Dating paragraph Essay Example | Topics and Well Written Essays - 500 words

Dating paragraph - Essay Example I currently work as support staff in the I.T department where most of my duties revolve around creating systems and getting applications and software that ensures operations efficiently. I work at a pharmaceutical company that brings in medicine and medical equipment from Europe and Asia mostly and sells to retailers within the country. My other hobbies include reading legal drama novels (in another life I would have probably pursued a career in law), dance/trance music and indie rock, and a good old-fashioned meal of fries and a cheeseburger. Things I am not too fond of include loud-mouthed and intolerant people, that is, people who cannot accommodate people that are different from them whether in physical appearance or social background, reggae music, celery (I don’t care how healthy it is, it tastes unpleasant!) and brown bread. That being said, I should point out that I do try to eat healthy and keep fit though I am not much of a runner. My choice of exercise is swimming thus warm weather places appeal to me, and cycling. My favorite alcoholic drink is vodka mixed with club soda and I indulge in this when I am out partying only, I generally do not enjoy drinking at home maybe an occasional glass of sweet red wine. This brings me to another revelation; I have a sweet tooth, which has cost me many visits to the dentist! I am looking for an outgoing girl to complement my laid-back nature who enjoys TV and movies as most of my free time is spent watching comedies and legal drama stuff. It would be a plus if she can bake, as I like to indulge my sweet tooth from time to time. Men should look for a girl that brings out their good parts and helps them become better. I am a good listener and I believe this is important in relationships as it makes communication easier. However, I hate confrontations, this makes me walk away from any potential arguments, and I will more likely than not let things slide when they should be aired out. I am working on this and at

Lesson V Research Paper Example | Topics and Well Written Essays - 750 words

Lesson V - Research Paper Example Further, Siva did not act ethically by suing Hess as he had not entered into a personal agreement with Hess but with 1138 LLC. If Siva wanted Hess to be personally liable for the debt, he would have asked Hess to sign the lease agreement in an individual capacity and hence Hess would have been personally liable (Cooper & Lyman, 1998) The appending of Mr. Soskin’s signature on the contract document indicating that he would personally guarantee any defaulted payments by Nashville holds him personally liable to pay the debt (Cheeseman, 2013). He therefore acted as a personal guarantor to Nashville LLC and any failed payments by the company would be recovered from Soskin’s personal assets as he became personally liable by signing a document with a paragraph saying â€Å"I personally guarantee...† If Soskin intended to act as just a representative as he stipulate in his defense, he would have therefore asked for an amendment of the clause which made him personally liable (Cheeseman, 2013) Under the subject of Liability of the franchisor, he case quoted is Martin v. McDonalds Corp. where McDonald’s was sued for negligence. The court’s decision held that McDonald’s was negligent for failure of following up and making sure that deficiencies in security at the Oak Forest Franchise were corrected. The liability of a franchisor therefore affects businesses in the United States as the franchisors are tasked to ensure that security procedures are adhered to and thus manuals should be circulated in all franchised business for conformance (Cheeseman, 2013). In the subject of right to accounting, Steeby v, Fial case is applied where Steeby sued Fial for breach of fiduciary duty while seeking for final accounting. The trial court found that Fial had in his actions violated the partnership agreement and hence breached the fiduciary duty by terminating the auditors and dissipating partnership assets. Also, he had terminated contracts for the clients

Who was John Collier, and what role did he play in creating a New Deal Research Paper

