Wall Building

Divider Building Several remarks in messages, on Facebook, and truly, even face to face, made me tragic this week. Whenever an individual was gone up against with a chance, they talked first about how they couldn't do it. Without jumping. Without an idea about attempting to figure out how to learn. They are building dividers over a level bit of ground that could prompt achievement. Models: I am hesitant to distribute on the grounds that I dont comprehend the contrast between independently publishing and customary. Darn, I dont realize how to compose a short story to participate in that challenge. Somebody will let me know Im boasting on the off chance that I tout my writing in broad daylight. Im apprehensive somebody will take my thought. I dont have enough cash to distribute. Such a significant number of essayists see the snags before they imagine the chance. They feel the agony before they get harmed. They jump before they are pricked. As I told the Nebraska Writers Guild a week ago: Go ahead and be apprehensive. Feel free to keep down, dreadful of what to do straightaway, since that just gives me and all these others the opportunity to pass you Whatever you think, do, or keep down doing, takes vitality. You can inject your vitality into being proactive and figuring out how to continue, or you can consume your vitality stressing over what may turn out badly. With the primary, you may pick up progress. With the second, you waste time. Settle on a choice, at that point seek after the arrangement or walk toward the objective. Peruse short stories and figure out how to think of them. Study the contrast between distributing openings until you are agreeable in your decision. Choose if youre stressed progressively over distributing or what individuals may state about you. Set out to submit, understanding the chances of somebody taking your work is miniscule. Set aside your cash or start a crowdfunding venture on Kickstarter.com and acquire the cash you need. There are choices. There are openings. Be that as it may, you need to connect for them. They don't come to you.

Compare and contrast the roles of memory and remembering in Arendt and Essay

Thoroughly analyze the jobs of memory and recalling in Arendt and Nietzsche - Essay Example Her situation towards the agitated idea of intensity grounded on the remembrances recommends the necessity to be cautious in digging her musings for potential property to illustrate to the philosophical issue of the establishments. Nonetheless, thinking about the memory as a fiery limit, according to the investigation of Arendt where it demonstrates that we should, advocates that we may productively see legitimization in equivalent terms. In any case, Arendt’s depiction of the connection between the memory of an aggregate ordered account and activity bears a fondness that is graphically fascinating to Nietzsche’s story of the course that good and standard qualities take after their first creation. The two features that the first demonstration is inventively basic, and casing this inclination to frame as one of the fundamental humankind limits. They digress, obviously, in their assessment of the effect that the recognition of the clever demonstration has on the later age s: Nietzsche watches the consistent ethical quality naturalization as one of the primary hindrances to moving past the predominant standards though Arendt sees memory as the political force guard. In thinking about the philosophical establishments issue, in any case, it is their equal valuation for the estimation of creation and activity that issues. This implies the basic standardizing claims authority comes, not from their fundamental rightness, however somewhat from the reality that in understanding that the root of those cases lies in a human capacity to deliver fresh starts, the memory of those cases may support future activity and increasingly political opportunity dynamic exercise. In the case of, following Arendt, scholars acknowledge a legitimization of introductory regularizing claims grounded in the capacity of the inquirer to propel an interesting arrangement of cases, it is insightful to obtain different parts of Arendt’s hypothesis of power and establishment, to o. Primarily, her conviction that activity, opportunity, and legislative issues itself require exposure additionally applies to the development of beginning standardizing claims. A similar accentuation on the majority that is fundamental for political life permits Arendt to divert her upheaval concentrate away from savagery. Furthermore, it guarantees rather that the characterizing highlight of effective unrest is â€Å"the interconnected standard of shared guarantee and regular deliberation.† A procedure of open legitimization applied to regularizing claims, supplemented by the memory of the underlying disclosure of that guarantee, would address two issues. Initially, it would satisfy a prerequisite understood in the quest for increasingly strong establishments: the necessity that we have the option to sanction a hypothesis upon that establishment that conveys weight in a pragmatic setting. Second, and urgently when taking a relevant perspective on political standards, by op pressing essential cases to the examination that the memory of their dynamic creation yields, we urge scholars to powerfully keep up intelligence between their primary cases and the world they try to depict and influence. The hypothetical impediment on primary cases that goes with this perspective on support presents an a lot more elevated level of fallibilism and possibility than the old met accounts permitted. Primary cases bolstered through a progressing procedure of support surrender any case to target truth or all inclusive pertinence. Along these lines, the

