Risk Groups for Urinary Tract Infections Essay Example | Topics and Well Written Essays - 2000 words

Risk Groups for Urinary Tract Infections - Essay Example Clinical physicians in medical microbiology categorize urinary tract infections into upper and lower tract infections on an anatomical basis. An infection of the bladder refers to cystitis and where the infection spreads to other areas, such as the ureters and the kidneys, the infection is pyelonephritis. Cystitis is, therefore, regarded as the lower urinary tract infection while pyelonephritis is the upper urinary tract infection. The latter is more severe and complicated than the former. In spite of the availability of several antibacterial factors such as urea concentration, pH, the salt content of the urine, osmolality, and other urinary tract inhibitors of bacterial adherence, several bacteria are still able to invade the urinary tract system. The bacteria predispose the patients to a variety of urinary tract infections. The common types of bacteria that correlate with a diverse range of urinary tract infections are the Gram-negative bacteria of E. coli and Klebsiella species. T he uropathogenic bacteria overcome the several urinary inhibitors to bacterial invasion such as the Tamm-Horsfall protein (THP), lactoferrins, low-molecular-weight oligosaccharides, bladder mucopolysaccharides, and secretory IgA. The bacteria, however, still adhere, grow, multiply, and resist against the host’s defence mechanisms even with the presence of bacteria inhibition factors and conditions. The result is massive colonization and subsequent urinary tract system infection (Stamm 2006, p. 2-4). The paper aims at reviewing the numerous bacteria that are responsible for the various urinary tract infections. It also highlights the laboratory diagnostic routine procedures used in the diagnosis of the bacteria in the most prone population groups, as well as, the infections exhibited by the general population. Many researchers and scholars in microbial urinary tract infections agree that the Gram-negative bacteria of E. coli and the bacteria associated with the Klebsiella species are the common organisms that cause urinary tract infections in both males and females.  

Ad Analysis Essay Example | Topics and Well Written Essays - 1500 words

Ad Analysis - Essay Example that I have selected is an ad depicting the poster for a new fragrance in the market that is called ‘Fantasy Twist’ launched by the famous artist Britney Spears. The unique thing about this fragrance is that it states it is 2 fragrances in 1 meaning that the perfume offers two different scents in the same bottle. The ad also shows two images of Britney Spears – in order to create two different perceptions or uses of the perfume, making it appealing to a larger number of people. By this I mean that the ad shows Britney in two different forms – the photo on top is in silver indicating the use of the perfume by day and the photo at the bottom shows her in black, indicating the use of the perfume at night. At first glance, the perfume looks very interesting because it offers something new and not many perfumes have two fragrances in them. This advertisement displays the aspect of womanhood at its best, with a unique fragrance that at its first glance appeals to the minds of the public however looks ordinary after carefully examining and understanding the use of the product. It must however be understood that since the model in the ad is Britney Spears, an artist who emphasizes the notion of feminism, the fragrance and the ad will only appeal to women and not men, for the purpose of purchase. Nonetheless, her photo looks very seductive so as to attract male attention to view the ad, which is the general perception upon looking at the photo from a man’s point of view. I have selected this advertisement because it is about a product that most people use – perfumes. Moreover, products that are endorsed by celebrities or launched as a part of their fashion lines tend to sell more in the industry just because of the brand value. Even if the product may not be good, the public tends to buy it anyway because of the goodwill attached to the celebrity that appeals to the minds of the consumers. Thus, as opposed to an ordinary perfume produced by a company, I

