Software Project Fails Research Paper Example | Topics and Well Written Essays - 1250 words

Programming Project Fails - Research Paper Example What is the genuine circumstance? Deciding if the assessments of those censuring programming ventures are realities, I assess a product venture that never observed its finish. Joined Kingdom is one nation that acknowledges innovation along these lines making programming emergency a standard in the area. NHS Connecting for wellbeing is a piece of the nations Department of wellbeing framed on first April 2005 supplanting the then shaped NHS Information Authority. The NHS Connecting for wellbeing had the errand of the national program for IT (NPfIT), an activity by the legislature to move the National Health Service in England towards a midway commanded electronic consideration records for patients. It was additionally expected to interface 300,000 general experts to 300 emergency clinics, giving a safe and evaluated access to these records by approved experts. A venture that would truly help the clinical division in England, the agreements for the NPfIT spine venture was granted in December 2003. NHS Connecting for Health stopped to exist on March 31, 2013 and programming emergency was to be faulted. The expense of the venture is assessed at  £12.4 billion as indicated by the national office of measurements; it started in 2000 and was expected for consummation in 2010. The venture was to; make the NHS Care Records Service, which handles the spine database and make the Choose and Book framework that would permit patients book their meetings with Doctors by means of their (PCs). It was likewise entrusted to think of a national broadband IT system to update the then utilized foundation and make an IT support for the Personnel including the Quality Management and Analysis System (QMAS). The program partitioned England into five locales called Clusters southern, London, Eastern, North West, West Midlands and the North East. Each bunch had a neighborhood specialist co-op and an organization contracted to convey the administrations. The task was the biggest non military personnel IT anticipate and it was chosen to

Mount athos

Mount Athosis a mountain on the landmass of a similar name in Macedonia, of northern Greece, brought in Greek Agion Oros transliterated much of the time as Hagion Oros, or in English, â€Å" Holy Mountain † . It is a topographic purpose of 20 Eastern Orthodox religious communities and is acceptable known for the way that it is a self-represented secluded region of the sanctum mountain. The solitary way one can see the mountain is by vessel. Only guys are permitted to see and are required to hold a specific gateway permit. In the event that one needs to populate in the â€Å" Garden of the Virgin † he ought to be part of the Eastern Orthodox Church and should be more than 18 mature ages old. In any case, there are non simply Christians that live on saddle horse Athos. There are other than a figure of Albanians who other than deal with the Holy mointain. There are watches that maintain the control, constabulary and Coast Guard that other than watch the request on the mountain. There nearness is extremely prudent. The 20 religious communities are:Megistis Lavras monasteryVatopediou monasteryIviron cloister †worked by GeorgiansHelandariou religious community †SerbianDionysiou monasteryoutloumousiou monasteryPantokratoros monasteryXiropotamou monasteryZografou religious community †BulgarianDochiariou monasteryKarakalou monasteryFilotheou monasterySimonos Petras monasteryAgiou Pavlou monasteryStavronikita monasteryXenophontos monasteryOsiou Grigoriou monasteryEsphigmenou monasteryAgiou Panteleimonos cloister †RussianKonstamonitou monasteryHowever I am heading out to talk around 5 of them. The initial 1 is the religious community of Great Lavra.It is the main cloister based on Mount Athos. . It is found by Athanasius in AD 963. Athanasius, started the structure of the buildings in 963, fitting to the desire of his companion and Byzantine Emperor Nikephoros II Phokas who subsidized the endeavor. Nikephoros had guaranteed Athanasius that he would without further ado turned into an ascetic. In any case, he passed on before he could keep up his guarantee. The rulers gave the religious community numerous grounds of things including the island of Saint Eustratius and the Monastery of Saint Andreas in Thessaloniki.. In 1655, the Patriarch Dionysios III, who other than turned into a religious, gave all his karma to Great Lavra..Treasures found in Lavre Monastery:The library of the cloister is situated behind the central church. It contains 2,116 Grecian original copies and 165 codices. Among them original copies of the New Testament: Codex Coislinianus, Codex Athous Lavrensis, Uncial 