The marketing plan Research Paper Example | Topics and Well Written Essays - 1000 words

The marketing plan - Research Paper Example It is also in competition with companies the develop applications especially mobile applications which imitate distinct capabilities that include sharing of photos as well as messaging and some of Facebook’s competitors include LinkedIn, Google+ and Twitter etc. Facebook has grown to be more valuable than Amazon in terms of the market value with a market capitalization that is in excess of USD 170 billion compared to the market capitalization of Amazon that has decreased to below USD 165 billion. From the previous earnings report, the social media company beat revenue estimates and realized more revenue from mobile advertisements which now account for a big percentage of the total advertisement revenue. Almost sixty-five percent of the users on Facebook are older than thirty-five making the average over forty while the users who are less than twenty four years of age make up only fourteen percent of the users. Of the total Facebook users, sixty percent are female and almost fifty seven percent have finished one form of college education or another while less than a quarter have a bachelor’s or a graduate degree. The social presence of Facebook is seen in 137 countries which is more than all other social networks that are in only 127 of these nations. The US has the highest presence on Facebook even though only a half of the population uses the social networking site. India and Brazil are the Facebook markets that are steadily growing (Treadaway and Smith, 2012). Advertisements on the network that target the people on mobile devices have the potential of fetching the network huge revenues and as a result of the plethora of information that is received from the members, it is able to send advertisements that interest the particular users making them have the option of charging more for the advertisements than other companies. The platform that has been developed by Facebook is

Controversy Analysis, fracking, air pollution, gasland Essay

Controversy Analysis, fracking, air pollution, gasland - Essay Example Because of its potential to harm the environment, especially through the pollution of air, making it difficult for both humans and wildlife to survive, is an issues which has been widely discussed (McKenzie et al 80). The potential effects of fracking on the quality of air has led to the decision by the United States government to set up rules whose aim is to ensure that there is a reduction of the pollution of air by those companies which are involved in fracking. Among the first activities which led to the development of public awareness concerning the detrimental effects of fracking was the creation of the documentary film, Gasland. This documentary was an attempt to create awareness, within the American public, of the effects of that attempts made by gas companies to extract natural gas in rural America have on the environment. Fracking means of gas mining done through the injection of chemicals and massive quantities of water at high pressures with the intention of cracking open the rocks deep beneath the surface and as a result releasing the natural gas (Byrne). As is evidenced in the film, while fracking has led to the emergence of the natural gas boom across the United States, there is also proof that this method of gas extraction has led to the contamination of the environment, especially air, which is an essential want for all Americans (Porter). The fact that this film came into prominence is one of the reasons why the American government chose to take steps to ensure that the natural environment is protected against destruction through companies which use fracking in the extraction of natural gas. Gasland has created a new awareness in the public concerning the devastating environmental effects of hydraulic fracturing, which is the main means through which natural gas is extracted in the mainland United States. The film works towards the establishment of means through which these issues concerning the conservation of the American environment can be discussed and viable solutions for the environmental problems caused by these activities by oil and gas companies can be found (â€Å"Gasland†). It can further be said that Gasland deals with the preservation, the development, and the return of the American natural environment to the state in which it was previously. Because of the influence of Gasland, the EPA was pressured to issue final air pollution standards whose main purpose is to ensure that all fracking operations conducted in the country use emission capture technology (â€Å"The Future of Fracking†). While this was the case, however, the EPA gave the gas companies required to implement these new rules what was termed a phase-in period before having to comply. The new regulations that were put in place, were the first of their kind that were aimed at limiting air pollution due to the fracking process (â€Å"Clean Air and Natural Gas†). These regulations have created the requirement that all the operato rs who use this method have to capture natural gas and volatile organic compounds that are produced while the wells are being prepared for the production of gas (â€Å"Senate committee examines EPA rule on air pollution from fracking†). The fracking method, while creating vast potential for natural