Cannabis Sativa Essays - Medicinal Plants, Herbalism,

Cannabis Sativa Hemp is the plant called cannabis sativa which is all the more usually called marijuana.Marijuana has been unlawful in the U.S.. since the time the Great Depression. The inquiry we should pose to ourselves is why?Why is a medication that has such huge numbers of gainful uses unlawful? Is it since its harming the young people of today? Is it in light of the fact that itleads to harder medications, the medical issues, the addictiveness, the transient memory impedance, the auto accidents,or is it just on the grounds that government officials reveal to us it is to our benefit? We have grown up discovering that weed is aterrible medication, and that utilizing it gives us mind harm, execute the entirety of our synapses, and causes us to lose our memory.The reality is however, that weed doesn't impact us in any of the ways recorded previously. The possibility that marijuanaimpairs momentary memory is valid, however deceptive. Any indications of momentary memory disability disappear once the client isno longer inebriated. Mostly the explanation we think pot is terrible is on the grounds that that is the thing that the Partnership for aDrug-Free America needs us to accept. They disclose to us that maryjane will cause cerebrum harm and memory impairment,it will execute synapses, and lead to more wrongdoing. In any case, what they neglect to make reference to is all the advantages we can get fromlegalizing weed. For instance, the therapeutic uses, and the material and development employments. It is likely thatlegalizing maryjane would diminish the crime percentage, and by legitimizing pot we will set aside a great deal of cash becausewe won't need to spend it on battling weed as a major aspect of the War on Drugs. There are numerous propensities much worsethan pot, one model being cigarette smoking. Tobacco smoking slaughters a greater number of individuals every year than AIDS,heroin, split, cocaine, liquor, fender benders, fire and murder joined. Tobacco smoking is the number onecause of preventable passing in the US. Tobacco smokers have multiple times the lung malignant growth of nonsmokers, twice theheart illness, and are multiple times bound to kick the bucket of coronary illness in the event that they create it. Does it bode well thattobacco is lawful and weed isn't, when such a large number of individuals kick the bucket from tobacco smoking every year and there isn't onereported instance of anybody ever passing on from weed use in its 10,000 years of utilization? You have likely heardthat one joint is that equivalent as 10 cigarettes, however this announcement is deceiving. In spite of the fact that cannabis contains the sameamount of cancer-causing agents as an equivalent measure of tobacco and more tar, tobacco is still more regrettable. Each yr 350,000Americans bite the dust from tobacco-related illness as indicated by the American Lung Association. A tobacco smokerconsumes considerably more tobacco than a weed smoker devours pot. This i s presumably in light of the fact that tobaccohas a 90% fixation rate while cannabis is less addictive than caffeine. Likewise, tobacco contains nicotine that mayharden the veins and might be answerable for a significant part of the heart sicknesses brought about by cigarette smoking. Cannabis onthe other hand contains the concoction THC which opens up the lungs and helps in the leeway of smoke and earth. Ithink it is protected to state that tobacco smoking is considerably more hazardous than weed smoking. Another negative behavior pattern isalcohol, which as I would like to think is the to top it all off. 8,000 American young people are slaughtered every year and 40,000maimed from driving impaired. The mortality figures for liquor use are 100,000 every year, contrasted with thezero maryjane passings. The measure of cannabis expected to murder somebody is 1 to 40,000, while the proportion for alcoholfluctuates between 1 to 4 and 1 to 10. Not exclusively do numerous individuals bite the dust every year from liquor harming, yet alcoholhas caused a large number of lethal fender benders. In spite of the fact that, pot, when used to the point of inebriation, impairsjudgement and response time, genuine investigations recommend that the impact liquor has on one's driving capacity is muchgreater than that of weed. Truth be told, it is discovered that 85% of maryjane related fender benders additionally included liquor. It issad to believe that a lawful medication like liquor, the medication of decision for most adolescents, causes such a large number of fatalities on ourhighways every year, yet maryjane is the medication that is unlawful. I for one feel that pot is an astounding plant, andit ought to be used today. The issue is that a great many people don't have the foggiest idea about the advantages that can come frommarijuana.