049, Uncial 0167, and little letters 1073, 1505, 2524, 1519. This accumulation is probably the most extravagant total of Grecian orig inal copies known to man. Probably the a large portion of import antiques found in the vestry are a composition of a Gospel with an aureate screen. This is a blessing from Nikephoros II Phokas. Hilandar Monasteryis a Serbian Orthodox religious community on Mount Athos in Greece. It was established in 1198 by the Serbian Saint Sava and his male parent, Grand Prince Stefan Nemanja. It is called â€Å" The Serbian cloister † on the grounds that its laminitiss are Serbs and first monastics were other than Serbes.. . Hilandar does non hold an archimandrite, however an under-abbot. The Mother of God through her Icon of Three Hands ( Trojerucica ) , is considered as the mother prevalent. Two medieval Bulgarian imperial sanctions, the Virgino Charter and the Oryahov Charter, have been found in Hilandar ‘s library. After the pre-winter of Serbia and Bulgaria under Ottoman guideline, the inflow of Serbian monastics diminished at the disbursal of Bulgarians. From the seventeenth to the nineteenth century, Hilandar was prevalently Bulgarian-populated: in his history of 1745, the Russian traveler Vasily Barsky composes that the monastics of Hilandar were all Bulgarians. Ilarion Makariopolski, Sophronius of Vratsa and Matey Preobrazhenski have all inhabited that spot, and it was in this religious community that Saint Paisius of Hilendar started his extreme Slavonic-Bulgarian History. TheSaint George the ZograforZograf Monasteryis a Bulgarian Orthodox cloister on Mount Athos ( the â€Å" Holy Mountain † ) in Greece. It was established in the late ninth or mid tenth century by three Bulgarians from Ohrid. It is possessed by Bulgarian Orthodox monastics. The cloister ‘s name is gotten from a thirteenth or fourteenth century symbol of Saint George that is accepted to hold non been painted by a human manus ( zograf ( os ) in Grecian organizations â€Å" painter † ( from zoe= † life † and grafos= † Scribe † ) and to have wonder-working forces. The most punctual composed grounds of the cloister ‘s being day of the months from 980. Since it was the solitary Bulgarian Monastery on Mount Athos the Bulgarian swayers bolstered it. The Zograf Monastery has other than gotten land endowments by Byzantine ( the primary provider being Leo VI the Wise ) , Serbian, and Rumanian swayers. The Zograf Monastery ‘s library is of a significant significance to the Bulgarian human advancement. It jelly medieval compositions, for example, a fifteenth century transcript of the passional of Saint Naum of Ohrid, the fourteenth century passional of Saint Paraskevi, the first unsmooth transcript of Paisius of Hilendar ‘s Istoriya Slavyanobolgarskaya and the History of Zograf. There can other than be discovered 388 original copies in Slavic and 126 In Greek.. Two medieval Bulgarian illustrious contracts, the Zograf Charter and the Rila Charter, have been found in the religious community ‘s library. Stavronika religious community is an Eastern Orthodox cloister at the sheltered region of Mount Athos in Greece, committed to Saint Nicholas. The religious community keeps a broadly known fourteenth century symbol of Saint Nicholas, known as â€Å" Streidas † on the grounds that whenever it was by chance found at the underside of the ocean, a shellfish had stuck at the forehead of St. Nicholas. Fitting to the legend, when the monastics of Stavronikita evacuated the clam, the holy person ‘s forehead drained. Stavronikita has a collection of numerous sanctums relics.. The cloister has a total of 171 original copies, out of which 58 are composed on material. A portion of the original copies bear essential iconography and trimming. St. Panteleimon Monasteryis a Russian Orthodox cloister based on the south-west side of the promontory of Mt. Athos in Greece. It is the biggest of the 20 religious communities on the Holy mountain.. The cloister was established by a few monastics from Kiev Rus in the eleventh century. That ‘s why it is known as ‘Rossikon ‘ , and customarily it was occupied by Kiev and along these lines by Russian Orthodox monastics. It was perceived as a different religious community in 1169. The religious community succeeded in the sixteenth and seventeenth hundreds of years since it was extremely supported by the Tsars of Moscovy. It declined significantly in the eighteenth century to the point that there were simply two Russian and two Bulgarian monastics left by 1730. The library contains 1,320 Grecian original copies and another 600 Slavonic 1s, each piece great as 25,000 printed books. In add-on, the library has a couple of precious relics, for example, the caput of Saint Panteleimon, one of the most well known holy people in Russia.