Question Conservation of Energy Essay Example for Free

Question Conservation of Energy Essay Missy Diwater, the former platform diver for the Ringling Brothers Circus had a kinetic energy of 15 000 J just prior to hitting the bucket of water. If Missys mass is 50 kg, then what is her speed? Solution: According to energy conservation, the kinetic energy at the bottom of the dive (15,000J) is equal to her gravitational potential energy before the dive. We can use this fact to find her dive height: PE = mgh h = PE/mg = 15,000J / (50kg)(9. 81m/s? ) 31m (rounded) Her speed can also be found from energy conseration: E(final) = E(initial) 0. 5mv? = mgh v = v[2gh] = v[2(9. 81m/s? )(31m) = 25m/s 2. A 750-kg compact car moving at 100 km/hr has approximately 290 000 Joules of kinetic energy. What is the kinetic energy of the same car if it is moving at 50 km/hr? Solution: KE =v^ 2 (Kinetic Energy = speed ^2 If the speed is reduce by a factor of 2 (as in form 100 km/hr) then the KE will reduce by a factor 4. Thus,the new KE = 290 000 J / 4 KE = 72 500 J 3. A cart is loaded with a brick and pulled at constant speed along an inclined plane of an angle of 30o to the height of a seat-top. If the mass of the loaded cart is 3. 0 kg and the inclined distance of the seat top is 0. 45 meters, then what is the potential energy of the loaded cart at the height of the seat-top? Solution : PE = mgh PE = 3 kg x 10 m/s/s x 0. 45m PE = 13. 5 J 4. A 75kg trampoline artist jumps vertically downward from the top of a platform with a speed of 5m/s. How fast is he going as he lands on the trampoline 2m below? If the trampoline behaves like a spring of spring constant 5. 2E104 N/m, how far does he depress it? Soluiton : a) s = 1/2(u+v)t 2. 0m = 0. 5 * 5m/s * t 2. 0m = 10 * t t = 2. 0m/20 t = 0. 1s b) Hookes Law states F=kx x is the displacement of the spring (depression) F = Restoring force k = spring constant Rearrange. x = F/k What is the force upon hitting the trampoline? We have the mass so lets work out the acceleration. Acceleration = velocity/time Acceleration = 5/0. 1 = 50m/s^2 F=ma F = 75*50 = 3750N Substitute into Hookes Law x = 3750/(5. 2*10^4N-m) = 0. 072m of depression

Agricultural Climate Adaptation: Pakistan Wheat Industry

Agricultural Climate Adaptation: Pakistan Wheat Industry Agricultural Climate Adaptation plan:  A Case Study of Pakistan wheat industry Lubna Naz 1.0  Introduction 1.1 Global warming as a result of climate change is projecting higher temperature and unpredicted rainfall pattern coupled with extreme events like flash floods and storm. This never seen before phenomena would be a threat to mankind in all sphere of life if no appropriate actions are taken. As elaborated in the Fourth Assessment Report (AR4) of IPCC (2007), the average temperature of the globe has risen to 0.6 °C between the year 1901 to 2000 and will projected to increase more by 1.8-3.4  °C by the end of this century. 1.2 Agriculture among the various sector of the economy of Pakistan is considered to be the most fragile sector to the unexpected changes in the climate that not only affect the amount of its production and quality but also put pressure on the availability of natural resources needed for the development of agriculture sector. Concurrently, wheat being an important agricultural industry for the economy of Pakistan is not spared from the effects of climate change. As a matter of concern, it is fundamental for all associates of the industry together with policy and decision makers to work out an adaptation strategy on how to overcome the negative impact of climate change and continue to remain a competitive sector. Successful and effective adaptation measures will need both strategic and tactical approach that based on best practices to cope with the adverse effect of climate change. Furthermore, an efficient screening and monitoring will also be needed in order to have better evaluatio n of the adapted practices that whether they are effective in controlling and minimizing the unfortunate impact of climate change. 1.3 The rise in temperature, unpredicted rainfall coupled with the increase intensity of extreme events such as drought and stress all have significant impact on the wheat industry in Pakistan. High Rainfall results in flood, waterlogged condition and hail damage that negatively affect the wheat production. As a consequence, infestation of insect, pest and diseases outbreaks and result in severe damage and in some cases even complete crop loss. Similarly, increase in temperature also negatively affects the yield of the wheat and cause major economic loss in Pakistan. As reported by Rasul et al. (2011) the rise in temperature greatly reduced the wheat yield in Pakistan particularly at sowing time and grain filling period. Furthermore, Rawson and Macpherson (2000) also reported