CASH FLOW Assignment Example | Topics and Well Written Essays - 750 words

CASH FLOW - Assignment Example Net earnings plus added back depreciation have contributed to the bulk of cash flow from operating activities, amounting to 3,883+1,682= $5,565 million. Increases/decreases in inventory, receivables, accounts payable, and other miscellaneous items have contributed the remaining $1,068M. Thus the increase has come mostly from the profits earned during the year. Out of the increase realized through operating activities, $1,129M have been used in investing activities, the major portion having been invested in capital expenditures. A small part has been accounted by sale of assets and property, and from sale of business. Financing activities have accounted for $4,048M of the outflow from the total of $6,651M contributed by operating activities. The bulk of this amount has gone in repurchase of stocks and in payment of dividends. Lowe’s The increase in cash and cash equivalents during the year 2011 was $364 million. The contribution from operating activities was $4,351M, of which the major portion was from net operating income ($1,839M) and depreciation ($1,579M). The net increase in cash and cash equivalents on account of these two items was $3,418M. The remaining amount of $931M has come from changes in current assets/liabilities and miscellaneous items. ... Increases/decreases in inventory, receivables, accounts payable, and other miscellaneous items have contributed the remaining $1,068M. Thus the increase has come mostly from the profits earned during the year. Out of the increase realized through operating activities, $1,129M have been used in investing activities, the major portion having been invested in capital expenditures. A small part has been accounted by sale of assets and property, and from sale of business. Financing activities have accounted for $4,048M of the outflow from the total of $6,651M contributed by operating activities. The bulk of this amount has gone in repurchase of stocks and in payment of dividends. Lowe’s The increase in cash and cash equivalents during the year 2011 was $364 million. The contribution from operating activities was $4,351M, of which the major portion was from net operating income ($1,839M) and depreciation ($1,579M). The net increase in cash and cash equivalents on account of these tw o items was $3,418M. The remaining amount of $931M has come from changes in current assets/liabilities and miscellaneous items. Of the cash generated by operating activities, $1,437M has been used in investing activities and $2,549M in financing activities. The major portion of the amount used by investment activities has gone to acquisition of property, which has partly been funded by net sale of investments, the remaining coming from cash generated in operating activities. The bulk of the cash used in financing activities has gone towards repurchase of shares and payment of dividends ($3,584M). This has been partly funded by issuance of long-term debt, the balance coming from cash generated in operating activities. Forecast of

Schematic Interface of Mobile Phone with Micro-Controller Essay Example for Free

Schematic Interface of Mobile Phone with Micro-Controller Essay Labels: circuit GSM/ EDGE Modem in PCI Interface Interface of mobile phone with micro-controller microcontroller schematic Supporting AT commands How To Interface a mobile Phone with micro-controller 8051 family like at89s51, at89s52, at89c2051 etc.The project is aimed at developing and testing the use of mobile phones to remotely control an appliance control system. The microcontroller would then control an device based on the information given to it. The proposed solution will need to be easy to use, simple, secure, robust and be useful on most mobile phones. To achieve this testing will need to be carried out to create a useful system. The report consists of a background into the area of 8051 microcontroller and mobile communication, how they are interfaced to each other and AT (Attention) commands set used in communication. The simplist method to interface a mobile with microcontroller is use mobile phone which support AT Commands. By using this we can directly connect that phone via datacable to microcontroller kit at a baud rate of 9600 and you can send AT commands to that mobile to read and send sms or other data of interest. The first thing in this regard is to find a mobile phone with AT Commands. Recommendation is use sony erricsons 290i . You can use any other mobile suitable for this purpose. The same program with slight modifications for AVR microcontroller. Which avr microcontroller you want to use and what is the sensor you want to interface. After connecting a mobile phone or GSM/GPRS modem to a computer, you can control the mobile phone or GSM/GPRS modem by sending instructions to it. The instructions used for controlling the mobile phone or GSM/GPRS modem are called AT commands. (AT commands are also used to control dial-up modems for wired telephone system.) Dial-up modems, mobile phones and GSM/GPRS modems support a common set of standard AT commands. In addition to this common set of standard AT commands, mobile phones and GSM/GPRS modems support an extended set of AT commands. One use of the extended AT commands is to control the sending and receiving of SMS messages. This device acts as interface between your microcontroller project and a GSM phone. It handles all modem data communication between the GSM phone and your micro-project. The best thing is that it decodes PDU into TEXT on the fly! It’s based on PIC16F877A microcontroller running on 16MHz at 5V. It has an onboard level converter for serial communication with the gsm phone because PIC’s UART RX input pin has a Schmitt trigger triggering at 4,5 5V while the phone is sending only approx. 