Management Decision Making of CEO of Skagen Designs - Free Essay Example

Skagens transfer of total manufacturing to India or China This report is designed to assist in making the decision whether to completely move the total manufacturing of Skagens products from its current manufacturers to a single country with cheaper labour costs. The report first highlights the advantages and disadvantages of going ahead with the transfer process. The second part of the report will review Skagens current operating systems in order to consider what possible changes might be needed if the proposal is being adopted. Current company strategy and objectives will be reviewed to determine whether the decision fits into firms broader operating framework. To conclude the report goes further to propose some decision making techniques (and the required data and data sources) from the Management Decision Making literature that can potentially assist in the decision making process. SECTION 1- Advantages and disadvantages of moving manufacturing process to India or China Advantages Transferring all manufacturing activities of Skagen to one low labour cost country comes with many benefits as well as challenges. Firstly there is the benefit of a lower Cost of labour. Skagen is labour intensive given that it produces a variety of products and does not engage in mass manufacturing. With lower labour costs, Skagen can significantly cut its prices to offer great quality products at lower prices. This will help the company to remain competitors and even to undercut it competitors in the area of watch manufacture. Some of its competitors such as DKNY, Guess, Police etc. are already manufacturing in low cost countries such as Mexico, China and the Philippines. These competitors are better placed to improve the quality of their products while keeping the price reasonable. This move will help the company to better compete in this competitive market. As a direct result the company can transfer labour cost savings to its consumers through lower prices while also ensuring higher profitability. Skagen currently runs its manufacturing from several locations. At present it sources parts and components from different countries even though the assembly process is completed in Denmark. Transferring all these processes to one low labour cost country will bring about consolidation of operations. The effect of consolidation is that proximity between different players in the manufacturing chain is increased and this can enhance effectiveness while cutting time and cost spent in moving materials and resources between different units in the supply chain. Control and monitoring becomes facilitated as all processes are carried out under one roof. A move of manufacturing operations to a low cost country can enable Skagen parent company to concentrate on its core strength which is design. The core competency of the company from the words of its two founders is design  [1]  . The move aligns with its vision statement which states By 2015,  S kagen Designs will be the first choice among suppliers, customers, consumers, and employees as the most innovative and profitable design goods company within our chosen strategic segments, products and markets. Disadvantages Low cost countries such as China and India have a poor reputation with regards to the durability of their products. Low cost manufacturing has always been associated with compromises in quality. It is no doubt that high end manufacturer have ensured that the most value adding part of their manufacturing process are kept in reputable manufacturing countries. The manufacture of Swiss watches for example has be restricted to Switzerland to ensure that the quality and long standing reputation of the product is not compromised. Moving to a low cost country such as India or China can cause a reputational dent on skagen products and also bring about other quality management issues. Low labour cost countries are associated with the production of lower quality products. Firms in low labour cost countries have historically been accused of unruly practices such as exploitation and the use of child labour. Skagen relies greatly on its reputation of high quality products and its corporate so cial responsibility to its communities. Transferring production from several countries and units to a single unit constitutes high manufacturing risk to the entire company. In the event of disasters such as earthquakes, fires or political turmoil such as strikes, civil wars, the Skagen Company will be highly exposed and severely compromised. Moving all units from many countries to one country also exposes the firm to macroeconomic fluctuations such as exchange rate changes and currency fluctuations. Operating in several countries provides a natural hedge to fluctuations within the global macroeconomic environment. This provides the firm with the ability of switching its production from one country to another depending on fluctuations within the global market environment. The firm will loose this advantage if it unifies its production process to one low cost country. Skagen raises a high percentage of its revenues from the US and Europe. It has developed its capabilities in the se markets and has kept its production facilities in close proximity to the market. This helps to cut costs involved in transportation. Given that Skagen is not a bulk manufacturer, the per-unit cost of transportation from its new production centres (China or India) will be very high and this may offset any benefits that may be accrued to the firm from cheaper labour costs. Due to the increased distance between the manufacturing facilities and the market, the company will incur additional losses in terms of inefficiencies by not being able to benefit from JIT (Just In Time) production. Due to increased distance from the market, there will be need for maintenance of a buffer stock to meet any unexpected fluctuations in demand. This represents increased (and irrelevant) costs to the company in terms of space, material and labour. In the same light there will be less flexibility in production and supply. Again considerations for EOQ (Economic Order Quantities) will have to be mad e. Small orders will at times have to be ignored because the fixed costs (such as processing and