Who was John Collier, and what role did he play in creating a New Deal for Native People - Research Paper Example John Collier became commissioner of Indian affairs in 1933 as appointed by President Roosevelt. Under Collier’s governance, federal policies had sweeping and permanent changes in favor of the Indians. One of these federal policies was the Indian Reorganization Act of 1934, which was also known as the â€Å"Indian New Deal† or the â€Å"Wheeler-Howard Act†1. The Indian Reorganization Act under Collier made lasting changes in the federal policy concerning Native Americans. One of these changes is ending the allotment of the tribal land to non-Native Americans. Two other changes include the act encouraging tribes to establish their own self-government and building a loan in order to finance tribe members who are putting up a business2. Prior to and aside from becoming a commissioner of Indian affairs, John Collier was also the executive secretary for the American Indian Defense Association, or AIDA, an organization which he himself founded in 1923, in order to fight for the protection of tribal property and religious freedom of Native Americans. Through the institution of AIDA, Collier was able to recommend doing away with the teaching to Indians of only the cultural values of whites. At the same time, it recommended that that Indian Service must provide the youth and their parents the necessary tools that will help them adapt not only to whites but also to Indians3. John Collier also asked Congress for the repeal of the Dawes Severalty Act of 1887. This particular law pressured American Indian tribes to abolish their own community lands and to have individually owned lands instead. The purpose of this was to promote Indian assimilation into the society of American whites. The Bureau of Indian Affairs, which Collier headed in 1933 provided for the successful passing of the Indian Reorganization Act in Congress4. John Collier’s idea of a â€Å"New Deal† for American Indians during his time definitely was all about the betterment o f this particular group of people. He became commissioner of Indian Affairs in 1933 and so helped reform law in favor of the Indians through the Indian Reorganization Act. He was also the founder and executive secretary of the American Indian Defense Association, which issued recommendations on how Indians should be treated and educated. Lastly, he asked Congress to repeal the Dawes Act of 1887 in order to protect the tribal lands of the Indians. Explain French patterns of contact with Native Americans: How did their goals and type of colonization affect the success or failure of relations with Native groups? The French colonizers’ diplomacy and immersion into Native American culture guaranteed the success of their colonization. The French arrived in North America in the 1600s5, and established their colony there. However, unlike the British, who did not respect the natives, the French afforded them with the best treatment as possible. The success of the colonial techniques o f the French that helped them establish New France in Canada was mainly due to their immersion in American Indian culture. The French were very interested in the culture and customs of Native Americans. The French took the time to learn the languages, habits and the ways of the Native American

Innovative Food and Beverage Marketing Ideas Essay

Innovative Food and Beverage Marketing Ideas - Essay Example Rock music usually has a strong back beat. (Wikipedia) In the late 1960s, rock music was blended with folk music to create folk rock, and with jazz, to create jazz-rock fusion. In the 1970s, rock incorporated influences from soul, funk, and Latin music. In the 1970s, rock developed a number of subgenres, such as soft rock, blues rock, heavy metal-style rock, progressive rock, art rock, techno-rock, syth-rock and punk rock. Rock subgenres from the 1980s included hard rock, indie-rock and alternative rock. In the 1990s, rock subgenres included grunge-style rock, Britpop, and Indie rock. (Wikipedia) The influence of rock and roll is far-reaching, and has had significant impact worldwide on fashion, film styles, and even the hospitality industry.. This impact is broad enough that rock and roll may also be considered a lifestyle in addition to a form of music. Rock music was the inspiration of Tigrett and Morton's Hard Rock Caf (HRC) that originated in London. (Wikipedia) HRC is a unique genre in the hospitality industry, being a chain of restaurants, hotels, and casinos that is known for its music and memorabilia rather than its food. Customers come to HRC mainly for the experience of the live music event, which is a highly strategic marketing innovation of the caf. It was founded in 1971 by music-loving entrepreneurs Isaac Tigrett and Peter Morton. The first HRC opened near Hyde Park Corner in London, in a former Rolls Royce car dealership show room. In 1979 Tigrett and Morton began to cover the walls with rock and roll ephemera. Hard Rock was most popular in the 1980s when some people engaged in the hobby of visiting as many locations as possible and collecting a Hard Rock t-shirt bearing the Cafe logo and the location name. The Hard Rock Cafe's motto "Love All, Serve All" was adopted from Tigrett's guru Sathya Sai Baba. (Wikipedia) The HRC Marketing Mix There are about eight million restaurants in the world and some 300,000 restaurant companies. The restaurant industry is a classic mature market. Companies face stiff competition and low profit margins. (Yahoo Finance) Thus, innovative marketing ideas are necessary for any restaurant business to remain competitive and sustainable. Like many other restaurants and cafes, Hard Rock adapts the descriptive labeling for its menu and more. It has reinvented the menu to become an art cum history book. But more than the artistic menu, what makes HRC sustainable is its marketing mix that combines music, food, museum and merchandising. According to Proctor (2000), positioning products in people's minds and making them attractive to market segments requires careful formulation of the marketing mix. Getting the right blend of the product, promotion price and distribution is essential to put the carefully carried out analysis into operation. The aim is to portray an image for the product or service that will match with how one wants the product to be visualised in people's minds, i.e. its positioning. Image is not only reflected in the promotional messages which are directed towards the target market but also in the pricing strategy, the mode of distribution and in the appearance of the product or service itself. Live Rock MusicHRC has position itself for dominance in a market that caters to customers who love not only