that wheat crop destroyed faster in waterlogged conditions and as a consequence seedlings of wheat die within two days and thus resulted in low yield. Apart from the low yield other identified impact of climate change on wheat industry is decrease in GDP, decrease in foreign exchange, effect policy making, penalties by buyer; for unable to supply the required amount of wheat grains, difficulty in transportation, outspread of insect and pest, affect the livelihood of the farmers and as consequence disturb the economy of the country. Many potential adaption measures such as crop management practices, new varieties, crop rotation and water management are used in wheat industry in Pakistan. However, these practices need to be customized, improve or incorporated in different ways to cope with the adverse effect of climate change. 2.0 Adaptation plan Appropriate adaptation plan is required in the wheat industry to minimize and prevent the damage caused by the adverse effect of climate change and increase the production and yield of the crop. Well planned and early adaptation strategies will not only save cost of production and cultivation techniques but in long term save millions of lives that depend on agriculture sector for their livelihood and employment. The adaptation strategies are needed at all levels of administration like local, regional and national. Therefore the objective of this paper is to set up an adaptation and mitigation plan for wheat industry in Pakistan to eradicate or minimize the challenges caused by high temperature, unpredicted rainfall and extreme weather condition. 2.1 Government involvement Pakistan is signatory to 15 Multilateral Environmental Agreements which is mainly related to climate change, biodiversity and rehabilitation. On the basis of its international commitments, Pakistan established a number of policies, projects and framework to reduce the environmental hazards such as National Disaster management Authority, Global Change Impact Study Centre and Task Force on Climate Change. However, the country is still in the hunt for further international assistance and support (khan et al. 2013). The government of Pakistan together with all the agencies involved should focus on capacity building, circulation of funds and technology, research for agriculture development, institution and framework and therefore, develop effective adaptation strategies and policies to reduce the vulnerability of wheat industry regarding changes in climate. 2.2New breeding program 2.2.1As describe earlier, temperature and rainfall both has devastating effect on wheat grain yield in Pakistan. Successful and productive plant breeding program is needed to be adapted to enhance the production and yield. The temperature is projected to increase in the northern areas of Pakistan coupled with high rainfall, in such area slow maturing cultivars having greater heat requirement should be planted that have positive effect on the photosynthetic activity of wheat. However, the region with the high temperature and decrease rainfall (arid and semi arid plains of Pakistan) the wheat cultivars having early flowering characteristics with wide row spacing should be sown as this will allow grain formation in cooler part of the year (Van Ittersum et al. 2003). Moreover, seed with good crop establishment, early hybrid vigour, responsive to increase in carbon dioxide concentration and ability to retain flower in windy and hot climate is needed to be planted (Richards 2002). Iqbal et al. (2009) also reported that crop varieties resistant to high temperature and of short duration should be planted in order to minimize the adverse impact of high temperature. 2.2.2 High temperature is expected to reduce the risk of frost and increase the grain yield. Therefore, wheat should be sown earlier so that plant can set up the grain formation in the cooler period when there is low risk of frost (Howden et al. 1999). Iqbal et al. (2009) also reported that alternative sowing dates should be used to avoid the adverse impact of high temperature on the crop at the time of sowing or other sensitive growth stages. 2.1.3 The climate change favours the infestation of insect, pest and diseases which lowered the yield of the crop. The best measure is to use integrated pest management strategy and Area Wide Management that is the coordination of the farmers and the policy makers of the entire areas. Furthermore, the use of genetically modified crop resistant to peat and disease should be introduced and cultural practices need to be modified such as mixed cropping and crop rotation to reduce the spread of disease (Stokes Howden 2008).Pakistan Agricultural research and development sector is focusing on all these strategies and development of new varieties of wheat to reduce the risk of climate change. 