Xpresso Lube’s service package Essay Essay Example

Xpresso Lube’s service package Essay Paper 1. Describe the Xpresso Lube’s service bundle?Xpresso Lube’s service bundle being alone and first of its sort provides assorted other services other than lube oil alteration. It provides for a scope of javas. a waiting country with good insides. music system and reading stuff appealing to different involvements. In the nucleus country of operations ( lube oil alteration ) . Xpresso provides an chance to the clients to see an anomalousness found in their auto. It besides provided transit installation to clients. 2. How are the typical features of a service operation illustrated by Xpresso Lube?The typical features of service operation illustrated by Xpresso Lube are as given below: ( a ) Emphasis was laid on client experience at the service station. ( B ) Comfortable waiting suites. java and music highlighted the aesthetics aspect ( degree Celsius ) Employed lifts alternatively of cavities to ease the clients holding a expression at the jobs in their autos ( vitamin D ) Provided transit which ensured that the clients were non worried about their commutation while their auto was being serviced ( vitamin E ) The clients were presented with right facts and honestness on portion of the station was paramount. We will write a custom essay sample on Xpresso Lube’s service package Essay specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Xpresso Lube’s service package Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Xpresso Lube’s service package Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer 4. What elements of Xpresso Lube’s location contribute to its success? The assorted geographical factors which contribute to Xpresso Lubes success are: 1. A thriving concern community2. Xpresso Lube’s location on a chief street near the university attracts a wide spectrum of clients3. Close propinquity of Xpresso Lube to local stores where people can see while their autos are being serviced. 5. Given the illustration of Xpresso Lube. what other services could be combined to â€Å"add value† for the client?

An Example of Dividend Policy Irrelevance Essays

An Example of Dividend Policy Irrelevance Essays An Example of Dividend Policy Irrelevance Essay An Example of Dividend Policy Irrelevance Essay AN EXAMPLE OF DIVIDEND POLICY IRRELEVANCE An example provides insight into the dividend irrelevance proposition. Suppose that now is time 0, and one year from now is time 1. Carter Company just paid its time 0 dividend (assume dividends are paid once per year), and plans to publicly announce its dividend policy for the next year. It is considering the following two policies (all dollar amounts in $millions). Policy I: At time 1, dividends = $110, new share sales = 0, treasury stock purchases = 0 Policy II: At time 1, dividends = $121, new share sales = $11, treasury stock purchases = 0 The time 1 total equity value (the $2,200 in column (3) of the exhibit below) is the time 1 market value of all shares (shares that were outstanding at time 0 and new shares issued at time 1. It is the ex-dividend (post time 1 dividend) value of the firm’s equity at time 1. This amount ($2,200) is the same under policies I and II because the firm’s assets and financial structure are exactly the same under I and II (implying the same time 1 total value of all the equity outstanding at time 1). We assume that the buyers of the new time 1 stock pay a fair price for the stock. Dividend policy (1) Time 1 dividend (2) Time 1 total equity value (time 0 shares + new time 1 shares) (3) Time 1 value of new time 1 shares (4)Time 1 value of old time 0 shares [= (3) ? (4)] (5) I$110$2,2000$2,200 II$121$2,200$11$2,189 Now let’s compute the time 0 value of the Carter stock if Carter announces policy I, and if it announces policy II. Assume an equity discount rate (k) of 10%. = = = $2,100 (1) = = = $2,100 (2) In the numerator of (2), ($2,200 ? $11) is the time 1 value of the time 0 shares (the shares that were outstanding at time 0, which equals the value of all the shares at time 1 minus the value of the new shares issued at time 1). The time 0 value of those shares is independent of dividend policy. At time 1, under policy II, the time 0 shareholders give up an $11 ownership interest in the firm’s shares in exchange for an $11 dividend payments; the transaction is a wash. This wash effect holds for any dividend policy change if there are no personal taxes.

