SOAP notes 1 & 2 Essay Example | Topics and Well Written Essays - 2500 words

SOAP notes 1 & 2 - Essay Example The patient further complains of general weakness of the whole body, painful aches all over his body, and itchy eyes, together with a running nose, sore and dry throat. He further complains of coughing. The patient subsequently denies that he has any form of nausea and vomiting. The history of the male patient is that he has been experiencing severe cold and nose blockage since birth. This shows that the patient has been having this problem ever since he was young. Further evidence shows that he has been under medication for the past years. He further claims that the drugs that he is been administered has been giving him difficulties during feeding and moreover during sleep. The patient further has a history of diabetes which he inherited from his parents. This diabetes has led to the lowering of his immune system response and the slow healing of wounds. This is manifested by the presence of the non - healing wounds on his right leg. ROS: Diabetes. Head: The patient claims of severe and recurring headaches. ENT: The patient complains of severe pain and discomfort during eating and also when talking on his throat. Eyes: The patient experiences sore and itchy eyes. He further experiences blurred vision due to the presence of tears on his eyes. Cardio: The patient complains of pain in the chest while breathing and coughing. ... The patient complains of a recurring and severe headache and sore throat. Allergies: The patient is not experiencing any form of allergy towards dust, cold, or drugs. Medications: The patient is under the medication of diabetes that he inherited from his parents. -Acetaminophen drug -Tylenol -Ibuprofen (Advil and Motrin) -Cough syrup -Other diabetes drugs PMH: -Diabetes -Wounds that take time to heal -Severe fever -Chills Past surgical hx: The patient has never undergone any form of surgical operations. Family hx: The patient has diabetes that he inherited from his parents. Social hx: The patient is married. Have three children; one son and two daughters. He denies that he uses drugs, but he smokes and also drinks alcohol. Objectives: Vitals: HR: 71, BP: 118/71, RR: 21, T: 103.0 oral Physical exam: The patient has a blood group of O+ (positive). He has unclear speech, and uses a lot of energy to walk. Cardio: The patient has a regular rhythm and rate. Resp: The bilateral breath of th e patient is not very clear because of sore throat and nose blockage. Thus, he is having difficulty in breathing. Skin: Dry, warm, the nose and the cheeks are pink in color. The patient also has flushed skin. Abd: Soft and non - distended. Lymph: There is presence of palpated lymph nodes under the armpits and other locations of the body. Stool for OC: Negative Labs (1/4/12) – pre transfusion: HGB: 7.9, HCT: 25.6, WBC: 12, PLT: 469, RBC: 2.21, MCV: 87, ALBUMIN: 2.0, PRE – ALBUMIN: 20.1, GLOBULIN: 5.0, IRON: 27 Labs (1/10/12) – post transfusion: HGB: 10.6, HCT: 30.9, WBC: 10, PLT: 430, RBC: 4.21, MCV: 84, RDW: 15.3, RETIC COUNT: 1.7, BUN: 29, CR: 1.12, GFR: 43. 2D Cardiac Echo (10/09/11) EF: 50 – 60% MVP ENT

Writing Today Essay Example | Topics and Well Written Essays - 500 words - 3

Writing Today - Essay Example The chapter is characterized by proposal examples which make it easier for the learner to master and comprehend the process. The chapter outlines the steps a student should follow in wring a proper proposal. First, the student has to find and focus on the content of the proposal. This part makes the bulk of the proposal. As such, the content is the major part of a proposal. Under the content, the problem to be solved is often identified and how it is to be solved or tackled. The learner must make this part as convincing as possible. Most people review a proposal’s viability by analyzing its content, the addressed problem, and the offered solutions. After inventing the content of the proposal, the next step is to draft the proposal. All the relevant ideas are synched and written down. Additionally, the proposal is organized in a coherent manner. Next, an appropriate style is applied to the proposal. Subsequently, the proposal is designed in a logical, understandable and easy to understand manner with all the major ideas, arguments or parts being clearly verified. To rid the proposal of minor and major grammar and structural mistakes, the document is revised and edited (Paine, Charles & Johnson-Sheehan, 2012). After this process, the proposal is ready for submission. A proposal can be developed by following three major stages. However, this depends on the inclinations of the target audience or sponsor. Some audiences may prefer a concept paper in advance. The concept paper basically focuses on the proposal’s content and problem to be solved. A preliminary proposal may follow the concept paper. Lastly, a full complete proposal is the developed. In this chapter, the authors have in fact followed their own advice in writing. They have done this by primarily making the text scannable, brief, and easy to navigate.