Yes or no, did Roman architecture show any artistic advance over Greek Essay

Yes or no, did Roman architecture show any artistic advance over Greek architecture If so, how; if not, why not - Essay Example Nonetheless, many of the buildings were turned into places of worship during the Christian era. This paper highlights how Roman architecture shows artistic advances over Greek architecture. Roman culture and architecture, in specific, is established on that of the Greeks. In the republican period, Roman architecture merged Greek components and developed structures like the curved arch and the round temple. The principle Roman advancement in architecture was the establishment of sophisticated arched construction. This is where a ceiling is held by arches. During the Greek era, arched building was uncommon and straightforward. The common style of construction was referred to as post-and-beam (Kleiner 14). This was made up of vertical posts that held horizontal beams. The Romans also made advances in the building materials. Early Greeks used stone, mud, plaster, and wood in their buildings. In their natural form, these structures could not exist for long. Nonetheless, the Greeks built their temple with limestone or marble. Moreover, early Romans also used similar materials, especially limestone and marble. The Romans advanced building materials by utilizing concrete in many of their structures. Concrete is a combination of lime mortar, sand, and water. It is stout but light, permitting the Roman architects to build free-flowing and larger buildings. In addition, temples are the only form of Greek architecture that are still in existence (Ching, Jarzombek and Prakash 59). These structures were discernible on the inside and ornate on the outside. Conversely, Roman structures still exist. This is because of their progress in building technology. Unlike Greek structures, Roman buildings were ornate both on the inside and outside, showing the desire f or pleasure. Also, Romans improved the construction details. Greek buildings are usually of post and lintel and rectilinear construction. The

