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Words: 365 - Pages: 2. . vocation than marriage and a requirement for ordained ministry. For Luther, sexuality is corrupted by lust, but also hardly anyone is capable of living without it. Thus celibacy leads primarily to falling below faithful marital sexuality into fornication, not rising above it. On these grounds, Luther rejected celibacy as a higher vocation and demanded that all Christians, with some rare exceptions, marry. Buy Research Papers Online Cheap Economics Principles? Luther believed that divorce with remarriage is possible, although only for very serious reasons such as, desertion and write my essay, adultery. In the Protestant view “marriage is my paper bacon a basis for the Christian Right view that the male-headed family is founded by God at creation.” They believe that there is only one right form of the write diabetic family, mandated by God at creation. Danielle Crittenden voiced her opinion saying, “women will lead happier lives with earlier marriages” (Crittenden). I, Robot Essay Topics & Writing? She believes this arguing that for cheap my essay careplan, nearly two generations women have been taught to get someone investigating how concentration affects between calcium carbonate deceive themselves about what it is they want.
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God. Words: 1929 - Pages: 8. Marriage and Sexuality in Midaq Alley. . Help Me Do My Essay Vision Of Shakespeare's Tale? Dr. Shouleh Vatanabadi Middle Eastern Cultures 11 December 2013 Marriage and Sexuality in Midaq Alley Naguib Mahfouz’s Midaq Alley, set in Cairo during the late years of World War II, was revolutionary and avant-garde not only structurally in the sense that it came to define a paradigm for the modern Arab novel, but also culturally given that it openly addresses issues of marriage and sexuality in my essay diabetic teaching, Egyptian society. Through relationships between male and female characters, Mahfouz heavily criticizes traditional societal views on the role of women and homosexuality. The characters Salim Alwan and Kirsha are male archetypes whose violent dysfunctional relationships with their wives serve to scholarship for cosmetology criticize the greater societal issue of subjugation of women. Meanwhile, Hamida’s various engagements with Abbas, then Salim Alwan, then Ibrahim Faraj, reveal attitudes of write my essay diabetic teaching extreme disrespect toward women and even unequal treatment for women before the law.
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Passion This is an emotional state of mind distinguished by cheap write teaching careplan intense physical stimulation, for example increased blood pressure and scholarship essay for cosmetology law school, heart rate. Commitment “The third ingredient is decision and commitment. Sternberg observed that when many people speak of love, they refer more to a conscious decision than to a feeling state. Emotions come and go, but commitments based on decisions remain constant unless they are deliberately revoked” (Baumeister Bushman, 2014). Intimacy “The second ingredient in Sternberg’s scheme is intimacy. Intimacy, in his view, is the common core of all love relationships. Cheap Write? It refers to feeling close to the other person” (Baumeister Bushman, 2014). This is a shared understanding, emotional closeness, and joint concern for each other’s happiness and wellbeing. Cheap? 2.) Which do you believe is most valid? Explain why.
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. ‘[They] took the bacon whore for first-aid treatment’ are the character Hussain Kirha’s last words about Hamida, which depicts the dismissiveness and aversion by which several of the novel’s characters view Hamida at the novel’s end. My Essay Careplan? One therefore asks: Is this how Mahfouz wants his readers to view Hamida at help comic of shakespeare's tale the novel’s end? Despite the my essay teaching greedy ambition that characterises the pretty alley girl who resents the restricted life that her Midaq Alley environment has to help me do my essay tale offer her, this essay seeks to show that although Mahfouz offers an write diabetic teaching off-putting representation of Hamida, it is do my still possible that she deserves our sympathy as much as our disapproval. In Chapter 5 we witness Hamida’ s daily promenade from Sanadiqiya to write my essay diabetic teaching careplan Mousky Street where the alley women’s hatred of Hamida is revealed in their conviction that she is ‘wild and write of acid affects carbonate, totally lacking in cheap diabetic careplan, the virtues of femininity. Mahfouz’s language depicts the women’s perception of Hamida’s behaviour. The adjective ‘unusual’ denotes Hamida’s singular attitude regarding how she wishes to lead her life, while the adjective ‘wild’ and the adverb ‘totally’ hyperbolise Hamida’s rebellious behaviour. One of the alley women even hoped ‘to God to Topics see her a mother too, suckling children under the cheap write careplan care of a tyrannical husband who beat her unmercifully! ‘ The adjective ‘tyrannical’ and the adverb ‘unmercifully’ emphatically outline the cruelly confined future that awaits Hamida should she remain in get someone write investigating of acid affects between calcium carbonate acid, the alley, and convey how the alley women wish for. Words: 1646 - Pages: 7. . Marriage in write my essay careplan, Islam The main purpose of marriage in Islam is to provide both genders male and females company to one another, affection to one another, and to create children. Write My Paper Francis Bacon? The Prophet Muhammad (SAW) described the importance of marriage as being half of your religion.
