Write My College Papers For Me

Write My College Papers For MeWhen I was in college, I got my first job writing my college papers for me. Now that I'm working full time, I wanted to take a moment and share how to write my college papers for me. It's not as hard as you might think it is.My first step in writing my college papers for me was deciding what kind of paper I wanted to write. I took some notes during my course, so I had an idea of what I wanted to write about. After all, no one ever said I would be writing a thesis, so I only needed to focus on the topic of my papers. I decided to write a paper on leadership and sales.I also wanted to write a paper on how sales and leadership changed the industry. I chose to research the topic, read books and articles, and draw information from interviews. I picked five years of history and focused on each one. At the end of the writing process, I had a great outline, which was exactly what I needed to get started.Writing an outline is important because it helps narrow dow n your choices. If you don't have any ideas, I suggest using an outline and getting to work. It is also a good idea to do some research before writing the paper. The more you know about the topic, the easier it will be. Also, if you want to find out about a new business idea, consider doing a search to see if anyone has used it yet.After I had a couple rough drafts completed, I submitted them to my professor, who gave them a thumbs up or down. In my opinion, it's important to give your professor your best work. I am not saying you have to show him/her your masterpiece, but you should not compromise with anything. I also never let anyone take credit for my work. Some people feel that way about their own work, but I don't want to give other people a piece of the pie.In terms of getting my letter grade, I took a lot of notes. I was the one who went to class, so I usually have a pretty good idea of what I'm working on. Usually professors will give students at least three or four tests a nd quizzes to help them with their grades. I didn't have that many tests to take, so I just wrote the ones I had a chance of getting a good grade on. For example, I took one in the class about specific types of marketing strategies.You also need to take into consideration what kind of credits you have in your senior year. If you don't, you can always skip those. If you do have credits in your senior year, make sure you use them!After you write your college papers for me, keep your grades at a good grade. Many students take too much time in getting a good grade and then spend the next year struggling. Be diligent in getting your work done, and you'll soon have your college papers for me.

The Fashion Revolution of 1789-1799 Essay - 1323 Words

nbsp;nbsp;nbsp;nbsp;nbsp;Between 1789 and 1799 France was going through great turmoil. Immense political and social upheavals were commonplace in the changing nation. New ideas were growing, ideas of freedom, government and of self-expression. Such new attitudes by the people gave rise to a new style of clothing. The clothing became more expressive and more ornate. People began to dress the way they wanted. French soon became the center stage for fashion. The French revolution, while failing in many aspects did one thing no one expected. The French revolution created a new image of fashion in France. There are several reasons that contributed to this occurrence. New beliefs of freedom, equality and self-expression each contributed†¦show more content†¦Curves became fashionable and in many cases tailors took it to the next level, producing the dell shaped full gown, what would have been thought of as vulgar and showy only a few years before. With this new freedom offered to t he people by the French Revolution the fashion grew form restrictive top loose and changed style long after. nbsp;nbsp;nbsp;nbsp;nbsp;New beliefs in equality also made a major contribution to the new image in France. No longer did class separate the people. When the working class took over everything turned upside down. While ornate and colorful clothes had once been only for the nobles and upper class, the new attitudes of equality became commonplace in all society, and no limits were held including the limits on clothes. There was no longer a specific line between what people of each class could were. Now businessmen could dress like a noble, and a noble could even dress like a peasant. With the introduction of machines that could mass-produce clothes, the costs for even the most ornate items greatly dropped. For a long time suits, especially with three pieces were a sign of the richest and gentlemanly people of society. With the introduction of a new coat called