Native Americans in the United States Essay Example for Free

Native Americans in the United States Essay Based on the ethnic groups (Table 1: Appendix), several beneficial values that helped to shape the United States lifestyle can be described (Holland, 2006). In particular, the brief summaries have given the clear picture of Multiculturalism in the United States in relation to the origin. The United States, for that matter, is captured as a multicultural society that is open to all people with different backgrounds. From an early time, several groups started moving into the region due to various reasons, which allowed for the development of a culturally diverse society. Hence, the United States substantially benefited from the cultural diversity as improved workforce was available for the various work scenarios. Despite the obvious benefits of multiculturalism in the society, some negative forms such as racism, stereotypes, prejudice, and discrimination flourished over several years (Holland, 2006). In the recent past, for example, several ethnic groups such as the African American, Hispanic, and Indian Americans have continually suffered racism, discrimination, and being depicted in certain stereotypes. Firstly, segregation between the Whites and Blacks was a key characteristic of the population before the rise of the civil rights during the 1950s and over (Holland, 2006). Workplaces, schools, commuter busses, and residential areas were segregated between the two groups until in 1954 when segregation in schools was banned. As a result, people started integrating on a multicultural perspective, which led to the realization of better performances and solutions for the workplaces. Besides the significant leap ahead, other factors such as prejudice and stereotyping still exist at the current date. For instance, the African American and Hispanic groups have been stereotyped in the villainous characters such as gangsters, robbers and the like for several decades (Holland, 2006). Such beliefs have existed for several years and are even a common occurrence in media the same way. Hand in hand, prejudice has also resulted from the occurrences. Therefore, prejudice and stereotypes are a normal situation in the culturally diverse environment of the United States. However, the multicultural nature of the country’s population resulted in some positive factors such as creation of a multicultural workforce that can meet the requirements of the target population in an effective manner (Kenyon, 2005). In connection to that, all the ethnic groups in the American landscape are subject to some positive, as well as, negative aspects of the cultural diversity. As a result, prejudice, stereotypes, racism, and discrimination that were once extremely high have considerably low effects on the modern and socially active populations. In conclusion, the United States still leads with regards to the benefits of cultural diversity among its people. Table 1: Multicultural Matrix and Analysis Worksheet. Part I: Matrix What is the group’s history in the United States? What is the group’s population in the United States? What are some attitudes and customs people of this group may practice? What is something you admire about this group’s people, lifestyle, or society? 1. The African American Several African American people are linked to a history of slavery since their ancestors were brought in the United States as slaves. This happened first during the 1600s-1700s, and where they assisted English colonialists to get American independence. Later, prominent leaders such as Martin Luther King, Jr. helped to change discrimination against Blacks. As a result, a breakthrough into the rampant segregation between the whites and blacks reduced. The African American has an approximate population of about 37 million forming about 13 percent of the total population of the United States. The African Americans are characterized by the practice of several cultural activities depicted in their music, art, and lifestyle. As such, they form a significant part of the USA as their culture substantially influenced the American culture. I appreciate the African American lifestyle and their music such as Hip-hop and reggae music. Additionally, I love their celebrations such as the Black history celebrations in which they remember their historic past. 2. The Hispanic and Latino American The Spanish became among the first settlers, before Europeans, to settle in some areas of America such as Florida and California. Several people of this group speak the English language only and have adopted the European-American Culture. On average, the Latino and Hispanic population in the United States is approximately 16 percent of the whole population. This accounts to almost 50 million people. The Hispanics are depicted as religious people who believe in helping one another. Families may be nuclear or extended, and the father is the final decision maker in the family setting, while the mother is the home care taker. However, all family members are expected to assist in the effective functioning of the setting. I love Hispanic music and their musicians such as Ricky Martin and Jenifer Lopez. Additionally, their Mexican foods are an excellent appetizer that I always cannot ignore. 3. The Indian American The Indian American officially became legal citizen in the United States in 1946. The Indians immigrated into the United States via other countries such as Jamaica, South Africa, and United Kingdom among other countries. The Indian population in America is reasonably low at approximately 0. 89 percent of the whole population. As such, this reflects to about 2. 5 million people. The Indian Americans have a strict cultural background and adhere to strict rule on religion, culture, and food among several other practices. Their religions are diverse and may include Hinduism, Islamism, Christianity, and Buddhism. I value the cultural practices of Indians especially those practicing Hinduism as they have fascinating ideas. One example is the caste system, where once in a low or high case system; one is destined to remain right there. 