3V from it’s TX pin. Control takes place by means of SMS (Short text Messages Service). When the mobile receives a predefined text message, like alarm ON or Start pump, the circuit automatically recognizes it as a command, and switches the output accordingly. At the componets level this project of mobile interfacing with microcontroller can be divided into these parts:- 1. Two mobile phones, one for general use and will be handled remotely, the second is specific mobile which will be interfaced with microcontroller 8051. 2. Microcontroller with necessary components inculding power supply, crystal, RS-232 components etc. 3. Interfacinf board, This is interfacinf board which will inculde the optocouplers, relays and other components required for interfacing of different input and output devices to microcontroller. 4. The hardware devices which are to be controlled through this projects will be connected to microcontroller usig above mentioned interfaing board. The procdure for the mobile controlling of different hardware is very easy. process begins on writing a SMS on mobile # 1, which will be transmitted to mobile # 2 through mobile networks. The second mobile will get that SMS and will transmit it to microcontroller via serial communication RS-232. The micocontroller 8051 will check, if it is according to predefine commnad then, according action will be performed.

What is Reality? Philosophy Essays

What is Reality? Philosophy Essays In this essay we look at the theories of Plato, Descartes and Locke and their views on what reality is, we look at what perception means to reality, and how everyones view on reality is different. As we begin to question what reality is, we learn more about ourselves and our perceptions of life, we begin to question ourselves, and we slowly learn what reality means to us, as individuals. This essay should hopefully encourage deep thinking about reality and existence; it aims to bring individuals to closer to understanding what life means to them. Every day we trust in our senses to tell us the truth, we believe what we see, smell, touch, hear, and taste, but do we ever question whether or not our senses are lying to us, do we ever stop to think that perhaps our senses are being manipulated? If we can doubt if our senses tell us the truth, than how can we know what really exists? An Individuals perception is completely their own, the way that one person perceives things, may be completely different than the way another individual perceives things. In one passage from Renee Descartes, he questions if beliefs are impossible even though they are derived from the senses. He asked himself how could it be denied that these hands or this whole body is mine? He then compares himself to mentally disturbed people saying that mentally disturbed individuals sometimes believe that they are somewhere, or that they see things, that are not correct. Who are we to question someone elses sanity? What is it that makes our perceptions reality and a mentally disturbed persons perceptions incorrect? (http://www.writework.com/essay/descartes-view-real) When a sentient being acknowledges that they exist in a world of physical objects, they also confirm that their sense perception functions to an extent which allows them to reason, even to a small degree, their physical existence. What is a physical object? Does a physical object have to be something you can see, touch, feel, taste, or smell or can a physical object exist without one being able to confirm its existence? Is the sensory perception of a fly wrong just because it has over a 1000 eyes or is the way humans view the world incorrect because we do not? A blind man can still help a person distinguish a colour because no one perception is ever totally interpreted by only one sensory organ. Many other animals on earth do not just rely on their sight for information about their world. For instance fish in totally dark areas of the ocean have no eyes and yet can still maneuve r around in their environment by sensing ripples in their area with special sense organs on their body. Birds also seem to use the magnetic lines of the earth to navigate south for the winter each year. It would be foolish to make the statement that all sensory perception of the world is circumspect and is exactly the same for all creatures. Firstly, we need to look at what perception and reality mean, the definition of perception is the  act  or  faculty  of apprehending  by  means  of  the  senses  or  of  the  mind;  cognition;  understanding. This means that perception is what we sense in our environment from what our senses and mind tells us. The definition of reality is the state or quality of being real (dictionary.com) but if we know what is real because of our perceptions and senses, how do we know our senses can be trusted to tell us the truth, and thus how do we know what is real? Every philosopher has searched within themselves for the answer to what is reality, and how we know what is real, but every philosopher has their own views on reality, to begin idealist Renee Descartes argued that sensations and experience can be doubted, so it is pure reason, not the senses, that must form the basis of Truth and what reality is. Next, an Idealist, Plato who claimed that the world of ideas, for example the ideal nature or essence of a tree or a circle or a color, was more fundamental, more real, than physical reality, and that physical reality, a tree for instance, comes into being as an imperfect instance of the ideal.  