14 Tax Experts To Follow Right Now!

14 Tax Experts To Follow Right Now! 14 Tax Experts To Follow Right Now! 14 Tax Experts To Follow Right Now!The tax filing deadline is coming up quick, but there’s still time to get (and use) strong advice from the experts. We’ve rounded up the greatest tax gurus on Twitter so you can get the best tips for filing your return this year, and each year to come!Get yourself a head start on those deductions with these top tax tweeters:  1. Jeff Rosan (@a_tax_pro)Jeff Rosan has been an enrolled agent of the U.S. Treasury Department for 30 years, meaning hes able to represent his clients directly before the IRS  (@IRSnews). His San Diego-based firm helps individuals and small businesses make their tax experience as painless as possible. The firm’s Twitter account shares helpful articles and advice with a special eye on raising awareness about tax scams. Give them a follow and stay a step ahead of the scammers!2. Janet Novack (@janetnovack)Janet Novack is the Washington D.C. bureau chief for Forbes  (@Forbes), focusing on tax advice and personal financial p lanning. Follow her for good information and advice about your own money matters, as well as her takes on the economic world at large.3. K Sean Packard (@AthleteTax)Would you rather read about sports than tax advice? Well, you can get both at once! K Sean Packard is the tax director for OFS  (@OFSWealth), a firm that offers tax advice and financial guidance to athletes and celebrities. Follow him for tax information and sports views. And are there tweets that mix sports and taxes? Of course there are! Check him out.4. Robert Raiola (@SportsTaxMan)We hear what you’re saying. You want another account that will provide you with a wonderful swirl of tax and sports takes. Perhaps an accountant so well-regarded by the sports world that they made him into a baseball card? Well, then you should follow Robert Raiola. When Sports Illustrated or The Washington Post needs a sports accountant to talk to, they talk to Raiola, and for just the low, low price of one Twitter follow, you can get hi s insights too!5. Sylvia F. Dion (@SylviaDionCPA)Sylvia F. Dion is the founder of PrietoDion Consulting Partners. She has over 22 years of tax experience and a Twitter feed that’s dedicated to not just personal tax advice, but important news stories about taxes in general. It’s a great way to get all the knowledge you need to make you seem like a tax genius at parties. Assuming that’s what they talk about at the parties you attend.6. Rick Telberg (@CPA_Trendlines)Rick Telberg is the former editor-in-chief of Accounting Today  (@AccountingToday), and his company, CPA Trendlines, offers in-depth research and tax analysis. His twitter feed highlights endless important articles and views to give you the full picture of the current tax environment.7. Tax Mama (@TaxMama)If you want your tax advice with a more personal touch, check out Tax Mama’s Twitter feed. Eva Rosenberg has been offering tax advice through books and the internet for a while now: her site has been around since 2 000, when most accountants were probably still figuring out how to use Excel. Check out TaxMama.com  to find the answers to your tax questions and even find out how to become an enrolled agent yourself.8. Kay Bell (@taxtweet)Kay Bell’s website is called DontMessWithTaxes.com  and the self-described “native Texan and tax geek” provides tax advice in an amusing, accessible way. She also writes regularly about racing for multiple trucking magazines, if you want your tax advice to be literally speedy. Are the racing articles actually related to the tax articles? You’ll have to find out for yourself!9. National Associations of Enrolled Agents (NAEA) (@Tax_Experts)Remember those enrolled agents we mentioned earlier? Well, there’s a whole organization of them, and you should follow their Twitter account. Their tax advice tends to be a little more tailored by region than some other accounts, so you can keep an eye out for the tips that make sense for where you’re at.10. Jason M. Blumer (@JasonMBlumer)Jason M. Blumer is an accountant who specializes in working with creatives. That means his Twitter feed, while informative, also has its own spin, mixing in advice with pictures of what his clients are up to.11. Rania Combs (@RaniaCombs)Rania Combs has a fully online law firm. So when you follow her, you know you’ll be getting tax advice from someone who is totally up to date. These are solutions for the taxpayer who’d rather spend their time online than waiting IN LINE. (Sorry.)12. Sandra Feinsmith (@SandraFeinsmith)Sandra Feinsmith is a CPA who works with nonprofit organizations. So when you follow her, you might also see some suggestions of where you can donate this year to get those deductions…  we mean… out of the goodness of your heart.13. Jim Frazier (@SalesTaxGuy)You’ve read about a lot of tax experts, but none of them so far have specialized in sales tax. None of them have been a sales tax gentleman, or a sales tax individual, if you will. But now we’ve got a sales tax guy to recommend! Jim Frazier posts all about sales tax and, given that it’s a tax you’re probably paying every day, it’s not a bad idea to learn more about it.14. Tracey Shannon Levy (@TaxAddict)Tracey Shannon Levy shares a wide range of tax articles across many different topics. Following her is a great way to diversify your tax knowledge base. One read through the feed and you’ll be up to date on the latest tax happenings.Follow all of these experts, and you’ll become a real tax expert yourself. But don’t get so distracted by tweets that you forget to file! File, then reward yourself with as many tax tweets as you like. The best reward!Also, be sure to check out the OppLoans ebook Tax Season 101: An OppLoans Explainer eBookTax Season 101 for an overview and step-by-step instructions for managing and filing your taxes.