The GAP: PESTEL, SWOT and Porters Five Analysis

The GAP: PESTEL, SWOT and Porters Five Analysis Elements of Analysis: The GAP Case PESTEL Analysis Utilizing the PESTEL (Political, Economic, Social, Technological, Environmental Legal factors) model, the key drivers and areas of significant impact for the competitive advantage in the GAP case are (Johnson, Scholes Whittington 2005, pp. 65, 68): Political – This seems only to be a factor with regards to operational differences between geographic/geopolitical regions, i.e., the US vs. the UK, and social welfare policies that affect actual garment construction. Social – This is a major driver of success as â€Å"fashion† and â€Å"style† would likely fall under this auspice. Specifically, the ability of the firm to generate the perception that its products reflect the fleeting sense of a trend is central to being a leader in retail fashion. Technological – This is a significant factor as the lack of a fully function European e-commerce platform was an opportunity cost that can be measured in lost market share valued in the multi-million pound range. SWOT Analysis Strengths The Gap has existed marketing power and presence and has prime, established retail locations throughout the US and UK. Weaknesses The inability to establish e-commerce on the UK side has lost not only sales opportunities but likely tarnished the image of a company that wants to be seen a ‘hip and trendy’ in a digital age in which competitive parity is ‘bricks and clicks’. Opportunities Through existing resources and brand equity, the Gap has the opportunity to regain one of the top spots in the mind of the consumer for fashionable clothing. One of the chief means of doing so is to quickly replicate the success of the online presence of the US business in the UK. Threats Perhaps the biggest threat is that one of the smaller boutique venues will achieve sufficient success to legitimately chip away at the mindshare of the consumer that Gap currently has on a scale that will be very difficult to reclaim. Porter’s 5 Forces As with the PESTEL framework above, only the most salient factors are indicated (Porter 1980, p. 4): Potential Entrants –The rise of small-scale boutique firms allow profit-taking from firms that do not have the ‘overhead’ of a corporation such as The Gap. This allows for greater flexibility and speed in the delivery of fashion to market. The Threat of Substitute Goods – Similar to â€Å"potential entrants†, there are not only other products that perform the same function but, in times in which economics dictate allocation of scarce consumer resources amongst items that, to some extent, fall under the category of highly discretionary spending. Contrary to this, one might argue that ‘fashion will always be in style’ and thus in-demand, the attractiveness of the industry will attract more entrants. Eventually, a form of homeostasis will be achieved but only at the expense of the exit of some less profitable firms. Industry Rivalry – The combination of the above two factors creates what is arguably a hypercompetitive environment characterized by larger firms seeking to sustain competitive advantage through enduring presence while small, flexible and fast firms seek to take perhaps a temporal portion by capitalizing on that which is most trendy. The Four P’s (Price, Promotion, Place Product) The concept of the marketing mix or â€Å"the 4 P’s† gives tremendous strategic insight into how the firm goes to market with its portfolio of goods and services. Price – Pricey but not so much that they cannot be seen as â€Å"luxurious necessities† for those for whom being ‘cool’ or ‘sexy’ is a real or aspirant lifestyle. Promotion – Consistent with other aspects of the marketing mix, television advertisements feature hip and trendy music, often done by somewhat older (yet still cool) musicians with engaging music. These featuring dancing or at least, rhythmic maneuvers, in which one must assume the clothes worn are as much a part of the causative agent for such behavior as the apparent youthful attraction and attitude of the performance crew. Place – Sold only through Gap stores in mainstream retail locations such as shopping malls and through, at least in the US, Gap-branded online channels. Product – Positioned as perhaps something that could be labeled as [young] ‘sexy casual’, such an offering virtually defines its market as those who are young and view (or want to view) themselves as fashionable and trendy. Products include shirts, jeans, sweaters, accessories and more and all geared at generating such a â€Å"feel† or experience for the wearer. Overall Business Strategy In general, a firm can have one of two broad strategies: cost-leadership or differentiation. With regards to differentiation, a firm may choose to segment based upon the customer by focusing on a niche or specialty market or they may choose product differentiation as by innovation