John Locke an empiricist said that the mind starts out without any knowledge and everything one knows is built up from experience through the senses. So who is right? Is there any one way to know what reality really is? In Descartes his first and second meditations he claims that all our beliefs can be doubted because our senses could simply be just an illusion, he goes on to say that although all our beliefs cannot be certain, because we think and experience, our minds must exist. Descartes argued that our ordinary experiences and views of the world cannot give us the kind of affirmed foundation on which all other knowledge and beliefs can be based. We are often dismayed to acknowledge that what we have learned is simply detriment, or that what our senses tell us is not certain. That should make us wonder about whether all the other things we believe might also be uncertain. So is there anything that we can know for certain without a doubt? We can doubt whether there is a physical world and whether we have a physical body. We can doubt whether our own reasoning can be trusted, so then what can we absolutely know for certain? Descartes gives an example that even if a higher power deceives us about a ll our other beliefs, there is one belief that we can be certain about, which is that we are thinking. Even to doubt this belief is proving that we are thinking. And since thinking cannot occur without there being something that does the thinking, this proves that we exist. When we think, it proves we have a mind, regardless of whether we have bodies. The body we experience as our own is not an essential part of our self because we can doubt its existence in a way that we cannot doubt the existence of our mind. Plato believed that reality was in the form of two separate worlds, he believed that something was an individual object, but could be put together into a larger group. For example there are multiple breeds of cats, but they all fall under a larger group, which is cats, or felines. Another analogy that Plato came up with was the allegory of the cave. Here the physical world is in the form of a cave, in which the humans are trapped from the beginnings of our life, where we are stationary and cannot move our heads, so we perceive only shadows and sounds. Without reason, one of us is released and is encouraged to travel upward to the entrance of the cave. This revelation is very confusing to the person. Then he is pulled to the entrance of the cave, where the light is hurting his eyes that are accustomed to the dark, which threatens the only security his life has known. The world of daylight represents the realm of Ideas. His eyes grow accustomed to the light and he can look up to the sun, and understand what the ultimate source of light and life is. This is symbolic of the Idea of the Good in the Realm. This gradual process is a metaphor of education, and enlightenment. Yet the real lesson of Plato is that the enlightened person now has a moral responsibility to the unfortunate people, still in the cave, to rescue them and bring them into the light. This lesson brings about Socrates famous quote, As for the man who tried to free them and lead them upward, if they could somehow lay their hands on him and kill him, they would do so. This is ironic in nature. The fact that this man is trying to help these people and they are so uneducated masses will resent him and threaten his life. Lastly, John Locke stated that we define objects by primary and secondary properties; primary properties being undeniably objective features such as size and shape, and secondary properties being subjective such as colour and taste. (http://www.youtube.com/watch?v=7dQpDNtsIAE) Lockes theory on reality is called Representative Realism, it is the view that sense data (an immediate object of perception, which is not a material object; a sense impression) somehow represents the objects and that these objects are causally involved in our production of the sense data. Our perception of objects is thus indirect; hence, representative realism is a kind of indirect realism. (An Introduction to Epistemology, second edition, 277) This view argues that we experience reality indirectly by perceptions that represent the real world. So, if we see a brown table, what we are actually seeing is not the table itself but a representation of it. In this way, differences of perception which occur due to c hanges in light conditions, position of viewer, etc., can be easily explained: it is not the object which is changing, only the perception of it. As an example, a man is standing on the corner of a busy road and witnesses two cars collide. Neither driver is hurt, but both step out of their cars to inspect the damage. Driver A is a young mother with a young child in the back of the car; driver B is a business executive in a hurry; the witness is an old man wearing glasses. As the two drivers argue about whose fault it was, the man approaches them and offers to confirm what he saw happening. What does each of them see? Whose is the correct view?   