2.3Crop rotation and management Various crop management practices can be used to reduce the risk of the wheat crop to environmental hazards. Such as in case of heavy rainfall the growers need to adapt the zero tillage practices so as to have greater infiltration. Avoid compaction of the soil by farm, machines, human and livestock traffic (Easterling et al, 2007). However, in poor rainfall areas of Pakistan wide rows and skip row planting should be practiced to increase the yield and stability of the wheat. Hammer et al. (1996) reported that the timing, variety of the crop and rate of fertilizer application should be based on the seasonal rainfall and available soil moisture and nutrient content of the soil. Furthermore, use of modern agriculture technology like laser land levelling and crop diversification should also be included into consideration. 2.4  Milling quality 2.4.1 Wheat grain contain high level of protein content such as durum wheat but increasing level of carbon dioxide in the atmosphere negatively affect protein content and hence reduce its flour quality. However, the reduction depend on the choice of cultivar selected and amount of nitrogen fertiliser applied (Rogers et al, 1998). To maintain the nitrogen content of the wheat grain, increase use of leguminous crop or increase use of nitrogen fertilizer need to be adopted (Hayman and Alston 1999). The growers should continuously monitor the nitrogen content of the paddock and should be well aware of the nitrogen management in the cropping system. Furthermore, nitrogen leaching, poor crop vigour, high rainfall during grain filling all contribute to decrease in protein content of the grain. Appropriate breeding program and effective policies is needed to enhance the quality of the harvest. 2.4.2 During the past 60 years there has been tremendous increase in flour mills in Pakistan. Starting with 19 flour mills, currently, 915 mills are working in Pakistan. It is therefore proposed that instead of having too many flour mills, only few huge mills should be accomplished which will positively affect the economy of the country. 2.5land and Water resource Management 2.5.1 Water is enormously important for agriculture sector of Pakistan and it economy, which depends on the scarce natural resources. The agricultural sector of Pakistan mainly depends on Indus river system (IRS) for 90% of its irrigation (Piracha and Majeed 2011). However, this natural resource is getting scarce with the time and proper water management practices should be reformed under the prevalence of climate change. According to Sayed (2008), the National Water Policy of the country has made a transparent and rational institutional framework policy to meet the demands of the twenty first century. Moreover, the Integrated Water Management Approach is also implemented based that is based on the utilization of both surface and ground water. The author also mentions that reallocation of water at the provincial level by balancing water availability to cropping system is one of the important task of the National Water Policy. Furthermore, according to Iqbal et al. (2009) present irri gation system of Pakistan need be customised to maximise the water use efficiency and appropriate irrigation technology should be used. Furthermore, the author also mentions that alteration in row spacing and the use of drought tolerant varieties need to be used to minimize the loss of water. The construction of small dams and checks on the Indus River and its tributaries would increase storage of water and decrease the severity of floods. 2.5.2  The unpredicted rainfall, rise in temperature and carbon dioxide concentration negative affect the composition of soil. The loss of nutrient such is phosphorus and nitrogen through surface runoff and leaching negatively affect the growth of the wheat. As reported by Hayman and Alston 1999 proper amount of nitrogen fertilizer should be added to the paddock in order to have good crop establishment. Moreover, proper soil management practices should be adopted to minimise the risk of surface runoff and leaching. 2.6  Transport infrastructure Hike in temperature as well as increase intensity and frequency of extreme events such as heavy rain, snowfall and flood have substantial impact on the transport infrastructure of Pakistan and cause severe destruction of railways, roads, shipping and airports. Effective adaptation measures should be taken to increase the resilience of infrastructure and this could be done by two ways. The first one is to construct the new infrastructure according to the magnitude and sensitivity of the particular area to the present and future predicted climate. Secondly the existing infrastructure should be made more resistant to changing climate by retrofitting and continues monitoring and maintenance. 2.7  Seasonal weather forecast As reported by Iqbal et al. (2009) the advance seasonal forecast is one of the best options to take appropriate adaptive measures. Furthermore, Crimp et al. (2006) also elaborated that â€Å"using climate information (seasonal forecast) in conjunction with system analysis producer can significantly reduce various risks†. On the basis of weather forecast, farmers need to adopt different operations. Such as if forecast is about the drier weather the farmers need to apply split application of some of nitrogen fertilizer to ensure good planting, and also maximize no till area. But if the forecast is about wetter season then farmers should sow the wheat earlier and apply fungicide to minimize the effect of leaf disease of wheat (Meinke and Hochman, 2000). 