Internet Censorship Of China, South Africa And Other...

Internet censorship in China, South Africa and other countries is something that prohibits real discussion from taking place regarding issues that affect the public. For instance, in China, certain key word searches are automatically filtered out so that users cannot find the information they are seeking. While Internet censorship may be good from one perspective (in terms of stemming the flow of child pornography, curbing false information, or putting a nation’s interests first), it can be viewed as bad from another perspective (in terms of cutting down on the opportunity to inform sides of a dialogue, promoting free exchange of ideas, or discussing why one form of pornography is allowed but not another). This paper will show why Internet censorship can be interpreted in both positive and negative ways depending on the perspective that one adopts (whether one is pro-Statist or anti-Statist). In short, pros and cons depend wholly upon one’s worldview and outlook. Th e first pro may be, as Lorentzen (2014) notes, that â€Å"a partial censorship strategy† is an effective way for governments to control the levels of discontent in their respective countries (p. 405). Lorentzen (2014) observes that this is a model that could be applied in China as it attempts to control its Internet content, though he argues that all nations could utilize it, â€Å"permitting half of the discontent to be reported when discontent is high and all of the discontent to be reported when discontent isShow MoreRelatedCensorship Will Always Interfere With Freedom Of Speech1396 Words   |  6 Pages Censorship will always interfere with freedom of speech. In Fahrenheit 451, by Ray Bradbury, censorship is one of the main topics depicted. Censorship including the banning of books has been an issue though out history. There has been violence similar to the book burnings by the Firemen in the novel. In Bradbury’s novel, Guy Montag is a Fireman who cannot understand why books have to be burned. He questions what is in the books that can’t be shared with people. Guy questions his boss, CaptainRead MoreCensorship Is Only A Temporary Setback1598 Words   |  7 PagesCensorship is Only a Temporary Setback Censorship will always interfere with freedom of speech. In Fahrenheit 451, by Ray Bradbury, censorship is one of the main topics depicted. Censorship including the banning of books has been an issue thoughout history. There has been violence similar to the book burnings by the firemen in the novel. In 2009, Harry Potter books as well as other novels and music records were burned by Paster Jack Brock in front of his congregation. He felt that these books wereRead MoreThe Importance Of Contemporary Art1660 Words   |  7 Pagesmessages of injustice that are conveyed by those who would not otherwise be heard by the public. Censorship is not only dangerous to our constitutional rights, but is also hyper specific to contemporary art and actively silences the messages of underprivileged and disadvantaged voices. In other words, we must avoid the unnecessary, unfair censorship of contemporary artists and their work. Not only is the censorship of art immoral, but it is a dangerous, irresponsible contradiction of our First AmendmentRead MoreThe Importance Of The Choice Of Tunisia2413 Words   |  10 Pagesall, Tunisia is a great example for our as a model of countries that switched from a complete oppressing and Internet censorship to a country where freedom of Speech is preserved. Second, Tunisia gave birth to the Arab spring through its Tunisian Revolution in January 2011. It was fueled by the use of social medias where the protests were being organized and supported through online networks (The use was mainly on Twitter and Facebook since other social networks, video-sharing and blogs such as YoutubeRead MoreChina After The Reform Area1377 Words   |  6 Pagesclassifies China as a ‘transitional developed country.’ More specifically, China is defined as one of the five BRICS countries. These countries consist of; Brazil, Russia, India, China, and South Africa. The BRICS countries do not share a global region, political systems, or economic systems. The textbook argues that the three main goals of these countries are prosperity, stability, and security. 