Primary Health Care for Diabetes Treatment

Primary Health Care for Diabetes Treatment Ashley Suy Molly is a married 82-year-old woman who is diagnosed with Type II Diabetes and has developed a leg ulcer on her lower left leg. The effects of having leg ulcers impacts Molly’s physical, mental and social health. Physically, Molly’s mobility has declined. She is unable to walk as with every step she takes it causes pain. A lack of physical activity, such as walking has led to weight gain as she has been advised to sit with her leg up as much as possible to speed up the healing process. Molly’s mental well-being would be negatively impacted as she will be mentally stressed from dealing with the leg ulcer and having no mobility to do day-to-day tasks. This disenables her to have independence as she relies on Pat, her husband, to do simple tasks for her as she is immobile which may lead to guilt for relying on him to assist her with daily tasks. The leg ulcer along with immobility will inflict negative effects on Molly’s social health. Not being able to go out to see her friends and her loved ones or spend time outside of home with Pat will cause an abundant amount of stress which will gradually lead to depression. The issues that will be primarily focused on are, Primary Health Care relating to Molly’s Leg ulcer, Principles of Wellness, the Wellness Model, Type 2 Diabetes in regards to Molly’s condition and how an Enrolled Nurse will support Pat through a time of distress of grieving and bereavement. Primary Health Care (PHC) is the primary contact of accessing health care and it is based on the needs of individuals and the country. It focuses on practical, scientifically sound and socially acceptable methods and resources that are made universal for people and families at an affordable cost that individuals and the country can afford to assist with their individual growth and development to maintain a healthy life (Koutoukidis, Stainton, Hughson, 2013, pp. 85-86). Since PHC is based on providing appropriate resources for individuals, Molly should be educated on the different types of services that will allow her to treat her health problem effectively. Some services include, home carers, community service, counsellors and online websites such as Diabetes Australia. As Molly suffers from a Leg ulcer she is evidently unable to participate in her regular community activities like she once use too. PHC encourages services that are scientifically sound and socially acceptable – as well as, relevant to the client. A way that PHC can be beneficial for her is through a home visiting service or physiologists that is subsidised by Medicare. PHC supports the involvement of a multidisciplinary team – integration of services that will assist Molly in the healing process. Nurses, dieticians, physiologist, podiatrists and GPs are the most appropriate types of multidisciplinary members. This team will educate her, Pat and her family with informa tion of diabetes, leg ulcers, proper nutrition, appropriate exercises and activities to promote her health as well as preventing future hospitalisation or illness exacerbations. ‘Wellness’ according to Student Health and Counselling Services (SHCS) (https://shcs.ucdavis.edu/wellness/) ‘is an active process of becoming aware of and making choices towards a healthy and fulfilling life’. The wellness model is a framework that individuals use to become aware of the interconnectedness of each dimension of the wheel and how they play a significant factor to healthy living. The Wellness Model consists of six dimensions: physical, social, intellectual, spiritual, emotional and occupational (Hettler, 1976). A principle of wellness is ‘the self is the only true healer’. This refers to the health professionals assisting individuals during the healing process. However, it is primarily up to ones’ body and mind to heal– as well as allowing time for full recovery. (Hoppers Institute, n.d). Another principle of wellness is ‘Prevention eliminates the need for treatment’. This simply means that the prevention of wellness should predominantly be focused on a solution or an outcome to eliminate the problem so there would not be a need for treatment. These principles apply to Molly as she has health professionals that help facilitate the healing process with dressing the wound three times a week and advising her to recover at home which is allowing time to pass by to allow full recovery. Prevention eliminates the need for treatment principle relates to Molly because she needs to limit the chances of leg ulcers from reoccurring again in the future. So, with a mixture of moderate exercise and a healthy diet it would minimise leg ulcers from occurring again. Another effective way to limit the chances of developing leg ulcers again is by using compression socks or hosiery to allow adequate blood circulation in the leg, thus preventing leg wounds. (Kenny, 2013) Type 2 Diabetes is insulin that is either, unable to produce what the body needs or the cells in the body are unable to use the existing insulin effectively (also known as, insulin resistance). (Falvo, 2014) According to Diabetes Australia (http://www.diabetesaustralia.com.au/Understanding-Diabetes/Diabetes-in-Australia/) an estimated 280 Australian’s develop Diabetes every day. It is the most common form of diabetes, affecting 85 – 90% of all people with diabetes. Although it usually affects adults over the age of 45, it is now affecting younger people even children as young as 3. Research has shown that women over the age of 45 and overweight are more susceptible to getting diabetes. Molly has been diagnosed with type 2 diabetic for 17 years. What happens in the body of a diabetic person is that the pancreas which controls glucose in the body makes less insulin (a hormone). However, if the existing cells in the body are unable to effectively use insulin, it makes it difficult to keep blood glucose levels (BGL) in an optimum range. The pancreatic cells cannot use existing insulin effectively thus, why she has been prescribed oral medication to control her blood glucose lev el. Diabetes contribute to leg ulcers as fatty substances called atheroma develops on the inside lining of the arteries reducing blood flow to various parts of the body. The most commonly affected area is the arteries in the legs – causing a decrease in blood supply to the feet (Kenny, 2014). Diabetic retinopathy is the most common diabetic eye disease. It is caused by changes in the blood vessels of the retina. Blood vessels in the eye may swell, or leak fluid. In some people, abnormal new blood vessels grow on the surface of the retina. A learning program for Molly’s Leg ulcer is a crucial factor in educating her on the