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However, while many people are enjoying the benefits brought by help me do my essay the dark vision of shakespeare's, the media, there have raised a public. The Influence of Modern Technology on Society. ? The Influence of Modern Technology on Society Don Yates Ohio University Writing and Rhetoric I English 151 Dee Anderson July 23, 2014 While technology is often described as the most important influence upon cheap write society, it remains a subject which has undergone little study. This situation. Young Black People and Criminal Justice. these social issues have fallen harshly on the black youths of today. Our contemporary society has portrayed today’s black youth as a corrupt group of minorities. Me Do My Essay The Dark Comic! The media’s part in this representation has caused a moral panic where black youths are seen today as troublemakers. ‘8% of young black people. Europa Europa Analytical Sociology Essay.
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Case Study: A Patient With Uncontrolled Type 2 Diabetes and Complex Comorbidities Whose Diabetes Care Is Managed by an Advanced Practice Nurse. The specialized role of nursing in the care and education of people with diabetes has been in cheap teaching existence for more than 30 years. Diabetes education carried out by nurses has moved beyond the hospital bedside into a variety of health care settings. Among the disciplines involved in Topics & Writing diabetes education, nursing has played a pivotal role in the diabetes team management concept. This was well illustrated in careplan the Diabetes Control and Complications Trial (DCCT) by the effectiveness of nurse managers in me do vision of shakespeare's tale coordinating and delivering diabetes self-management education. These nurse managers not only performed administrative tasks crucial to cheap write diabetic, the outcomes of the me do the dark vision DCCT, but also participated directly in patient care.1. The emergence and subsequent growth of advanced practice in nursing during the past 20 years has expanded the direct care component, incorporating aspects of write my essay teaching careplan both nursing and medical care while maintaining the teaching and counseling roles. Both the clinical nurse specialist (CNS) and nurse practitioner (NP) models, when applied to chronic disease management, create enhanced patient-provider relationships in which self-care education and counseling is provided within the context of disease state management. Scholarship For Cosmetology? Clement2 commented in a review of diabetes self-management education issues that unless ongoing management is part of an education program, knowledge may increase but most clinical outcomes only minimally improve. Advanced practice nurses by the very nature of their scope of practice effectively combine both education and management into their delivery of care. Operating beyond the role of educator, advanced practice nurses holistically assess patients’ needs with the understanding of cheap write my essay diabetic teaching careplan patients’ primary role in the improvement and maintenance of their own health and wellness.
In conducting assessments, advanced practice nurses carefully explore patients’ medical history and perform focused physical exams. At the completion of assessments, advanced practice nurses, in scholarship for cosmetology conjunction with patients, identify management goals and cheap my essay determine appropriate plans of care. A review of can someone do my essay leadership patients’ self-care management skills and application/adaptation to my essay diabetic teaching, lifestyle is incorporated in initial histories, physical exams, and plans of care. Many advanced practice nurses (NPs, CNSs, nurse midwives, and I, Robot Topics nurse anesthetists) may prescribe and adjust medication through prescriptive authority granted to them by their state nursing regulatory body. Currently, all 50 states have some form of cheap write prescriptive authority for advanced practice nurses.3 The ability to prescribe and adjust medication is a valuable asset in caring for scholarship essay individuals with diabetes. Write My Essay Diabetic? It is a crucial component in the care of people with type 1 diabetes, and write my paper the great francis bacon it becomes increasingly important in cheap the care of patients with type 2 diabetes who have a constellation of comorbidities, all of which must be managed for successful disease outcomes. Many studies have documented the effectiveness of advanced practice nurses in managing common primary care issues.4 NP care has been associated with a high level of satisfaction among health services consumers.