or similar pursuit (Porter 1980, p. 35). Using this general approach, the Gap clearly pursues a strategy of seeking competitive advantage by differentiating product offerings (what it does) to those for whom a sense of ‘urban/sub-urban-esque’ fashionable â€Å"personal style† is very relevant to their lifestyle (the target market) through a combination of exclusive retail locations and a corollary online venue (the where of it’s strategy). Corporate Social Responsibility The idea of corporate social responsibility is best expressed by the notion of, â€Å"†¦ the extent to which an organization exceeds the minimum obligations to stakeholders as specified through regulation and corporate governance† (Johnson, Scholes Whittington 2005, p. 191). With regards to the GAP case, such a perspective is evident when they actively seek to position themselves not simply as seeking to establish sustained competitive advantage but the advantages conferred to everyone through sustainable business. Specifically, through their alliance to support AIDS awareness and suffering, they achieve profits and good works. Antithetically, one critique would likely be to question not the outcome but the motive for doing so. The Resource-Based View The essence of the resource-based view of the view establishes the lens of the â€Å"VRIO framework†. That is, for a firm to achieve sustained competitive advantage, its resources must be valuable, rare, inimitable and organizational in nature (Barney 2007, p. 138). With this in mind, it seems to follow that the best sources of such are resources which are intangible rather than tangible. From this perspective, the ability of GAP to attract and retain designers who can consistently replicate and market what is or is about to become â€Å"fashionable† at competitive costs would meet such criteria. Strategic Recommendations The essence of the Gap to maintain/re-establish sustainable competitive advantage is to be able to be both â€Å"big† and â€Å"small† simultaneously. The competition seemingly enjoys the element of first-mover advantage with regards to their ability to operate under the radar only to appear with trendy products in the market that less insightful firms can then attempt to copy. Correspondingly, the ability of the boutique firm to mass-produce and distribute a successful product is far less than that of the Gap with it established manufacturers and well-oiled distribution channels. Thus, the Gap needs to adopt fast, flexible methods of getting fresh and accurate insights into production and into stores. In the classic business decision, the Gap has but two options: make or buy. That is, they can either allocate resources in the form of time, talent or treasure (aka, money) to acquire these abilities or they may choose to outsource these functions to other firms. Perhaps a hybridized solution is to form strategic alliances with such smaller firms that have these resources in abundance but lack the marketing and manufacturing power of the Gap. Such a solution would achieve the goal of the acquisition, even if temporary, that the Gap seems to lack as it seeks to create lasting sources of competitive advantage in the face of the hyper-competitive, mature yet dynamically fickle industry of upscale casual fashion apparel. Mature vs. Dynamic Firm The Gap competes in a arguably mature but changing and constanting renewing industry. A â€Å"mature† industry can be characterized by the following (Barney 2007, p. 94): Slowing growth in total industry demand. The development of experienced repeat customers. A slowdown in the increases in production capacity. A decrease in new product introductions. An increase in the level of international competition. An overall reduction in industry profitability. With these criteria, the retail fashion clothing industry is perhaps somewhat unique in that each year brings something of a second-chance to capture the market. Though the degree of competitiveness and production capacity indicate a mature industry, the new arrivals to the target customer segment in regards to age, affluence and attitudes provide a potentially rich new customer base. These factors lead to the classification of the industry as being â€Å"mature† but yet quite â€Å"dynamic† in the sense that technology and the preferred tastes of an ever-changing consumer segment create a need for the Gap to acquire marketing insights and speed and flexibility in production to bring such high-margin, high-risk products as fashion clothing to market. Key References Barney, J. (2007). Creating and Sustaining Competitive Advantage, 3rd edition. Upper Saddle River, New Jersey: Pearson Prentice-Hall. Johnson, G., K. Scholes, and R. Whittington. (2005). Exploring Corporate Strategy, 7th edition. Harlow, England: Prentice-Hall. Porter, M. (1980). Competitive Strategy: Techniques for Analyzing Industries Competitors. Boston, Massachusetts: The Free Press.