prevention of reoccurring leg ulcers. Some teaching methods that would be used are verbal discussions about Diabetes, her eating habits, exercising routine and lifestyle. Since she has put on weight, she feels tired and unwell. A dietician and a local GP will work together to review current blood and other tests that will be mixed together to come up with a suitable diet plan. The dietician will then provide Molly with written information that she will be able to take home to follow, thus achieving her physical health. (Dieticians Associated of Australia, 2014) Another method of teaching is through a physiologist who can demonstrate various low to mild exercise routines where the activities are suitable and safe to follow as well as assist with Molly’s current immobility (Allied Health Profession Australia [AHPA], 2010). As mental health for Molly is a risk factor, beyond blue encourages that maintaining connections with friends, family and the community can prevent feelings of loneliness and isolation and help to stay mentally healthy (Beyond Blue, 2013). This first link is a publication regarding leg ulcers and how to care for them, thus educating Molly on Leg ulcers. Molly will need to read this publication to understand it or have a relative or health professional explain it to her. http://www.awma.com.au/publications/vlu_patient_info_a4_2012-08-21.pdf The second resource that Molly can learn from is the Leg Ulcer Prevention Program (LUPP) which is an electronic multimedia client education package for people receiving care regarding leg ulcers. The program is delivered at home via a nurse’s personal computer, so Molly will not have to move too much. Also, she can listen and watch the multimedia. (Kapp, S; Miller, C; and Donohue, L, 2010) Grief and loss are two major feelings that Pat has encountered as Molly passed. Grief is a response to loss. People experience grief differently; some may go through sadness, anger, anxiety, disbelief, panic, relief or even numbness. (Healey, 2010) To relieve Pat’s grief, an Enrolled Nurse would offer basic reassurance that he is not alone, an opportunity for him to talk about the loss of his wife, encourage him to seek help from other resources if he needs, such as psychologists, counsellors, or mental health services. The Australian Centre for Grief and Bereavement (ACGB) offers support groups that will help participants in many ways. Some of the groups that they offer are Bereaved Partners, Death of a Parent, For Men, Pet Loss and many more. ACGB also shares stories of other people that have gone through loss (Australian Centre for Grief Bereavement, n.d). Another service available is the ‘Compassionate Friends Victoria’, a group that offers ‘men’s space’ where bereaved men go along and discuss issues together. (Compassionate Friends Victoria, 2014) Primary Health care along with the Wellness Model play a major role in the quality of life that Molly has experienced. Type 2 Diabetes has a major affect on Molly’s health, thus contributed to leg ulcers. Pat will gradually move on from grieving over the loss of his wife with the help of support groups. Word Count: 1591 References Donna R. Falvo.(2014). Medical and Psychosocial Aspects of Chronic Illness and Disability (Ed. 5) (p.377) Beyond Blue (2013). Older People and Depression. Retrieved from: http://www.beyondblue.org.au/resources/for-me/older-people hopperinstitue.com. (n.d.).Principles of wellness. Retrieved from http://www.hopperinstitute.com/wellness.html Diabetes Australia (2013). Type II Diabetes. Retrieved from: http://www.diabetesaustralia.com.au/Understanding-Diabetes/Diabetes-in-Australia/ Bill Hettler, MD. (1976). The Six Dimensions of Wellness Model. Retrieved from http://c.ymcdn.com/sites/www.nationalwellness.org/resource/resmgr/docs/sixdimensionsfactsheet.pdf Gabrielle Koutoukidis., Kate Stainton., Jodie Hughson. (2013). Health promotion, education and wellness. In Elizabetch Coady Jane Coulcher (Ed.6), Tabbner’s Nursing Care (pp. 85-86). Tim Kenny. (2013).Venous Leg Ulcers. Retrieved from: http://www.patient.co.uk/health/venous-leg-ulcers-leaflet shcs.ucdavis.edu (n.d) Wellness. Retrieved from: https://shcs.ucdavis.edu/wellness/ compassionatefriendsvictoria.org.au.(2014). Retrieved from Compassionate Friends Victoria: http://www.compassionatefriendsvictoria.org.au/ grief.org.au. (n.d.).Grief.Retrieved from Australia Centre for Grief Bereavement: http://www.grief.org.au/grief_and_bereavement_support/understanding_grief/about_grief Justin Healey. (2010). Coping with Grief and Loss: Vol. 319.Coping with Grief and Loss. Australia: The Spinny Press.

John Donnes The Indifference :: Poets, Poetry, Prose

John Donne's "The Indifference" is a love poem that can be interpreted in a number of ways. Not only is the meaning of the text debatable, but the audience for which the poem was intended can be argued as well. The language Donne uses leaves room for the reader's imagination and intellect to take over and decide to whom he is talking and why. The author is writing to a specific audience for a specific reason, trying to convey his point through his verse. While not all people agree as to whom this poem is intended for or whom the speaker is actually talking to, I have a good understanding as to what Donne is trying to accomplish by writing "The Indifference" and whom the voice of the piece is actually talking to. The interpretation that I found to be most convincing is that he is speaking to a woman, who is by herself, and he is letting her know what kind of qualities (or lack there of) he is looking for. He is giving a disclaimer to her on the type of person he is and how he views relationships so she knows what she's getting herself into. The first stanza starts off with the speaker listing opposite character types. All of the types listed refer to different types of women, "Her whom the county formed, and whom the town" and "Her who still weeps with spongy eyes, / And her who is dry cork, and never cries". The speaker is not referring to one type of woman in particular, but to all women in general. He is telling the woman that he is addressing know just how many different types of woman he can or will potentially be interested in. Another interesting aspect of the first stanza is Donne's wording at the beginning of each line. He starts each with either "I can love" or "Her who". This is his passive way of informing the reader as to what type of woman he can and wants to love: any woman who is alive and willing to take a chance on him. It is not until the final two lines of the stanza that he actually puts any requirements as to what kind of a woman he specifically wants, "I can love her, and her, and you and you, / I can love any, so she be not true".