It is evident that the mind knows not things immediately, but only by the intervention of the ideas it has of them. Our knowledge therefore, is real, only so far as there is conformity between our ideas and the reality of things. But what shall be here the criterion? How shall the mind, when it perceives nothing but its own ideas, know they agree with things themselves? (John Locke, 452) So who is right? These are just three different views on reality out of hundreds, and possibly even thousands from other philosophers, but is there any one way to know if one philosophers theory is right over another? One thing most of these theories have in common is that our perceptions of reality, how we view things through our senses and the different objects we see, may not be what is certainly real, they suggest that what our perceptions of reality are, are not really what reality is. What this means is that for the average person living, their reality is based upon ignorance towards other truths. Throughout the span of humanity, we as a species have looked upon the workings of the universe through the lens of religion, using it to explain the unexplainable. However, secularized sciences began to surface and thus, scientific explanations began to replace religious beliefs. What was previously the affliction of ignorance towards the people who used religion to perceive the world around them transformed into a truth. However, as the sciences and technology grew more advanced, previous scientific theorems began to be disproved by newly discovered ones. Again, the ignorance transforms into truth; nonetheless, each and every time ignorance converts to truth new ignorance manifests. As an example in while inside the matrix, Neo had no idea that his reality was created by the workings of a machine. To him, the food he ate was real, and the punches he took in the face were painful. He perceived the mechanical world he resides in to be reality, to be real. However, as soon as he awakens to the new reality, outside of the machine, his previous life became an obsolete truth to him, and this new one became his new reality. Reality is a cycle of truth and ignorance, and will continue to be so eternally. Unless one is omniscient, there will always be a truth, a fact, in existence that will carry the potential to disprove everything we know. As humans we struggle to know why we exist and what reality is, but many of us are too afraid to give up the comfort of believing what we see to be true to discover the answers to what reality is, because of this there are select few individuals who question their life and what it means, these individuals give insight to others and are able to teach other individuals about what it means to question our existence and perceptions. Although for many of us the theories of philosophers such as Descartes, Plato, and Locke may seem wildly unlikely, the more we question what reality is, the more we ourselves create new theories about reality, and they themselves may seem far-fetched to other individuals. We may look at what other philosophers have theorized in the past, but for us, as individuals, to discover what reality means to us personally, we must think deeply ourselves, we must theorize and question ourselves until we are so confused by our questions we no longer know what it means to exist. We cannot rely on other theories of reality because everyone perceives reality differently, what one person may perceive is different than what another person may perceive, and because of this not everyone can have the same views and theories on what reality and existence means. Some of us may see God as an important part and influence in our reality, while others may not. Some people may say nothing truly exists, and that we are just an illusion and others may say everything they see is real. No one is wrong; our individual views on reality are personal, our perceptions are not the same as other individuals perceptions, and that does not mean one is wrong or right. What it means is that we as humans have the responsibly to question ourselves, to question what it means to live. In order for any of us to achieve true happiness we must question reality, existence, and our perceptions. If we live in ignorance, we are not truly being happy; we are letting ourselves be satisfied with not understanding the world. Thinking deeply about reality inspires growth, it inspires us to realize there is more to the world then what we can see, the world is a limitless place of our desires.

The Nurse and Friar Laurence are responsible for Romeo and Juliets deat