The Truth About the Quebec Issue :: essays papers

The Truth About the Quebec Issue The Canadian unity crisis involving Quebec has been a controversial issue since before the country^s confederation. Surrounding the seemingly unsurpassable dilemma of unity there are three main obstacles. The significant lack of action for Canada on the part of many francaphone Quebecois, prevents any profound attachment to the country on their behalf. A mood of intransigence on the part of Canadians outside Quebec serves to alienate and anger the individuals within the province. A perceived leadership vacuum throughout Canada on behalf of its citizens contributes to a widespread feeling of hopelessness (Reid, 1991). The complexity of, and speculation towards, the Canadian unity crisis masks the infallible truth that while presently, there is no solution to the problem there is some hope for the future. Within the province of Quebec there is a significant lack of patriotism or any real attachment for Canada. In 1995, The Angus Reid Group asked a national sample of Canadians to describe how they personally felt about Canada. Four options were given: * I am strongly attached to Canada-I love the country and what it stands for; * I am attached to Canada, but only so long as it provides me with a good standard of living; * I am not attached to Canada and would prefer to see it split up into two or more countries; and * I would prefer to see Canada amalgamate with the United States. (Reid, 1995) Outside of Quebec, there was evidence of a high level of patriotism with over 85% of Canadians saying that they are deeply attached to the country and what it stands for. In the province of Quebec, only one-third of the population and only 20% of the francophones, displayed this level of affection for Canada. While there is debate over the cause for these statistics, some individuals believed that the statistics were as a result of lingering wounded pride because of the failed Meech Lake accord in 1991. Many Quebecois were insulted by the way that many Canadians outside of Quebec trivialized the situation, and the province^s demands. Others believe that this problem is indirectly the result of Canada^s official bilingual status. The reasoning behind this is that biligualism serves to even further alienate and differentiate the French within the country. This poses a difficult conundrum. Bilingualism can not be abolished because while it serves to alienate, it is also perceived! by the French as preserving their unique culture and identity. One hope is that through Canadian media a new stronger more unified identity can be achieved. Arguably, the CBC is this best forum for this shift in values because of its