A Game of Thrones Chapter Six

Catelyn Of all the rooms in Winterfell's Great Keep, Catelyn's bedchambers were the hottest. She seldom had to light a fire. The castle had been built over natural hot springs, and the scalding waters rushed through its walls and chambers like blood through a man's body, driving the chill from the stone halls, filling the glass gardens with a moist warmth, keeping the earth from freezing. Open pools smoked day and night in a dozen small courtyards. That was a little thing, in summer; in winter, it was the difference between life and death. Catelyn's bath was always hot and steaming, and her walls warm to the touch. The warmth reminded her of Riverrun, of days in the sun with Lysa and Edmure, but Ned could never abide the heat. The Starks were made for the cold, he would tell her, and she would laugh and tell him in that case they had certainly built their castle in the wrong place. So when they had finished, Ned rolled off and climbed from her bed, as he had a thousand times before. He crossed the room, pulled back the heavy tapestries, and threw open the high narrow windows one by one, letting the night air into the chamber. The wind swirled around him as he stood facing the dark, naked and empty-handed. Catelyn pulled the furs to her chin and watched him. He looked somehow smaller and more vulnerable, like the youth she had wed in the sept at Riverrun, fifteen long years gone. Her loins still ached from the urgency of his lovemaking. It was a good ache. She could feel his seed within her. She prayed that it might quicken there. It had been three years since Rickon. She was not too old. She could give him another son. â€Å"I will refuse him,† Ned said as he turned back to her. His eyes were haunted, his voice thick with doubt. Catelyn sat up in the bed. â€Å"You cannot. You must not.† â€Å"My duties are here in the north. I have no wish to be Robert's Hand.† â€Å"He will not understand that. He is a king now, and kings are not like other men. If you refuse to serve him, he will wonder why, and sooner or later he will begin to suspect that you oppose him. Can't you see the danger that would put us in?† Ned shook his head, refusing to believe. â€Å"Robert would never harm me or any of mine. We were closer than brothers. He loves me. If I refuse him, he will roar and curse and bluster, and in a week we will laugh about it together. I know the man!† â€Å"You knew the man,† she said. â€Å"The king is a stranger to you.† Catelyn remembered the direwolf dead in the snow, the broken antler lodged deep in her throat. She had to make him see. â€Å"Pride is everything to a king, my lord. Robert came all this way to see you, to bring you these great honors, you cannot throw them back in his face.† â€Å"Honors?† Ned laughed bitterly. â€Å"In his eyes, yes,† she said. â€Å"And in yours?† â€Å"And in mine,† she blazed, angry now. Why couldn't he see? â€Å"He offers his own son in marriage to our daughter, what else would you call that? Sansa might someday be queen. Her sons could rule from the Wall to the mountains of Dorne. What is so wrong with that?† â€Å"Gods, Catelyn, Sansa is only eleven,† Ned said. â€Å"And Joffrey . . . Joffrey is . . . â€Å" She finished for him. † . . . crown prince, and heir to the Iron Throne. And I was only twelve when my father promised me to your brother Brandon.† That brought a bitter twist to Ned's mouth. â€Å"Brandon. Yes. Brandon would know what to do. He always did. It was all meant for Brandon. You, Winterfell, everything. He was born to be a King's Hand and a father to queens. I never asked for this cup to pass to me.† â€Å"Perhaps not,† Catelyn said, â€Å"but Brandon is dead, and the cup has passed, and you must drink from it, like it or not.† Ned turned away from her, back to the night. He stood staring out in the darkness, watching the moon and the stars perhaps, or perhaps the sentries on the wall. Catelyn softened then, to see his pain. Eddard Stark had married her in Brandon's place, as custom decreed, but the shadow of his dead brother still lay between them, as did the other, the shadow of the woman he would not name, the woman who had borne him his bastard son. She was about to go to him when the knock came at the door, loud and unexpected. Ned turned, frowning. â€Å"What is it?† Desmond's voice came through the door. â€Å"My lord, Maester Luwin is without and begs urgent audience.† â€Å"You told him I had left orders not to be disturbed?† â€Å"Yes, my lord. He insists.† â€Å"Very well. Send him in.† Ned crossed to the wardrobe and slipped on a heavy robe. Catelyn realized suddenly how cold it had become. She sat up in bed and pulled the furs to her chin. â€Å"Perhaps we should close the windows,† she suggested. Ned nodded absently. Maester Luwin was shown in. The maester was a small grey man. His eyes were grey, and quick, and saw much. His hair was grey, what little the years had left him. His robe was grey wool, trimmed with white fur, the Stark colors. Its great floppy sleeves had pockets hidden inside. Luwin was always tucking things into those sleeves and producing other things from them: books, messages, strange artifacts, toys for the children. With all he kept hidden in his sleeves, Catelyn was surprised that Maester Luwin could lift his arms at all. The maester waited until the door had closed behind him before he spoke. â€Å"My lord,† he said to Ned, â€Å"pardon for disturbing your rest. I have been left a message.† Ned looked irritated. â€Å"Been left? By whom? Has there been a rider? I was not told.