2.8  Disaster risk reduction Unpredicted pattern of monsoon rain and melting of glacier due to rise in temperature increase the level of water in the Indus Delta of Pakistan and subsequently these phenomena result in flooding. Effective strategic plan is required to maintain the continuous and balance water flow in the river and to meet the future demands of the society. As reported by sheikh et al. (2008) expansion of the natural reservoir capacity is needed in order to decrease the risk of flooding and drought and to address the consequent decrease in the river flow after all glacier have been melted. Moreover, the authors also mention that the reservoir should also be expanded in order provide the minimum water flow to the sea to prevent the intrusion of the water into the Indus delta region and to meet the future needs of the water. 2.9  Economy and Financial institution 2.9.1 As stated earlier, Pakistan economy largely depends on agriculture sector and wheat is the main staple crop of the country. The decrease in yield and quality of wheat has negative impact on the economy of Pakistan. In order to minimise the burden on the economy of Pakistan, development of new policies and appropriate measures to be implemented that could help in eradicating the hazards and catching the positive effects of climate. 2.9.2 Loan policies of financial institution can greatly limit the option for the growers to adjust farm management practices in light of change. These financial institutions may have to change their policies according to the needs of the farmer and predicted changes in the environment. Moreover, they should support and educate the farmers about onward selling and play constructive role the industry. 3.0  Barriers to adaptation strategies 3.1 Pakistan being an agriculture country is extremely vulnerable to climate change. However, Pakistan does not have the proper monitoring and screening system for the prediction of extreme events like flood, storm or changes in the climate that makes the development of short term adaptation strategies and mitigation measures immensely difficult. Although several weather station are working in different parts of the countries, but still due to the diverse topography some significant region are left uncovered (Climate Risk Adaptation Profile 2011). Moreover, the existing findings proposed that Karakorum glacier are expanding but these finding are based on the restrictive information of glacier snouts and suggest that loss of mass in Karakorum glacier reduce the quality and availability of water. As reported by to Sheik et al. (2008), there is a lack of current knowledge and evaluation techniques on the effect of climate change on the Hindu Kush region and lack of understanding and mod el assessment of glacier melting pattern and flow of water in Indus River. All these need to be address in order to have better evaluation of the problem. Moreover, the Hunza river basin has no meteorological station that severely constraint the utilization of Model River flows under climate change. References Piracha, A., and Majeed, Z. (2011). Water Use in Pakistan’s Agricultural Sector: Water Conservation under the Changed Climatic Conditions. International Journal of Water Resources and Arid Environments 1(3): 170-179. Climate Risk and Adaptation country profile. (2011). Vulnerability, risk reduction and adaptation to climate change Pakistan. Global facility for disaster reduction and recovery. Crimp S, Gaydon D, Howden M, Hall, C, Poulton P, Hochman Z. (2006) Managing Natural Resource Issues in a Variable and Changing Climate. Final Report to Land and Water Australia, Managing Climate Variability Program. pp86. Easterling, W.E., Aggarwal,P.K., Batima,P., Brander,K.M,. Erda, L., Howden, S.M., Kirilenko, A., Morton, J., Soussana,J.F., Schmidhuber, J., and Tubiello, F.N.(2007): Food, fibre and forest products. Climate Change 2007. Impacts, Adaptation and Vulnerability. Hammer, G.L., Holzworth, D.P. and Stone, R. (1996) The value of skill in seasonal forecasting to wheat crop management in a region with high climatic variability. Aust. J. Agric. Res. 47: 717-737. Howden, S.M., Reyenga, P.J., and Meinke, H. (1999) Global Change Impacts on Australian Wheat Cropping. Report to the Australian Greenhouse Office. CSIRO Wildlife and Ecology Working Paper 99/04, Canberra, pp121. IPCC (2007): Fourth Assessment Report (AR4), Climate Change 2007, Intergovernmental Panel on Climate Change, Cambridge University Press, Cambridge. Iqbal, M.M., Arif, Goherr, M. A., and Khan, A. M. (2009). Climate-change aspersions on food security of Pakistan. A scientific journal of COMSATS – SCIENCE VISION. Vol.15 (1). Khan, F., Ahmad, A, and Atta-ur-Rehman. (2013). Tracking Adaptation and Measuring Development (TAMD) in Pakistan. Appraisal and Design Phase Report. Meinke, H. and Hochman, Z. 2000. Using seasonal climate forecasts to manage dryland crops in northern