transportation) per order outweigh the profits to be made from the order. This move can potentially inflict less flexibility in service quality management. Skagen has over the years built a reputation of high service quality. It for example provides a lifetime guarantee to all its products (as stated on its website). A suitable variable that measures service quality in this case could constitute the time taken for the company to repair or replace faulty products. A move to India or China implies that its American customers with faulty products will have to wait for months so that the products are moved back and forth from the US to Asia and back to the US for collection. This will take time and will not reflect well on the quality of the service provided by the firm. The result is less flexibility with meeting customer needs and potentially poorer customer service. Both countries; India and China, are plagued with political and other economic issues. Business laws in china require most new firms to form alliances with local firms. There is a limited potential for Greenfield investment in China and this will result to a potential alteration of the ownership structure of the firm. The political situation in both countries cannot be classified as risk-free. China is ruled by a communist-type government and its democracy and political system has been subject to much controversy. India on the other hand shares a border with very unstable (politically) countries such as Pakistan and Afghanistan. The condition can become quickly volatile at any time given the recent events in the region. Moving ALL manufacturing operations to this area laden with political uncertainty will therefore be extremely risky for the company. Again there is a possible lack of skill and craftsmanship in both countries. The production of watches requires specialist skill and precision. Thi s is the reason why the Swiss have excelled in the industry over time. Moving such delicate processes to countries reputed for highly unskilled labour might cause further problems due to unavailability of skilled craftsmen. Moving from several locations to one location is very expensive. The costs of moving are considerably high as they include termination of contract charges, abandonment or quick sale of old facilities and equipment, building of new manufacturing facilities, recruitment and training of new staff and many other set up costs. Skagen has already acquired equipment, factories and land which it uses in production and it has also invested heavily to train employees in its production processes. Leaving these very valuable assets will constitute a huge waste on company resources. Again, the company has already signed contracts with employees, suppliers etc which it will have to annul in order to move its production facilities away from their present locations. Cancellat ion of employment contracts could be very costly in terms of compensation and litigation costs from litigations that may potentially arise. Many firms have moved to India and China to allow them source the raw materials at cheaper rates in order to cut costs. Skagen current sources parts (raw materials) for the manufacture of its products from several countries. Its choice of countries from which it sources it raw materials will be based on several considerations such as material (product) costs, quality, delivery lead times and appropriateness (meets firm policy, objectives and strategy). Skagen stands to benefit nothing in terms of raw material sourcing by moving its manufacturing operations to China or India. The next section will examine the effects of a potential move on the firms operating system. SECTION 2- Effect on operating system Current Operating systems Every system is made of components, elements, subsystems and a boundary. In the case of Skagen, the operating system transforms inputs into outputs through a manufacturing process (manufacture of watches) and a distribution process (sales and repair of watches). The case study highlights three main firms that are involved in the operating system of skagen. The skagen operating system is Hard because it is made of technology (in terms of watch design and manufacture), objectives (high quality production at reasonable prices), not many stakeholders (owned by Henrik and Charlotte Jorst, sources its products from several countries, use few distributors and repair centres), which can thus be easily revised or changed Skagen is neither a mass producer nor a customizer in terms of its marketing strategy. On its website Skagen emphasizes that its unique selling proposition is its ability to consistently provide beautifully designed and crafted watches, with a high quality at reasonab le prices. It therefore does not compete on price but competes on quality (in terms of consistency, durability and design). There are no aspects of product flexibility as Skagen does not take orders for customized products from individual clients. The Operating system of Skagen showing links between the different subsystems is shown as below; Raw materials Design Manufacture Assembly Parts Repair Centres Distributors Customers Skagen operating system Changes needed for the operating system The current manufacturing subsystem is sparse as there are many parties supplying materials and parts to the assembler in Denmark. There is a large network where materials suppliers feed part manufacturers who in turn feed the assemblers. In a new system with only one manufacturer, all subsystems will be curled in under one roof. i.e. At one end raw materials will be fed into the factory and finish products pulled out from the other end. The new operating system including changes is shown in the diagram below; Design Assembly Materials Repairs Parts Distributors Customers India/China New Operating system of Skagen; Move to India/China SECTION 3-Strategic fit of decision Current firm strategy and objectives The firm is built on principle that beautifully designed high-quality objects can be created at reasonable prices. The Skagen Denmark Collections reflect owners Charlotte and Henrik Jorsts creative Danish spirit with clean, elegant designs, skilful craftsmanship and technical perfection. The Jorsts have a hand in designing each piece of the Skagen Collection, from watches to jewellery