In diabetes, the role of advanced practice nurses has significantly contributed to improved outcomes in the management of type 2 diabetes,5 in specialized diabetes foot care programs,6 in the management of diabetes in pregnancy,7 and in the care of pediatric type 1 diabetic patients and I, Robot Essay Topics & Writing Assignments their parents.8,9 Furthermore, NPs have also been effective providers of write my essay careplan diabetes care among disadvantaged urban African-American patients.10 Primary management of these patients by get someone my paper bacon, NPs led to improved metabolic control regardless of whether weight loss was achieved. The following case study illustrates the clinical role of advanced practice nurses in the management of a patient with type 2 diabetes. A.B. is a retired 69-year-old man with a 5-year history of write teaching type 2 diabetes. Do My Negative? Although he was diagnosed in teaching careplan 1997, he had symptoms indicating hyperglycemia for 2 years before diagnosis. He had fasting blood glucose records indicating values of 118–127 mg/dl, which were described to him as indicative of “borderline diabetes.” He also remembered past episodes of nocturia associated with large pasta meals and Italian pastries.
At the time of I, Robot Essay & Writing Assignments BookRags.com initial diagnosis, he was advised to lose weight (“at least 10 lb.”), but no further action was taken. Referred by his family physician to the diabetes specialty clinic, A.B. presents with recent weight gain, suboptimal diabetes control, and foot pain. He has been trying to lose weight and increase his exercise for the past 6 months without success. He had been started on glyburide (Diabeta), 2.5 mg every morning, but had stopped taking it because of dizziness, often accompanied by sweating and a feeling of my essay teaching mild agitation, in the late afternoon. A.B. Papers Online Cheap Economics 1? also takes atorvastatin (Lipitor), 10 mg daily, for hypercholesterolemia (elevated LDL cholesterol, low HDL cholesterol, and elevated triglycerides). He has tolerated this medication and adheres to cheap my essay diabetic, the daily schedule. During the scholarship essay law school past 6 months, he has also taken chromium picolinate, gymnema sylvestre, and cheap my essay careplan a “pancreas elixir” in an attempt to improve his diabetes control. He stopped these supplements when he did not see any positive results. He does not test his blood glucose levels at home and expresses doubt that this procedure would help him improve his diabetes control. “What would knowing the numbers do for investigating how concentration of acid affects the reaction between calcium carbonate and hydrochloric acid me?,” he asks. “The doctor already knows the cheap write teaching sugars are high.”
A.B. states that he has “never been sick a day in my life.” He recently sold his business and has become very active in a variety of volunteer organizations. He lives with his wife of online 48 years and has two married children. Cheap Write My Essay Teaching Careplan? Although both his mother and can someone do my father had type 2 diabetes, A.B. has limited knowledge regarding diabetes self-care management and states that he does not understand why he has diabetes since he never eats sugar. In the past, his wife has encouraged him to treat his diabetes with herbal remedies and weight-loss supplements, and she frequently scans the cheap my essay diabetic teaching Internet for the latest diabetes remedies. During the past year, A.B. has gained 22 lb.
Since retiring, he has been more physically active, playing golf once a week and gardening, but he has been unable to lose more than 2–3 lb. He has never seen a dietitian and has not been instructed in self-monitoring of blood glucose (SMBG). A.B.’s diet history reveals excessive carbohydrate intake in the form of bread and pasta. Essay For Cosmetology? His normal dinners consist of 2 cups of cooked pasta with homemade sauce and write my essay three to four slices of Italian bread. During the day, he often has “a slice or two” of bread with butter or olive oil. He also eats eight to ten pieces of fresh fruit per day at meals and as snacks. Buy Research Online? He prefers chicken and fish, but it is usually served with a tomato or cream sauce accompanied by pasta. His wife has offered to make him plain grilled meats, but he finds them “tasteless.” He drinks 8 oz. of red wine with dinner each evening.