History of Relational Database

Hao-Wei He Wilmington University October 9, 2010 Abstract Database system have been inseparable with our daily life, since IBM developed the hierarchical database management system in 1969, database system has been innovated many times, such as hierarchical database, network database, relational database, and object-oriented database. Nowadays, relational database still is the most popular model used by different industries; this article is going to introduce the history of the relational database.History of Relational Database Data, which can be defined as an entity of meaning, it is the original material to construct message and knowledge. Thanks to the assistance of computer, data processing practices reached several important milestones. The earliest way to store data are done through manual file management, all documents will be filed and then store, but this method had many processing restrict, such as search, storage takes up a lot of space, and cannot be access by people at t he same time.After IBM announced the first set of hard disk drive for data storage in 1956, due to the innovate development of hard drive, and the access speed much faster than magnetic tape, it replaced the tape drive gradually, and then direct access file system developed. Although direct access file system could access each files directly and improved a lot of missing, but since the objects are files, it still lack of flexibility of processing. Database can be considered to automatically query and modify data sets.There are a variety of database types; from the simplest store all kinds of information forms to large-scale database systems that able to process a variety of mass data storage, are widely used in all inspects of applications. The advantages of database management system: * Reduced redundancy * Integrated data * Integrity * Data commonality * Protect data safety and privacy The disadvantages of database management system: * Overall operating cost will increase * More c omplex to use Need to backup regularly, or unexpected conditions will cause serious data damage * Hard to training database administrator * Difficult to integrate or manage different format from multi systems Therefore, there was an idea about divide files into a sum of record, and store it as an unit in the computer, it also formed the â€Å"Centralized Database System†, it can record a record through hard disk drive, and can directly navigate to the record or fields for further data processing and computing.This concept also derived to the following data types: * Hierarchical Data Model (1960s) Use record as a processing unit, and organize record by tree structure. As a result of the characteristic of tree structure, hierarchical data model particularly suitable for describe â€Å"One to Many† data composition relationship but â€Å"Many to Many† relationship. * Network Data Model (1970s)As a result of the tree structure does not reflect network connection rel ationship between data and data, so after hierarchical data model, some groups proposed â€Å"Network Data Model†, organize records by network structure. However, records in both Hierarchical data model and network data model use link to strung together, so when programming applications must accommodate the structure status between links, a lot of dependencies between programming applications and data structure, and the independence of data is hard to reach, cause the system difficult to maintain. Relational Data Model (1970 ~ present) Edgar Codd, a British computer scientist, proposed â€Å"Relational Data Model in 1970, emphasize the applications should not have any dependencies with internal structure of data, it also known as â€Å"Data Independence†, this data model lead the development of the database system entered a new milestone. In relational data model, data use record as a processing unit, and organize record in tabular form.The applications just face to t he tabular structure, without to understanding the internal structure of the data. Conclusion Relational Database Management System (Relational DBMS) is the most widely used database management system in recent years, the mainly reason is the concept of relational data models is simple, and the basic theory was developed very completely. Since Relational Database management System be proposed in 1970, almost all the commercial database management systems are based on this model.We often hear of the data table, is a relational database foundation.References Yung-Fang Chen, Relational Database management system lecture, Retrieved from http://allen. chen. name/teachdata. htm Jeffrey H. , Mary P. , & Heikki T. (2009). Modern Database Management 9th Edition. Upper Saddle River, NJ: Pearson Shou-Jeng Tseng. Review Database System and Future Research Develop. Taiwan, Retrieved from http://www. iicm. org. tw/communication/c1_1/page02. html.

America & Germany Essay

America never wanted to participate in World War 1, in fact in August 1914 when the war broke out in Europe; President Woodrow Wilson issued a declaration of neutrality. Preferring to remain isolated from the war, America tried to broker peace between the allies and the axis, the war was in Europe; America did not need to get involved. On May 7th 1915, German U-boats, patrolling in the Atlantic Ocean, fired torpedos at the British passenger ship Lusitania sinking her in 20 minutes. 128 Americans were killed. Woodrow Wilson, demanded that Germany stop attacking passenger ships, and declared that America was too proud to fight. Wilson also tried to mediate a compromise settlement but failed. He also repeatedly warned that America would not tolerate unrestricted submarine warfare, as it was in violation to American ideas of human rights. Wilson was under great pressure from former president Theodore Roosevelt, who denounced German â€Å"piracy† and Wilson’s cowardice. In January 1917, Germany announced it would destroy all ships heading to Britain. Although Wilson broke off diplomatic ties with Germany, he still hoped to avert war by arming merchant vessels as a deterrent. Nevertheless, Germany began sinking American ships immediately. On February 1917, British intelligence gave the United States government a decoded telegram from Germany’s foreign minister, Arthur Zimmerman that had been intercepted en route to his ambassador to Mexico. The Zimmerman Telegram authorized the ambassador to offer Mexico the portions of the Southwest it had lost to the United States in the 1840s if it joined the Central Powers. However, because Wilson had run for re-election in 1916 on a very popular promise to keep the United States out of the European war, he had to handle the telegram very carefully. Wilson did not publicize it at first, only releasing the message to the press in March after weeks of German attacks on American ships had turned public sentiment toward joining the Allies. Later, on 2 April 1917, Wilson asked Congress for a declaration of war and four days later all but six senators and fifty representatives voted for a war resolution. The Selective Service Act that was passed the following month, along with an extraordinary number of volunteers, built up the army from less than 250,000 to four million over the course of the conflict. General John Pershing was appointed head of the American Expeditionary Force (AEF) and led the first troops to France Then, on April 6th 1917, America declared war on Germany.