to sunglasses. In their vision statement Skagen hopes that by 2015,  Skagen Designs will be the first choice among suppliers, customers, consumers, and employees as the most innovative and profitable design company within its chosen strategic segments, products and markets. In its mission statement Skagen Designs strives to create a global community of enthusiasts with its commitment to designing an impressive and unique yet attainable product while offering outstanding customer service  to its customers and consumers. An objectives tree (based on the limited information about the compan y can be shown as follows; SKAGEN OBJECTIVES TREE Competitive pricing Skilful Craftsmanship Preferred by suppliers, consumers, customers an employees Outstanding customer service High quality products Community of enthusiasts Beautifully designed Skilled motivated staff Social responsibility Reputation, pride and prestige Development of value chain Materials Quality Parts Repairs and maintenance Objective Tree of Skagen Fit to current strategy and objectives A move of manufacturing process to one country; India or China, fits within its broader framework since its unique proposition is its designs which can be done in its headquarters in Nevada, Hong Kong and Denmark. However, a move to either of these countries can potentially dent its ability to meet its mission to offer outstanding customer service to our customers and consumers. As discussed above issues may arise with service quality management with respect to time spent to effect customer repairs and returns. SECTION 4- Decision making techniques There are several useful decision making techniques to support the decision making process in this case as indicated by the management decision making literature. The most comprehensive technique is the S.M.A.R.T analysis. SMART is a mnemonic for Simple Multiple Attribute Rating Technique. It is relevant to this decision as there are many objectives to be met from the decision. The technique was developed by Edwards (1971)  [2]  in a paper entitled social utilities. The method can be used to quantify the results from each cause of action and the costs measured against the benefits. There are 8 steps involved in the full process. These include; Step 1: Identify the decision maker(s)- Management Step 2: Identify the alternative courses of action- Move to India or maintain status quo Step 3: Identify the attributes which are relevant to the problem This can be done by looking at the costs and benefits in a cost benefit analysis using a decision tree tool. Bene fits Costs -Cheaper labour costs -Skagen focuses on key competency- design -Lower prices -Increased competitiveness -Relocation costs- buildings, equipment, set up -Settlement fees- contract termination for current employees -Recruitment and training of new employees -Political and economic risks -Manufacturing risks (manufacturing at a single location) -Less flexibility in production -Potential issues with service quality management -Higher transportation costs -Loss on benefits of JIT production -Potential shortage of required skill and craftsmanship Skagen Moving Abroad Costs Benefits Recruitment Political and Economic Risks Relocation costs Settlement fees Transportation costs Reputational damage Loss of Flexibility Low Labour cost Lower prices Increased competitiveness Focus Cost-Benefit analysis- Skagen Step 4: For each attribute, assign values to measure the performance of the alternatives on that attribute. Through sensitivity analysis and estimation procedures, dollar values could be affixed to the attributes highlighted above. Data sources could include; Internal analysis, contractors supplier surveys, constructors quotations, financial statements, consultants etc. The Delphi method for estimating and forecasting can be used to improve on data quality. For example, relocation costs can be computed from the building estimates and estimates of costs of machinery that will be required while Settlement fees could be computed based on current salaries, number of employees and their contract terms. Step 5: Determine a weight for each attribute. The attributes could be ranked in order of importance or given a weight on a scale from 1 to 10 to show their relevance to the company. Step 6: For each alternative, take a weighted average of the values assigned to that alternat ive. At this stage a weighted average is computed for each alternative given the assigned values and the weight of the attribute Attribute Weight China/India Do Nothing Score Final Score Score Final Score Recruitment Costs 0.1 -80 -8 -10 -1 Relocation, Start up, Settlement fees 0.3 -100 -30 -5 -1.5 Loss of Flexibility 0.05 -30 -1.5 -5 -0.25 Political economic risks 0.15 -50 -7.5 -20 -3 Lower prices 0.05 100 5 0 0 Labour costs 0.25 80 20 0 0 Competitiveness 0.1 40 4 20 2 Total 1.00 -18 -3.75 Step 7: Make a provisional decision. Based on the averages arrived at for each alternative a decision can be made. Based on my assumptions, the firm will be in a better position without the move. I assume for example that labour costs will not change it stays at its current location, recruitment costs will be significantly higher if it moves, prices wont change if it stays but will reduce if it moves, competitiveness will slightly increase if it moves and it will be exposed to higher political and economic risks if it moves. Step 8: Perform sensitivity analysis This is a robustness check, wherein assumptions are revised and altered to see if the assumptions used for the analysis materially affect the decision arrived at. In a nutshell, on the subject of whether such a move will be beneficial for Skagen, it seems there is little to be gained from transferring operations to India or China. From the above, it is evident that while certain benefits in terms of labour costs will be accrued to the firm from the move, the costs of such a move significantly outweigh all the benefits. A move completely alters the operating system of Skagen and this alteration might require the introduction of new and costly processes. The SMART decision analysis framework can be better used to evaluate the alternatives in this case. Other techniques such as SERVQUAL, Break-Even Analysis, EOQ, TQM and Balanced Score Card will be useful when operations are commenced.