the frock coat, â€Å"designed as part of a three piece suit† (Yarwood, 223), everything changed. Even the common men no w had the ability to imitate the richer people of their society. While many times this would not be allowed, in order to keep a fine line between the classes, with theShow MoreRelated Jacques Louis David Essay2128 Words   |  9 Pages David was the virtual art dictator of France for a generation. Extending beyond painting, his influence determined the course of fashion, furniture design, and interior decoration and was reflected in the development of moral philosophy. His art was a sudden and decisive break with tradition, and from this break modern art is dated. David studied with Vien, and after winning the Prix de Rome (which had been refused him four times, causing him to attempt suicide by starvation) he accompaniedRead MoreThe Rise Of The Revolution1063 Words   |  5 PagesMany revolutions have taken place throughout human history. Conflict is almost inevitable, as human beings have had a tendency to thirst for power since the beginnings of civilization. With the rise of monarchies, the â€Å"divine right of kings†, and social caste systems, disgruntlement with the government from subjected citizens is probable. A mean for substantial and exponential changes to the â€Å"system† is by way of revolution. Revolutionaries often are victims of suffering and hardships, imposed uponRead MoreEssay on French Neo Classical988 Words   |  4 PagesThe French Neo Classical era of theatre has influenced today’s society in a number of ways including woman’s fashion, dance, architecture and theatre performance. 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Seeking equality, libertyRead MoreThe Impact of the French Revolution on European Society in Terms of Its Social Thinking4261 Words   |  18 PagesIMPACT OF THE FRENCH REVOLUTION ON EUROPEAN SOCIETY IN TERMS OF ITS SOCIAL THINKING NAME : NORHAFIZA BINTI OTHMAN MATRIC NUMBER : 900704145544001 NRIC : 900704145544 MOBILE : 013 6292463 E-MAIL : fieza040790@yahoo.com TUTOR’S NAME : WAN AMINUDDIN BIN WAN AB. HAMID LEARNING CENTER : PETALING JAYA SEPTEMBER 2012 CONTENTS Content Page 1.0 INTRODUCTION 3 2.0 FRENCH REVOLUTION 5 2.1 The Impact of French Revolution 5 2.2 EffectRead MoreTo Know About France, and Its History, Culture, French People and Democracy in France5199 Words   |  21 Pagesin all sector like in the working place against owner, against government laws, against President’s attitude. 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Chronic Kidney Disease for Recent Literature and Publication

Question: Discuss about theChronic Kidney Disease for Recent Literature and Publication. Answer: Introduction The present paper will critically discuss CKD with reference to a case study of a patient, Glenda, who has the condition. The stages of CKD, the pathophysiology of CKD, management strategies and health promotion strategies will be analyzed. This is in a bid to demonstrate an understanding of patient-centered care and application of policy and principles of management of chronic kidney disease. The approaches of care in Glendas case will be critiqued on basis of appropriateness and any recommendations or alternatives posed with support from recent literature and publication; an evidence-based approach. Case description Glenda is a 56-year-old aboriginal woman from Tiwi islands. She presented to the local health center with complaints of facial pruritus, anorexia, nausea, and lethargy. She appeared confused. Her vitals were normal except for an elevated blood pressure of 159/97 mmHg. Her urine analysis was positive for protein. Glenda has a past medical history of similar complaints. She also presented with generalized edema, joint pain and stiffness, and lethargy in 2010. Her vitals had been erratic with a fever of 38.80 C, a pulse rate of 98 bpm, an elevated respiratory rate of 22 and a hypertension of 180/100 mmHg. Her urinalysis showed rust-colored urine that was positive for blood and protein. This was two weeks after a sore throat. She was then diagnosed with post-streptococcal glomerulonephritis and treated. Her social history involved her binge drinking fortnightly four or more drinks. She also smoked an average of 20 cigarettes per day. She had some estimated forty smoking pack years. She c laimed to exercise by frequently walking around the island. Her nursing discharge suggested monthly follow-up with measurements of blood pressure and urinalysis. During the current presentation, lab investigations were done. They showed an elevated urea of 45mmol/l, elevated serum creatinine of 1132 umol/L, decreased creatinine clearance of 8.2 ml/min, decreased serum sodium levels at 128 mEq/L, elevated serum