† â€Å"There was no rider, my lord. Only a carved wooden box, left on a table in my observatory while I napped. My servants saw no one, but it must have been brought by someone in the king's party. We have had no other visitors from the south.† â€Å"A wooden box, you say?† Catelyn said. â€Å"Inside was a fine new lens for the observatory, from Myr by the look of it. The lenscrafters of Myr are without equal.† Ned frowned. He had little patience for this sort of thing, Catelyn knew. â€Å"A lens,† he said. â€Å"What has that to do with me?† â€Å"I asked the same question,† Maester Luwin said. â€Å"Clearly there was more to this than the seeming.† Under the heavy weight of her furs, Catelyn shivered. â€Å"A lens is an instrument to help us see.† â€Å"Indeed it is.† He fingered the collar of his order; a heavy chain worn tight around the neck beneath his robe, each link forged from a different metal. Catelyn could feel dread stirring inside her once again. â€Å"What is it that they would have us see more clearly?† â€Å"The very thing I asked myself.† Maester Luwin drew a tightly rolled paper out of his sleeve. â€Å"I found the true message concealed within a false bottom when I dismantled the box the lens had come in, but it is not for my eyes.† Ned held out his hand. â€Å"Let me have it, then.† Luwin did not stir. â€Å"Pardons, my lord. The message is not for you either. It is marked for the eyes of the Lady Catelyn, and her alone. May I approach?† Catelyn nodded, not trusting to speak. The maester placed the paper on the table beside the bed. It was sealed with a small blob of blue wax. Luwin bowed and began to retreat. â€Å"Stay,† Ned commanded him. His voice was grave. He looked at Catelyn. â€Å"What is it? My lady, you're shaking.† â€Å"I'm afraid,† she admitted. She reached out and took the letter in trembling hands. The furs dropped away from her nakedness, forgotten. In the blue wax was the moon-and-falcon seal of House Arryn. â€Å"It's from Lysa.† Catelyn looked at her husband. â€Å"It will not make us glad,† she told him. â€Å"There is grief in this message, Ned. I can feel it.† Ned frowned, his face darkening. â€Å"Open it.† Catelyn broke the seal. Her eyes moved over the words. At first they made no sense to her. Then she remembered. â€Å"Lysa took no chances. When we were girls together, we had a private language, she and I.† â€Å"Can you read it?† â€Å"Yes,† Catelyn admitted. â€Å"Then tell us.† â€Å"Perhaps I should withdraw,† Maester Luwin said. â€Å"No,† Catelyn said. â€Å"We will need your counsel.† She threw back the furs and climbed from the bed. The night air was as cold as the grave on her bare skin as she padded across the room. Maester Luwin averted his eyes. Even Ned looked shocked. â€Å"What are you doing?† he asked. â€Å"Lighting a fire,† Catelyn told him. She found a dressing gown and shrugged into it, then knelt over the cold hearth. â€Å"Maester Luwin—† Ned began. â€Å"Maester Luwin has delivered all my children,† Catelyn said. â€Å"This is no time for false modesty.† She slid the paper in among the kindling and placed the heavier logs on top of it. Ned crossed the room, took her by the arm, and pulled her to her feet. He held her there, his face inches from her. â€Å"My lady, tell me! What was this message?† Catelyn stiffened in his grasp. â€Å"A warning,† she said softly. â€Å"If we have the wits to hear.† His eyes searched her face. â€Å"Go on.† â€Å"Lysa says Jon Arryn was murdered.† His fingers tightened on her arm. â€Å"By whom?† â€Å"The Lannisters,† she told him. â€Å"The queen.† Ned released his hold on her arm. There were deep red marks on her skin. â€Å"Gods,† he whispered. His voice was hoarse. â€Å"Your sister is sick with grief. She cannot know what she is saying.† â€Å"She knows,† Catelyn said. â€Å"Lysa is impulsive, yes, but this message was carefully planned, cleverly hidden. She knew it meant death if her letter fell into the wrong hands. To risk so much, she must have had more than mere suspicion.† Catelyn looked to her husband. â€Å"Now we truly have no choice. You must be Robert's Hand. You must go south with him and learn the truth.† She saw at once that Ned had reached a very different conclusion. â€Å"The only truths I know are here. The south is a nest of adders I would do better to avoid.† Luwin plucked at his chain collar where it had chafed the soft skin of his throat. â€Å"The Hand of the King has great power, my lord. Power to find the truth of Lord Arryn's death, to bring his killers to the king's justice. Power to protect Lady Arryn and her son, if the worst be true.† Ned glanced helplessly around the bedchamber. Catelyn's heart went out to him, but she knew she could not take him in her arms just then. First the victory must be won, for her children's sake. â€Å"You say you love Robert like a brother. Would you leave your brother surrounded by Lannisters?† â€Å"The Others take both of you,† Ned muttered darkly. He turned away from them and went to the window. She did not speak, nor did the maester. They waited, quiet, while Eddard Stark said a silent farewell to the home he loved. When he turned away from the window at last, his voice was tired and full of melancholy, and moisture glittered faintly in the corners of his eyes. â€Å"My father went south once, to answer the summons of a king. He never came home again.† â€Å"A different time,† Maester Luwin said. â€Å"A different king.† â€Å"Yes,† Ned said dully. He seated himself in a chair by the hearth. â€Å"Catelyn, you shall stay here in Winterfell.