The Separations Of Common Hearing Loss - 1126 Words

This research paper focuses on the separations of common hearing loss issues within the hard of hearing community, elucidating three groups that are considered the major division that identify within the Hard of hearing community, appropriately. There are a few distinguishing common, yet complex challenges, and universal problems of living within their culture. Based on the qualities of psychosocial perspectives of hearing loss, there are distinctive views of socialism, activities and everyday life that affects his or her lifestyle. Partially, the sense of hearing could be considered a major predicament during a later age of hearing loss, and could create a miscommunication that can cause changes to jobs, relationships and life. Even though people can jump from one view to another contingently based on experiences they have encountered, usually there are three perceptions based on the implicit connotations of their situations. Commonly, these three categories of this spectrum contain how people often react to hearing loss, and their psychological development that subsides. Within the influence of social and personal situations such as hearing loss, the majority way of living, communication and emotional behaviors sums out a clear understanding of their lifestyle and potential. There are specific characteristics and life challenges that hard of hearing people face when trying to adapt to the hearing world. (Characteristics of Hearing Impairment) Trauma is the mostShow MoreRelatedHearing Loss And Its Effect On The Audience s Ability867 Words   |  4 PagesHearing loss can impact the listener’s ability to spatially separate the target signal and the masker. Researchers have indicated that the benefit obtained from spatial release from masking is less for individuals with hearing loss from individuals with normal hearing (Gallun et al., 2013; Abrogast et al., 2005). 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Questions On Information Security System - 1271 Words

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Clinical Reasoning and Treatment Guidelines

Question: Discuss about the Clinical Reasoning and Treatment Guidelines. Answer: Introduction: Clinical reasoning is a mode of judgment of nurses in the managing of patients. In clinical reasoning a couple of significant aspects to be taken into account are clinical diagnosis to find out accurate risk of the patient and clinical judgment to implement suitable management to the patient. It has been proved that effective and efficient clinical reasoning has positive outcome in patients. Clinical reasoning becomes very important aspect of healthcare system because there are increasing evidences of unfavourable patient results. Modern-day learning and teaching techniques are not all the time aid in the improvement of clinical reasoning skills, however it can be acquired through experience. Implementation of clinical reasoning in two priority areas such as impact on ADL performance and increased fall and injury risk in Johann Silvermann are considered in this case of Johann Silvermann (Levett-Jones et al., 2010). Impact on ADL performance: Impact on ADL performance was the first clinical priority considered for Johann Silvermann. Johann Silvermann is suffering with tremors in his hands. As a result, he is facing difficulties in his daily activities such as doing buttons of shirt, tea making, cooking, , and doing shoe laces. Tremors are regular problem in aged patients and as Johann is suffering from Parkinson's disease, it is adding more complications to his tremors. Due to these tremors there can be positive as well as negative functional consequences in case of Johann. Negative consequences can be reflected as helplessness of Johann in performing his daily activities and posstive consequences can be reflected by developing positive attitude and determination to carry out his daily activities with confidence. (Mauk, 2013). Identifying issues : Nurse can play significant role in improving daily activities of Johann by developing physical, psychological and social confidence in him (Levett-Jones et al., 2010). Nurse should take into account that he is living alone as he is denied to go to his brothers home. Nurse should be aware that his economic condition is not sound and he is not in position to have attendant to assist in his daily activities. Nurse should identify his illness and schedule of his daily activities. Nurse should be capable of collecting this information through observation and also should discuss with to collect information. Nurse should make a note of type of problems faced by Johann in current situation and in the past and total duration since he was facing these problems. Nurse should gather information about interests of Johann and particular tasks and mode of assistance he required. This person centred intervention by the nurse, helps in maintaining the comfort level and relaxed co ndition of Johann (Dalton et al., 2015; Levett-Jones et al., 2010). Nurse should take care that there should not be any effect on