potassium levels at 6 mEq/L, reduced bicarbonate levels at 11.5 mEq/L, an increased anion gap at 20, reduced calcium at 1.98mg/dL, elevated phosphate at 5.4 mg/dL and a reduced PH of 6.1. This interprets to a uremia, hyponatremia, hyperkalemia, hypocalcemia and a hyperphosphatemia with an anion gap metabolic acidosis. The presentation fits a picture of deranged renal function. CKD was established and she was started on hemodialysis on account of uremia and metabolic acidosis. She, however, opted for peritoneal dialysis in order to move back to her rural island and enjoy life and culture. Chronic Kidney Disease CKD according to Queensland Health (2015), is glomerular filtration rate (GFR) less than 60ml/min/1.73m2 with or without evidence of kidney damage for more than three months or evidence of kidney damage including albuminuria, hematuria not of urological origin, pathologic or anatomic kidney changes with or without deranged GFR for more than three months. It is estimated that one in eight Australians has indicators of CKD making it a very common condition (Kidney Health Australia, 2015). Of these, 10% do not know they have the condition as one can lose up to 90% of kidney function without any signs or symptoms (Kidney Health Australia, 2015). It is one of the major cardiovascular risk factors as it increases mortality due to cardiovascular causes (Levey Coresh, 2012). For this reason, early detection and management are important. Risk factors There are eight major risk factors for CKD progression and cardiovascular risk (Kidney Health Australia, 2015). Risk stratification and health promotion to prevent progression of CKD and cardiovascular events are targeted at the risk factors that are modifiable. The risk factors include diabetes mellitus, hypertension, established cardiovascular disease, family history of kidney failure, obesity with BMI of more than 30kg/m2, smoking, 60 years or older and Aboriginal or Torres Strait Islander origin (Kidney Health Australia, 2015; Levey, Astor, Stevens, Coresh, 2010; Razmaria, 2016; Murphree Thelen, 2010). Glenda has three of the eight risks in that she has hypertension, is a smoker with forty pack years and is an aboriginal from Tiwi islands. According to the Australian absolute cardiovascular risk assessment tool, Glenda has a high risk of developing cardiovascular disease in the next five years. Pathogenesis The pathogenesis of CKD starts with a renal insult. In Glendas case, this was post-streptococcal glomerulonephritis. The mechanisms of injury in her case was as a result of a sore throat she had in 2010. The body produces antibodies against streptococcal proteins as it tries to clear the sore throat. These antibodies, however, cross-react with basement membrane proteins in the kidney causing glomerular damage (Colledge, Walker, Ralston, 2013). At first, the glomerular membrane becomes leaky, losing the capacity for selective permeability hence large molecules like albumin pass through giving the patient proteinuria. The damage to glomerular components can affect vascular components giving rise to hematuria. Further damage starts leading to nephron loss reducing the excretory capacity of the kidney hence the progressive reduction in GFR. The kidney, however, has a large capacity for compensation and the remaining nephrons hypertrophy and hyper filtrate as they try to maintain the GFR within the normal range (Barrett, Barman, Boitano, 2017; Marieb Hoehn, 2013). This has been postulated to have an impact on the progression of kidney damage as the kidneys are overworking. One can lose up to 90% kidney function before symptoms appear (Kidney Health Australia, 2015). When the symptoms set it, they are related to renal function and represent the complications of CKD (Johnson Bonner, 2012). Inability to excrete waste is the main one leading to uremia. Glenda has uremia as manifested by facial pruritus (Colledge, Walker, Ralston, 2013). The kidney has important roles in maintaining metabolic homeostasis. When deranged, the kidney cannot buffer leading to metabolic acidosis. Glendas metabolic acidosis is anion gap positive metabolic acidosis due to increase in anions like phosphates. There are mineral derangements with calcium loss as calcium is replaced with phosphate leading to hyperphosphatemia (Murphree Thelen, 2010). Anemia is a complication as the kidney is an important synthesizing organ for erythropoietin. This is apparent in Glendas case as her hematocrit is on the lower side, an indication of anemia. Sodium and water handling is affected in CKD with sodium retention and fluid overload (Murphree Thelen, 2010). This is a major cause of ed ema in CKD. There is the development of renal bone disease due to derangements in