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This book is printed on recycled, acid-free paper containingRead MoreGp Essay Mainpoints24643 Words   |  99 Pages GP NOTES 2010 (ESSAY) Content Page 1. Media a. New vs. Traditional b. New: narcissistic? c. Government Censorship d. Profit-driven Media e. Advertising f. Private life of public figures g. Celebrity as a role model h. Blame media for our problems i. Power + Responsibility of Media j. Media ethics k. New Media and Democracy 2. Science/Tech a. Science and Ethics b. Government and scientist role in science c. Rely too much on technology? d. Nuclear technologyRead MoreBrand Communication Strategy3796 Words   |  16 Pages * China: how convert the name of google? It was difficult to translate the name google because you can not spell it in China. What should be the brand name in China, does he has to sound the same? †¦ The risk: change the brand identity The bureaucracy could be not suitable for the google model, measure the impact of that kind of change. Chinese people could see that business model as not professional with too much distractions because the values are not the same between the 2 countries. Chinese

Analysis Of The Movie Dope - 1730 Words

I recently watched the Netflix movie, Dope, a coming-of-age movie that doubles as a parody and a dedication to the 1990s-vintage ghetto generation. Malcolm and his friends Jib and Diggy are nerdy high school seniors who bond over anything ‘90s related, play music together in their punk band, and have grown up together in â€Å"The Bottoms,† in Inglewood, California. Malcolm was trying to escape a gang one day when he had an encounter with a neighborhood drug dealer named Dom. Dom ended up invited him to his birthday party, and with hesitation, Malcolm and his friends decide to go. After an eventful night, Malcolm and his friends later discover that Dom had stashed a handgun and a large amount of drugs in his backpack to hide it from the police who raided the party. The rest of the movie plays out into a war over the drugs that Malcolm accidentally possessed. Malcolm ends up selling the drugs and promises Dom’s prominent supplier, who was also coincidentally Malcol m’s college interviewer, the profits made from the drugs. Malcolm makes this deal with him only as long as he helps Malcolm achieve his goal of getting into Harvard. Malcolm ends up setting up the supplier with the police while still getting into Harvard and finally being able to get out of the hood. In terms of black masculinity, Malcolm counteracts the hyper-aggressive stereotypes that some have in their head about young African-American men. In the movie Dope, numerous aspects of intersectionality are represented inShow MoreRelatedBlack Culture And The Black Experience1943 Words   |  8 Pagesthrough their sacrifices, as a teacher, mentor, lawyer, military hero, aspiring writer, or wannabe Native American warrior, is able to physically save—or at least morally redeem—the person or community of folks of color, by the film s end. Every movie needs a hero. The hero is a necessary plot device: It anchors the story and gives the audience a character to root for. In Hollywood though, the heroic character is often a white savior. The white savior is the well-intentioned, generous, and kind-heartedRead More Relationships and Marriage - Dont Marry!1494 Words   |  6 PagesDont Marry! Marriage is quite likely the one most damaging force our species have ever invented, up to and including war. Harold Christensen, author of Marriage Analysis, is not the only person who believes marriage is in many ways hogwash. To borrow a phrase from the 1980s, young women simply have to say no to marriage. Not only is it unnecessary, but a bad habit as well. 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The following sections of this BookRags Premium Study Guide is offprint from Gales For Students Series: Presenting Analysis, Context, and Criticism on Commonly Studied Works: Introduction, Author Biography, Plot Summary, Characters, Themes, Style, Historical Context, Critical Overview, Criticism and Critical Essays, Media Adaptations, Topics for Further Study, CompareRead MoreResearch on Persuasive Techniques Used in Advertising Industry12297 Words   |  50 Pagesmedia refers to the institutions that provide such messages: newspapers, magazines, television, radio, film and multimedia Web sites. The term also is used for the specific institutions of mass media, such as radio networks and television stations, movie companies, music producers, and the Internet. 2|Page Introduction to Research RESEARCH Research is an inseparable part of human knowledge. 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Don Quixote Essay Free Essays