  Ã‚  Ã‚  Ã‚  Ã‚  In Shakespeare’s play Romeo and Juliet the characters Nurse and Friar Laurence are to blame for Romeo and Juliet’s Problems.   Ã‚  Ã‚  Ã‚  Ã‚  The way Friar Laurence encouraged Romeo and Juliet to get Married, The way the Nurse is contradictory in her views of Romeo and Paris, When Friar Laurence secretly married them, the way the Nurse is secretive about the affair and does not tell the Capulet’s or the Montague’s, when Laurence gave Juliet the sleeping potion, the way Laurence believed he was doing the right thing without thinking of the consequences, and the way Laurence leaves Juliet’s Tomb when he hears the watch coming, all combine to result in the lovers death.   Ã‚  Ã‚  Ã‚  Ã‚  In act II scene III, Romeo goes to see Friar Laurence to tell him that he no longer loves Rosaline, but has fell in love with Juliet. This amazes Friar Laurence, but he promises to marry them,   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"O, she knew well   Ã‚  Ã‚  Ã‚  Ã‚  Thy love did read by rote, that could not spell.   Ã‚  Ã‚  Ã‚  Ã‚  But come, young waverer, come, go with me.   Ã‚  Ã‚  Ã‚  Ã‚  In one respect I’ll assistant be.   Ã‚  Ã‚  Ã‚  Ã‚  For this alliance may so happy prove   Ã‚  Ã‚  Ã‚  Ã‚  To turn your household’s rancour to pure love.† (Friar Laurence, Act II Scene III, sentence 87-92)   Ã‚  Ã‚  Ã‚  Ã‚  By doing this, Friar Laurence has gone behind Capulet and Montague’s back, and started the momentum behind the lover’s tragedy.   Ã‚  Ã‚  Ã‚  Ã‚  In a few parts of the play, the Nurse speaks of Romeo and Paris with Juliet, each time she has a different view on who Juliet should be with,   Ã‚  Ã‚  Ã‚  Ã‚  LADY CAPULET   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"Marry, that ‘marry’ is the very theme   Ã‚  Ã‚  Ã‚  Ã‚  I came to talk of. Tell me daughter Juliet,   Ã‚  Ã‚  Ã‚  Ã‚  How stands your dispositions to be married?†   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  JULIET   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"It is an honour that I dream not of†   Ã‚  Ã‚  Ã‚  Ã‚  NURSE   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"An honour! Were not I thine only nurse,   Ã‚  Ã‚  Ã‚  Ã‚  I would say thou hadst sucked wisdom from thy   Ã‚  Ã‚  Ã‚  Ã‚  Teat.†   Ã‚  Ã‚  Ã‚  Ã‚  LADY CAPULET... ...p;  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Exit Friar What’s here? A cup, closed in my true loves hand? Poison, I see, hath been his timeless end. O churl! Drunk all, and left no friendly drop To help me after? I will kiss thy lips. Haply some poison yet doth hang on them To make me die with a restorative. She kisses him Thy lips are warm!† WATCHMAN ‘within’ â€Å"Lead, boy. Which way? JULIET â€Å"Yea, noise? Then I’ll be brief. O happy dagger! She snatches Romeos dagger This is thy sheath, there rust, and let me die   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  She stabs herself and falls† (Act V Scene III, sentence 144-176)   Ã‚  Ã‚  Ã‚  Ã‚  In this act, Rome and Juliet die. This is brought about by the Friars plan to help Romeo and Juliet escape to Mantua, which failed.   Ã‚  Ã‚  Ã‚  Ã‚  Without the meddling from the Nurse and Friar Laurence, Romeo and Juliet might not have died. Friar Laurence and the Nurse are responsible for Romeo and Juliet’s death. Bibliography William Shakespeare - Romeo And Juliet - Complete Edition

Going After Cacciato

Waking up from the American Dream in Going after Cacciato (Tim O'Brien) What passing-bells for these who die as cattle? Only the monstrous anger of the guns. Only the stuttering rifles' rapid rattle Can patter out their hasty orisons. (from Anthem for Doomed Youth, Wilfred Owen) Sassoon's epitaph â€Å"All Soldiers are dreamers† at the beginning of the novel functions as a signpost signaling the shape the novel will take. It does not merely deal with brutal horror, it is imagination. Reality and dream, fact and imagination are interwoven.The choice of Siegfried Sassoon suggests the Great War, the English experience of war, which can be compared to the American Vietnam experience, for it had the same impact: total disorientation and national trauma because of lost values. This novel then deals, in story and structure, with the war experience, but also with the US society's influence on that war through the ordinary soldier. The common grunt raised the question how to act proper ly in this horrible situation, in which he even did not know whether his presence was morally justified or not.Yet he concluded that, although he knew this war was just as insane as any other war, he should not run away from his duty. He stayed in the war, because of his personal obligations to society. Not out of idealism, but merely because his people expected him to. In novels dealing with Vietnam we often see veterans coming back into the American society (like in Caputo's Indian Country), but here we are confronted with the country itself. The novel Going after Cacciato deals with the journey to Paris an American soldier fantasizes about.It is November 1968 and Spec. Four Paul Berlin is in his observation tower in Quang Ngai, Vietnam, by the South China Sea, performing his tour of duty, which lasts 365 days for the common grunt, the foot soldier he is. He feels he has come to Nam in another way than soldiers had gone to the Second World War and to Korea. His lieutenant, Lt Cors on had been in Korea, and he was looking back to it with nostalgia: â€Å"In Korea, by God, the people liked us. Know what I mean? They liked us. Respect, that's what it was. And