† His words were like an icy draft through her heart. â€Å"No,† she said, suddenly afraid. Was this to be her punishment? Never to see his face again, nor to feel his arms around her? â€Å"Yes,† Ned said, in words that would brook no argument. â€Å"You must govern the north in my stead, while I run Robert's errands. There must always be a Stark in Winterfell. Robb is fourteen. Soon enough, he will be a man grown. He must learn to rule, and I will not be here for him. Make him part of your councils. He must be ready when his time comes.† â€Å"Gods will, not for many years,† Maester Luwin murmured. â€Å"Maester Luwin, I trust you as I would my own blood. Give my wife your voice in all things great and small. Teach my son the things he needs to know. Winter is coming.† Maester Luwin nodded gravely. Then silence fell, until Catelyn found her courage and asked the question whose answer she most dreaded. â€Å"What of the other children?† Ned stood, and took her in his arms, and held her face close to his. â€Å"Rickon is very young,† he said gently. â€Å"He should stay here with you and Robb. The others I would take with me.† â€Å"I could not bear it,† Catelyn said, trembling. â€Å"You must,† he said. â€Å"Sansa must wed Joffrey, that is clear now, we must give them no grounds to suspect our devotion. And it is past time that Arya learned the ways of a southron court. In a few years she will be of an age to marry too.† Sansa would shine in the south, Catelyn thought to herself, and the gods knew that Arya needed refinement. Reluctantly, she let go of them in her heart. But not Bran. Never Bran. â€Å"Yes,† she said, â€Å"but please, Ned, for the love you bear me, let Bran remain here at Winterfell. He is only seven.† â€Å"I was eight when my father sent me to foster at the Eyrie,† Ned said. â€Å"Ser Rodrik tells me there is bad feeling between Robb and Prince Joffrey. That is not healthy. Bran can bridge that distance. He is a sweet boy, quick to laugh, easy to love. Let him grow up with the young princes, let him become their friend as Robert became mine. Our House will be the safer for it.† He was right; Catelyn knew it. It did not make the pain any easier to bear. She would lose all four of them, then: Ned, and both girls, and her sweet, loving Bran. Only Robb and little Rickon would be left to her. She felt lonely already. Winterfell was such a vast place. â€Å"Keep him off the walls, then,† she said bravely. â€Å"You know how Bran loves to climb.† Ned kissed the tears from her eyes before they could fall. â€Å"Thank you, my lady,† he whispered. â€Å"This is hard, I know.† â€Å"What of Jon Snow, my lord?† Maester Luwin asked. Catelyn tensed at the mention of the name. Ned felt the anger in her, and pulled away. Many men fathered bastards. Catelyn had grown up with that knowledge. It came as no surprise to her, in the first year of her marriage, to learn that Ned had fathered a child on some girl chance met on campaign. He had a man's needs, after all, and they had spent that year apart, Ned off at war in the south while she remained safe in her father's castle at Riverrun. Her thoughts were more of Robb, the infant at her breast, than of the husband she scarcely knew. He was welcome to whatever solace he might find between battles. And if his seed quickened, she expected he would see to the child's needs. He did more than that. The Starks were not like other men. Ned brought his bastard home with him, and called him â€Å"son† for all the north to see. When the wars were over at last, and Catelyn rode to Winterfell, Jon and his wet nurse had already taken up residence. That cut deep. Ned would not speak of the mother, not so much as a word, but a castle has no secrets, and Catelyn heard her maids repeating tales they heard from the lips of her husband's soldiers. They whispered of Ser Arthur Dayne, the Sword of the Morning, deadliest of the seven knights of Aerys's Kingsguard, and of how their young lord had slain him in single combat. And they told how afterward Ned had carried Ser Arthur's sword back to the beautiful young sister who awaited him in a castle called Starfall on the shores of the SummerSea. The Lady Ashara Dayne, tall and fair, with haunting violet eyes. It had taken her a fortnight to marshal her courage, but finally, in bed one night, Catelyn had asked her husband the truth of it, asked him to his face. That was the only time in all their years that Ned had ever frightened her. â€Å"Never ask me about Jon,† he said, cold as ice. â€Å"He is my blood, and that is all you need to know. And now I will learn where you heard that name, my lady.† She had pledged to obey; she told him; and from that day on, the whispering had stopped, and Ashara Dayne's name was never heard in Winterfell again. Whoever Jon's mother had been, Ned must have loved her fiercely, for nothing Catelyn said would persuade him to send the boy away. It was the one thing she could never forgive him. She had come to love her husband with all her heart, but she had never found it in her to love Jon. She might have overlooked a dozen bastards for Ned's sake, so long as they were out of sight. Jon was never out of sight, and as he grew, he looked more like Ned than any of the trueborn sons she bore him. Somehow that made it worse. â€Å"Jon must go,† she said now. â€Å"He and Robb are close,† Ned said. â€Å"I had hoped . . . â€Å" â€Å"He cannot stay here,† Catelyn said, cutting him off. â€Å"He is your son, not mine. I will not have him.† It was hard, she knew, but no less the truth. Ned would do the boy no kindness by leaving him here at Winterfell. The look Ned gave her was anguished. â€Å"You know I cannot take him south. There will be no place for him at court. A boy with a bastard's name . . . you know what they will say of him. He will be shunned.† Catelyn armored her heart against the mute appeal in her husband's eyes. â€Å"They say your friend Robert has fathered a dozen bastards himself.