I need help creating a thesis and an outline on Clinical Examination of Mr Robinson. Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is required. 1. Mr Robinson presented to the Emergency unit after vomiting a massive amount of blood. His current status represents a state of hypovolemic shock which was caused by a large amount of blood in his vomit.

Mild to moderate hypovolemia only leads to resting tachycardia, however blood loss of at least 50 per cent results in supine hypotension (Saltzman & Fieldman 2013). The loss of blood leads to reduced intravascular volume and inadequate tissue perfusion. This causes a reduced arterial pressure and decreased tissue perfusion. hence the tissues are deprived of oxygen and nutrients (Lippincott Williams & Wilkins 2009). Mr Robinson presented with increased blood urea nitrogen suggesting renal failure due to “a large quantity of blood” in his vomiting, pointing out towards the massive reduction in intravascular volume leading to hypovolemia.

Mr. Robinson’s initial presentation is consistent with the signs of hypovolemic shock and presented to the Emergency room with cold and clammy skin, tachycardia and anxiousness. His pulse was 130 beats per minute which were weak and thread in nature, exhibiting hypovolemia. As a compensatory effect, the respiratory rate is increased leading to hyperventilation, in an attempt to increase the partial pressure of oxygen in arterial blood. Mr. Robinson’s respiratory rate was 36 breaths per minute, suggesting that he was hyperventilating as a compensatory response to the metabolic acidosis.

&nbsp.Acute upper gastrointestinal bleeding can present either as blood in vomiting (hematemesis) or melena (blood in stool). In the given case, the patient presents with massive upper GI blood loss through vomiting which leads to a medically critical state of hypovolemia. Approach to diagnosis of a medical case first revolves around the history of the patient.

Hi, I am looking for someone to write an article on microsoft zune vs apple ipod Paper must be at least 500 words. Please, no plagiarized work! The Apple iPod and Microsoft Zune: Playing the Same Tunes Differently People enjoy listening to music because it can relax and soothe one’s nerves and at the same time, pump up one’s energy. This goes to show that music plays an important part of life. Music players have changed significantly since the first phonograph was invented. Today, the most popular devices are called media players because they do not only play music but show pictures and play videos as well. The two most popular media players in the market today are the Apple iPod and the Microsoft Zune.

Apple released their first ever portable media player, iPod Classic, in 2001. Like the usual portable media players, one can listen to music, watch videos, show pictures and even play games on the iPod (Kahney). Apple has since modified the original iPod and has made it small and wearable (iPod Shuffle) and with more and more features like having built-in Wi-Fi and enabling it to record and edit HD videos, download and play online games, among other things (iPod Touch). Each product has its own device generation as well.

Microsoft released its own media player device in the year 2006 and called the original Zune 30. The numbers in their name indicates how big the capacity of the device is. Zune 30 can play songs, video and show pictures just like the iPod. The only difference is that photos and videos can be watched or played in either portrait or landscape mode (Broida). The Zune can also be modified to play games and can play in many different audio formats. It also has a Zune-to-Zune wireless sharing of music and photos. Next is Zune 4 which has the generation of 8 and 16. According to Surhone et al. (2010), it can be clicked 5 ways. Like its predecessor, it has Wi-Fi used for wireless sharing of photos and music in other Zune. It has also a FM radio. Zune 80 or 120 was the next release for the Microsoft, which produce positive results as it was called an “iPod alternative” (Surhone, et al). The features are the same as its previous predecessor but with higher capacity as the number indicated in the name and bigger screen. The most recent release is the the Zune HD. As its name suggests, one can buy and rent high-definition (HD) movies and TV shows, play HD radio, download apps and games and surf the internet on the Zune HD (Surhone, et al).

Zune and iPod have a lot of things in common. The two media players initially had the same capacity for music and photos but Zune had more capacity when it came to videos. Zune has a bigger screen, display mode can be portrait and initially released its media players with Wi-Fi. Zune HD and iPod Touch have almost the same features, except for iPod Touch having the FaceTime application (Ricker).