Hiv / Aids And Aids Essay -- AIDS, Immune system, HIV, South Africa

The entirety of the population of South Africa has been adversely affected by HIV/AIDS both in regards to the health of the people, and the economy of the country (Barks-Ruggles). For a few years now, the GDP of South Africa seems to have peaked in 2010, and has consistently lowered since. While not all of this is the result of HIV/AIDS, some of it is related. HIV/AIDS can affect the economy of South Africa in many ways, one such way is that it can it can lead to the death of many current and potential workers. As of 2015, the percentage of HIV prevalence in the population of population of South Africa is 19.1 (HIV). Another concern for the economy of South Africa comes from how productivity could be... ... middle of paper ... ...s languages of South Africa, who could teach communities about the virus, and could teach them how to treat those with the disease themselves would be a great step forward. I would also advise that we set up more clinics trained to help those with HIV/AIDS in areas of South Africa where it is most prevalent, such as KwaZulu-Natal, where as of 2009 around 39 percent of the adult population are infected (Dugger). If the areas with the highest amount of those with HIV/AIDS are targeted, it could lead to the information being spread out from there. The charity program AVERT based out of Brighton, United Kingdom, has been suggesting similar ideas, and is currently focusing their efforts towards helping those in the hotspots in South Africa. In short, HIV/AIDS must be combated if the world, let alone South Africa, wants to be able to control the rate at which it is spread.

How Oil and Gas Could Affect the Economy Research Paper

How Oil and Gas Could Affect the Economy - Research Paper Example This paper tells that the use of oil and gas may continue to change and affect the economy, dependent on how it is used within various regions of the world.   If this resource continues to fluctuate, it can lead to either a recession in the economy or growth and expansion of various regions. The use of oil and gas is no longer one that is based in different regions of the world. It has now become a dependent resource from every region, with most resources coming from regions such as the Middle East and being outsourced into different places of the globe. Each of the areas that produce oil and gas first has to find the natural resource through an oilfield that can continue to produce the right demands for various regions of the world. The current demand has led to most oilfields producing an average of 260 billion barrels a year, some which produce as much as 25 billion barrels a day. As the gas and oil continue to be produced, it leads to instant fluctuations with pricing. The equa tion that is used is based on the amount of oil and gas that are available for different regions of the world, specifically with estimates of how much oil and gas can be recovered from the selling prices of the oil and gas. For example, if not as much oil and gas can be produced from an oilfield, then the prices will begin to rise in the economy and will alter how much one spends on the amount of gas or oil for their needs. The main effect that the oil production has on the world economy is based on a rise and decline of pricing and production. As the rise of oil demands continue, there is the inability to continue with the amount of production that takes place through the oil that is available. The geological constraints and technological problems are making it so that there are limitations in the amount of production. The result is that political influences and other factors begin to affect the economy by raising prices and creating different ways to find oil.

Time mangement Essay Example | Topics and Well Written Essays - 500 words

Time mangement - Essay Example Goals and priorities can be said to be what we intend to achieve and what we have to do to achieve our goals. In my case, I would be going to college which means that it would be the number one priority. College will prepare me for the future. But going to college will not be the only thing that I will do. I have other things to consider also to fully function as a person such as family, friends and recreation while not losing my sight of my goal of going to college. Hence, time management has to come in for me to plan and budget my time so that I will be able to attend to all of my obligations effectively. Once in college, I have to set my priorities straight. Sunday night to weekdays will be dedicated solely to school. That means no partying during weekdays. A couple of hours or three for recreational sport is allowable for as long as there would be no major exams coming. Friday night is for partying and hanging out with friends. Saturday would be spent for my self or any major research that is needed for school. If there are no projects or major paper that needs to be written, Saturday would be a nice time to go out of town, play video games or just hang around with family and friends. Sunday would be exclusively for family. Activity can vary from watching movie or just having a plain good old barbeque picnic in our backyard. During weekdays and in school, time has also to be effectively managed. It will not be enough just not to party during those time but more importantly, is for me to know what to do with my time. College is not just about attending classes. It also involves reading, going to the library, writing papers and spending some time with friends. After classes, it would be better to rest a couple of hours to refresh myself so I can study later. If there are no exams or heavy classess in the next day, spending a couple of hours in the gym or basketball court would be healthy and a pleasant