bone turnover and secondary hyperparathyroidism (Murphree Thelen, 2010). Hypertension is both a cause and complication of CKD (Kidney Health Australia, 2015). Early detection and screening Due to the chronicity of CKD, eventual decline into end-stage renal failure and high cardiovascular risk, early detection and management of CKD is paramount (Razmaria, 2016). Screening for CKD is done to those who have any of the eight risk factors for developing CKD. Screening involves regular measurement of GFR and albuminuria with appropriate urinalysis, blood pressure monitoring, and blood sugar monitoring. If there are factors showing an increased risk, monitoring should be done every 1 to 2 years (Queensland Health, 2015). Staging and discussion CKD progresses through five stages as kidney function deteriorates to kidney failure. These stages form a continuum. The new staging recommendations take into consideration the GFR and the urine albumin-creatinine ratio (Kidney Health Australia, 2015). The management of CKD is heavily influenced by these stages hence a clear staging system should be used (Bauer, Melamed, Hostetter, 2008). Calculation of GFR is one of the variables that can affect this. Two methods exist; Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) formula and Modification of Diet in Renal Disease (MDRD) formula. The CKD-EPI formula is recommended (OCallaghan, Shine Lasserson, 2011). From these calculations, Glendas estimated GFR and need for dialysis put her at stage 5 of CKD. Stage one of CKD is when GFR is less than or equal to 90ml/min/1.73m2 in at least two urinalysis tests for more than three months (Kidney Health Australia, 2015). Stage 2 is when GFR is between 60 to 89 ml/min/1.73m2 in at least two urinalysis tests for more than three months. However, for these two stages, the GFR can be normal and CKD is only diagnosed if there is a sign of renal damage for example albuminuria, hematuria not of urological origin, pathologic or anatomic kidney changes (Kidney Health Australia, 2015). This is because the estimation of GFR can give low numbers for otherwise healthy individuals. Urine albumin-creatinine ratio (ACR) should be done to stratify the patient in categories of low, moderate or high risk of progressive renal impairment (Kidney Health Australia, 2015; Glassock, 2010) Management goals at these stages are aimed at slowing progression of kidney damage and cardiovascular risk management (Castner, 2010). This stage can be treated in the primary care setting but the bigger issue is assessing cardiovascular risk. CKD is a large risk for mortality from cardiovascular causes and a patient is more likely to die from cardiovascular causes than kidney failure (Johnson Bonner, 2012). Pointers of progressive kidney disease may include hematuria, rapidly worsening renal function, albuminuria, family history of renal failure and hypertension (Castner, 2010). Long-term monitoring of renal function, blood pressure, and proteinuria is indicated. Avoidance of nephrotoxic drugs is also an important nursing consideration. Lowering of cardiovascular risk starts with reducing the blood pressure. Angiotensin-converting enzyme (ACE) inhibitors and Angiotensin receptor blockers (ARBS) are the first line therapy for BP reduction in CKD and renal protection (Queensland Health, 2015). They decrease the risk of end-stage kidney disease by up to 40 %. Lifestyle modifications should be implemented including smoking cessation, appropriate nutrition change for example low sodium and low-calorie diet, weight reduction, reducing alcohol intake and increasing physical activity (Kidney Health Australia, 2015). Glycemic control is another measure. Lipid-lowering drugs can be used to further lessen the risk. Glenda should have been advised on these modifications early. She has three of the eight risk factors making these modifications crucial to her care. Stage three is divided into two subgroups; 3a and 3b. Stage 3a is when GFR is between 45 to 59 ml/min/1.73m2 in and 3b between 30 to 44 ml/ min/1.73m2, in at least two urinalysis tests for more than three months (Kidney Health Australia, 2015). This separation accurately stratifies risk assessment as 3a CKD present a low to moderate risk while 3b represents an already moderate to high risk of progression and cardiovascular events (Wyatt, 2016). Management of CKD at this stage involves monitoring and slowing kidney damage, cardiovascular risk, avoidance of nephrotoxic drugs and fluid overload, adjusting medication to fit kidney function, identification of complications of CKD and prompt referral to a nephrologist (Kidney Health Australia, 2015). As renal function worsens so do the complications. Treatment of these complications reduces