the immigrants had come from the same countries as those who first settled in America. So they typically shared the same values as the original settlers. In the beginning of the twentieth century, most of the immigrants came from southern and eastern European countries. Some also came from Puerto Rico, the West Indies and Mexico. In contrast to the Protestant majority, these newer immigrants tended to be Catholics or Jews, and had different morals and values. By World War I, immigrants were pouring into the United States, and the majority of those immigra nts were of this new variety. This alarmed the citizens on the United States. They felt their ways of life were threatened by the ways and beliefs of the newcomers. It was not just that the immigrants were economic competitors, or that theirShow MoreRelatedThe Great Gatsby By F. Scott Fitzgerald1356 Words   |  6 Pagestragic story of the roaring twenties, he demonstrates different aspects of the 20s metaphorically through his main characters including Nick Carraway, Tom and Daisy Buchanan, Jay Gatsby, George and Myrtle Wilson, and Jordan Baker. He relates each person to different aspects to further their personal characterization and give them motives to each of the choices they make, resulting in how the book ends. This furthers his development and shows the dark and brutal side of the twenties that is not normallyRead MoreCharacteristics Of The American Dream In The Great Gatsby1615 Words   |  7 Pagessaid in his novel Haunted,Thats the American Dream: to make your life into something you can sell. In the novel The Great Gatsby by F. Scott Fitzgerald, the protagonist is a man named Gatsby who is accustomed to the party lifestyle of the Roaring Twenties. The novel follows a group of people living in a fictional town known as West Egg and East Egg.The two towns represent old money and new money. Jay Gatsby overcomes his poor upbringing and earns an enormous amount of money only to be rejectedRead MoreEssay on The Roaring Twenties1209 Words   |  5 PagesThe Roaring Twenties Do you ever find yourself wondering why the 1920s were called the Roaring Twenties? The Roaring Twenties was a celebration of youth and culture. During the 1920s, many different forms of art, music, and literature began. There were many changes that took place in the 1920s, and many people were influenced by these changes. The Roaring Twenties was a constant party because America was celebrating the victory of World War I. Many customs and values changed in the UnitedRead MorePublished In Examinerlike Gestalt Therapy Which Was Introduced1618 Words   |  7 Pageschapters twenty seven and twenty eight of America, A Narrative History by Tindall and Shi. I will discuss Normalcy and the Great Depression while exploring the contradictions of the Roaring Twenties and the Jazz Age during the conservative Presidencies of Harding, Coolidge and Hoover. The decade of the twenties went from an economic boom defined by the Roaring Twenties to financial disaster of the Great Depression. Each of these Presidents was involved in the transitions found during the twenties. WetherRead MoreHow Is The Great Gatsby Film Analysis Of The Movie1055 Words   |  5 PagesThe Great Gatsby: Film Analysis The movie The Great Gatsby is set during the roaring twenties in Manhattan New York City. Where the young protagonist Nick Carraway (Tobey Maguire) is narrating his life story when he moved to New York. He introduces a young playboy millionaire by the name of Jay Gatsby (Leonardo DiCaprio) and his obsessive love for Daisy Buchanan (Carey Milligan). This movie is the most recent adaptation of F. Scott Fitzgerald classic American novel, directed by Baz Luhrmann who doesRead MoreThe Roaring Twenties : The Causes And Impacts Of The 1920s1363 Words   |  6 PagesThe Roaring Twenties The 1920s influenced the world as we know it today. Many important historical events that occurred during this decade, such as the stock market crash and prohibition, altered U.S history and world history intensely. The fashion and hairstyles of the 1920s made an impression on fashion and hairstyles of the 21st century. One of the most familiar symbol of the 1920s is the flapper. Entertainment was also changing; movies became extremely popular during this era. The 1920s wasRead MoreThe Role of Food in The Great Gatsby and The Grapes of Wrath Essay837 Words   |  4 Pagesbackground in The Great Gatsby. For instance, chapter three of The Great Gatsby describes â€Å"buffet tables, garnished with glistening hors-d’oeuvre, spiced baked hams crowded against salads of harlequin designs and pastry pigs