Australia. In: Hammer, G.L., Nicholls, N., Mitchell C. (eds.) Applications of seasonal climate forecasting in agriculture and natural ecosystems: The Australian experience. Kluwer Academic Publishers, Dordrecht, The Netherlands, p 149-165. Rasul, G., Chaudhry, Q. Z., Mahmood, A., and Hyder, K. W. (2011). Effect of Temperature Rise on Crop Growth Productivity. pakistan journal of meteorology, 8 (15). Rawson, H. M., and Macpherson, H. G. (2000). Irrigated Wheat: Managing Your Crop. Food and Agriculture Organization of the United Nations, Rome. pp 27-28. Rogers,G.S., Gras P.W., Batey I.L., Milham P.J., Payne, L., and Conroy, J.P. (1998) The influence of atmospheric CO2 concentration on the protein, starch and mixing properties of wheat flour. Aust J Plant Physiology 25:387-393. Richards, R.A. (2002). Current and emerging environmental challenges in Australian agriculture- the role of plant breeding. Australian Journal of Agricultural Research 53, 881-892. Sheikh, M. M., Iqbal, M. M., Ali, G., and Khan, A. M. (2008). Global warming in the context of Pakistan: major concerns and remedial strategies. Symposium on â€Å"Changing Environmental Pattern and its impact with Special Focus on Pakistan†. Stokes, C.J., and Howden, S.M. (2008). An overview of climate change adaptation in Australian primary industries – impacts, options and priorities. Report prepared for the National Climate Change Research Strategy for Primary Industries. Sayed, A.H. (2008). Climate change and its realities for Pakistan. Manager Policy, Freshwater World Wide Fund for Nature, Pakistan. Symposium on â€Å"Changing Environmental Pattern and its impact with Special Focus on Pakistan†. van Ittersum, M.K., Howden, S.M., Asseng, S. (2003) Sensitivity of productivity and deep drainage of wheat cropping systems in a Mediterranean environment to changes in CO2, temperature and precipitation, Agriculture, Ecosystems and Environment, 97:255-273.

A Comparison of Two Types of Treatment for Alcoholism Essay -- Biology

A Comparison of Two Types of Treatment for Alcoholism One of the largest debates in the study of alcoholism is the etiology of the disorder. The prevailing theory today seems to be that alcoholism is a disease, a biological affliction that can only be ameliorated by abstinence or medication. However, there are those who believe alcoholism has its roots in environmental influences and that the disorder is a maladaptive pattern of behavior. The two main methods currently employed for treating alcoholism reflect the foundations of the two main theories. Perhaps the most widely known method is the "Twelve Step" program created by the founders of Alcoholics Anonymous (AA) (1). Underlying this process is the belief that alcoholism is a biological disease that can never be cured, nor can it even be hindered without the use of external forces(2).. Members of AA are required to admit that they are powerless to fight alcoholism and need to relinquish control to a "power greater than ourselves." (3).This power can take any form for the adherents to the program, yet there is repeated mention of God and other aspects of Christian spirituality(4). More relevant to the topic at hand is the belief that alcoholism is a biological disease, which can be inferred from the acknowledgement that help with alcoholism can only come from God. This implies that alcoholism is out of one's own hands and thus should not be considered a "character flaw" or an aspect of personality; it also implies that alcoholism is something more intrinsic to the individual. In fact, the Big Book, the handbook of AA, states that alcoholism is a medical disease. (5).. Indeed, there is a substantial amount of evidence to support this assertion; this is based on tre... ...h in U.S./Canada http://www.alcoholics-anonymous.org/em24dc14.html 2)The Twelve Steps of Alcoholics Anonymous http://www.alcoholics-anonymous.org/em24doc6.html 3)A Newcomer Asks http://www.alcoholics-anonymous.org/ep24doc1.html 4)The 12 Step Cafà © http://www.12steps.org/Brochure/12step/STEPS/STEP1.htm 5)The Doctor's Opinion http://www.recovery.org/aa/bigbook/ww/doctors_opinion.html 6)Neuroscience Research and Medications Development http://www.niaaa.nih.gov/please-note.htm 7)Alcoholism http://www.noah.cuny.edu/wellconn/alcoholism.html 8)Animal Models in Alcohol Research http://www.niaaa.nih.gov/please-note.htm 9)Children of Alcoholics: Are They Different? http://www.niaaa.nih.gov/please-note.htm 10)The Genetics of Alcoholism http://www.niaaa.nih.gov/ 11)Treatment of Alcoholism http://www.mentalhealth.com/mag1/p5h-al10.html

Kate Chopins The Awakening †In Defense of Edna Pontellier :: Chopin Awakening Essays