Relative market share Essay Example for Free

Relative market share Essay (Ratio of company share to share of largest competitor) HIGH LOW â€Å"STAR† â€Å"QUESTION MARK† â€Å"CASH COW† â€Å"DOG† Figure 2 BCG Matrix of BMW 3. 1 Porter’s five forces Porter’s Five Forces are business analysis tools that help companies to assess the environmental forces that influence a company. This business analysis tool works by dividing environmental forces into five different categories (Figure 3). The interesting feature of Porter Five Forces is it leads companies to understand the extent of challenges faced by companies within a particular industry as the framework provides a systematic way of thinking about how competitive forces work at industry level and how they determine profitability. Figure 3 Porters Five Forces 3. 1. 1 Rivalry Rivalry exhibits the intensity of competition in a particular market. In case of BMW, the company faces fierce competition since currently there are many automobile manufacturers that compete in the same premium markets. In addition, many multi segment automobile manufacturers also set up special division to target premium market like Toyota Motor that set up Lexus brand to compete with premium cars like BMW, Mercedes Benz, Rolls-Royce, and Jaguar. Figure 4 shows the global auto industry ranking by market cap as of April 2006. The figure describes that at that time, BMW is not listed in the ranking and therefore they need multi strategy to generate greater market capitals. Figure 4 Global Auto Ranking 3. 1. 2 Threat of Substitutes Substitute products are products of other industries that may have significant impact to the prices decision and other features of automobile products. In case of BMW, the product substitutions are many kinds of affordable transportations including mass transports such as intercity high-speed trains, trams, motor bikes, and bicycles. Another product substitution for BMW is the increasing demands for green technology. In automobile industry, it refers to the use of alternative technology like hybrid technology or solar cells. Although the market share of these products are still relatively low, currently BMW has not shown intense program to launch the green car. In fact, several automobile manufacturers have started their program to head for producing the future cars that use hybrid cars like Toyota Prius and Alphard and Honda Civic, and GM’s Saturn Vue Green Line. 3. 1. 3 Buyer Power Buyer power has significant impact on the producing industry. The buyer power is perceived to be strong enough if they are in the minority in numbers and there are numerous producers or automobile manufacturers. In the automobile industry the buyer is the people who purchase vehicles or cars. Buyers have considerably high bargaining power because customers usually have much information regarding the vehicle they intend to purchase. They are usually knowledgeable about cars specifications, price, and dimension since most car manufacturers identify these in brochures and on websites. Another critical decision that buyers have is about the fuel consumption of cars. This information is rarely printed in cars brochures but usually they get the information for auto magazines that conduct test drive. Buyers have other powerful forces on the automobile industry since the advanced Internet technology lets customers to shop online or design and customize their cars. A key feature of Internet is customization in which BMW also enable customers to customize some features of their purchased cars in order to suit their needs. In addition, automobile industry exhibits low switching costs because customers can easily move to one dealer to another during the selection process. They can also trade their ole cars when buying new ones since many dealers now also own or cooperate with used car divisions. Figure 5 shows the global auto production representing the demands-production capability that each brand/automobile manufacturers have. In the figure, BMW is in the 14th place. However, it does not reflect the quality of BMW since BMW like other European premium cars are well-known for their quality products. Figure 5 Global Auto Productions by Manufacturers in 2002 Source: OICA 3. 1. 4 Supplier Power Supplier power is typically low within the motor industry because a vehicle has various amounts of different components and there are a large number of suppliers available to cater for this. This means Toyota/GM can easily swap suppliers if they are not happy with the quality or price of the components ordered.