and turkeys bewitched to a dark gold† (Thomas, 2010). Here, Gatsby’s ostentatious display merely offers a descriptive backdrop for the story. They do not eat it. Inste ad, its presence simply provides a conspicuous display of wealth. Quite the opposite is true in The Grapes of WrathRead MoreThe Role of Women in The 1920s Essay1497 Words   |  6 Pagesstates still refused to give in, but this didn’t stop the National American Woman Suffrage Association. In 1916, Carrie Chapman Catt, president of the NAWSA, worked vigorously to get women’s organizations from all over the country together and fight side by side. â€Å"One group of activists, led by Alice Paul and her National Woman’s Party, lobbied for full quality for women under the law† (Divine). She used mass marches and hunger strikes as strategies, but she was eventually forced to resign because ofRead MoreThe Influence of the Jazz Age911 Words   |  4 Pageswhite upper class Americans loved it too. â€Å"At the end of the first World War 1 many more possibilities existed for women in the work force, in their social lives especially in the entertainment indus try. (boundless par.3) The average women/in the roaring twenties began to have many more possibilities than ever before with their career life. Especially black women who sang. But even though their talent was strong they weren’t recognized as they should have been until the 30’s and 40’s. The 1920’s was supposedlyRead MoreThe New Women Of The Great Gatsby By F. Scott Fitzgerald1230 Words   |  5 Pageswere making breakthroughs in society that were unheard of. The 1920’s was a time for women reinvent themselves, and this was portrayed by the female characters in the novel, The Great Gatsby, by F. Scott Fitzgerald. During the time of the â€Å"Roaring Twenties,† there were a lot of technological advances as well as more career opportunities for women. In her article, â€Å"A New Women,† Louise Benner explains about how vacuum cleaners, irons, and washing machines were the most popular devices, and how they

Interview Victoria Sanders And Interview - 1511 Words

The professional I selected to interview was Victoria Sanders. I chose to interview this professional because I admire the work she does. I am still not sure what I want to do with my MFC when I obtain it, but for now I would like to work with children victims of abuse and families. I want to help children with their trauma and help them grow in a positive manner. Children are the future generation therefore they need all the support and understanding they can get. I gain a sense of happiness and fulfillment when I work with children. I have previous experience working with children and I enjoyed every opportunity. Children are fun, happy and love to play. I wouldn’t mind having a career where all I do is play. In the beginning I want to focus on that population and then explore out. One of my overall goals is to own my own practice and give back to the community. I met Victoria Sanders this school semester she is my professor for one of my counseling classes. The course is held Thursday nights 7pm-9pm and she is always full of energy. I have grown to admire Mrs. Sanders and the work she provides to the community. One can see how passionate she is about her work through the form she expressed herself and how she glows when she is teaching to her students. Mrs. Sanders is a great example of someone who I share the same interest. Although not having much experience she took on the challenge to open up her own business, in my opinion that is admirable. Some of theShow MoreRelatedRebranding for Kfc1539 Words   |  7 PagesHistory of Kentucky Fried Chicken: In 1930 Harland sanders opened a small restaurant called â€Å"Sanders court and Cafe†. In 1936 was made honorary Kentucky Colonel in recognition of his contribution to the state’s cuisine. In 1940 the secret recipe of 11 herbs and spices were born. In 1957 Kentucky fried Chicken used to be sold in buckets. In1966 The Kentucky Fried Chicken Corporation goes public. In 2002 the tricon global Restaurant Inc which owned KFC changed its name to YUM! Brands.INC InRead MoreEuthanasi The Controversial Issue Of Euthanasia1650 Words   |  7 Pageslegalisation of AS. However, within the process of legalising VE in Australia some ethical issues may arise. Opponents of euthanasia, especially the religious groups, find that voluntary euthanasia lacks ethics, not respecting the sanctity of human life. (Sanders, K Chaloner, C, 2007) Medical experts also face this dilemma, ending a patient’s life directly or indirectly, morally wrong. The Doctrine of Double Effect (DDE) is where a person carries out an act, while foreseeing the negative consequences. (BoninRead MorePresidential Election : President Of The United States1504 Words   |  7 PagesVictoria Zayas English 071 Jon E. Stern July 6, 2016 2016 PRESIDENTIAL ARGUMENT When it comes to the topic of the 2016 presidential election most of us will readily agree that the decision on who is to become the President of the United States of America is a difficult choice. Where this agreement usually ends, however, is on the question of who is a better fit for Presidency. WhileRead MoreA Religious Organization1509 Words   |  7 Pagesthe most are the after school programs, the music programs offered at schools, even food shelters to help out struggling families. Wal-Mart is helping out more than the Mormon Church does, and the Mormon Church is not taxed. A stated in Newsweek by Victoria Bekiempis: Church of Jesus Christ of Latter-day Saints, of which Cragun is formerly a member, only gave .7 percent of its annual income to charity between 1985 and 2008. Wal-Mart, on the other hand, gives about $1.75 billion in food aid to charitiesRead MoreUnderstanding Healthcare3421 Words   |  14 Pagesis clear that organizations which manage to reduce employees occupational stress, would promote their employees well-being. KEEGEL, T., OSTRY, A. LAMONTAGNE, A. D. 2009. Job Strain Exposures vs. Stress-Related Workers Compensation Claims in Victoria, Australia: Developing a Public Health Response to Job Stress. Journal of Public Health Policy, 30, 17-39. DANIELS, K. 2004. Perceived risk from occupational stress: a survey of 15 European countries. Occupational Environmental Medicine, 61, 467-470Read MoreHuman Resources Management150900 Words   |  604 Pages Operational Role of HR Management Operational activities are tactical in nature. Compliance with equal employment opportunity and other laws must be ensured, employment applications must be processed, current openings must be filled through interviews, supervisors must be trained, safety problems must be resolved, and wages and salaries must be administered. In short, a wide variety of the efforts performed typically are associated with coordinating the management of HR activities with the actionsRead MoreFactors Related to Students Performance in Nat13438 Words   |  54 Pagesreading surveyed on and database documents which are significant research materials in this study. The purpose is shown that the content of the subject matter in this study are supported by the authorities. Local Related Literature From the interview of Bulatlat Magazine dated June 2006 to the Chairman of Alliance of Concerned Teachers (ACT), Mr. Jerry Tinio said that public school students do poorly in diagnostic and achievement tests. Last June 2002, the overall performance score of Grade IVRead MoreAlternative Dispute Resolution Mechanism21967 Words   |  88 PagesAdvisory, Conciliation and Arbitration Service (ACAS) was set up in 1974 to deal with industrial disputes, and at the end of the 1980s commercial mediation services became available, corresponding to the Lord Chancellor’s statement in a television interview, â€Å"Mediation and other methods of resolving disputes earlier, without going to court, produce satisfactory results to both sides are, I think, very much to be encouraged† (Acland, 1990). The ADR movement has been gaining popularity, and a movementRead MoreGuidelines, Policies And Procedures Within Ownu.k Home Nation Affecting The Safeguarding Of Children And Young Peopl e10852 Words   |  44 Pagesstipulates that every child should be healthy, stay safe, enjoy and achieve, make positive contributions and achieve economic well-being. These guidelines led to the 2004 Children Act as a direct result of the Laming Report following the death of Victoria Climbie. This report criticised the way in which the case was handled and made over 100 recommendations to overhaul child protection throughout the UK the main points of which included that there should be a much closer working relationship betweenRead MoreThe Effects of Advertising on Children33281 Words   |  134 PagesMelbourne Central Tower 360 Elizabeth Street, Melbourne PO Box 13112 Law Courts Melbourne Vic 8010 Tel: 03 9963 6800 Fax: 03 9963 6899 TTY: 03 9963 6948 Sydney Central Office Level 15, Tower 1 Darling Park 201 Sussex Street, Sydney PO Box Q500 Queen Victoria Building NSW 1230 Tel: 02 9334 7700, 1800 226 667 Fax: 02 9334 7799 Australian Communications and Media Authority ii Contents PREFACE.....................................................................................................