He stopped smoking more than 10 years ago, he reports, “when the cost of cigarettes topped a buck-fifty.” The medical documents that A.B. Cheap Write? brings to this appointment indicate that his hemoglobin A 1c (A1C) has never been 8%. His blood pressure has been measured at 150/70, 148/92, and 166/88 mmHg on separate occasions during the past year at the local senior center screening clinic. Although he was told that his blood pressure was “up a little,” he was not aware of the need to keep his blood pressure ?130/80 mmHg for both cardiovascular and renal health.11. A.B. has never had a foot exam as part of his primary care exams, nor has he been instructed in preventive foot care. Essay Law School? However, his medical records also indicate that he has had no surgeries or hospitalizations, his immunizations are up to teaching careplan, date, and, in general, he has been remarkably healthy for can someone essay negative many years. A physical examination reveals the following: Weight: 178 lb; height: 5?2?; body mass index (BMI): 32.6 kg/m 2. Fasting capillary glucose: 166 mg/dl.
Blood pressure: lying, right arm 154/96 mmHg; sitting, right arm 140/90 mmHg. Pulse: 88 bpm; respirations 20 per minute. Eyes: corrective lenses, pupils equal and write my essay diabetic careplan reactive to light and accommodation, Fundi-clear, no arteriolovenous nicking, no retinopathy. Lungs: clear to auscultation. Heart: Rate and rhythm regular, no murmurs or gallops. Vascular assessment: no carotid bruits; femoral, popliteal, and dorsalis pedis pulses 2+ bilaterally.
Neurological assessment: diminished vibratory sense to essay, the forefoot, absent ankle reflexes, monofilament (5.07 Semmes-Weinstein) felt only above the write teaching careplan ankle. Results of for cosmetology laboratory tests (drawn 5 days before the office visit) are as follows: Glucose (fasting): 178 mg/dl (normal range: 65–109 mg/dl) Creatinine: 1.0 mg/dl (normal range: 0.5–1.4 mg/dl) Blood urea nitrogen: 18 mg/dl (normal range: 7–30 mg/dl) Sodium: 141 mg/dl (normal range: 135–146 mg/dl) Potassium: 4.3 mg/dl (normal range: 3.5–5.3 mg/dl) • Total cholesterol: 162 mg/dl (normal: 200 mg/dl) • HDL cholesterol: 43 mg/dl (normal: ?40 mg/dl) • LDL cholesterol (calculated): 84 mg/dl (normal: 100 mg/dl) • Triglycerides: 177 mg/dl (normal: 150 mg/dl)
• Cholesterol-to-HDL ratio: 3.8 (normal: 5.0) AST: 14 IU/l (normal: 0–40 IU/l) ALT: 19 IU/l (normal: 5–40 IU/l) Alkaline phosphotase: 56 IU/l (normal: 35–125 IU/l) A1C: 8.1% (normal: 4–6%) Urine microalbumin: 45 mg (normal: 30 mg) Based on my essay, A.B.’s medical history, records, physical exam, and lab results, he is online principles 1 assessed as follows: Uncontrolled type 2 diabetes (A1C 7%) Obesity (BMI 32.4 kg/m 2 ) Hyperlipidemia (controlled with atorvastatin)
Peripheral neuropathy (distal and symmetrical by cheap teaching, exam) Hypertension (by previous chart data and exam) Elevated urine microalbumin level. Self-care management/lifestyle deficits. • High carbohydrate intake. • No SMBG program.
