Characteristics Of Authentic Literacy Instruction Education Essay

Attributes Of Authentic Literacy Instruction Education Essay Presentation At the point when youngsters appear on the scene, they accompany the intrinsic want to investigate their encompassing and this is found in their every day collaboration with nature around them when it includes language advancement and the sky is the limit from there. They effectively take an interest in their learning of communicated in and composed language from their folks and others connections (Teale Sulzby, 1986). They see print on the planet through signs on shops, along the street and even the market and start to cause affiliations when they to investigate printed material (i.e.paper and colored pencils, and story books). They build up their worked encounters by evaluating various things, testing and imagining their own skill levels. As the activities take on all the more significance, they increment their insight into how composed language is shaped and how they work in reality, contingent upon various circumstances (Goodman, 1986). Accordingly, this present reality offers th ese kids a whole domain that is actually rich with language encounters that the kids can learn and create in a characteristic setting. These settings will likewise include human connections that influence how kids might possibly utilize the proficiency instruments they experience (Tharp Gallimore, 1988). Not at all like the unfilled record that a few people accept kids are brought into the world with, they are really indispensable individuals from a unique framework in which nature impacts (Bronfenbrenner, 1977). The more kids utilize the assets accessible to them in nature to develop their insight and abilities corresponding to building progressively strong comprehension of components in the abstract world, they are participating in taking care of issues that uses psychological aptitudes and through their communication with individuals from their condition. Accordingly, childrens finding out about proficiency is vitally attached with reasonable activity, coming about because of their need to control, control, and capacity in their condition. Beyond question at that point, kids can't get away from the real factors of perusing and composing, which are so much a piece of their lives as there are such a significant number of connections and settings that are connected to these real factors (Teale Sulzby, 1986). Through taking an interest in exercises that require intellectual and open capacities, kids are brought into the employments of these capacities by their parental figures in manners that may support and create them. Thus, childrens soonest originations of proficiency and systems for perusing and composing are probably going to be shaped through exercises that are frequently socially prompted (Bruner, 1972). Along these lines, the case for validness in proficiency is a characteristic procedure. Genuineness alludes to the genuine encounters an individual encounters when completing explicit exercises (Ableser, 2008). This includes beneficial encounters that are normally happening in the lives of youngsters and people. At the point when a kid contends with her parent on the benefits of getting a pooch, the focuses and contentions gave are a consequence of a characteristic and genuine explanation behind doing as such. This legitimacy is conveyed into the zone of education in the study hall as the idea appears to be an intelligent movement of using the inborn interest and reason for completing an action as a piece of the way toward learning, into the study hall educators objective of getting her understudies to learn and do scholarly related exercises. The valid exercises that people regularly practice in everyday circumstances are imitated in the study hall. Lamentably the normal acts of the way of life what individuals do in every day, week after week, and month to month patterns of action don't appear to be scholastically adequate to fulfill the instructive guidelines set by the force that be. Such practices, for instance, incorporate looking for the best deal, making sense of the wellbeing risks of microwaves or inspecting costs for an arranged occasion are not deciphered satisfactorily and consequently appear to be inadequate here and there. Legitimate proficiency rehearses then appear to have flopped here and there. Bona fide Literacy Defined However, regardless of mishap, the intensity of credibility can't be denied as when schools offer study halls that are bona fide education coordinated, its potential in offering learning encounters that are like how kids learn, in actuality, outside of the study hall is an energizing possibility (Newmann Wehlage, 1993). At the point when understudies learn through genuine undertakings, understudies are attempting to make importance from their encounters and these encounters permit understudies to make significant associations (Snowball, 1992). Valid proficiency conditions additionally necessitate that understudies use correspondence in accepting and expanding their learning encounters. Without correspondence, the advancement of true encounters will be frustrated . Rhodes and Shanklin, (1993) call for valid education encounters in the homeroom, for example, perusing and composing, to hold indistinguishable open purposes from when understudies are outside of the study hall. When