The Main Purpose of Magnetic Separation Machine Essay Example for Free

The Main Purpose of Magnetic Separation Machine Essay The magnetic separator is one of commonly used preparation equipments in magnetic separation factory. It has dry and wet two types. According to types of magnets, it can be divided into permanent magnet type and electromagnet type. It is also can be divided into strong magnet type, middle magnet type and weak magnet type according to the magnetic field strength. Different magnetic separators have different characteristics and performance. The common things have magnetite iron ore (belong to strong magnetic minerals), hematite (belong to weak magnetic minerals), limonite, lens iron ore, siderite (they are weak magnetic minerals), etc. They are the raw materials of iron and steel industry, Chinas iron ore grade is low, most of the impurities high, so more than 80 percent of the need for magnetic separation. Manganese, such as hard manganese, pyrolusite, rhodochrosite are weakly magnetic, commonly used in magnetic separation recovery. Ilmenite, wolframite, monazite (phosphorus cerium lanthanum mine), niobium-tantalum minerals are weakly magnetic minerals. Also commonly used in the recovery of magnetic separation. If the above examples are magnetic minerals as a purpose of mineral recovery (the magnetic minerals as a concentrate) is regarded non-metallic mineral beneficiation of iron, titanium and other mineral impurities harmful ingredients, generally magnetic method removed. For example, the beneficiation of kaolin, kyanite, quartz, feldspar, tourmaline, etc. are generally used magnetic separation to remove iron, titanium minerals. Heavy media beneficiation ferrosilicon or magnetite to do to increase the quality, magnetic separation is a simple and effective method of recycling to increase the quality of this application, common in the coal preparation plant. The broken ore crushing crusher broken cavity into the Iron Crusher will be damaged, commonly used magnetic separation to remove the material in the iron. Comprehensive utilization of the useful ingredients in the processing of waste, wastewater, waste gas, such as three wastes to protect the environment, application of magnetic separation is also available. Example, recycling steel slag in steel mills, power plants deal with fly ash, steel mill wastewater treatment, there is the method of magnetic separation. The magnetic fluid separation method is a new magnetic separation process, the use of a magnetic liquid in a magnetic field may increase the role of objects immersed in the great magnetic force can separate objects of different density. The United States, Japan and other countries using magnetic fluid separation method to deal with auto junk, and our country are mainly used in the beneficiation of diamonds

Titanic :: essays research papers

Titanic Titanic was the largest ship in the world, built by a workforce of 17,000. The ultimate in turn-of-the-century design and technology. First-class suites ran to more than $ 55,000 in todays dollars, and when she sailed on her maiden voyage from Southampton, England on route to NY , she held among her 2,227 passengers. The cream of industrial society, including colonel John Jacob Astor. Macys founder; U.S. congressman Isidor Straus and Thomas Andrews, the ships builder. The ship was built of easily sealed-off compartments. If, for some unimaginable reason, the hull were punctured, only the compartment actually ruptured would flood. In an worst case example - builders figured that the Titanic would take from one to three days to sink, time for nearby ships to help, because there was only 16 lifeboats. Unfortunately, things didn't work out that way. On April 14th, 1912 at about 7:30, at the first ominous hint of disaster has came. Into the earphones of the wireless operator on duty came amessage from the steamer California: Three large bergs five miles southward from us. But the Titanic continued to rush through the deepening darkness. The temperature was one degree above freezing. When lookouts Frederick Fleet and Reginald Lee had come on duty at 10 P.M., the sky was cloudless and the air clear. At around 11:30 P.M., just half an hour before they were to be rewired, a slight haze had appeared, directly ahead. And about two points on either side. Suddenly - his training causing his reflexes to function instinctively. Fleet gave the warning bell and immediately reached across the crowns nest to the bridges telephone. In its compartment on the starboard side. He rang   ms bell urgently. Fleet replaced the telephone and gripped the crowns nest rail. At 11:40 P.M., April 14 , 1912 ; The lookouts spotted the iceberg   a quarter-mile ahead. Had they not alerted the bridge, the ship would not have attempted a turn. At 11:40P.M. ; the ship sideswipes the ice. Because of the steels ductility,it would have absorbed massive amounts of energy. The ice crashed right through the plating as it grinded along the side, Strinking at an angle like s 300-foot zipper. ON midnight, April 14-15; fist six   compartments were filling; water was beginning to slosh over. 12:40.; water filled 2,000 bathtubs 1:20 A.M.; The bow dipped; water flooded through anchor - chain holes. At 2:10 A.M.; The Titanic titled to 45 degrees or more and stress reaches nearby 15 tons per square inch. The keel bends; The bottom plating buckles. At 2:15 A.M.; The stern   grew heavier and until it   reached some 16,000 tons of in - water weight .