4. The American Asian Asians of the Chinese background came into the United States due to mainly conflicts from their countries. One situation was the Vietnam War, which led to massive migration of the affected into the USA. In the 1970s and 1980s, therefore, was time for the largest Asian migration into the United States. The Americans Asian account for about 5 percent of the United States’ population. As a result of cultural diversity, the American Asians are exposed to several challenges. I admire the Chinese way of life that comprises of fun in the form of art and craft. Additionally, I find pleasure watching some of their movies and appreciate the Yoga. 5. The Native Americans The Native Americans were the original settlers of the United States of America. Relevant sources indicate that they enabled undetectable communication during the World War II using their native language. As pertains to name, the Native Americans are recognized as the first settlers of the United States. However, they account for a small population percentage of about 1 percent. The Native Americans culture show dissimilar practices in all other nations. In particular, those living on reservations show dissimilar cultures from the ones not living on reservations; however, some similarities may exist in their heritage and traditions. The Native Americans fascinate me with their incredible lifestyle such as them living in tepees and their spiritualism. 6. The Bahamian American The Bahamian American migrated into the United States from the Caribbean during the late 19th century in search for job offers in the agricultural sector. The Bahamian American has an extremely low population of about 40,000 people. Hence, it accounts for approximately 0. 01 percent of the whole population. Bahamian Americans preserved their cultural heritage; hence, have a distinguished way of living and culture. The Bahamian way of living and cultural heritage provides an excellent measure of modern living from historical setting. Their cultural practices are engaging. Part II: Analysis Basing on the above listed ethnic groups, several beneficial values that helped to shape the United States lifestyle can be described. In particular, the brief summaries have given the clear picture of Multiculturalism in the United States in relation to the origin. The United States, for that matter, is captured as a multicultural society that is open to all people with different backgrounds. From an early time, several groups started moving into the region due to various reasons, which allowed for the development of a culturally diverse society. Hence, the United States substantially benefited from the cultural diversity as improved workforce was available for the various work scenarios. Despite the obvious benefits of multiculturalism in the society, some negative forms such as racism, stereotypes, prejudice, and discrimination flourished over several years. In the recent past, for example, several ethnic groups such as the African American, Hispanic, and Indian Americans have continually suffered racism, discrimination, and being depicted in certain stereotypes. Firstly, segregation between the Whites and Blacks was a key characteristic of the population before the rise of the civil rights during the 1950s and over. Workplaces, schools, commuter busses, and residential areas were segregated between the two groups until in 1954 when segregation in schools was banned. As a result, people started integrating on a multicultural perspective, which led to the realization of better performances and solutions for the workplaces. Besides the significant leap ahead, other factors such as prejudice and stereotyping still exist at the current date. For instance, the African American and Hispanic groups have been stereotyped in the villainous characters such as gangsters, robbers and the like for several decades. Such beliefs have existed for several years and are even a common occurrence in media the same way. Hand in hand, prejudice has also resulted from the occurrences. Therefore, prejudice and stereotypes are a normal situation in the culturally diverse environment of the United States. However, the multicultural nature of the country’s population resulted in some positive factors such as creation of a multicultural workforce that can meet the requirements of the target population in an effective manner. In connection to that, all the ethnic groups in the American landscape are subject to some positive, as well as, negative aspects of the cultural diversity. As a result, prejudice, stereotypes, racism, and discrimination that were once extremely high have considerably low effects on the modern and socially active populations. In conclusion, the United States still leads with regards to the benefits of cultural diversity among its people. Part III: Sources Holland, C. (2006). Ethnic and Religious Diversity in Central America: An Historical Perspective. Retrieved November 12, 2011 from the Prolades Website: http://www. prolades. com/Ethnic_Religious_Diversity_CAM-Holland. pdf Kenyon, A. (2005). The Importance of Diversity in the Workplace. Retrieved November 11, 2011 from the Leading Today Website: http://www. leading today. org/Onmag/2005%20Archives/may05/ak-may05. html Reference List Holland, C. (2006). Ethnic and Religious Diversity in Central America: An Historical Perspective Retrieved November 12, 2011 from the Prolades Website: http://www. prolades. com/Ethnic_Religious_Diversity_CAM-Holland. pdf Kenyon, A. (2005). The Importance of Diversity in the Workplace Retrieved November 11, 2011 from the Leading Today Website: http://www. leading today. org/Onmag/2005%20Archives/may05/ak-may05. html