† â€Å"And none of them has ever been seen at court!† Ned blazed. â€Å"The Lannister woman has seen to that. How can you be so damnably cruel, Catelyn? He is only a boy. He—† His fury was on him. He might have said more, and worse, but Maester Luwin cut in. â€Å"Another solution presents itself,† he said, his voice quiet. â€Å"Your brother Benjen came to me about Jon a few days ago. It seems the boy aspires to take the black.† Ned looked shocked. â€Å"He asked to join the Night's Watch?† Catelyn said nothing. Let Ned work it out in his own mind; her voice would not be welcome now. Yet gladly would she have kissed the maester just then. His was the perfect solution. Benjen Stark was a Sworn Brother. Jon would be a son to him, the child he would never have. And in time the boy would take the oath as well. He would father no sons who might someday contest with Catelyn's own grandchildren for Winterfell. Maester Luwin said, â€Å"There is great honor in service on the Wall, my lord.† â€Å"And even a bastard may rise high in the Night's Watch,† Ned reflected. Still, his voice was troubled. â€Å"Jon is so young. If he asked this when he was a man grown, that would be one thing, but a boy of fourteen . . . â€Å" â€Å"A hard sacrifice,† Maester Luwin agreed. â€Å"Yet these are hard times, my lord. His road is no crueler than yours or your lady's.† Catelyn thought of the three children she must lose. It was not easy keeping silent then. Ned turned away from them to gaze out the window, his long face silent and thoughtful. Finally he sighed, and turned back. â€Å"Very well,† he said to Maester Luwin. â€Å"I suppose it is for the best. I will speak to Ben.† â€Å"When shall we tell Jon?† the maester asked. â€Å"When I must. Preparations must be made. It will be a fortnight before we are ready to depart. I would sooner let Jon enjoy these last few days. Summer will end soon enough, and childhood as well. When the time comes, I will tell him myself.†

Azeotrope Definition and Examples

Azeotrope Definition and Examples An azeotrope is a mixture of liquids that maintains its composition and boiling point during distillation. It is also known as an azeotropic mixture or constant boiling point mixture. Azeotropy occurs when a mixture is boiled to produce a vapor that has the same composition as the liquid. The term is derived by combining the prefix a, meaning no, and the Greek words for boiling and turning. The word was first used in a publication by English chemists John Wade (1864–1912) and Richard William Merriman in 1911. In contrast, mixtures of liquids that do not form an azeotrope under any conditions are called zeotropic. Types of Azeotropes Azeotropes may be categorized according to their number of constituents, miscibility, or boiling points: Number of Constituents: If an azeotrope consists of two liquids, it is known as a binary azeotrope. An azeotrope consisting of three liquids is a ternary azeotropes. There are also azeotropes made of more than three constituents.Heterogeneous or Homogeneous: Homogeneous azeotropes consist of liquids that are miscible. They form a solution. Heterogeneous azeotropes are incompletely miscible and form two liquid phases.Positive or Negative: A positive azeotrope or minimum-boiling azeotrope forms when the boiling point of the mixture is lower than that of any of its constituents. A negative azeotrope or maximum-boiling azeotrope forms when the boiling point of the mixture is higher than that of any of its constituents. Examples Boiling a 95% ethanol solution in water will produce a vapor that is 95% ethanol. Distillation cannot be used to obtain higher percentages of ethanol. Alcohol and water are miscible, so any quantity of ethanol can be mixed with any quantity to prepare a homogeneous solution that behaves like an azeotrope. Chloroform and water, on the other hand, form a heteroazeotrope. A mixture of these two liquids will separate, forming a top layer consisting mostly of water with a small amount of dissolved chloroform and a bottom layer consisting mostly of chloroform with a small amount of dissolved water. If the two layers are boiled together, the liquid will boil at a lower temperature than either the boiling point of water or of chloroform. The resulting vapor will consist of 97% chloroform and 3% water, regardless of the ratio in the liquids. Condensing this vapor will result in layers that exhibit a fixed composition. The top layer of the condensate will account for 4.4% of the volume, while the bottom layer will account for 95.6% of the mixture. Azeotrope Separation Since fractional distillation cannot be used to separate components of an azeotrope, other methods must be employed: Pressure swing distillation applies pressure changes to change the composition of a mixture to enrich the distillate with the desired component.Another technique involves the addition of an entrainer, a substance that alters the volatility of one of the azeotrope components. In some cases, the entrainer reacts with a component to form a nonvolatile compound. Distillation using an entrainer is called azeotropic distillation.Pervaporation involves separating components using a membrane that is more permeable to one constituent than the other. Vapor permeation is a related technique, using a membrane more permeable to the vapor phase of one component than another. Source Wade, John, and Richard William Merriman. CIV.- Influence of Water on the Boiling Point of Ethyl Alcohol at Pressures above and Below the Atmospheric Pressure. Journal of the Chemical Society, Transactions 99.0 (1911): 997–1011. Print.