Poor understanding of diabetes. A.B. presented with uncontrolled type 2 diabetes and a complex set of can someone do my negative leadership comorbidities, all of which needed treatment. The first task of the NP who provided his care was to select the most pressing health care issues and prioritize his medical care to address them. Although A.B. stated that his need to lose weight was his chief reason for seeking diabetes specialty care, his elevated glucose levels and his hypertension also needed to cheap my essay careplan, be addressed at the initial visit. The patient and his wife agreed that a referral to a dietitian was their first priority.
A.B. acknowledged that he had little dietary information to help him achieve weight loss and that his current weight was unhealthy and “embarrassing.” He recognized that his glucose control was affected by large portions of bread and pasta and agreed to start improving dietary control by reducing his portion size by one-third during the week before his dietary consultation. Weight loss would also be an important first step in buy research papers 1 reducing his blood pressure. The NP contacted the registered dietitian (RD) by telephone and referred the patient for write a medical nutrition therapy assessment with a focus on buy research papers cheap economics 1, weight loss and improved diabetes control. Cheap Diabetic Teaching? A.B.’s appointment was scheduled for the following week. The RD requested that during the intervening week, the patient keep a food journal recording his food intake at do my essay meals and snacks. She asked that the cheap write diabetic careplan patient also try to estimate portion sizes. Although his physical activity had increased since his retirement, it was fairly sporadic and weather-dependent. After further discussion, he realized that a week or more would often pass without any significant form of exercise and that most of his exercise was seasonal. Whatever weight he had lost during the can someone negative leadership summer was regained in the winter, when he was again quite sedentary. A.B.’s wife suggested that the two of cheap write diabetic careplan them could walk each morning after breakfast. She also felt that a treadmill at home would be the I, Robot Topics & Writing Assignments best solution for getting sufficient exercise in inclement weather.
After a short discussion about the positive effect exercise can have on glucose control, the patient and his wife agreed to write my essay careplan, walk 15–20 minutes each day between 9:00 and my paper bacon 10:00 a.m. A first-line medication for this patient had to be targeted to improving glucose control without contributing to weight gain. Thiazolidinediones (i.e., rosiglitizone [Avandia] or pioglitizone [Actos]) effectively address insulin resistance but have been associated with weight gain.12 A sulfonylurea or meglitinide (i.e., repaglinide [Prandin]) can reduce postprandial elevations caused by increased carbohydrate intake, but they are also associated with some weight gain.12 When glyburide was previously prescribed, the patient exhibited signs and teaching careplan symptoms of hypoglycemia (unconfirmed by SMBG). Me Do My Essay The Dark Of Shakespeare's The Winter's? ?-Glucosidase inhibitors (i.e., acarbose [Precose]) can help with postprandial hyperglycemia rise by blunting the effect of the entry of carbohydrate-related glucose into the system. Write My Essay Teaching Careplan? However, acarbose requires slow titration, has multiple gastrointestinal (GI) side effects, and reduces A1C by get someone write my paper investigating of acid the reaction between calcium, only 0.5–0.9%.13 Acarbose may be considered as a second-line therapy for write my essay diabetic teaching careplan A.B. but would not fully address his elevated A1C results. Metformin (Glucophage), which reduces hepatic glucose production and improves insulin resistance, is not associated with hypoglycemia and can lower A1C results by 1%. Although GI side effects can occur, they are usually self-limiting and can be further reduced by slow titration to dose efficacy.14. After reviewing these options and do my essay negative leadership discussing the need for improved glycemic control, the NP prescribed metformin, 500 mg twice a day. Possible GI side effects and the need to avoid alcohol were of concern to cheap my essay teaching, A.B., but he agreed that medication was necessary and that metformin was his best option. The NP advised him to take the medication with food to leadership, reduce GI side effects.
The NP also discussed with the patient a titration schedule that increased the dosage to 1,000 mg twice a day over a 4-week period. She wrote out this plan, including a date and time for telephone contact and medication evaluation, and write diabetic careplan gave it to the patient. During the visit, A.B. and his wife learned to use a glucose meter that features a simple two-step procedure. Online Cheap Economics Principles 1? The patient agreed to use the meter twice a day, at my essay teaching careplan breakfast and dinner, while the metformin dose was being titrated. He understood the need for glucose readings to guide the choice of medication and to evaluate the effects of his dietary changes, but he felt that it would not be “a forever thing.” The NP reviewed glycemic goals with the patient and buy research economics principles his wife and assisted them in deciding on initial short-term goals for weight loss, exercise, and medication.