Sue Kim 29 October 2012 Honors Literature Don Quixote Essay â€Å"With these word and phrases the poor gentleman lost his mind,† (Cervantes 20). In the beginning of Don Quixote, the reader is introduced to a man engulfed in chivalric books, who soon loses his mind in the stories of knighthood. Don Quixote is labeled as an insane man by the narrator who soon proves this statement through Don Quixote’s delusions and eccentric behaviors. We will write a custom essay sample on Don Quixote Essay or any similar topic only for you Order Now As the narrator describes the delusions, the narrator’s tone is overly mocking towards Don Quixote’s delusional acts. However, ignoring the narrator’s mocking tone, Don Quixote’s foolish acts can be judged reasonable by comparing Don Quixote’s delusions to the actual situation. In Cervantes’ Don Quixote, Don Quixote is portrayed as a delusional person with a tendency of expressing eccentric behaviors; however, Don Quixote’s delusions can be judged reasonable if the audience looks at the acts of Don Quixote as a childish and immature approach to regarding things in life. There are three types of delusions and eccentric behaviors shown by Don Quixote that can be seen as reasonable: delusions and eccentric behaviors connected with concrete objects, coincidental situations, and in situations where Don Quixote admits his madness and tries to explain his own supposed madness. The most commonly mentioned scene of Don Quixote is when Don Quixote has delusions about windmills being giants. Delusions and eccentric behaviors connected with concrete objects happen as Don Quixote sees some concrete objects as slightly different objects. This pattern is seen when Don Quixote interprets windmills as giants. â€Å"thirty or forty of the windmills [†¦] thirty or more enormous giants† (Cervantes 58). The audience may perceive Don Quixote as insane because he confuses two similar objects. The massive windmills’ blades are similar to the massive giants’ arms and the trunk of the windmill is similar to a giants’ body. Don Quixote’s childish actions are analogous to those of a child identifying a beautiful woman in an elegant dress as a princess. An image of a giant is conjured when thinking of a windmill because they are so similar in appearance; therefore, an image of a princess can be conjured when seeing a beautiful woman and dress. Don Quixote also perceives a barber’s basin to be a helmet. â€Å"Do you know what I imagine Sancho? This famous piece of the enchanted helmet [†¦] resembles a barber’s basin as you say,† (Cervantes 155). To turn a basin upside down creates an object similar to a helmet. The reader can compare Don Quixote’s ridiculous actions to the behavior of children as they have swordfights with sticks. Don Quixote, seemingly childish and naive, can nonetheless be judged reasonable because in both the windmill scene and the basin scene, the two objects being compared had similar qualities and were seen from a childish perspective. Don Quixote also had delusions on fortuitous situations. Don Quixote’s delusional behaviors on coincidental situations can be judged reasonable because they are spontaneous. The delusions of Don Quixote are similar to the delusions that â€Å"normal† people would have. Well, [the cloud of dust] conceals a vast army, composed of innumerable and diverse peoples, which is marching toward us,† (Cervantes 126). A cloud of dust could hide anything from a small pin to a immense army. Therefore, it is reasonable for Don Quixote to believe a vast army is hidden inside the cloud of dust and rampage into the cloud of dust. Don Quixote’s belief on the cloud of dust can be related to the actions of a child as he or she imagines there is a mon ster underneath their bed. In both situations, Don Quixote and the child are afraid of the unknown hidden from their view. A comparable situation happens as Don Quixote faces with two friars and a carriage on one path and has the delusion that the friars are kidnapping a princess in the carriage. â€Å"You wicked and monstrous creatures, instantly unhand the noble princesses you hold captive in that carriage, or else prepare to receive a swift death as just punishment for your evil deeds† (Cervantes 62). Don Quixote can be judged reasonable because his immature, quick assumptions correspond with those of a child as he or she immediately assumes a punishment when their full name is called. A normal adult may not have attacked the friars, but a man with a childish mind would have shown eccentric behavior like Don Quixote. All of these delusions are acceptable if they are pursued to imitate one’s role model. Madness can be conceived if a person’s role model is also considered insane. Don Quixote explains about his insanity as, â€Å"In the same manner, Amadis was the polestar the morning star, [†¦] the one who should be imitated by