Dementia care

Dementia care ‘The public outdoor world is rarely conceived of as an appropriate setting for a person with dementia’: Critically discuss this statement with reference to your reading and practice or caring experience. Use at least one case study or vignette of up to 350 words taken from your practice or caring experience. This should support your argument and illustrate either the opportunities and/or the challenges of accessing the outdoors. Assignment to be: 2500 words People with dementia have the right to a dignified, healthy, safe, and friendly environment where they are treated as equals regardless their increasing age or diminishing capabilities. (Mitchell et el., 2004). They can still maintain their abilities to cope independently throughout the early or mild stages of dementia. They still have the desire to stay independent and have control over their own lives. It is essential for people with dementia to experience regular mental and physical exercise to keep their minds and bodies active and to maintain social contact. If the streets in their neighbourhoods are not designed to meet their needs they will be trapped in their homes, because their previously safe and secure neighbourhood changed into a harmful and dangerous environment. There is an increasing need improve urban design through the Local Planning Authorities, as such urban planners should take in consideration the implication of not only normal ageing but they should enable indi viduals with various types of cognitive impairments to maintain their independence (Burton Mitchell, 2006). Effects and challenges of dementia Physical, mental, and psychological changes are due to the ageing process, and can encompasses several slight impairments in hearing, vision, ability, mobility, and memory. These affect elder individual’s ability to live in their surroundings with ease. This is even more difficult for individuals with dementia because they have to cope with both the normal ageing effects and the challenges of dementia that cause a threat to their personhood and result in the loss of identity (Burton Mitchell, 2006, Chaudhury, 2008). Dementia pose a number of behavioural, personality, and cognitive changes for example restlessness, agitation, depression, and anxiety. There is a typical decline in physical and mental abilities. They develop a typical style of mobility in the form of an unsteady shuffling pace with a stooped posture, always looking down and as such they are not aware of their surroundings. Dementia also result in sensory impairment which can include hearing and vision. Colour ag nosia is often intensified by dementia, dark colours and combinations thereof is difficult to distinguish. There might also be impaired depth perception, sharp colour contrasts or patterns on the ground will be interpreted as steps or holes, shiny or reflective surfaces looks slippery and wet, buzzy designs or repetitive lines will cause dizziness and that can result in trips or falls. The mental decline in dementia is permanent and incurable, it might progress gradually and result in unpredictable physical deterioration. During the mild to moderate stages their short-term memory is very fragile and their long-term memory remains acute (Burton Mitchell, 2006). Negative feelings The statement, ‘The public outdoor world is rarely conceived of as an appropriate setting for a person with dementia’ said it all. â€Å"There are currently over 750,000 people with dementia in the UK and this is predicted to rise to about 870,000 by 2010 and over 1, 8 million by 2050†. (Burton Mitchell, 2006, p. 27). But people with dementia is disabled and disempowered by the unfriendly and unsafe environment, it does not meet their cognitive impairment needs, which is ignored. Accessibility for these individuals have become a huge problem, there is positive transformations for normal disabilities but not effective enough to take into consideration the different barriers for individuals with dementia and their unique impairments. Burton and Mitchell (2006) found that individuals with dementia experience negative feelings that include fearfulness and anxiety. This is due to the fear associated with their decline in mobility and vision. Burton and Mitchell also i ndicated the complications and risks presented by existing city environments for instance irregular paving, poor seating, no shelter, steep inclines, a lack of signposting, and bicycles on footpaths. The psychological and social difficulties are also serious obstacles for example, poor bus services, inaccessibility of local shops, insufficiency of toilet services, and the possibility of getting lost. Constant noise of heavy traffic flow disturbs the person with dementia’s hearing and has an influence on their concentration. Unexpected, loud sounds often frighten them. Another ‘no-go’ facility is the moving stairways in any public building, it hinders a person with dementia who suffers vision-impairment to judge the stairways distance and speed. (Blackman et al. 2010) Vignette The above findings support the caring experience in my practice in that the public outdoor world is not an appropriate setting for a person with dementia, they do experience obstacles and challenges on a daily basis when accessing the outdoors as proven in my vignette: One of the residents, Mr X, in my care setting has been experiencing Schizophrenia