The Awakening – In Defense of Edna    Does everyone have the right to happiness?   It is stated in the Constitution that we as Americans have the right to life, liberty, and the PURSUIT OF HAPPINESS.  Ã‚   In the novel The Awakening by Kate Chopin the main Character Edna has a comfortable life.   A sweet loving husband, cute children, enormous amounts of money and an extremely large house.   Yet with all of this Edna is not fulfilled. Edna never took time to examine her life to see what she wanted out of it.   After marriage, Edna wanted the freedom to explore her mind, find herself and find what this person liked.   In the following I will defend the actions Edna took to find her happiness as irrational as they may seem.    This story took place in the late 1800's when women's liberation was never heard of.   In this era women were supposed to find happiness in serving their husbands and taking care of the children.   There were no other options within the restrictive boundaries of marriage, and divorce was never an alternative. Women's lives were austere and self enrichment or self gratification were often times cast aside relative to the more mundane tasks of daily life.   Most women accepted this but Edna did not.   She figured that life was more than constantly doing for someone else.   She wanted time for herself in order to figure out who she was.   Some may see this as selfish but everyone is entitled to â€Å"me† time and space.   Although I admit she did not go about it in the best way at times; Edna still was in going in the right direction.    Edna's marriage to Leonce Pontellier was to spite her father the Colonel because Leonce was of a different religious faith.   Also, Leonce was unceasingly devoted to Edna which was something that had never occurred in any other relationship. Edna, who had not experienced many male relationships before this was naive when it came to men.   This naivetà © affected her in such a way that she neither knew love and it's limitations nor the experience it took to make it through a relationship.   This showed Edna's immaturity which was a big issue in this story. This shown as the woman inside who had been asleep all those years. Her relationship with Leonce was what she sought to find happiness in.    After six years of marriage to Leonce,   Edna felt an ever-growing void in her life.   She gave up all of her responsibilities such as taking care of her children when they were sick and she never spent time playing with them.

Decreasing Catheter Associated Urinary Tract Infections Essay

Urinary Tract Infections are one of the most common hospital-acquired infection and many are associated with an indwelling catheter. For each day a catheter is in place the risk of developing a CAUTI increases 3%-7% (Kahnen, Flanders, & Magalong, 2011 ). Although indwelling urinary catheters are widely used in hospitalized patients and can provide an appropriate means of therapeutic management, they are often used without clear indications putting the patient at a risk for complications during their hospitalization. Complications related to a urinary catheter include physical and psychological discomfort to the patient, bladder calculi, renal inflammation and most frequently CAUTI (Bernard, Hunter, & Moore, 2012, 32(1)). Not only does the urinary catheter cause complications to the patient and put them at a higher risk for morbidity and mortality they also increase the hospital costs. Therefore CAUTIs are considered by the Medicare and Medicaid Services to represent a reasonably prev entable complication of hospitalization and as such will not provide any additional payment to hospitals for CAUTI treatment (American Association of Critical Care Nurses, 2012). A great amount of attention has been placed on improving quality of care and minimizing preventable harms that are occurring in the healthcare setting. With the passage of the Deficit Reduction Act of 2005 and the implementation of the Final Rule in October 2008 the CMS, Centers for Medicare and Medicaid Services, will no longer pay hospitals for the additional cost of care resulting from hospital-acquired conditions such as CAUTI (Palmer, Lee, & Wroe, 2013, 33(1)). Urinary tract infections can lead to bacteremia which can produce fever, chills, confusion, hypotension and leukocytosis, but more seriously can lead to the patient becoming septic (Palmer, Lee, & Wroe, 2013, 33(1)). More than 13,000 deaths occurred in 2002 associated with UTI and increased the costs of hospital visits by an additional $600 per CAUTI episode by increasing the length of the hospital stay, tests needed and antibiotics administered (Meddings, Reichert, & Rogers, 2012). Guidelines  have been established and CAUTI prevention bundles have been implemented throughout hospitals to aid in the reduction of CAUTI. These bundles outline a group of evidence based interventions aimed at reducing overall usage of indwelling urinary catheters, encourage timely removal of catheters no longer clinically indicated, and delineates infection prevention strategies to follow when catheters are in place (Kahnen, Flanders, & Magalong, 2011 ). Indications for use of an indwelling catheter for a short term period, meaning less than 30 days, include urinary retention, obstruction of the urinary tract, close monitoring of the urine output of critically ill patients, urinary incontinence that poses a great risk to the patient because of stage 3 or greater ulcer to the sacral area, and for comfort care of the terminally ill patient (Bernard, Hunter, & Moore, 2012, 32(1)). Even