all of us who serve under the banner of love and chivalry. This being true, [†¦] that the knight errant who most closely imitates Amadis will be closest to attaining chivalric perfection† (Cervantes 193). Don Quixote realizes that people call him insane; thereupon, he explains that he is merely following in the footsteps of his role model, Amadis. Don Quixote’s guilelessness relates to those of a child as he or she looks up to his or her role model as the child grows up. A related situation happens in Sir Gawain and the Green Knight. â€Å"Said Gawain to the king, ‘If you would, noble lord, Bid me rise from my seat and stand at your side, [†¦] And I have asked you for it first, it should fall to me† (Pearl Poet 246). Gawain is upraising his uncle, King Arthur. Gawain’s honor for King Arthur allows him to imitate King Arthur by asking for the task of beheading the Green Knight. All of Don Quixote’s actions can be assimilated as childish. If Don Quixote’s actions were perceived plainly as childish and immature thought process, the readers can acquire a different definition of chivalry and knighthood from Don Quixote. Chivalry and knighthood is known to be for those that are loyal and brave. However, if Don Quixote’s chivalric, but ridiculous actions were plainly childish actions, chivalry becomes the dream of young children. Chivalry becomes an immature game played by children. Knights would not be the symbol of courage, but the symbol of playfulness and being silly. With Don Quixote’s childish perception towards chivalry and knighthood, the readers can acquire a new sense of what loyalty and courage are. Citations * Cervantes, Miguel De. Don Quixote. New York City: HarperCollins Publishers Inc. , 2005. Print. * Pearl Poet, . Sir Gawain and the Green Knight. Print. How to cite Don Quixote Essay, Essays

Nursing Care of Crrt Hyovolemia free essay sample

This care study aims to outline the care provided to a patient during one 12hour shift. It will present the patients cause and course of ICU admission, identify problems both potential and actual, focussing particularly and two main problems. The nursing interventions preformed will be critically analysed and supported with research. Finally the care will be critically evaluated areas of possible improvement will be outlined. Patient chosen is a 36yr old male pseudonym ‘Frank’ chosen for the purpose of confidentiality. Frank was day one post re- do orthotic liver transplantation (OLT) with roux -en-y anastomosis. He had his initial OLT for Primary sclerosing cholangitis secondary to auto-immune hepatitis preformed 5 days previously and required and urgent re-do transplant due to Hepatic vein thrombosis not responsive to conservative treatment. Prior to his re-do transplant he had required CRRT due to acute kidney injury(AKI) related to large blood loss of 2. 5litre due to coagulopathy related to liver failure. We will write a custom essay sample on Nursing Care of Crrt Hyovolemia or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page He was currently receiving CRRT. Frank has a past medical history of auto immune hepatitis, Ulcerative colitis (total colectomy with ileostomy formation in 08 with recurrent adhesions, stomal varices, osteoporosis, Left bundle branch block (Asymptomatic). He is a single man with both his elderly parents NOK. He was unable to work due to long term illness and lives with his parents 10miles away from the hospital. Autoimmune hepatitis is a chronic hepatitis characterised by auto immune features, generally including the presence of circulating autoantibodies and a high serum globulin concentration (Krawitt 2006). This results in the body initialling in error an immune response to the liver cells and causing inflammation damage and death of the liver cells. Primary sclerosing cholangitis is the inflammation, scarring and death of the bile ducts. Ulcerative colitis is one of the risk factors Hepatic artery thrombosis occurs in estimated 2. 5% of liver transplants with aprox 50% requiring retransplantation(Stange et al 2003). It was in franks case diagnosed following routine ultrasound of liver ducts and Doppler to assess blood flow from the hepatic arteries. ARF in liver disease is common and can occur due to renal hypo perfusion or increased renal vascular resistance. (Betrosian et al 2007) and occurs in aproximatley 23% of chronic liver failure patients (Agarwal et al 2009) ASSESMENT Frank has a GCS of 9/15. He had previously been on sedation and analgesia. But was currently having a sedation vacation as recommended by kress et al (2000). He was eye opening to pain and obeying commands. Richmond agitation score(RASS) was -2 light sedation. On respiratory assessment Frank was intubated and ventilated on Pressure support ventilation (PSV)requiring minimal support of PS 8 PEEP 5 fio2 . 