for many years and he has also diagnosed with Vascular Dementia. He was from the local area and very familiar with the neighbourhood and community and is well known by some of the locals. He had free access in and out of the Care Home for many years but recently we received a phone call from a local shop that informed us that Mr X had lashed out towards one of their staff members who approached him to support and guide him. At one stage Mr X entered a private property without consent. He also developed some injuries on his lower legs and hands and also got on the wrong public transport. It was not very pleasant to involve the police to locate Mr X and to guide him back to his own home. After observing Mr X’s change in behaviour we determined that there was a deterioration in his physical and mental functioning, for example he could not remember where a toilet facility was available and used the ally of the local shop. He also entered a private property because that was his previous home. Due to the uneven walkways he also tripped and fell, injuring his legs and hands. Furthermore, Mr X could not read or understand the electronic screen at the bus stop causing him to use the wrong public transport. We had to involve Mr X’s General Practitioner to review his medical treatment and according to the legislation we had to redo his risk assessments. Out of experience and observation we are aware that a person with dementia experience bad days and good days, and it can be problematic to specify at what stage their dementia has developed. But Mr X still has the capacity to make his own decisions and as such he decided to continue with his daily visits to the local neighbourhood as normal. We understand and support his decision, because this daily routine ‘walk about’ was very vital to maintain his self-respect, independence, and his quality of life. However, Mr X agreed to inform staff when he is leaving the facility and when he can be expected back, following the internal home policy to keep him safe and secure. Positive transformations As mentioned above there was positive transformations for normal disabilities, the UK Disability Discrimination Act updated in 2005 affected a change in attitudes towards design for disability in order to meet the needs of anyone with disability. Accessibility has become the most important problem because of the increasing population of older individuals and more positive attitudes towards disability in general. Recently the mission for dementia friendly communities received an enhancement from the Prime Minister’s Challenge on dementia: a national challenge. In his challenge the Prime Minister highlighted three key areas (see Prime Minister’s Challenge, 2012, p.5) Driving improvements in health and care. Creating dementia friendly communities that understand how to help. Better research. Mitchell (2012) identified only six projects that have addressed the dementia-friendly design of neighbourhoods. That includes a three year research project, which was sponsored by the Engineering and Physical Sciences Research Council (EPSRC). Individuals with dementia and older people in the community were directly involved, through escorted walks around their own neighbourhoods and in depth interviews. During the research the neighbourhoods were measured, mapped, and evaluated by using a developed checklist of environmental features. This research identified six key design principles that are necessary and required to make the streets and neighbourhoods more dementia friendly. The streets need to be safe, comfortable, accessible, familiar, legible, and distinctive (Burton Mitchell, 2006). Familiarity The roads and outdoor environments and features should be recognisable and easily understandable by older individuals, especially for the person with dementia who experience confusion, spatial disorientation, and memory difficulties. Individuals with dementia do not recognise modernistic unfamiliar designs, they are used to traditional designs with the main entrance facing the street with normal swinging doors and not revolving or sliding doors. They also fail to recognise modern designed street furniture, for example modern bus shelters, telephone boxes, or an automated ‘Superloo’ (Burton Mitchell, 2006, Mitchell et el., 2004). To achieve familiarity in the outdoor environment the following can be done. Long-established streets can be maintained, local styles, materials, and forms should be used for new developments, and any changes should be incremental and on a minor-scale (Burton Mitchell, 2006, Mitchell et el., 2004). Legibility Legible roads refers to an easy to recognise network of directions and junctions with simple, obvious signs and noticeable, unmistakeable features. Some individuals with dementia sub-consciously use various techniques to find their way. These include visualising their route through mental maps, route planning by using the same route every time, and they can follow symbols that are realistic and clear. Most individuals with dementia find it difficult to follow or understand the outdoor signs. A cluster of signs is very confusing and difficult to read and understand. People with dementia prefers straightforward, simple signs fixed to the wall. For example the post office sign is familiar and the colour is acceptable for people with colour agnosia. Another technique they tend to use