Glucose monitoring would serve as a guide and diabetic teaching assist the leadership patient in modifying his lifestyle. A.B. drew the line at cheap write careplan starting an antihypertensive medication—the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec), 5 mg daily. He stated that one new medication at a time was enough and that “too many medications would make a sick man out of get someone write my paper calcium carbonate acid me.” His perception of the state of his health as being represented by cheap my essay teaching, the number of medications prescribed for him gave the advanced practice nurse an important insight into the patient’s health belief system. The patient’s wife also believed that a “natural solution” was better than medication for I, Robot Topics & Writing BookRags.com treating blood pressure. Although the use of an cheap my essay diabetic, ACE inhibitor was indicated both by the level of hypertension and by the presence of microalbuminuria, the decision to write my paper investigating how concentration of acid the reaction calcium carbonate and hydrochloric, wait until the next office visit to further evaluate the write my essay careplan need for antihypertensive medication afforded the patient and his wife time to buy research papers cheap economics principles 1, consider the importance of cheap my essay teaching careplan adding this pharmacotherapy. Help Me Do My Essay Of Shakespeare's Tale? They were quite willing to read any materials that addressed the prevention of diabetes complications. However, both the patient and his wife voiced a strong desire to cheap write teaching careplan, focus their energies on cheap economics principles 1, changes in food and physical activity. Cheap My Essay Diabetic? The NP expressed support for their decision.
Because A.B. was obese, weight loss would be beneficial for many of his health issues. Because he has a sedentary lifestyle, is 35 years old, has hypertension and Essay BookRags.com peripheral neuropathy, and is being treated for hypercholestrolemia, the NP performed an electrocardiogram in write teaching careplan the office and referred the patient for law school an exercise tolerance test.11 In doing this, the NP acknowledged and respected the write my essay teaching mutually set goals, but also provided appropriate pre-exercise screening for buy research cheap economics the patient’s protection and safety. In her role as diabetes educator, the NP taught A.B. and his wife the importance of foot care, demonstrating to the patient his inability to feel the light touch of the cheap teaching monofilament. She explained that the loss of protective sensation from peripheral neuropathy means that he will need to be more vigilant in checking his feet for any skin lesions caused by poorly fitting footwear worn during exercise. At the conclusion of the visit, the NP assured A.B. that she would share the essay plan of cheap write teaching care they had developed with his primary care physician, collaborating with him and discussing the findings of me do vision any diagnostic tests and procedures.
She would also work in write teaching careplan partnership with the RD to reinforce medical nutrition therapies and improve his glucose control. In this way, the NP would facilitate the continuity of care and keep vital pathways of buy research papers online cheap principles communication open. Advanced practice nurses are ideally suited to play an cheap write my essay diabetic, integral role in the education and medical management of people with diabetes.15 The combination of clinical skills and can someone essay leadership expertise in teaching and counseling enhances the delivery of care in a manner that is both cost-reducing and effective. Inherent in the role of advanced practice nurses is the understanding of shared responsibility for health care outcomes. This partnering of nurse with patient not only improves care but strengthens the patient’s role as self-manager. Geralyn Spollett, MSN, C-ANP, CDE, is associate director and an adult nurse practitioner at the Yale Diabetes Center, Department of Endocrinology and Metabolism, at Yale University in New Haven, Conn. Write My Essay Teaching Careplan? She is an associate editor of Diabetes Spectrum.
Note of disclosure: Ms. Spollett has received honoraria for speaking engagements from Novo Nordisk Pharmaceuticals, Inc., and Aventis and has been a paid consultant for Aventis. Both companies produce products and devices for the treatment of diabetes. 2017 by online cheap economics 1, the American Diabetes Association. Diabetes Spectrum Print ISSN: 1040-9165, Online ISSN: 1944-7353 .