The Reality Of Reality Tv Essay - 1919 Words

This particular episode of Dancing with the Stars was scheduled on a Sunday, 7-8:35pm, TV3. As stated by Horrocks (2004), this time is during the prime viewing time, with substantial numbers of audience members watching television. According to Creeber (2008) the genre of reality TV is typically shaped by the weekend program, followed by results and elimination – hence, Dancing with the Stars has performances on Sunday and results of voting of Monday. As shown by Throng (2015), this episode, screened July 12, had 346,930 people watching with a potential audience share of 8.3% of total viewers watching TV at that time, which can be compared to the competition on other stations (Neilsen, 2015; Throng, 2015). TV One screened Sunday at 7-8pm (442, 700 viewers, 10.5% share of the total audience) followed by House Hunt 8-8:30pm (302,820 viewers, 7.2% share of the total TV audience) (Neilsen, 2015; Throng, 2015). TV One is aimed at older audiences, thus, viewers older than the key d emographic of Dancing with the Stars would most likely have watched TV One during this time. TV2 however, was in direct competition with TV3 during this time as it had a similar reality TV talent show screening – The Voice Australia (Neilsen, 2015). This show is aimed at a slightly younger demographic due to the target audience of TV2 being younger, however, because of the time slot and genre it is in competition with Dancing with the Stars (Neilsen, 2015). However, The Voice Australia, had only 188,450Show MoreRelatedThe Reality Of Reality Tv951 Words   |  4 Pages Reality TV and You Television shows were created to entertain the public and soon generalized shows became a bore. Reality TV shows are widely varied but are similarly based on the lives of non-fictional characters that brings out their daily challenges and achievements. This genre of TV programs gives a huge impact to its audience of, mostly, twelve to nineteen year olds. Critics and bloggers heavily criticize the negative teachings of Reality TV and indirectly force viewersRead MoreThe Reality Of Reality Tv Essay1601 Words   |  7 Pagesreasons. Reality TV is a common source of entertainment on various channels and media outlets. The purpose of reality TV is to â€Å"promise more drama, suspense, and laughter while pushing the envelope of what is morally and socially acceptable, funny, and, of course entertaining† (Glouner et al.). This type of media allows real people to connect to those on TV. Reality is not completely real, there are aspects of it that are scripted, rehearsed and complet ely altered (Crouch). Reality TV has existedRead MoreThe Reality Of Reality Tv908 Words   |  4 PagesToday’s audience grabs hold of reality TV now a day. Looking forward week to week to watch these unscripted real life situation shows. In a way it s becoming increasingly hard to avoid not watching. Some viewers see the TV show and tend to be attention seekers, and reality TV allows them to fantasize about achieving status through instant fame. Too much reality TV may lead viewers to idealize real world situations, like romanticizing dating. Like when Truman saw the girl in the library who was anRead MoreThe Reality Of Reality Tv991 Words   |  4 PagesI truly believe that reality TV needs a different name. At first reality TV was created with the aim to depict reality, but over time different interests and actions have resulted in doing the opposite of this. I would even go so far to say that reality TV has become just as fictional as fiction based television. â€Å"Reality† is defined as â€Å"the world or the state of things as they actually exist, as opposed to an idealistic or notional idea of them†. However, Reality TV in no way represents this definitionRead MoreThe Reality Of Reality Tv Essay2065 Words   |  9 Pagesis also generally known that children can be easily influenced by what they see on television. Reality TV is no exception to this rule. It may appear that reality TV is a benign phenomenon but it is in fact a virus that has quickly diseased our society. More specifically, it attracts girls most mercilessly by affecting them negatively as to how they perceive themselves. Indeed, girls who watch reality TV learn that deceit and meanness is normal behaviour in order to achieve success, begin to self-objectifyRead MoreReality Tv1014 Words   |  5 PagesReality TV Blake Brandt Reality TV has unseen effects and is detrimental to society. Reality TV is the current trend on TV that has brought back the buzz to television, but it also has unforeseen effects on its viewers. Some examples of Reality TV shows include: American Idol, The Bachelorette, Americas next top model, fear factor, etc...These shows range from singing talents, overcome their fears, to looks and beauty. Reality TV brings drama and voyeurism to its viewers by making its viewersRead MoreReality Tv1076 Words   |  5 Pagesmedia, reality