Hunters in the Snow

Mikael Habtezion Mrs. Walker English 1B 5 July 2011 A Snowy Haven A neighborhood full of eyes watching with judgmental thoughts aimed at you. Gossip behind every corner, evaluating everything you do, avoiding any contact with someone so profligate. No one wishes to be in such a lonely and ostracized state. That’s why everyone strives to conceal each troublesome and embarrassing problem in their lives, appearing to the world as a worry-free, cheerful, and enthusiastic person.In the short story â€Å"Hunters in the Snow† by Tobias Wolf this act of concealing a person’s inner and true self in order to avoid judgment occurs amongst the main characters. There are three men who go on a hunting trip: Kenney, Frank, and Tub. As they find themselves unable to find deer to hunt, Tub shoots Kenney in fear of being shot himself since Kenney was threatening to shoot him first. The hunters reason amongst themselves that they have to drive him to the hospital themselves, but on the way Tub and Frank stop to warm up at bars a few times.In this story we learn that Tub claims to have problems with his glands, which is why he is overweight, and we get a clue that Frank is hiding something about his personal life in a conversation with Kenney. Throughout the story, these characters are always covered with white snow, even as the title suggests. Symbolically, white is a color of purity and innocence; throughout the story, Frank and Tub seem more innocent than their true selves would actually allow. Not until the end when they go into the bar to warm up and the snow â€Å"melts† off, are their genuine personalities and their secrets revealed.In â€Å"Hunters in the Snow† Wolf cleverly uses snow as a metaphor to mask Frank and Tub’s personal problems. In this short story, Frank’s personal problems are secreted through the metaphor of snow. The reader knows that he has a family: a loving wife and kids. Throughout the story the author ex poses nothing about Frank that would cause the reader to judge him in any way. However, one thing is brought up about a â€Å"certain babysitter† but not enough evidence is given in order to judge him yet (622). During the story, Frank was driving â€Å"with the now blowing in his face† (629). When Wolf says this, he elucidates to the observant reader that the snow is covering him. The white snow is brightening his outward appearance, and in turn, letting his inward appearance fade away. After their friend Kenney gets shot, they drive him to the hospital. They author displays them as good friends at this point. On the trip, Frank argues that they have to stop at a bar because â€Å"if [him] and Tub don’t get warmed up [they’re] going to freeze solid† (631). By saying this Wolf strengthens his metaphor as he puts more snow on him.When they arrive at the bar Frank orders coffee and he â€Å"craddl[es] the steaming cup in his hands. His skin was bone white† (631). At this moment, Wolf is placing the false identity next to what reveals it. He places the door next to the key; this key will unlock the secrets which lay behind that door. Wolf displays how white Frank is and how innocent he looks, but also in a parallel manner he displays the steaming coffee, which can literally melt that snow away and figuratively â€Å"melt† his false identity away. Right after the melting begins to take place, Frank’s inner secrets become revealed.Frank confides in Tub as he exposes that â€Å"[he] thinks [he’s] going to be leaving Nancy, [his wife]† (631). Tub tries to find a reason for this and becomes curious if Nancy has been having an affair. However, Wolf completely takes away Frank’s haven of innocence by elucidating that â€Å"Nancy hasn’t been running around†¦[Frank] has† even though â€Å"[s]he’s been damned good to [him] all these years† (632). By saying this, Fr ank’s refuge beneath the snow’s innocence is lost, and he becomes a target for judgment by the reader.After warming up and letting