Schmoker (2007) characterized bona fide proficiency, he clarified that understudies who figure out how to peruse, compose and think successfully (p.448) do so whenever they are offered chances to take part in top to bottom perusing higher-request addresses that is later used to contend and bolster an understanding from at least one writings (p.490) in their all-encompassing composition. The study hall conversations that are produced from both credible perusing and composing encounters are additionally bona fide encounters. Purcell-Gates, Duke and Martineau (2007) added to this by explicitly referencing valid perusing materials, for example, those that include composed classes like books, paper articles, reminders, specialized systems and in any event, welcoming cards. Attributes of Authentic Literacy Instruction What might bona fide proficiency guidance resemble in the study hall? As referenced already, the degree of credibility can be affected by the sort of perusing and composing materials that the instructor uses, for example, tradebooks rather than the conventional utilization of reading material, which are intensely composed for explicit school-related objectives. For understudies to encounter legitimate proficiency experiences, there should be deliberate yet in addition significant encounters where the education occasion isn't the ultimate objective of the action yet rather coordinated into the genuine objective reason. Credible education assets incorporate messages regularly found inside a childs domain, for example, exchange books, transport calendars, maps, and journals. Individuals are likewise esteemed assets, as they can offer firsthand records and individual information to the procedure of request. At the point when understudies approach various assets, exercises can turn out to be increasingly credible, understudies can all the more unmistakably convey their message, and be all the more completely occupied with legitimate education occasions (Wortman, 1993). Rhodes and Shanklin (1993) propose that a homeroom that implies to be bona fide ought to permit understudies to settle on decisions and have a state in their learning encounters. This decision engages understudies in study hall collaborations and dynamic activities (Wortman, 1993). Snowball (1992) shares this idea that when understudies are given a decision to design, investigate and share their thoughts, there is more reason to the exercises. Indeed, Pachtman and Wilson (2006), in one of his investigations features understudy decisions in expanding inspiration. Pachtman and Wilson (2006) stressed on genuine perusing and researched understudies suppositions on what they saw as important and drawing in understanding practices. Understudies who were offered more noteworthy decision and state in their learning encounters were progressively connected with and assumed liability for their learning because of their personal stake from the dynamic. Understudies liked to settle on their own decision of the books they were going to peruse and the achievement of those valid materials in persuading the understudies was a reasonable sign that educators should observe that decision permits genuineness and instructors can utilize this data to design their exercises (Pachtman and Wilson, 2006). Beside books, legitimate encounters are characterized through the people decision to make and offer important and intentional content for a self-chose crowd (Wortman, 1993, p. 1). This would imply that in zones, for example, composing, understudies as opposed to completing the errand of composing a letter to somebody, whom the instructor had chosen previously, understudies can settle on choices on who their letters can be coordinated to. A study hall that is centered around bona fide education must be applicable to the lives of the understudies. As much as decision and the kind of materials can help make a bona fide proficiency condition. Instructors and understudies have educational plan requests put on them and if any validness is included, it stays shallow. The instructor can address the issues of the educational program and stay true, even pertinent to the understudies. For instance, in a unit on untamed life, the instructor may make an action where understudies research on explicit leatherback turtles. This movement meets the prerequisites of the educational program, anyway is as yet immaterial to the understudies. To meet significance in a valid proficiency study hall, the instructor could permit understudies to investigate on a creature that the understudies choose their own which has pertinence to their individual lives. A few understudies might need to investigate on penguins they saw at the zoo or the cheet ah, somebody has contrasted them and. The understudies will reference from various sources, for example, the Internet, magazines, and master sources. The understudies will choose what they need to do with the data they have accumulated, regardless of whether it is to keep in touch with somebody in the administration, produce an introduction to hotspot for assets to support a particular untamed life safeguarding store or even think of a natural life bulletin to be imparted to their schoolmates. This movement will meet the necessities of genuine assets, decision and pertinence; and still fulfill educational plan needs. Significant exercises permit understudies to chip away at