the risk of progression and slows kidney damage. It is still paramount to continue cardiovascular risk reduction as for earlier stages (Welch, Johnson, Zimmerman, Russell, Perkins, Decker, 2015). These are the final stages of CKD as one slips into the end-stage renal disease. Stage 4 of CKD is when GFR is 15-29 ml/min/1.73m2 in at least two urinalysis tests for more than three months. Stage 5 is when GFR is less than 15 ml/min/1.73m2 in at least two urinalysis tests for more than three months or a requirement for dialysis (Kidney Health Australia, 2015). Glenda is at stage 5 of CKD owing to her need for dialysis. The absolute indication for her dialysis was uremia and metabolic acidosis with hyperkalemia (Rivara, Chen, Nair, Cobb, Himmelfarb, Mehrotra, 2017). Glenda should continue her peritoneal dialysis as outcomes are observed. If the condition worsens hemodialysis should be restarted as options of renal transplantation are sought. Management at this stage should be monitored by a renal specialist. The goals of care include monitoring for complications and cardiovascular events, preparation for informed decision making on the approach regarding end-stage renal failure (Ki dney Health Australia, 2015). They eventually would need dialysis or renal transplant. Conclusion In conclusion, CKD is a chronic illness that progresses through five stages each with a number of management strategies and goals. Early detection through screening is important in managing and slowing the progress of the disease. Cardiovascular risk assessment and reduction of the eight risk factors should be done regardless of the stage of the disease. Glenda is at the final stage 5 of CKD and should be managed by specialists with end-stage renal failure in mind. References Barrett, E., Barman, M., Boitano, S., (2017) Ganongs review of medical physiology. (24th edition). New York: McGraw-Hill Medical Bauer, C., Melamed, M. L., Hostetter, T. H. (2008). Staging of Chronic Kidney Disease: Time for a Course Correction. Journal of the American Society of Nephrology, 19(5), 844-846. Caravaca-Fontn, F., Azevedo, L., Luna, E., Caravaca, F. (2018). Patterns of progression of chronic kidney disease at later stages. Clinical Kidney Journal, 11(2), 246-253. doi:10.1093/ckj/sfx083 Castner, D. (2010). Understanding the stages of chronic kidney disease. Nursing 2018, 40(5), 24-31. Colledge, N., Walker, R, Ralston, S. (2013). Davidsons principles and practice of medicine. 21st edition. London: Elsevier. Glassock, R. J. (2010). Is the presence of microalbuminuria a relevant marker of kidney disease? Current Hypertension Reports, 12(5), 364-368. doi:10.1007/s11906-010-0133-3 Johnson, V., Bonner, A. In Brown and Edwards (eds) (2012). Nursing Assessment: urinary system. Lewis's Medical-surgical nursing. (3th E.). Sydney: Elsevier, pp 1226-1248. Kidney Health Australia. (2015). Chronic Kidney Disease (CKD) Management in General Practice. (3RD Ed.). Australia, Melbourne: Kidney Health Australia. Levey, A. S., Coresh, J. (2012). Chronic kidney disease. The Lancet, 379(9811), 165-180. Retrieved from HTTPS://DOI.ORG/10.1016/S0140-6736(11)60178-5 Levey, A., Astor, B., Stevens, L., Coresh J. (2010). Chronic kidney disease, diabetes, and hypertension: whats in a name? Kidney International, 78, 19-22. Marieb, E. Hoehn, K. (2013). The Urinary System. Human Anatomy and Physiology. USA: Pearson, pp 1023- 1060. Murphree, D. D., Thelen, S. M. (2010). Chronic Kidney Disease in Primary Care. The Journal of the American Board of Family Medicine, 23(4), 542-550. Retrieved from doi:10.3122/jabfm.2010.04.090129 O'Callaghan, A., Shine, B., Lasserson, D.S. (2011). Chronic kidney disease: a large-scale population-based study of the effects of introducing the CKD-EPI formula for eGFR reporting BMJ Open, 1(2), 308. Queensland Health, (2015). Chronic Conditions Manual: Prevention and Management of Chronic Conditions in Australia. (1st Ed.). The Rural and Remote Clinical Support Unit, Torres. Razmaria, A. A. (2016). Chronic kidney disease. JAMA, 315(20), 2248-2248. doi:10.1001/jama.2016.1426 Rivara, M. B., Chen, C. H., Nair, A., Cobb, D., Himmelfarb, J., Mehrotra, R. (2017). Indication for dialysis initiation and mortality in patients with chronic kidney failure: a retrospective cohort study. American Journal of Kidney Diseases, 69(1), 41-50. Welch, J. L., Johnson, M., Zimmerman, L., Russell, C. L., Perkins, S. M., Decker, B. S. (2015). Self-Management Interventions in Stages 1 to 4 Chronic Kidney Disease: An Integrative Review. Western Journal of Nursing Research, 37(5), 652-678. doi:10.1177/0193945914551007 Wyatt, C. M. (2016). A rose by any other name: is stage 3a chronic kidney disease really a disease? Kidney International, 91(1), 6-8.