While the two media players were quite alike, they also had their differences. The wireless sharing wasn’t initially available for the Apple iPods. iPods can share photos but only through their applications by using the PC or Mac. Perhaps one of the most critical differences is that since Zune is manufactured by Microsoft, Zune media players can only be used on PCs not on Mac (Layton). Some consumers are discouraged from using Zune because they claim that Zune has software installation issues and can’t be used as external hard drive. However, Zune is cheaper than the iPod and the music downloads are cheaper too.

iPods and Zune have their own online music market, which are iTunes and Zune Marketplace respectively. Music for the iPod can be found at iTunes only unlike other media players which can be used like flash drives in installing files. Also, because of the protocol given for the wireless shared music for Zune, one is forced to buy or rent the music in the Zune Marketplace (Layton). Thus, consumers who go for cheaper devices, cheaper music download, ease of music downloads, and Wi-Fi sharing, generally opt for Zune while those who prefer more popular, more features and more applications, go for an iPod.

References

Broida, Rick. How to do everything with your Zune. McGraw-Hill Professional, 2007.

Layton, Julia.&nbsp. “How does Zune compare to iPod?”&nbsp. 15 November 2006.&nbsp. HowStuffWorks.com. &nbsp.02 April 2011.

Kahney, Leander. The cult of iPod. No Starch Press, 2005.

Ricker, Thomas. “zune vs. iPod specification smackdown.” 3 October 2007. EndGadget.com. &lt. http://www.engadget.com/2007/10/03/zune-vs-ipod-specification-smackdown&gt. 02 April 2011.

Surhone, L., Timpledon, M., Marseken, S. (2010). Zune HD. 02 April 2011.

Need help with my writing homework on Traditional Way and Agile Way of Management. Write a 2000 word paper answering; Iterative or agile method involves incremental development. The system and the process is gradually built and has an advantage over other methods. For instance, if there is a need to modify the management process or the direction of the system needs to go through sudden abrupt changes. agile management system has a better chance to cater for the change then other methods. One relatively rigid method is ‘waterfall method’.

In comparison with the agile project management, the waterfall method uses clearly (or with less flexibility) defined deliverables for the life cycle of the project. The higher management of a company performs a complete audit of the system before it is incorporated into the project management.

Agile project management method cuts the processing time considerably. Projects that took months to complete in the past are being accomplished within weeks or days. This project managing method modifies the conventional iteration processes waterfall and makes them more flexible and advanced.

Despite the fact that agile management is rarely used to manage a mega project, it is no less crucial than the conventional of traditional project management methods and tools. A mega project can be divided into several parts and then these small parts can then be governed and managed by agile management. That is why a collage of management methods and tactics are incorporated in one project. The core difference between agile and traditional project management rests in their estimating techniques.

Create a 1 page page paper that discusses access to care. Access Care The article highlights Massachusetts’ experience with health care reform especially by examining data on employment in the healthcare industry to ascertain the impact on the health workforce. According to the article, the Massachusetts’ healthcare legislation served as a model for the national healthcare reform legislation passed in 2010. Although the state has achieved almost near universal insurance coverage there have been challenges of growing health insurance premiums, increased spending on healthcare, as physicians are concerned with access to primary care and administrative burdens (Staiger, Auerbach & Buerhaus, 2011). The article indicates that the healthcare reform in Massachusetts has triggered growth of total healthcare employment per capita. However, the growth was primarily based on administrative occupations and patient care support professionals and not amongst physicians and nurses. This is probably because the physicians complained of the administrative burden that the law imposed on them. The program may be costly because of the need to employ more physician and nurses.

Effects of Increased Access to Care on the Providers

Increased access to care will have a great impact on physician who may in turn get dissatisfied with their jobs and perhaps quit. The increased access will promote third party payment arrangements, which largely compromises the independence and integrity of the medical profession. Moreover, the physicians will be subjected to increased government regulation as well as oversight and will mostly be dependent on unreliable government reimbursement for medical services thus resulting into tremendous pressure amongst the practitioners. Patient centered health care reform should be adopted that restores doctor patient relationship thus making physicians the key decision makers in the delivery of care as patients become key decision makers in financial care but not the government.

Reference

Staiger, D. O., Auerbach, D. I., & Buerhaus, Peter R.N. (2011). Health Care Reform and the Health Care Workforce — The Massachusetts Experience.&nbsp.The New England Journal of Medicine,&nbsp.365(12), e24. Retrieved from http://search.proquest.