How To Grow Your Blog Traffic By 1,044% In 1 Year

How To Grow Your Blog Traffic By 1,044% In 1 Year My blogs traffic grew 10 times larger in less than a year. I want to show you how to have the same success. When I became the content director for LDS.net, one of my companys long-time underused sites generated about 65,000 hits a month. Within less than a year, the site generates more than 700,000 hits a month. Generating a traffic revolution for your blog has never been easy, but it is doable. We grew by integrating into our process every step of the way. The Best Advice On How To Grow Your #BlogTraffic By 1,044% In 1 Year1. Find Your Audience When we talk about website growth, we are talking about people. We wanted more people to take time out of their day to read our posts. You do, too. When we spend so much time looking at bounce rates, session numbers, and growth trajectories, it’s easy to lose track of the humans at the heart of our work. When we talk about website growth, we are talking about people. #marketingIf you want those numbers to increase, you can’t afford to look past the people. Fittingly, Google Analytics can actually be the easiest place to learn about the people on your site. Google Analytics will help you identify six attributes of your readers: Age Gender Location Acquisition Site Interests Technology Use those tools to see which of these attributes go together most often to create sketches of the kind of reader on your site. For example, we identified a 59-year-old female from Cedar City, Utah, who clicked on one of our links from Facebook on her two generation old iPhone. She’s family focused. We found all that information on Google Analytics. It started sounding like a well-rounded  person who we could actually get to know. You can probably imagine this woman in your head. After that, we used  Ã¢â‚¬â„¢s 8-step process  for developing a reader persona to flesh out this womans story. Give your persona a name. We did this three times to match our most common types of readers. Every week, my team and I read through each of the personas to ask how well were meeting their needs. For each article we release, we make sure its written to one of our readers. As we grew, we wrote new potential reader personas, then attempted to attract them to the site. When it worked, we added the personas permanently. Our growth occurred from attracting more of our current audience and by adding additional audiences. Writing personas during this time allowed us to personalize our growing audience. Writing personas will help you personalize and grow your audience. #marketing2. Plan Your Content I’ve worked with around forty writers in the two years since our site first launched. And most writers seem to have one major personality trait in common: We thrive under deadlines. Writers thrive under deadlines. #writingWriters often make the perfect the enemy of the good, and without a method to help, we will dawdle around trying to write a masterpiece. solves this problem. We plan our content by targeting our primary persona and the content type that we want to write. We use six primary content types on our site: Listicle How to Feature Ultimate guide QA Infographic We create new articles directly onto the calendar and start with the title that identifies our persona and content type. For example, â€Å"Stephanie Torres-QA† Once you know your reader persona and content type, youll know what to write.The topic comes next. Often, once we know our reader and content type, we know exactly what that kind of reader will want. This helps you get the best ideas with the least amount of time brainstorming. If you don’t immediately know what article topic you want, move on to the title. has a fantastic list of the most successful blog title structures. Pro Tip: As you see great blog titles online, add them to your own list. If you need more ideas, it’s time to brainstorm. Everyone on my team is able to generate ideas by using at least one of ’s four brainstorming ideas. The beauty of this method is that as soon as you have an idea, it’s already on a calendar ticking down. Recommended Reading:  9 Types Of Blog Posts That Are Proven To Boost Traffic 3. Title Your Articles If you didn’t use one of ’s title structures, then you need to nail down a title before you start. Certain titles work better because they promote a type of content your reader wants. Ask yourself this: What does my reader want to know? Start with a successful title, and then quality content will follow. There is no better headline analyzer available than s. I know because LDS.net looked everywhere for one. Take your time using the tool. It can be tempting to start with one title, and play only with variations of that. We brainstorm at least ten title variations and then run them through the headline analyzer. Since the headline analyzer keeps track of your previous titles, we can  easily choose those that perform best and try many variations of those until we have winning title that will perform well. One of our early successes was the article, â€Å"Mormon Jokes That Will Make You Smile.† We began with a number of article titles we thought would sound good. Titles like: The 29 Funniest Mormon Jokes 29 Hilarious Mormon Memes You Need to See These Mormon Memes LDS Memes That Will Have you Rolling in Laughter 29 Mormon Jokes to See Right Now 29 Images to Make You Smile We were able to see immediately which of those title structures had potential and which didn’t. The advantage of having so many initial ideas is that you can mix and match to find combinations that work. And even though we didn’t know the final number of jokes we would use, we didn’t hesitate to use a placeholder number in the headline analyzer. Eventually, we tried the final title which scored an impressive 87. Unsurprisingly, it was the biggest hit we’d had on the site to that point. 4. Use A  Task Template About one week after we started using , I wrote to ask them if there was a way to create a task template. There wasn’t, but they promised they would integrate it soon. Today we use task templates on every article we publish. The advantage of task templates is that as soon as we have an article idea, everyone who will need to work on that article instantly has tasks on their to-do list to ensure that the article is out on time. As an editor, this is a huge organizational burden taken off my desk. No longer do I need to bother writers with regular emails; instead, I can just check in on any overdue items. Here is our 6-Step editorial process: Step 1: Content Quality This editorial step covers tone, research accuracy, and writing problems such as using cliches, and clarity. There are plenty of tips on the blog to help you perfect your content quality: Tone: How To Write For Your Intended Audience How To Build Your Brand With Humor So Youll Feel Like A Human Research: This Is The Marketing Research Process That Will Take Your Content To The Next Level Writing: 150+ Blog Ideas That Will Absolutely Kill Writers Block These Lazy Writing Mistakes May Be Turning Off Your Readers Step 2: Organization We make sure that the introduction and call to action are written according to our best practices, and ensure that presentation is as simple as possible. Recommended Reading: How To Write Irresistible Blog Post