The condition known as delirium

The condition known as delirium Introduction This assignment will examine the condition known as delirium and will focus on a clinical case study (please see appendix 1. for the full overview of the clinical case study) of a gentleman called Halim* who has presented in the emergency department with his two daughters. This assignment will be separated into two distinct parts; the first part of this assignment will provide a clinical overview of delirium and will explore what the condition is, the common features, clinical causes and interventions available to manage and treat the condition. This will provide the reader with an understanding of the components that constitute the condition of delirium. The second part of the assignment will then focus on placing the acquired knowledge of delirium on to the clinical case study of Halim so that a more detailed clinical exploration can be completed; with focus being placed on the role of the practitioner and their interventions in addressing the key issues. *To protect and respect client confidentiality all names have been changed and any identifiable data censored for the purpose of this assignment. Delirium Clinical Overview Delirium, also sometimes referred to as an acute confusional state, is a common clinical condition that presents with individuals experiencing disturbances in consciousness, cognitive function and perception, which has an acute onset and fluctuating course (NICE, 2010). The important clinical characteristic of a delirium is that the onset is quite rapid; it may present and develop within a very short period of time, usually over the course of a few hours or days (Brown Boyle, 2002). It is not uncommon for an individual to present to hospital settings with symptoms of delirium and it is important to acknowledge that individuals who already are hospital inpatients or in a care setting may also develop delirium; it is a condition that traverses the inpatient and community settings. Literature suggests that there are two types of delirium; hypoactive delirium is characterised by individuals experiencing withdrawal, lethargy, introversion and sleepiness whereas people with hyperactive delirium have heightened arousal, restlessness, agitation and aggression (NICE, 2010). There is also a third variation where individuals may experience a mixture of both hyper and hypoactive symptoms which can make diagnosis very difficult. It is suggested that delirium can often be mistaken for dementia, worsening of pre-existing cognitive problems and old age; however delirium is a clinical syndrome that differs from these other conditions as it is the sudden and acute onset that tends to vary throughout the course of the day that identifies it as delirium rather than any other disorder (Meagher, 2001). It is reported frequently within the literature (Wong et al., 2010; NICE, 2010; Meagher, 2001; Brown Boyle, 2002; Cole, 2004 and Siddiqi House, 2006) that patients with delirium experience a reduced ability to focus and concentrate; perceptual disturbances which includes delusions, paranoia and hallucinations; fluctuations in presentation; difficulty in following conversation or direction; rambling or changing topic; disorganised thinking and disturbances in consciousness. In addition to these clinical symptoms there also may be mood disturbances and changes in neurological presentation with individuals experiencing changes in muscle tone, tremor and involuntary jerking (Map of Medicine, 2011). Delirium occurs due to underlying physical pathology (American Psychiatric Association, 2000) and although symptoms may present as symptoms of mental illness the condition itself has originated usually from some kind of underlying infection, disease or event that has impacted on the individuals physical health status (Wong et al., 2010). Examples of possible causes for delirium include; hypovolaemic shock, cardiac failure, myocardial infarction, head trauma, seizure, metabolic disorders such as liver or renal failure, fluid and electrolyte imbalance, infection, malignancy, dehydration, post operative state, pain, constipation or urinary retention. In addition to these common causes delirium may also be induced by individuals experiencing complications from drug interactions and withdrawal; and included in this is prescribed medications, illicit drugs and alcohol (Map of Medicine, 2010). Delirium is a very serious condition and it cannot be underestimated as the mortality rate for individuals is very high even after discharge from hospital for up to 12 months (McCusker et al., 2002), other complications from delirium also include patients having to stay longer in hospital which means they are exposed longer to hospital acquired infections, persistent cognitive deficits and an increased risk of the individual being discharged into residential care rather than return to living independently are also factors (Wong et al., 2010). With the symptoms of delirium presenting as the onset of an acute mental illness it is possible for debate to arise as to which clinical team should be responsible for the management of the patient; additionally; in light of the evidence presented; it would be easy for the individual with delirium to be overlooked or not be investigated for the reasons behind the onset of the condition which is probably why the mortality rate is so high; underlying physical conditions that are not assessed, treated or managed will continue to affect the health status of the individual. Statistically more than half of delirium cases go unrecognised by health professionals (Inouye et al., 1998). Prevention of delirium is more effective than treating it once it has developed (Brown Boyle, 2002) therefore it is important for healthcare professionals to be aware of the risk factors, symptoms and causes of delirium for individuals under their care either in hospital or in the community. If delirium has already developed then it is the responsibility of the healthcare team to manage the condition quickly and efficiently to reduce further problems and difficulties for the individual; recognizing the mortality rates associated with a diagnosis of delirium should facilitate efficiency. To assist with obtaining a clearer clinical perspective of delirium and the impact it has on an individual a clinical case study shall now be explored. Halim Clinical Exploration Halim was admitted to the emergency department and when the clinical