the snow melt off, it is unveiled that Frank has lost the purity he once had in the reader’s eyes and has stooped to a lower level of respect. After he confesses himself to Tub, â€Å"[t]he snow fall lightened and the clouds began to roll back off the fields† (633). When this is stated, the metaphor of the snow as a refuge which hid Frank’s secrets begins to fade away since his secret is made known to the reader. Not only does Frank use snow to hide himself and appear to be innocent, but Tub does as well.As his nickname suggests, Tub is overweight. When the three friends were hunting and took a break, everyone brought out their own fulfilling food, except for Tub. When they ate, â€Å"Tub put out one hardboiled egg and a stick of celery† and when his friends wondered how he can eat like this but still be gaining weight, Tub defended himself by saying, â€Å"’What am I supposed to do?†¦ It’s my glands’† (623). However, earlier when he was getting picked up by Kenney and Frank to go hunting, â€Å"a sandwich fell out of his pocket† then â€Å"[h]e picked up his sandwiches and cookies† (621).The reader is given an idea that something is fishy and it can be seen that there is more to the story than meets the eye, but we are not given enough information to judge Tub yet. When Frank and Tub were trying to help Kenney into the back of the truck after he was shot, Tub accidently dropped him. Frank became frustrated and declared, â€Å"You fat moron†¦ You aren’t good for diddly† (629). After this incident, Wolf pushes the reader to sympathize with Tub in his time of being isulted and therefore Wolf cleverly makes the previously aroused suspicions disappear.After they get Kenney in the truck, and they hit the road, â€Å"the snow was moving white wall in front of their lights; it swirled into the cab through the hole in the windshield and settled on them† (630). Wolf persists with his metaphor and shelters Tub’s inward identity and secrets with this white snow that displays purity. On their way to the hospital, Frank and Tub stop again to warm up. They used â€Å"an automatic hand dryer in the bathroom and they took turns standing in front of it†¦letting the jet of jot air breathe across their faces and chests† (633).This becomes Tub’s threshold to letting his secrets out. Just like Frank, Tub’s snow and light begin to melt away and his personal and embarrassing problems become visible. Tub sits down with Frank and throws his shrouded problems into the open for disclosure. Tub admits that â€Å"’when [he] said that about [his] glands, that wasn’t true. The truth is [he] shovels it in’† (634). With this, Tub is completely relinquished of his ivory   tower and his secret is revealed. Tub becomes a target for judgment, just like Frank, for the reader.As the essay has illustrated, snow is used as a metaphor by Wolf in order to hide the true identities and inward secrets of Frank and Tub. When the snow melts off of these hunters, their skin is revealed and likewise their inner secrets come to the surface and become subject to judgment. Everyday people become subject to judgment by society for large mistakes such as having an affair to small ones such as stepping on someone’s toe. It is almost impossible not to be judged in some way by society, just as it is almost impossible not to judge others.We tend to look at people as if we are better than them without even considering our own state of being. For example, a person shouldn’t accuse a neighbor of having a dirty floor, when their own carpet is soiled with three times the dirt. As time passes by hopefully we can look past the faults of our fellow human beings, an d accept that we are humans and have our own faults and have no business taking the roll of â€Å"judge† when it is unnecessary. Then can we abide in a world without the fear of being our true self; then we can progressively work on our personal problems and strive to become more improved and upright people.