in order to find their way is familiar landmarks and environmental features, such as the letterbox at the corner or a street cafà ©. It can happen that individuals with dementia get lost at times, that is d ue to confusion, disorientation, or distractions like sudden loud noise that causes a break in concentration (Burton Mitchell, 2006, Mitchell et el., 2004). To achieve legibility in the outdoor environment, streets should be laid out on an irregular grid pattern, staggered and this will allow the connection of routes that is easy to understand. Forked and T-junctions decrease the amount of routes and offer focus points at the end of the roads (Burton Mitchell, 2006, Mitchell et el., 2004). Distinctiveness Distinctive streets replicate the community’s character through the use of a variety of features, colours, forms and materials that provide the buildings and streets with their own character and identity. It is essential for people with dementia to follow a route with a variety of local styles, shapes, sizes, and colour that will help them maintain concentration. They prefer a visit to the parks that presents them with mix activities such as enough seating, greenery, and public art (Burton Mitchell, 2006, Mitchell et el., 2004). To achieve distinctiveness and to help dementia people find their way in the outdoor environment it is important to provide interesting and understandable places, use landmarks, and environmental features. Firstly, make use of aesthetic features such as water pumps, attractive gardens, hanging baskets, fountains, and trees. Secondly, use practical features for example street furniture that includes familiar letter boxes, red K6 telephone box, bus shelters, and safe public seating (Burton Mitchell, 2006, Mitchell et el., 2004). Accessibility Accessibility states to which degree the local streets empower people with any physical, mental, or sensory impairment to reach, enter, and walk to places they wish to visit. Older people, including people with dementia are no longer able to drive on their own or to use any public transport. Their trips are limited, due to their personal capabilities, to local places within walking distance for their homes. With the decline of their mobility they cannot walk fast or far distances and they struggle to cope in crowded places because they need enough space on the walkways. Level changes also create barriers for frail people, similarly ramps or steps are a challenge for people with mobility problems (Burton Mitchell, 2006, Mitchell et el., 2004). To attain accessibility for frail people, they should preferably live no more than 125m from the nearest post box or telephone with 2m wide pathways and no more than 500m from crucial services and facilities. There should also be public seating every 100m to 125m (Burton Mitchell, 2006, Mitchell et el., 2004). Comfort Comfort for older people and people experiencing permanent incapacity can include streets that allow them to visit places of their choice without any mental or physical agitation, it provides them with a welcoming and calm feeling (Burton Mitchell, 2006, Mitchell et el., 2004). To achieve a comfortable environment the streets must be designed in a way that it is welcoming, quiet, open, and accessible by providing enough public seating, shelter, and toilets. The seating must preferably be a wooden seat with arm and back rests. Bus stops should provide shelter, with transparent sides and flat seats of non-slippery material that do not conduct cold or heat (Burton Mitchell, 2006, Mitchell et el., 2004). Safety Safety is a critical characteristic of a friendly environment for dementia people, they have to be able to move around without fear of tripping, falling, being run-over, or attacked. Safe streets will be well-lit, wide, plain, level, non-slippery, non-reflected, and smooth footways with isolated bicycle lanes and in front of building entering ways (Blackman et al., 2010, Burton Mitchell, 2006, Mitchell et el., 2004) The above principles outline the design guidelines to a more outdoor friendly environment for people with dementia. Burton and Mitchell (2006) also provides 65 recommendations and by using these it will support the design and re-design of an easy to use and welcoming neighbourhood. To summarise, it is clear that people with dementia, at least during their mild to moderate stages, can still maintain their ability to cope independently and any regular mental and physical exercise is essential to maintain their self-respect, independence, and their quality of life as seen in the vignette. That is why it is so important to us to ensure that the outdoor environment is accessible, open, and safe for people with all stages of dementia. If this cannot be achieved the environment out there becomes a scary and frightening world for people with dementia. Although, the neighbourhood environment is not dementia friendly at present there is positive improvements and pressure from Government, through the Prime Minister’s Challenge on dementia. Importantly, the research project identified six principles of a dementia friendly environment that can be used for future planning and implementations. This will ensure that all new developments that take these principals into consideration will be in line with suggested and prescribed rules that cater for a safe and accessible environment for people with dementia.