TV stars like Snooki and Kim Kardashian are on the rise. Most channels on television have at least one reality show, from following housewives to remodeling homes of real life families. However, there are some reality programs that display bad examples, especially for young audiences that are keeping up with each episode. On MTV people see girls being drunk in public, addicts doing drugs, and young girls raising babies at young ages; these are situations seen on reality TV shows. JeremyRead MoreReality Tv869 Words   |  4 PagesRUNNING HEAD: Reality Television, why? Reality Television, why do we watch these shows? Norma Gallegos ENGL122 Allorah Wyman Feb 4, 2013 Reality Television As a child growing up watching televisionRead MoreReality Tv1784 Words   |  8 Pagesthing they do is turn on the television set. According to a survey done by Emory H. Woodard and Natalia Grindina, â€Å"on average, people are watching over 51 hours of television- that is five hours a day of TV on average for the last quarter of the year. Teenagers (12 to 17) spend 103 hours watching TV a month, whereas senior citizens (65 or older) spend 207 hours†(Media in the home) With the slumping economy, people are forced to stay at home to conserve resources. Although there are plenty of economicalRead More Reality TV Essay1074 Words   |  5 Pages Reality TV: The Rise of a New Show â€Å"The Contender† nbsp;nbsp;nbsp;nbsp;nbsp;One of the newest shows to hit the vast majority of reality TV shows that already exist is The Contender. The Contender is a show that focuses on all the hardships, training, pain, and dilemmas that a boxer, who is preparing to fight, must endure. The Contender will be a very successful show, because it has the attributes of raw emotion that can’t be found when a director is yelling ‘action,’ and ‘cut.’ By raw emotion

Timing of Noninvasive Ventilation Failure

Question: Discuss about the Timing of Noninvasive Ventilation Failure. Answer: Introduction: Mucociliary clearance system is a very important lung defence mechanism it is made up of mucus, periciliary layers and ciliary epithelium and cough clearance mechanism. In a healthy person, the cilia beat at perfect frequency hence propelling mucus up the airway (McIlwaine et al., 2017). Disease such as chronic obstructive pulmonary disease cause the impairment of the mucociliary system, this is due to one or more condition such as dehydration of the periciliary, lack of lubricant activity and defective cilia (Bashir et al., 2016). Leading to ineffective airway clearance. Diffusion is the process that enables the exchange of gas between the alveoli and the pulmonary capillaries, the concentration difference between the oxygen and carbon dioxide gases should always be maintained by ventilation and perfusion. Conditions such as pneumonia and acute respiratory distress can cause the collapse of alveoli and as a result stopping alveoli ventilation leading to gas exchange impairment as suggested by Ozyilmaz, Ugurlu, and Nava (2014). Risk of impaired ventilation Probable causes to impaired ventilation could be associated with weak cough reflex and excessive secretion as experienced by the patient as suggested by (Nicolini et al., 2014). However, the risk factors for the early impairment can be due to hypoxemic respiratory failure at the same time poor arterial blood gas is considered as a major cause (Ozyilmaz, Ugurlu, and Nava, 2014). It is caused by intake of an insufficient nutrient that cant meet the bodys metabolic demands. In such cases, the caring nurse should be able to understand the nutritional requirement of the patient and develop a dietary regime in consultation with a nutritionist. A diet rich in protein and carbohydrate is always preferred according to (Reeves, Tran, and Collins, 2016). This problem can be caused by conditions that create a promising environment that enables the disease to develop and thrive such conditions include compromised primary body defence system due to damage caused on the mucociliary system and lack of proper blood circulation due to tissue damage on the alveoli capillaries. Nursing problem: Imbalanced nutrition: less than body requirements (Anker and Larsson, 2016). Underlying cause or reason: Poor dietary management, Lack of proper feeding (Sehgal, Dhooria, and Agarwal, 2017). Goal of care Nursing interventions Rationale Indicators your plan is working Improved diet intake to meet caloric need Boosting immune Give frequent oral care and Remove expectorated secretions Avoid giving patient very hot or very cold foods. Unpleasant smell can be deterrent to appetite. Can cause nausea and vomiting Extremes temperature can aggravate coughing spasms Improved appetite Increased body weight Absence of coughs when eating Nursing problem: Risk of infection Underlying cause or reason: Not washing hands and not handling sterile equipment aseptically Goal of care Nursing interventions Rationale