Watergate Nursing Home case analysis

Dropped medical malpractice claims: their surprising frequency, apparent causes and potential remedies. The articles states that not all malpractice claims eventually get to trial and this Is not because the cases are frivolous In nature. The rate at which claims are â€Å"dropped†, abandoned, adjudicated or withdrawn has been found to be quite alarming and costly.From the article, we understand that some claims are dropped because of the long process it goes through before getting to trial of which some plaintiffs are not patient enough to wait for, some are dropped because in the process of litigation and tattling the claims out, they discover some facts or pivotal information that â€Å"lowers their assessment of the value of their case or claims†. The article also found that a case can be dropped due to reasons that should have been foreseen by the plaintiff and his attorney.Thorough investigations should be made by a plaintiff and his attorney before filling a laws uit as this would reduce the number of claims which ultimately reduces the litigation cost. Some scholars from the university of Michigan found that â€Å"when defendants provide Information efficiently to plaintiffs, It helps educe the number of new cases and proportion of cases In which settlement payments are made but on the other hand, Insurers and some others are of the thought that doing this would increase the number of claims because this gives the plaintiff more incentive to continue with their claims†.The writer recommends that a penalty should be imposed for every dropped claim as this would help reduce the number of cases that get dropped or abandoned eventually. Also, insurers, hospitals and plaintiffs should try as much as possible to settle cases amicably at reasonable amount before cases goes any further thereby minimizing the number of claims roped. There should be a more efficient process of dealing with malpractice cases before claims are been made and hosp itals and Insurers should put all hands on deck to â€Å"focus reform efforts on plaintiff malpractice specialists rather than lawyers†.Gallon, D. (2011). Dropped medical malpractice claims: Their surprising frequency, apparent causes, and potential remedies. Health Affairs. 30(7), 1343-50. Retrieved from http://search. Protest. Com/deceive/880104481 Watergate Nursing Home case analysis By Olla-Mandamus The articles states that not all malpractice claims eventually get to trial and this is not cause the cases are frivolous in nature. The rate at which claims are â€Å"dropped†, ultimately reduces the litigation cost.Some scholars from the University of Michigan found that â€Å"when defendants provide information efficiently to plaintiffs, it helps reduce the number of new cases and proportion of cases in which settlement payments are made but on the other hand, insurers and some others are of the before claims are been made and hospitals and insurers should put all h ands on apparent causes, and potential remedies. Health Affairs, 30(7), 1343-50. Retrieved

Decline of Rural America essay

Decline of Rural America essay Decline of Rural America essay Decline of Rural America essayThe issue regarding the decline of rural America has been widely discussed in the mass media sources. In the video Great cities: Rise of the megalopolis, there is much important information about the formation of cities, associated changes in rural areas, and alternatives leading to higher quality of life. After viewing this video, it is necessary to define the positive and negative impacts of the growth of mega-cities. In fact, mega-cities create serious problems, but at the same time, provide massive opportunities for human beings (Korgen Furst, 2012).The positive effects of the increased growth of mega-cities include the use of new technology, communication and transport systems to enhance the quality of life; the ability to provide top quality services in different fields of human activity, etc. In addition, mega-cities can be viewed as sources for imagination, invention and technological innovations. Mega-cities constitute the main growth engine of humanity as they generate new opportunities for human beings.   In general mega-cities have become a new form of development of human civilization. Mega-cities with population of 10 million people and more help to increase the level of urbanization aimed at improving the quality of life (New Atlantis, 2007).The negative effects of the growth of megalopolises include high poverty rate, unemployment, high crime rate, poor health care, air pollution and water pollution, gender discrimination, and other problems. These problems lead to social conflict. The influx of new immigrants leads to considerable social, economic and cultural problems. Moving back to the country could not solve the social problems created by our move to the urban areas because the same problems could exist in rural areas. Rural areas are also affected by the problems caused by new technologies.   Although mega-cities create many problems, they remain very attractive to young people coming from all parts of th e world (New Atlantis, 2007).  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Thus, it is necessary to conclude that the decline of rural America is inevitable. The growth of communication, transportation, commerce and other areas of human activity requires the use of mega-cities as the main sources for human development.