though there are guidelines to follow urinary catheters are often placed for inappropriate or poorly documented reasons with totals close to 50% not being needed (Bernard, Hunter, & Moore, 2012, 32(1)). The majority of unnecessary urinary catheters are placed in the emergency department without a doctor order or if there is an order there is no documentation of the need for the catheter. This lack of documented rationale has proved to be an ongoing problem. Other factors relating to catheters are that the assessment of the continued need for the catheter is often overlooked and the catheters remain intact without proper indications. Urinary catheters are often used for personal preference of the nursing staff and even with the best nursing care, each day a catheter is present the risk for infection goes up 3%-10% (Burnett, Erikson, & Hunt, 2010). Evidence based strategies are used to decrease the use of indwelling urinary catheters. Some of these strategies are nurse driven and include the charge nurse or staff nurse assessing the need for the catheter after a period of time and discussing with the doctor the finding or following a standing order for the catheter. Data was collected on this process for a 6 month time frame and showed that the active intervention of daily consultation and review of the need for a catheter significantly reduced the number of indwelling urinary catheter days per month as well as the number of CAUTIs (Bernard, Hunter, & Moore, 2012, 32(1)). Another study according to Fakih et al. (2008) used  quasi-experimental design that made use of nurse led multidisciplinary rounds. The nurses were given education guidelines on the indications for urinary catheters based on recommendations by the CDC, Centers for Disease Control and Prevention (Fakih, 2008). During the daily rounds of the nurse if there wer e no indications for the continued use of the catheter the nurse would contact the physician for an order to discontinue. This process drastically reduced the number of days the catheter was used and also the percentage of catheters in use (Fakih, 2008). According to the American Association of Critical Care nurses the expected practice of a nurse to reduce CAUTIs is that prior to the placement of the catheter assess the patient for any accepted indications and alternatives, adhere to aseptic technique for placement and maintenance of the catheter, document all instances of the catheter including the insertion date, indication and removal date. Nurses should also promptly discontinue the urinary catheter as soon as the indications expire. In order to follow the best practice there should be written guidelines for the catheter including indications and that only patients meeting these requirements have urinary catheters placed (American Association of Critical Care Nurses, 2012). Have available in the department devices, supplies, and techniques that allow alternative routes (American Association of Critical Care Nurses, 2012). Several other actions are recommended such as reviewing on a daily basis the need for the catheter, develop systems to ensure prompt removal of the catheters, implement infection surveillance programs to measure the days and rates of CAUTI, and develop an action plan to address needed improvements (American Association of Critical Care Nurses, 2012). Surveillance data suggests that 4.5 out of 100 hospitalized patients get hospital acquired infections with 32% of them having a urinary tract source associated with a catheter (Meddings, Reichert, & Rogers, 2012). One assessment made in the research was that hospitals with higher CAUTI rates may not have a higher incidence of CAUTI than another reporting hospital they may do a better job documenting the results of indwelling catheter use. By 2015, rates of hospital-acquired events will be used to report hospitals performances and compare them nationwide causing a reduction in the payments  made by Medicaid. References American Association of Critical Care Nurses. (2012). Cathter-Associated Urinary Tract Infections. AACN Bold Voices, 13. Bernard, M., Hunter, K., & Moore, K. (2012, 32(1)). Review of strategies to decrease the duration of indwelling urethral catheters and reduce the incidence of catheter associated UTI. Urologic Nursing, 29-37. Burnett, K., Erikson, D., & Hunt, A. (2010). Strategies to prevent Urinary Tract Infection from Urinary Catheter Insertion in the Emergency Department . Journal of Emergency Medicine, 546-550. Fakih, M. D. (2008). Effects of nurse led multidisciplinary rounds on reducing the unnecessary use of urinary catherizations inhospitalized patients. Infection control and hospital epidemiology, 815-819. Kahnen, D., Flanders, S., & Magalong, T. (2011 ). CAUTI: Making them Matter. Academy of Medical Surgical Nurses, 4-7. Meddings, J., Reichert, H., & Rogers, M. (2012). Effects of nonpayment for hospital acquired CAUTI. American College of Physicians, 305-312. Palmer, J., Lee, G., & Wroe, P. (2013, 33(1)). Including Catheter-Associated Urinary Tract Infections in the 2008 CMS Payment Policy: A Qualitative Analysis. Urologic Nursing, 15-24.