24. ABG supported adequate ventilation and oxygenation. Respiratory rate 16 regularly work of breathing was normal and relaxed. Lung fields clear on auscultation. Productive cough on suctioning aseptically using size 12 (Pederson et al) Cuff inflated at 30cmh2 (Stewart et al) with Achieving adequate tidal volumes of 6mls per Kg as recommended by ARDs net 2000. . Frank was maintaining a mean arterial pressure of 68mmg on 28 mc/hr. f Noradrenaline which was administered through a dedicate lumen of a central line and labelled accordingly. The MAP of 65mgh was identified patient parameter as recommended by le Doux as cited in Delinger et al 2009 to ensure adequate perfusion of the vital organs including renal perfusion. Alarms were set within patients parameters. Pulmonary artery flotation catheter was in situ with systolic 21mmgh, diastolic 9mmgh MAP 13 svo2 76% and estimated cardiac output 8. 8 wedge pressure of 6 mmgh as performed by intensives. Central venous pressure of 3mmgh. Lines were transduced a phlebosatic axis, pressure 300mmgh. PAFC secured at pillow sutures secure syringe deflated and locked measured as 60cm as checked with previous shift. Large bore rapid infuser remained in situ since surgey. On examination Frank had widespread peripheral oedema upper and lower extremities. Hypothermic. Left bundle branch block on ECG. HB 8. 0 pale peripherally to feet pulses present on Doppler related to alpha effect of Noradrenaline. Terlipressin QDS, 2. 5 litres renal no urine output post op had been on CRRT since the intra operative period. Exchange 30mls/kg/hr. heparin due to thrombosis Frank had a wide bore NGT on free drainage. He was not receiving enteral feeding as post biliary reconstruction and roux loop anastomosis of the biliary tree , Enteral feeding is not recommended in the first 48hrs post operatively to reduce the risk of biliary leakage at the anastomosis. (Welsh et al 2004) Stoma at ileostomy site was pink , protruding and functioning small amount of fluid. Abdomen was slightly distended firm to touch with transplant surgery site dressing dry and intact. On examination he had widespread peripheral oedema indicating third spacing. Periperal odema was asseseds by pushinf on bony prominence for 5 seconds . Odema is classified as mild-severe or +1-=4 (Kirton 1996)14 His oral mucosa was dry. His lactate was raised at 3 indicating lactic acidosis. Treatment of the problem was multifactorial and involves continuous communication with the multi-disciplinary team, Monitoring patient for response to treatment, and observing and treating side effects of condition and treatments. The use of CVP as an indicator of fluid status is debated. CVP is dependent on venous return to the heart, right ventricular compliance, peripheral venous tone and posture (Al Khalil and Webb 2004) some or all of these may be present in the vulnerable ICU population and as a result leave space for unreliability. There is little concrete evidence to support the use of CVP monitoring (Ahrens 2010) and current developments such as technologies to accurately measure stoke volume may be future everyday practice Franks jugular venous pressure was measured to estimate intravascular fluid volume. Not present. Moist mucous membranes, good skin turgor, and prompt capillary refill. Considering frank had received four units of RCC intra operatively and his haemoglobin was 8 as recommended by Hebert et al 1999) fluids were prescribed by the physician. 500mls of colloid fluid was prescribed. A continuous debate between the choices of fluid for fluid resuscitation exists . Colloid fluids contain large molecules than crystalloids and are argued that these large molecules poorly diffuse outside the vascular space thereby reducing the leakage of fluid to the extra vascular space and maintaining cardiac output for longer thereby reducing volume required for favourable result. Moranville et al 2010) However in a Meta-analysis of research of evidence of effect of crystalloid versus colloid fluids, there was no clear benefit of either on mortality (Alderson et al 2001). A safe study carried out in 2004 was a RCT of 6997 patient receiving either saline ( Crystalloid) or Albumin (Colloid)showed no difference in 28 day mortality in either group( Fifner et al 4004 ) . The fluid was administered to frank via central line using alcohol swabs to clean port when accessing lumens to reduce risk of line contamination. CDC guidelines 2009).