it was a decent war (†¦ The trouble's this: Nobody likes nobody. (p. 134) New were the blindness of war, the inertia, drugs were taking over, the creation of the new word â€Å"fragging†, i. e. killing a superiour officer It all illustrated this war was supposed to be different from those wars in which Paul Berlin's ancestors had fought, with in their mind the American dream. However, Vietnam was not different at all. Soldiers who enthousiastically started their participation in Vietnam, were as quickly traumatized by the killings, as any other soldiers. A war like any other war.Stories that began and ended without transition. No developing drama or tension or direction. No order. (p. 255) When Paul realizes this, the main question for him is how to determine his own place in it. As he does not know an anwer, the possibility, or rather the necessity of dreaming something else in the face of horror, is brought to Vietnam. He starts to think about Cacciato. This bloke fishes in the world's Great Lake Country where everybody says there is no fish. He dutifully goes through all the motions and all of a sudden het gets out, and Paul is intrigued.Paul's squad is sent to go after Cacciato. They are following the unmarked character and find him more and more almost a holy character, less defined as they go along. Finding him a friendly leader almost, they follow him. From soldier among soldiers, he develops into a friendly symbolical figure pointing the way. The seductiveness of Cacciato leads them on. He sheds his war implements. He is that annoying, different, seperate chap who bounces the ball, who nobody can trace and think of, who does not really exist, he has not even got a first name!Cacciato, that just fulfills. Going after Cacciato means â€Å"going after a dream† , following that dream, but it can also mean â€Å"going after to actually get that dream†. Time and time again there is this ambiguity of going on the hunt after Cacciato, or following the Italian on desertion; there is the choice between reality and dream for Paul. Cacciato, who nobody has actually seen, has hit upon an idea which his indeterminance made possible, and it speaks to the imagination. Paul goes after him, catches him, thus completing his mission, but lets Cacciato escape.Cacciato then leads them through the beautiful high country, through orderly Mandalay, normal Delhi, to a beheading in gruesome Tehran, all the way via Athens to Paris; the change of scenery symbolizes the hope Paul first feels, gradually turning into despair and total confusion. His experiences on the way show Paul that he cannot actually leave the war behind. â€Å"Can't get away from it,† Doc mumbled. â€Å"You try, you run like hell, but you just can't get away. † â€Å"It's the truth. † (p. 178) Arrived in Paris and having hugged, outbursts of rain and thunder presage the forthcoming difficulties.Reality soon makes the squad go and hunt down Cacciato again. Oscar, the streetwise Detroit black, insists on the Real Politik of getting Cacciato to save their own skins from punishment for desertion. They have to arrest Cacciato and abandon their dream, because society expects them to do so. â€Å"Oscar's right,† Doc said, and sighed. â€Å"You can't get away with this shit. the realities always cath you. † â€Å"But maybe. † â€Å"No maybes. Reality doesn't work that way. † (p. 275) Paul Berlin is not ready yet to stop Cacciato and lets him escape again. Choosing reality and turning his back on the dream are, however, close at hand.In the promotion scene Paul remembered himself answering questions to a committee that scared the living daylights out of him. â€Å"Why do we fight the war? † they asked him, but at the s ame time the committee told him the answer: â€Å"to win†. Very afraid, he repeated this and got the job. Paul then realizes society urges him to do as he is told, and not to think for himself, as society will do that for him. He has to conform and shut up. He knows this cannot be right, but on the other hand his fantasized run for Paris would have been an equally unhappy experience to him in reality.For fantasy it had been all along. His dream of going after the freedom and peace Cacciato led him to, had all been a dream within a dream. The latter dream was dreamt in order to avoid having to solve the dilemma of staying in or running away from the war. He finally woke up from that dream, for now he had found the answer: he had to go through it; trying to escape and fleeing from social obligations was not according to his background, his personality and his beliefs. â€Å"I fear what might be thought of me by those I love. I fear the loss of their respect.I fear the loss of my own reputation. Reputation, as read in the eyes of my father and mother, the people in my hometown, my friends. I fear being an outcast. † (p. 286) The novel is structured round three elements that are in accordance with the three different activities of Paul Berlin's conscience: reflection, imagination and memories; he is wondering how people die in the war, he thinks about going to Paris and he stands on guard. The killings of war and their stories are told non-chronologically, as if they happen at this very moment.Paul Berlin tries to get things straight, tries to get a chronological list of the men killed. He needs order, wants to