Introductions Thatll Keep Your Readers Reading How To Write A Call To Action In A Template With 6 Examples Step 3: Readability We understand that web content gets scanned, so we want to make sure that our images, headlines, and captions do a good job of keeping our readers engaged. Recommended Reading: The Ultimate Guide To Using Color Psychology In Marketing + Free Color Schemes How To Write Headlines That Drive Traffic, Shares, And Search Results 21 Social Media Engagement Tactics That Will Grow Your Audience Step 4: Proofreading On our team, we make sure a person besides the writer and editor proofreads the writing to ensure that we don’t get stuck in a  trap of reading what we thought we wrote. Recommended Reading: What To Do When You Dont Have A Proofreader Step 5: Search Engine Optimization We integrate our keyword  while ensuring our tags and meta descriptions are up to par. Recommended Reading: How To Make An SEO Content Strategy That Will Improve Your #1-3 Results By 248% An SEO Driven Approach To Content Marketing: The Complete Guide How To Boost Traffic With 27 Important SEO Tips Step 6: Visual Design This step covers integrating images into the article, as well as preparing a featured image and social media images. Recommended Reading: Should You Use Stock Or Free Images For Blog Posts? How To Attract An Audience With The Best Blog Photography Tips (+128 Free Images) 5 Super Easy Ways To Create Images For Your Blog Posts How To Make The Best Blog Graphics (For Non-Designers) We use three different task templates that slightly alter these six steps depending on the type of content we are publishing. Infographics are seen multiple times by our design director, for example, while ultimate guides require an earlier start. If you work by yourself, or on a smaller team, task templates can be a great way to reflect your own personal process. I set a task template on the articles that I write so I wont forget to complete an outline, conduct interviews, or do proofreading. 5. Send to Social Media Once you have a valuable piece of content, it’s time to find an audience. Before using , less than one-third of one percent of our traffic came from social because promoting content regularly took too much time. Today, more than  fifty percent of our traffic comes from social. One-click social sharing from our calendar has saved us so much time, we now personalize posts to best take advantage of each social network. also makes resharing content a breeze. We always intended to reshare content, but a week later, you’re often on to the next post. Being able to plan out three month’s worth of shares at one time has allowed us to maximize each article’s content. Plus you can use the task template to remind people on your team to share the article!No matter how much success you have with web #content, you can always do better.6. Keep Improving Perhaps the most important thing we do is that we always try to improve. The blog  consistently has useful and thought-provoking content. We always pass around the blog posts with our team and make changes based on the advice we read. No matter how much success you have with web content, you could be doing better. And in this industry, best practices change all the time. It’s essential to stay connected with industry leaders so that you avoid falling behind. For example, soon after we released our Mormon Jokes article, published a blog post about how to grow your email list. We used this advice to start our own email list, reshared the article over email, and generated a 10%  bump in traffic. By integrating into every step of my publication process, my site grew by leaps and bounds. What products have you found success with? How have you integrated them into your site’s workflow?

Graduation Speech Essay Example | Topics and Well Written Essays - 250 words

Graduation Speech - Essay Example Effective planning is my greatest strength, and the one I shall rely on to manage my time and complete the MBA successfully at the university. My knowledge of elements of effective planning and experience in implementing the elements establishes the strength. I will particularly rely on advice from friends who have completed MBA programs and from the institution’s faculty for knowledge on scope of the program. I will then analyze anticipated learning environment and identify my specific needs for the MBA. I will then identify motivation factors and be strategic in my planning for the program, based Cowher and Dickson’s concept of effective planning (2009). I will develop a grand plan and mini plans for every course unit. I will use my MBA, after graduating, for long term and short term objectives. The immediate application of the qualification will be to secure a job that will help me gain professional experience and develop my career. Long-term applications will be establishment and management of my private consultancy firm, and attainment of a social position that will help me engage in social responsibility. These will also have positive effects on the university’s image, as a stakeholder to social responsibility through efforts of its

Identify qualitative methodology in journal articles and critically Research Paper

Identify qualitative methodology in journal articles and critically review its applicability to the study - Research Paper Example ents were quite appropriate for the study, as capturing the essence of what drives both the management of change and the influence of the processes and systems at two different companies on female workers with varying degrees of education and experience. In order to fully assess different perspectives on these views, the unstructured interview allowed the subjects to freely express their unique experiences and viewpoints regarding the role of women in the workplace and how their roles are defined through different social lenses. Additionally, the unstructured interview, as opposed to the simple survey or questionnaire format, allows the researcher to dig deeper into the human behavioral aspects which drive various decision-making in the workplace. It is a relatively common fact that, from an HR perspective, people have various needs in the professional environment linked to autonomous working conditions and empowerment in order to feel fully valuable to an organization. With this in mind, had this study taken a more quantitative approach, such as the utilization of surveys to locate patterns of behavior at the two workplaces described in the research article, it would have limited the potential of the study by limiting responses to a set series of researcher-designed criteria. For instance, a multi-tick survey instrument, such as a series of questions with potential responses ranging from 1-10 based on personal opinion, might have captured whether specific patterns existed in terms of individual worker pers pectives on the role of women in the workplaces. However, the more behavioral aspects of managing people, such as the soft approach to human resources management where people development is paramount, would be missing from this approach, which justifies this study’s use of the informal interview template to provide for free expression of ideas and unique perspectives. One notable limitation to this study’s design involves its lack of clear objectives: What