history was obtained from his daughters it was identified that there had been a rapid change in his cognitive status which had been observed within a 24 hour period as his daughter had not been alerted to any concerns when she had spoken to him the previous evening. In light of the evidence it is possible for practitioners at this point to consider that Halim has developed an acute syndrome such as delirium and the next stage is to explore this further. On completion of the basic observations it was evident that there are physical abnormalities present. From visual observation of the patient it is clear he has altered mental status, dry skin and cracked lips. From clinical measurement of heart rate, blood pressure, temperature and oxygen saturation levels, there is further evidence of physical abnormalities that may contribute to changes in cognitive function to such an acute degree. Obtaining clinical history often involves information being sought from third parties to support clinical findings particularly if the patient is impaired cognitively. Halims daughters were able to give an account of a gentleman who had experienced marital problems and divorce due to alcohol misuse and evidence remains that he continues to consume alcohol regularly. In addition to this there is a history reported of Halim neglecting his diet to the extent his daughters provide food for him when they visit, he also engages in health limiting behaviours by smoking and consuming high levels of caffeine on a daily basis. The history obtained from Halims daughters identifies a gentleman who is successfully self- employed, he has hobbies and interests although his social network has reduced and although he engages in health limiting behaviours such as smoking, drinking alcohol and neglecting his dietary needs; he has remained independent within his own home. The evidence suggests there has been an acute change and with this information and the clinical evidence indicating Halim is experiencing tachycardia, high temperature, hypotension and dehydration the clinical evidence provides a strong indication that he is experiencing symptoms of delirium. Further investigations are required to gain a greater understanding of what physical changes have occurred so that underlying causes are treated, however the practitioner should take some time to explain to the family members what tests are being completed and what the medical team are treating Halim for. The family must be very distressed by the changes to their father and by communicating the outcomes of the assessment and responding to any questions they may have will be beneficial as it is reported that the experience of delirium is frightening for both the patient and their carers and the value of reassurance cannot be underestimated (Mohta et al., 2003; Jacobson Schreibman, 1997). Managing Halim in terms of obtaining his consent to agree to treatment and investigations may be difficult because of the level of cognitive change and because his understanding and judgement may be impaired because of the delirium; therefore it is important that the practitioner and family are familiar with legal frameworks and hospital policies that are in place to ensure the rights of all parties are being protected. An example of this would be practitioners being familiar with the hospitals delirium policy, being well versed in patients rights and by having knowledge about legislation such as the Mental Capacity Act (The Stationary Office, 2005). As stated previously the experience of delirium may be frightening for Halim and therefore the practitioner should endeavour to implement nursing and care strategies that reduce distress, improve orientation, address physical health status and ultimately minimise the duration and impact of the delirium. Examples of the interventions that can be implemented include; working with the multi disciplinary team to treat the underlying cause of the delirium. This may include providing pain control, regulation of bowel and bladder function, ensuring adequate diet and fluid intake is promoted and recorded. Another intervention that is reported to be effective in supporting patients with delirium is for care staff to provide a safe and therapeutic environment. This would mean that Halim is offered reassurance and support, all activities are carefully explained; and for Halim this may mean that a Farsi speaking interpreter is found to facilitate communication between him and the medical team as he reverts to the language of his birth when speaking with the clinicians. In expanding the opportunity to communicate with Halim, this may increase his comprehension of what the medical team are trying to achieve and reassure him that the procedures being carried out; like attempting to obtain a urine screen. Due to the life threatening nature of Delirium it is essential for all physical screens and assessments to be carried out to ensure early identification of the reason for the onset of the condition, if the therapeutic interventions are unable to be implemented due to Halim remaining agitated and acutely confused then as a last resort medication may be considered in an attempt to reduce his level of arousal enough to ensure clinical procedures and care can be delivered. Psychotropic medication can be prescribed in delirium in an attempt to reduce the levels of distress and agitation and for Halim it may be beneficial to ease his levels of arousal enough so that medical interventions can take place; it is important to note however that psychotropic medications have side effects that include; extra pyramidal side effects, mobility impairment, sedation and cardiac interaction therefore they must be used with extreme caution and Halim should be monitored closely. Conclusion Halim has presented to the emergency department with a delirium and the impact of this on his health and welfare should not be underestimated by practitioners. With mortality rates in delirium being worthy to note it is essential that care pathways are developed to ensure the physical health and mental wellbeing of patients like Halim are met concurrently. Clinical, environmental and behavioural interventions are acknowledged to reduce the impact, intensity and duration of the condition; therefore practitioners should work intensively to ensure a delirium presentation is treated efficiently and effectively to ensure mortality rates are reduced and recovery is facilitated as quickly as possible.