keep it straight, but he has problems with this. The structure of the novel reflects the structure of any war: it is confusing and without order, sometimes a mess and going in different directions. The hero solves this problem by making up a story himself. It is a story in the third person, told as a reality, told almost as observed by an omni scient observer, who has no involvement; but at the same time we know they are Paul Berlin's imaginations.All of a sudden this woman comes up in the he-country of Vietnam; only in imagination a beautiful girl is possible there. By the end of the novel the reader knows that the squad never went after Cacciato any further than the hill, and that Paris only denoted the illusion of seeking the Far West. In reality they had always been in the Far East. The unlimited possiblities of the Imagination, as that of the United States and its American Dream as well, fail in the reality of the Vietnam War.Berlin, whose name points to the American commitment to saveguard freedom (by setting up the airbridge to the city of Berlin under siege of the Soviets in 1948) finds himself in a situation in which the values, ideals and intentions of the United States no longer have the absolute meaning they seemed to have in previous wars. In Paris, the heart of Western civilization, Paul Berlin lacked the co urage to free himself, even in his dreams, and reality took over: No question, it was all crazy from the start. None of the roads led to Paris. p. 203) He has to accept that he and his comrades would be the very deserters, who would flee from the original idea of the American Dream, that told them that the only way if you really wanted to overcome all problems is to keep on trying. Only Cacciato, who with his childish simplicity and innocence, with his optimism and his individual power embodies the mythical American loner, he frees himself from the society that tells him what to do. He is, however, lost, together with these values, in the Vietnam War.The American Dream had led young Americans into a place where they had no right to go. They were supposed to fight and defeat the Viet Cong to serve the American nation, but in this war, just like in any other, confusion and death were the real victors; the war served no American purpose at all. The lesson Paul learned from the Vietnam War was far from significant: â€Å"Don' never get shot†. â€Å"There it is,† said Eddie Lazzutti. â€Å"Never. Don' never get shot. † (p. 254) He might have learned that back home in the US as well.So in Vietnam this trail West was a fake one. In Fort Dodge you could build good solid houses, in the wilds of Wisconsin you fraternized with your father who told you, back there, to look for positive things in the war. In Nam, however, there is only the squad, and all of a sudden this â€Å"boom†, like in Billy Boy Watkins' story, the case of the grunt dying of fright. It is the ultimate war story, the story of Vietnam. So Paul starts dreaming his own dream, he rejects the American dream. He nevertheless does not reject reality.Like Arthur Dimmesdale in The Scarlet Letter by Nathanial Hawthorne, he does not want to give in to the code of society, but does not want to be lured into the moral wilderness either. He wants to stay part of that society, although he knows its claims are based on air. â€Å"†¦ it is this social power, the threat of social consequences, that stops me from making a full and complete break. † (p. 286) However nasty the war may be, it is better to take part than to be isolated, so Paul Berlin ends his dream, in order to face reality. bibliography: Going after Cacciato (Tim O'Brien) Walking Point: American Narratives of Vietnam (Thomas Myers)

Coronary Artery Disease Nursing Care Plan

Coronary Artery Disease Tabatha Turner Practicum I Arkansas Tech University Coronary Artery Disease â€Å"Acute coronary syndromes represent a spectrum of clinical conditions that are associated with acute myocardial ischemia† (Gulanick & Myers, 2011). Coronary Artery Disease (CAD) is one of these clinical conditions that affect approximately 13 million people (Rimmerman, 2011). Because coronary diseases are the leading cause of death in men and women, nurses need to be involved in the care and education of people with or without CAD. Prevention is the best cure. Nurses play an important role in the treatment of CAD by offering and supplying comfort for anxiety and pain, minimizing symptoms and side effects, educating patients on the disease process, and helping to reduce risks and promote healthier lifestyles. Pathophysiology The heart is supplied blood, oxygen, and nutrients by the coronary arteries. When functioning normally, the coronary arteries ensure adequate oxygenation of the myocardium at all levels of cardiac activity (Klabunde, 2010). CAD is a heart disease that is caused by impaired blood flow to or through the coronary arteries. Several disorders can arise from the disease ranging from myocardial ischemia to myocardial infarction. Blood flow through the coronary arteries is usually dictated by the heart’s need for oxygen. It is controlled by physical, metabolic and neural factors and uses 60 to 80% of the oxygen in the blood that flows through the coronary arteries (Porth, 2011). When this blood flow is interrupted, damage ensues. Blood flow can