Graduation Speech -- Graduation Speech, Commencement Address

The old poet Kahlil Gibran, a long time ago, once said, "You work that you may keep pace with the soul of the earth. For to be idle is to become a stranger unto the seasons, and to step out of life's procession, that marches in majesty and proud submission toward the infinite." An interesting thought, that we work in order to keep pace with the earth. Now, I'm sure you're asking yourself, how can my near minimum wage job, where the customers treat me like a doormat and I still have to be pleasant and chipper, keep me in sync with the soul of the earth. Well I imagine there are higher rewards to part-time high school jobs, but other than the always too small pay checks, I am hard pressed to fathom them. Yet, that is not the kind of work I am speaking of. And then there is school work. Yes of course there are obvious rewards, such as these diplomas we are about to receive, to putting in a lot of time, energy and hard work into our studies. However, today I am here to talk about another aspect of work. It is work that many of us have been involved in one way or another either in sch...

Traditional and Internet Dating Essay -- Dating Social Values Changes

Traditional and Internet Dating At some point in our lives where we are searching for that special someone. The methods of going about dating have changed quite dramatically over the years. Going out has grown from traditional dating, to internet 'dating', to group dating.   Ã‚  Ã‚  Ã‚  Ã‚  Traditional Dating has changed over the years. In my generation the girls can ask the guys, there is no telling where they might go on a date, or they might just hang out at home, which did not happen as much 25 years ago. My generation's moral values are changing too: sex on the first date happens more frequently now. Many Years ago a guy would go pick the girl up at her house, was introduced to her parents and have a talk with them before taking their little girl out for a first date. Now, however, guys and girls meet somewhere or the guy just beeps the horn and in many cases the parents do not meet the guy with whom their daughter is going out. When my parents were young, dating was something taken seriously, and knew someone for a period of time before ever asking her out on a date. Today a date may be just something to do for fun or if you are bored. Nowadays many people "hook-up" at bar, clubs or random parties. : I wonder what changes are to be in the futur e of dating.   Ã‚  Ã‚  Ã‚  Ã‚  What kind of person goes online and uses personal ads to meet their mate. The Internet changing everything from the way we shop to the way we find driving directions. Cyberspace has become the hottest pick-up jo...

European History Essay

The way the eastern civilization would live is how people dream of living today. The eastern peoples put others above themselves. The way the western civilization used to live is how we live today: caring about ourselves for the most part. Even though the eastern side of living is how most people wanted to live, there are some positive characteristics of the western side that are worth incorporating. A common problem today is that we don’t think. A trait of eastern culture is the being contemplative. There are countless problems that could be avoided if thought would have gone into the situation. Life is a strategy that is filled with decisions. It is inevitable that mistakes will be made, but there will be less if you think before you act. In life there are always consequences for your actions. What most people don’t realize is that there can be positive consequences. This is something that the western civilization honored; the rewards or the positive consequences of the life they lived. Having the good things in your life isn’t as rewarding as working for the grand prize. Towards the end of your life, what will you have that reflects what you work for? In the eastern civilization, working with less is held high in standards. As the years go by, people always want more and more but is it really necessary? For example, heated seats and electronic windows are nice in our vehicles but we don’t actually need them. The eastern peoples learned to work with what they were given, even if it was less than what they wanted. Technology is taking over the world. With this new interference with human life, the beautiful art of work will soon be forgotten. There are amazing things that humans can do as long as they work for it. The western civilization figured this out and put activity high on the list of standards. Life is short and there may be things that we miss if we don’t work to see what it has in store for us. Both the eastern and western civilization contain characteristics that would benefit the human race. A mixture of the two would be a perfect way to live. Placing others higher in value than yourself is a trait that isn’t common in the world today. Even though, putting others first is something great, you need to think about yourself too. You only have one life and one chance to make it the best. Do what makes you happy and you will see that others will come with you.