Indicators your plan is working Prevent hospital- acquired infections Prevent reinfection Keep the patient clean to prevent more infections Maintain asepsis for dressing changes and wound care. peripheral IV management, and catheter care and handling. Teach patient hand washing techniques. Reduced chances of transmitting or spreading pathogens. Interrupting the transmission of infection along the chain of infection is an effective way to prevent infection. Reduced cases of opportunistic infection. Reduced cases of hospital acquired infections. Nursing problem: Ineffective airway clearance Underlying cause or reason: Infection, allergy Goal of care Nursing interventions Rationale Indicators your plan is working Increased Patient air exchange. Patient will classify methods to enhance secretion removal. Keep patient safe from complications Patient to be taught how to cough Use well lubricated soft catheters Coughing help patient remove most secretions reduces irritation and prevents trauma to mucous membranes. Smooth cough and more secretion removed Ruduced irritation Nursing problem: Risk of impaired ventilation Underlying cause or reason: freezing temperatures Goal of care Nursing interventions Rationale Indicators your plan is working Keep patient warm To improve patient breathing Advice patient to put on warm clothing during winter. Advice the patient to warm the room during winter blood vessels and breathing airways contract in chilly air. Helps in keeping the environment around the patient warm No Shivering No breathing problems Nursing problem: Dehydration Underlying cause or reason: lack of water in the body for proper physiology (Ghosh et al., 2015) Goal of care Nursing interventions Rationale Indicators your plan is working Hydration of the patient Administering I.V fluids to the patient Teach the patient about the importance of taking more water Advice patient to take fruits that are watery such as watermelon I.V fluids helps the body to improve electrolyte balance Improved blood circulation No dryness of mouth No dizziness Treatment of COPD Oral Prednisone prescribed to the patient is a type of corticosteroid which helps in reducing the symptoms of COPD by reducing inflammation along the walls of the lung (Kruis et al., 2014). This drug is also prescribed to the patient to prevent acute exacerbation (McCarthy et al., 2015). The use of oral prednisone combined with other therapies is highly beneficial to patients with an acute exacerbation of COPD, there was clinically significant improvement among the hospitalized COPD patient who were treated using oral prednisone combined with other therapies according especially patients with hypercapnia and those without (Keen et al., 2017). However, oral prednisone should be avoided as it is considered to carry risks such as muscles wasting hence should be avoided as part of primary care as recommended by Keen and Medarov (2017). Due to the side effects caused by administering oral prednisone to the COPD patient is the responsibility of the nurse to adequately inform the patient ab out the potential side effect as well as the benefits the side effects should be monitored and nurse intervention needed where necessary to minimize them (Kruis et al., 2014). An acute respiratory deterioration of among the patients suffering from COPD can be as a result of other conditions such caused by bacterial infections among them pneumonia and venous thromboembolism among others. According to a randomized control study conducted by Janson et al. (2013), the risk of infection from pneumococcal was high among the COPD patients the findings are supported by (Sethi et al., 2016). Neville the patient is also at elevated risk of contracting pneumonia. Therefore, amoxicillin is recommended as part of the treatment regime (Jaiswal et al., 216). It is the responsibility of the nurse to take note of Mr. Neville history regarding the use of antibiotic. This information will enable the nurse to advise on the use of amoxicillin as prescribed. Ipratropium bromide is a type of anticholinergic that act by blocking muscarinic receptors, as a result it causes bronchodilation (Jarenbck et al., 2016). The dominant reversible airway obstruction activities have been associated with the parasympathetic cholinergic activity (Keen and Medarov, 2017). The drug protects the airways by preventing bronchospasm and it also prevents the increased production of mucus. According to (Afonso et al., 2011), there was an improved function in peripheral airway through increased airflow, reduced air trapping and reduction in the degree of alveoli hypoventilation after administering an anticholinergic drug such as Ipratropium bromide. Neville expressed symptoms such as shortness of breath on exertion and increased production of purulent sputum. Therefore, the doctors needed to prescribe bronchodilator such as Ipratropium bromide to help the patient have smooth breathing