Policy Proposal Research Paper Example | Topics and Well Written Essays - 3500 words

Policy Proposal - Research Paper Example When all else fails, the oppressed may take up to armed struggle and attempt to secede from the parent nations and this brings in a long period of conflict marred with wars and fights in which innocent people get killed. During such times, the nation has to bring about a policy that would attempt to assuage the grievances of the minority people and attempt to bring them back in the mainstream politics and make them give up arms (Stavenhagen, 1996). The paper provides a policy that recommends a strategy for conflict resolution in a fictional country called Calendra. The paper is organized as follows: in Chapter 2, a situational analysis is first performed to understand the activities that have occurred and to identify the stakeholders. In Chapter 3, a literature review of implemented policies across the world is provided, that have addressed the same issues. In Chapter 4, a set of policies are recommended for Calendra.. Chapter 5 gives the conclusions and sums up the paper. As given in the case study, an armed conflict has been occurring for the past 18 years in the Western part of the Calendra where the Lathi people have been staying. These people make up 12% of the population and want to secede form the country as they have some severe grievances that have not been met. The dominant ethnic group is the Pugn and this race is which is concentrated in the north and east of the country. The fighting elements of the Lathi are few in numbers and in the 18 years of conflict, their strength has varied from 700 to 10,000. It must also be noted that the total population of Calendra is about 8 million and in the western region where the conflict occurs and where the Lathi are in power, the population of Lathi is about 45%. The Lathi have a number of grievances an the main ones are: that Lathi have been marginalized in the national power structure and the bureaucratic apparatus of the

Specialised nursing Essay Example | Topics and Well Written Essays - 3000 words

Specialised nursing - Essay Example The presentation of depression of people with autism, which is a pervasive developmental disorder, is coloured by the underlying disorder, considerably altering the manner in which it presents (Munden and Perry, 2002, 13). Nursing assessment, diagnostic process, care plan, and care delivery would thus be very complicated. The clinical presentation further complicates the already existing difficulties in communication. There is a necessity of increased nursing knowledge base to ensure people with autism receive a prompt diagnosis and appropriate treatment (Stewart et al., 2006, 103-116). Mr. John has been admitted to the hospital with a diagnosis of gastric cancer. Therefore, it is expected that he has presented in an advanced stage, where palliative surgery is the only means of treatment, and the outlook is poor. His understanding about his condition would be poor. The nurse who is left with his care has several challenges. Most important is his inability to communicate. The patient remains conscious about that, and as a result becomes anxious. The basis of nursing in his care would depend on social exchange between him and his nurse. However, the social impairment is extreme, leading to situations where his well-defined needs may fail to be adequately considered. The classical triad of impairments in him would be social relationship, social understanding, and imagination and social communication. These patients are often extremely anxious in an unfamiliar environment, and from that angle, admission to a hospital is a very difficult issue to deal with. The nurse must be aware of this fact, and the problem may be further aggravated by failure to communicate (Valente, 2004, 236-243). His advanced stage of gastric cancer needing palliative surgery places him in the need of palliative nursing care. Many autistic individuals need palliative care, and their care needs are different (Dell et al., 2008, 177-182). His palliative care need would need extra input from the nursing services. Palliative care is implemented for people with impending death, and being an autistic individual, his morbidity and mortality patterns, healthcare needs, presentation of symptoms, conceptualization of illness and death, and issues around education and training will be different. Palliative care has been defined as active total care for patients whose disease is unresponsive to curative management. The nursing goal is to achieve the best possible quality of life for both the patient and his family. Being autistic exerts limitations in adaptive skill areas, such as, communications, home living, skills in social relations, self-care, academic skills, concepts in health and safety, and leis ure and work. All these factors may influence his care (Tuffrey-Wijne, 2003, 55-57). The associated depression in this patient is another problem. Depression frequently coexists but is very difficult to identify, since many of these patients are noncommunicative. Behaviours may escalate or patients may shut down, where the nurses must rely on their interpretations of their behaviours and the environment. The nurse must be aware about this possibility. The presentation depends on the patient's age, level of intelligence, and level of verbal skills. There may be history of crying spells, sad affect, increasing aloofness or social withdrawal, and disturbance of sleep and