dignity of Johann while providing nursing care to him. Nurse should make sure that Johann should not feel helpless while assisting in his daily activities and he should lose his self confidence and self esteem in the society and community. After the collection of information about the daily activities of the Johann, nurse should make inference about the particular activities for which he requires help, vital daily task for him, order in which he perform his tasks, any alternative method is there to perform his task which is more comfortable to him, what is change in current activities form his earlier activities, are these activities really beneficial to him and he would feel more relived and relaxed due to planned activities. Nurse should take in confidence Johann about planned activities by demonstrating him planned activities and seeking his opinion on planned activities. This exercise would assist nurse in making final conclusion on type of activities and mode of activities, Johann seeking. This would help nurse to make necessary changes in the plan according Johann suggestions and make this plan more acceptable and suitable to Johann. Goals: Next step for nurse in clinical reasoning of Johann is to establish perfect goals for improvement of Johann. (Brown Shah 2013). Goals should be set to give Johann to seek improvement in performing daily tasks of Johann not only in physical way but also to give him psychological, mental and social advantage to him. These goals should be time bound and these goals should assess improvement of Johann in ascending order. Take action: Support to Johann was extended in the daily activities like movement within the home, clothing, during meals, at the time of toilet use and maintaining personnel hygiene (Cooper, 2013). Decided daily tasks were categorised into independent activities like meals, activities under supervision like movement within the home, activities seeking limited assistance like personnel hygiene and activities seeking extensive assistance like clothing and toilet use. Evaluation: To assess improvement in the daily activities, these activities were evaluated at set predetermined time points like seven days and thirty days. There was improvement observed in the movement within the home, in taking meals, personnel hygiene, however there was no improvement in the clothing and toilet use (Ciro, 2014). Reflection: I was energized and delighted to help Johann in his routine tasks. I understand that care of patient in non-medication mode is demanding than care of patient with medication. It requires lot of experience, expertise and interpreting capability about the exact situation of the patient. These things cannot be acquired in classroom teaching; however your skills can teach things. This experience will definitely help me to take responsibility such type of patients. Fall and injury risk: Fall and injury risk was the second priority area considered for Johann. It has been well established that fall risk is the major problem in aged people like Johann and moreover, Parkinson's disease of Johann is added complication for his fall risk. Without any help, he is living in as two-storey building. Johann has to take care of all his daily tasks without help of anybody and in near past he experienced problem in performing his tasks on his own. Furthermore, while he is living in two-storey building, there are chances of his fall. There can be both positive as well as negative consequences of his fall and injury (Mauk, 2013). In negative impacts owing to the fall, he may have severe injuries, further it can be complicated by remained unnoticed as he is staying alone and suitable treatment not feasible before condition becomes worsened. In terms of positive consequences, Johann can become more alert due to the fall and he can perform all his routine activities more carefully and avoid performing risky tasks . It has been well established from the prior evidences that nursing intervention is the paramount option for the prevention of fall and injury in case of Johann (Dalton et al., 2015). Identifying issues: Nurse should keep in mind that due to his old age and as he is living alone in his two-storey, there is possibility of fall for Johann while performing his routine tasks. Before initiating nursing strategy for fall to Johann, nurse should know about the fall history of Johann and whether he is consuming any medicines which are responsible for his fall. Nurse should collection information about fall condition of Johann by asking him questions and nurse should have keen observation on his movements. Next task for nurse post information collection is to study the evidences form collected information and make inferences about the causes and risk factors of his fall. Nurse should circumvent inappropriate information such as fall occurred due to manual mistakes. Nurse should compare fall reasons of Johann due to natural reasons and manual reasons. Nurse should assess reasons for fall of Johann by applying well established techniques like One-Legged Stance Test (OLST) an d Timed Up and Go (TUG) test (Phelan et