and reduced mucus production. It is the responsibility of the nurse to monitor and intervene whenever any side effect occurs to the patient. Such side effect to be watched by nurse include dry mouth, cough, and urinary retention. Signs of deterioration of COPD Early identification of indicators suggesting deteriorating patient condition contribute immensely towards reducing mortality, avoidable morbidity, the length of stay and associated healthcare costs to the patient (Ninane et al., 2017). Therefore, there is a need for the nurse to inform the patient about the benefits of reporting such signs immediately after they appear. Psychological changes witnessed in COPD patient should be considered as one of the indicators of worsening of COPD patient. According to (Doyle et al., 2014), deterioration in mood, increase level of fear are some of the indicators that the patient need further review by a doctor. The researcher recommended the use of hospital anxiety and depression scale to be used to assess the patients condition. According to (Bratas et al., 2010), pulmonary rehabilitation has shown to improve the depression among COPD patients. It is therefore, important for the patient to be well informed about such signs so that he will be able to report them immediately to the nurse. Severe pain in the chest of a patient can be another indicator for a deterioration of COPD, this can be attributed to damage done on the lungs caused by the persistent bacterial infection like pneumonia which is nonresponsive to the antibiotics. Identifying this early sign in the case of patient Neville will help the doctor in reviewing the treatment regime to enhance the healing process. Presence of constant wheezing during sleep this is an indicator that there is continues airway obstruction caused by the mucus within the airways. This can cause air trapping and lack of proper breathing. Fatigue can be also related to nutrient imbalance. When such is reported, a dietary regime can then be developed depending on his current situation to help manage nutrient imbalance. He could be suffering from respiratory acidosis. I would perform chest physiotherapy to promote adequate ventilation and maintain an airway to the patient, Suction can be carried out to clear the airway. I would also administer theophylline combined with salbutamol to further maintain and prevent narrowing of the airway, I.V fluids may also be administered to correct patients dehydration. I am Nurse Kimberly Registered Nurse for Mr. Neville. Neville is a 62-year-old man with established chronic obstructive pulmonary disease and has a long history of smoking. He has not completely refrained from smoking but he has reduced to 10 cigarettes per day. He was admitted three days ago with worsening dyspnoea, cough and increased purulent sputum. In the last one day, he has developed further deteriorating signs of COPD including depression, fatigue, tachycardia and slightly elevated blood pressure. He has been treated for nasal prong oxygen @ 2l/min to maintain oxygen saturation 88-92%, he has been on high protein and carbohydrate diet. The patient has been treated with ipratropium bromide and salbutamol nebulizers, oral prednisone, oral amoxicillin, prn paracetamol and coloxyl. In the last one day, he developed more complication after being nebulized with a prn salbutamol, he was restless, anxious, plucking randomly at his bed linen, dyspnoeic, flashed skin and diaphoretic. H e further presented with more complication his oxygen saturation was 98%, elevated heart rate of 110 beats /minute, with his respiratory rate dropping to 8-10 breathes/minute. I have suspected respiratory acidosis. Therefore, in response I have put the patient on oxygen controlled concentration using venturi mask, administered oral theophylline at the same time, chest percussion and chest vibration have been performed on the patient. It was also necessary to perform suctioning to the patient to clear the airway. The patient was also put on 2L/day of I.V fluid. The use of amoxicillin was continued. I would recommend the following: Continuously asses his respiratory status; monitor the vital signs frequently; monitor his neurologic status; maintain accurate fluid intake; carry out acid blood gas analysis; request for laboratory analysis of serum electrolytes. Reference Afonso, A. S., Verhamme, K., Stricker, B. H., Sturkenboom, M. C., Brusselle, G. G. (2011). Inhaled anticholinergic drugs and risk of acute urinary retention.BJU international,107(8), 1265-1272. Akner, G., Larsson, K. (2016). Undernutrition state in patients with chronic obstructive pulmonary disease. A critical appraisal on diagnostics and treatment.Respiratory Medicine,117, 81-91. Bashir, S., Muzamil, J., Guru, F. R., Mohsin, N., Nabi, F., Kanwar, M. S. (2016). Patterns of infections in chronic obstructive pulmonary disease exacerbations and its outcome in high dependency area, intensive