be blocked by atherosclerosis, the buildup of fats and cholesterol in and on the artery walls (plaques) (Mayo Clinic, 2012). These buildups can be either stable and obstruct blood flow or unstable, â€Å"which can rupture and cause platelet adhesion and thrombus formation† (Porth, 2011). When the plaques are disrupted and a thrombus is formed, blood flow is obstructed and a myocardial infarction (MI) can occur. This obstruction starves the heart of oxygen and can cause angina (chest pain) and necrosis of the heart muscle. Risk Factors There are modifiable and non-modifiable risk factors for CAD. Patient teaching should include modifiable risks that can be avoided such as smoking, obesity, uncontrolled hypertension, high LDL levels and low HDL levels, uncontrolled diabetes, high stress, and sedentary lifestyles (Mayo Clinic, 2012). Many of these can be controlled by diet, exercise, and smoking cessation. Non-modifiable risk factor include age, gender (men are more at risk for CAD but women’s risk increases after menopause), and family history. According to the Mayo Clinic, the patient’s risk is highest if their father or brother was diagnosed with heart disease before age 55, or their mother or sister developed it before age 65. Since these factors cannot be controlled, it is extremely important to control the modifiable ones especially if the patient is at greater risk due to non-modifiable factors. Pathophysiology of MI Myocardial infarctions affect approximately ? million people each year in the US. 50% of the people affected die before reaching the hospital (KU, 2012). MI is characterized by the ischemic death of myocardial tissue associated with CAD. This occurs when blood flow through the coronary arteries is significantly reduced or blocked and the heart muscle does not receive enough oxygen. A â€Å"heart attack† usually has a quick onset with chest pain being the significant symptom due to the lack of oxygen (Porth, 2011). Other symptoms can be fatigue, dyspnea, and heart palpitations. Treatment for CAD The goal in treating CAD is to restore adequate coronary perfusion. If that is not possible, medications can be used to reduce the oxygen demand by the heart (Klabunde, 2011). Treatment options for CAD include reducing risk factors, use of medications, and surgery. Patients can slow the disease process by stopping smoking, eating healthier, and participating in more active lifestyles. Medications that can be used are anti-platelets and anticoagulants that dissolve clots, or anti-angina drugs such as beta blockers (decrease myocardial oxygen consumption by decreasing the actions of the sympathetic nervous system), calcium channel blockers (decreases eart rate and strength of contraction and relaxes blood vessels, decreasing blood pressure), or nitroglycerin (dilates the arteries to increase blood flow, reducing myocardial oxygen consumption) (Smeltzer, S. , Hinkle J. , Bare, B. , & Cheever, K. 2010). Usually cardiac catheterizations are done to determine blockage percentages (Appendix B). In extreme cases of CAD, stents can be implanted within the artery to restore blood flow or bypass grafts can be placed from an artery or vein elsewhere in the body to bypass the diseased segment (Klamunde, 2010). Nursing Diagnoses CAD can be life threatening if the disease is allowed to progress. Therefore measures should be taken to prevent progression. Proper, thorough assessment and nursing interventions can help. The first priority nursing diagnosis for a patient with CAD would be: Ineffective cardiac tissue perfusion related to reduced coronary blood flow secondary to CAD as evidenced by chest pain, blood pressure of 164/88, and pulse ox of 90% on room air. This is the first priority because if the heart is not properly fed, the pump can fail and will result in inadequate circulation for the whole body which could cause death. The second priority nursing diagnosis would be: Acute pain related to ischemia secondary to CAD as evidenced by restlessness, increased blood pressure, 143/88, and verbal report of pain in left shoulder and left jaw of 8/10 (on a numeric 1-10 scale) that has been unrelieved by over the counter medications. If pain is not managed, the body systems will continue to respond increasing vasoconstriction which in turn increases BP which could eventually lead to a cardiovascular accident or death. The third nursing diagnosis for a patient with CAD that is a smoker and has an unhealthy diet is: Risk prone health behavior related to inadequate comprehension of disease process as evidenced by patient smoking ? a pack of cigarettes a day and eating fast food and fried foods regularly. These behaviors are both modifiable risk factors and should be included in the patient teaching. Nursing Goals For the priority nursing diagnosis of Ineffective Cardiac Tissue Perfusion, he goals would be:Patient will attain adequate tissue perfusion and cellular oxygenation as evidenced by a pulse ox of 96% or above on 2L oxygen by nasal cannula within 8 hoursPatient will verbalize an understanding of the disease process and the therapy regimen by discharge.The goals for the diagnosis of Acute Pain would be:Patient will verbally describe the level (using a numeric 1-10 scale) and characteristics of their pain every 2 hoursPatient will report pain goal of