al., 2015). From this techniques nurse should acquire information about the fall reasons of Johann in current situation. Based on the information collected information from these tests and from earlier evidences, nurse should interpret that main reason behind fall of Johann in his daily tasks and it is a severe issue in case of Johann. Goals: Directed towards these reasons of fall, nurse should decide some goals for Johann to prevent his fall. These goals should include both medical and non-medical interventions. Take action: Medical interventions include vitamin D administration at high doses and abandonment of or reduced frequency of Parkinson's disease medicines. Exercise or physical training and application of body protectors specifically for joints and hip region are the non-medical interventions for fall in Johann. Nurse should initiate vitamin D administration to Johann at high doses and continued upto one month. Also, nurse should reduce administration rate of Parkinson's disease medicine for one month. Nurse should teach some exercise to Johann and asked him to continue up to one month. Also, nurse asked him to walk daily at least 15 minutes in the front space of his home. Nurse offered him accessories like hip protectors and body protectors. Evaluation: Nurse evaluated each goal at predermined time points and at the end of one month. At the end of one week, there was improvement in the fall of Johann in case of exercise. In case of vitamin D administration, there was small fracture in his elbow in first week, however after that there was no fracture upto completion of one month. Three were two falls in the first week in case of Parkinson's disease medicine withdrawl, however there were no fall after that upto completion of one month. In case of body protector use In case of body protector use, there were two small injuries to Johann in first week, however there were no injuries after that upto the end of one month (Levett-Jones et al., 2010). Reflection: While managing fall and injury condition of Johann, I understand problems of older people and how difficult it is to convince these people to convince them. I learned that it is very important to maintain these peoples self-belief and I succefully achieved this. So, I got confidence on myself also to handle such type of patients in future also. Foe the very first time, I managed a patient both for his physiological and psychological disturbances. For this, I used both medication based and non-medication based interventions. Conclusion: Clinical reasoning was implemented in the two priority areas like impact on ADL performance and increased fall and injury risk in Johann Silverman. In this process of application of clinical reasoning, nurse evaluated both the negative and positive consequences of respective priority areas. Before initiating particular intervention, nurse studied the patient and made inference of his current clinical situation. In doing this process nurse collected all the information related to the patient, analysed it, made rational diagnosis of the condition, identified risk factors, decided nursing intervention goals, discussed with patient, amended these goals according to patient comfort level to maintain patient dignity, implemented nursing intervention tasks with fixed goal, evaluated these goals and analysed the outcome of the nursing intervention in that particular task. It has been concluded that implementation of Millers functional consequences theory of framework and Levett-Jones clinica l reasoning demonstrated positive outcome in the treatment of patient condition. References: Bell, J.S., Blacker, N., Edwards, S., et al. (2012). Osteoporosis-pharmacological prevention and management in older people. Australian Family Physician, 41, 1108. Brown, T. A., Shah, S.J. (2013). Evidence-Based Clinical Reasoning in Medicine. People's Medical Publishing House USA. Cooper, C. (2013). Fundamentals of Hand Therapy: Clinical Reasoning and Treatment Guidelines for Common Diagnoses of the Upper Extremity. (2nd edition). Elsevier. Ciro, C.A. (2014). Maximizing ADL Performance to facilitate aging in place for people with Dementia. Nursing Clinics, 49(2), 157169. Dalton, L., Gee, T., Levett-Jones, T. (2015). Using clinical reasoning and simulation-based education to flip the enrolled nurse curriculum. Australian Journal Of Advanced Nursing, 33(2), 28-34. Levett-Jones, T., Sundin, D., Mark, B., Hague, K., et al. (2010). Learning to think like a nurse. HNE Handover For Nurses And Midwives, 3(1), 15-20. Levett-Jones, T, Hoffman, K., Dempsey, J., Jeong, S.Y., et al. (2010). The 'five rights' of clinical reasoning: an educational model to enhance nursing students' ability to identify and manage clinically 'at risk' patients. Nurse Education Today, 30(6), 515-20. doi: 10.1016/j.nedt.2009.10.020. Mauk, K. L. (2013). Gerontological Nursing: Competencies for Care. (3rd edition). Jones Bartlett Learning. Phelan, E.A., Mahoney, J. E., Voit, J. C., Stevens, J.A. (2015). Assessment and management of fall risk in primary care settings. Medical Clinics of North America, 99(2), 281293.