care setting in a tertiary care hospital.Community Acquired Infection,3(3), 77. Bhattacharya, A., Bhargava, S., Singh, V., Talwar, D., Whig, J., Rebello, J., ... Gogtay, J. (2016). Efficacy and safety of ipratropium bromide/salbutamol sulphate administered in a hydrofluoroalkane metered-dose inhaler for the treatment of COPD.International Journal of Chronic Obstructive Pulmonary Disease,11, 1469. Ghosh, A., Boucher, R. C., Tarran, R. (2015). Airway Hydration and COPD.Cellular and Molecular Life Sciences: CMLS,72(19), 36373652. Jaiswal, A., Chichra, A., Nguyen, V. Q., Gadiraju, T. V., Le Jemtel, T. H. (2016). Challenges in the Management of Patients with Chronic Obstructive Pulmonary Disease and Heart Failure with Reduced Ejection Fraction.Current heart failure reports,13(1), 30-36. Jarenbck, L., Eriksson, G., Peterson, S., Ankerst, J., Bjermer, L., Tufvesson, E. (2016). Bronchodilator response of advanced lung function parameters depending on COPD severity.International Journal of Chronic Obstructive Pulmonary Disease,11, 2939. Keen, C., Medarov, B. I. (2017). Current strategies in chronic obstructive pulmonary disease management.Journal of Public Health and Emergency,1(2). Kruis, A. L., Boland, M. R., Assendelft, W. J., Gussekloo, J., Tsiachristas, A., Stijnen, T., ... Chavannes, N. H. (2014). Effectiveness of integrated disease management for primary care COPD patients: results of a cluster randomised trial.The Effectiveness of Integrated Disease Management in COPD Patients,349, 189. McCarthy, B., Casey, D., Devane, D., Murphy, K., Murphy, E., Lacasse, Y. (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease.The Cochrane Library. McIlwaine, M., Bradley, J., Elborn, J. S., Moran, F. (2017). Personalising airway clearance in chronic lung disease.European Respiratory Review,26(143), 160086. Nicolini, A., Ferrera, L., Santo, M., Ferrari-Bravo, M., Del Forno, M., Sclif, F. (2014). Noninvasive ventilation for hypercapnic exacerbation of chronic obstructive pulmonary disease: factors related to noninvasive ventilation failure.Pol Arch Med Wewn,124(10), 525-31. Ozyilmaz, E., Ugurlu, A. O., Nava, S. (2014). Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies.BMC pulmonary medicine,14(1), 19. Reeves, A., Tran, K., Collins, P. (2016). Nutrition During Noninvasive Ventilation: Clinical Determinants and Key Practical Recommendations. InNoninvasive Mechanical Ventilation(pp. 203-207). Springer International Publishing. Sehgal, I. S., Dhooria, S., Agarwal, R. (2017). Chronic obstructive pulmonary disease and malnutrition in developing countries.Current opinion in pulmonary medicine,23(2), 139-148. Sethi, S., Anzueto, A., Miravitlles, M., Arvis, P., Alder, J., Haverstock, D., ... Wilson, R. (2016). Determinants of bacteriological outcomes in exacerbations of chronic obstructive pulmonary disease.Infection,44(1), 65-76.

Sonnet 29 Essays - Sonnet 1, Sonnet 29, Sonnet 20,

Sonnet 29 Despite popular belief, William Shakespeare was considered a great poet before a great playwright. He accomplished writing at least 154 sonnets and other poems of love. In this paper, I will analyze one of his greatest sonnets. One of the most famous of his sonnets is number XXIX. This sonnet is one long sentence, but it still follows the usual Shakespearean pattern of three quatrains (four line sections) and a couplet. It also follows the traditional rhyme scheme for Shakespearian sonnets: ababcdcdefefgg. The first quatrain tells how the narrator is feeling. From reading these four lines, you sense his loneliness and sense of abandonment by fate, G-d, love, and other men. I believe the key line in this quatrain is line 3 (When, in disgrace with fortune and men's eyes,). Here I feel Shakespeare is saying that this person who is very depressed, is crying out for help to others, but he is such an outcast that not even "deaf heaven," meaning God and the angels of heaven or listening to his cries. The second quatrain starts off with a line that shows the narrator wishes to be more optimistic. He realizes that in order to achieve his goals, he must believe in himself first and stop being so depressed. The second half of the quatrain shows he is envious of other men's possessions and riches when he says, "Desiring this man's art and that man's scope, With what I most enjoy contented least." Moving into the third quatrain, you see that the speaker begins to reflect on himself and starts to compare himself with his friends. You know this when "Haply I think on thee, and then my state," is said. Just as you start to think the speaker is going back into a state of self-pity, you realize the speaker's inspired sprits are rising like "the lark at break of day". Sonnet XXIX ends with a couplet that has an uplifting message. One the speaker remembers the love of his friend and what great things he has, it makes him happy with his life. So happy he wouldn't even consider swapping his place with a king.