The Annual Inflation Rate Essays - Monetary Policy, Inflation

The Annual Inflation Rate The Annual Inflation Rate Pretty much all that we do as a country loans to the yearly swelling rate. In this article, however, I have picked four of the most significant factors that impact swelling the most. Expansion is the continued increment in costs, or as it were, a consistent decrease in the purchasing intensity of the dollar. I have concocted a condition that incorporates the accompanying factors: the joblessness rate, the government subsidizes loan cost, per capita pay, and new home deals. These factors reliably have demonstrated a relationship to the swelling rate and aggregately may assist with clarifying the reason for expansion. The principal variable I picked was the joblessness rate. This is the yearly normal of people 15 years old or more seasoned, effectively looking for and accessible for work, yet jobless. (BLS). The connection among joblessness and expansion ?gives proof of a short-run exchange off between the two factors known as the short-run Phillips bend? (BLS). The relationship recommends that by tolerating higher swelling levels, the Fed can utilize financial approach to invigorate the economy and briefly decrease joblessness. At the point when costs go up, the wages are influenced too. This happens provided that no alterations are made, at that point similar wages will purchase less products and enterprises, which influences purchaser spending. Less spending implies less benefits, which finishes in cutbacks and higher joblessness. The other side uncovers the impact of joblessness on expansion. The theory for this variable is that as the joblessness rate diminishes, the yearly expansion rate wil l increment. The thinking here is that if more individuals are utilized and have cash, there is all the more spending, more interest, and in this manner costs will rise. The second factor I picked was the government subsidizes loan cost. Government reserves are the Fed's channel of influencing the economy through the banks. The Fed intends to keep up a consistent economy with consistent development and stable costs. An excessive amount of cash brings about cost increments, or swelling. Too minimal expenditure eases back development. To build cash, the Fed purchases bank-claimed government protections. It pays with stores, which empower more advances, which empower more stores, etc. To lessen cash, the Fed sells government protections, and banks pay from their Fed accounts. This decreases holds, constraining banks to diminish credits. So they raise financing costs to customers and organizations. ?While lessening advances, a bank may find that its stores are not exactly permitted deprived guidelines. To remain lawful, it telephones for a one-night advance from a save money with overabundance saves. The acquired finances move from one bank's Fed record to another's, hence the name government reserves? (Fedpoint15, p.2). The government support loan cost is a decent marker of what points the Fed has for the economy and what state we are right now in. The theory for this variable is that if the Fed raises loan costs, there must be an excessive amount of cash in the economy. The Fed is foreseeing an ascent in swelling rates. So an ascent in government finance loan fees will uncover an ascent in the swelling rate. The following variable I decided to clarify swelling was per capita salary. At the point when customers have and are going through more cash, costs will keep on climbing. Pay however, assumes another job in swelling. An ascent in per capita salary is a decent marker of higher wages. Pay acceleration is an immediate consequence of low joblessness rates. The more individuals working the more cash is being made and spent, more interest and along these lines more significant expenses. Investigate an alternate edge. (Lonski, p.1). The speculation here is that according to capita salary builds, swelling will likewise increment. More cash implies all the more spending and more interest, as expressed beforehand. Hence, costs will swell. Different elements may likewise assume a job, for example, when loan costs are raised to battle expansion. Will we at that point see the contrary impact happen? The fourth and last factor I decided to help clarify swelling was new home deals. Development spending is a decent pointer of our country's economy, however the genuine acquisition of new homes is presumably a superior marker of customer spending. On the off chance that the houses are constructed and nobody is getting, it doesn't support the economy. ?Volume of deals

Word of the Week! Equanimity Richmond Writing

Word of the Week! Equanimity Richmond Writing Special thanks to Rita Willett,   MD, Healthcare Studies and Department of Biology, for our word this week.   As with our word in the last post, equanimity is hard to say and even harder to spell, but it speaks volumes in print. It provides just the right lexical item for a factious, even frightening time. The OED Online provides These definitions: The quality of having an even mind. . . .Fairness of judgement, impartiality, equity. Lets try it in a medical sense, given our source: Patients went beyond noting how the physicians advice was medically sound; they emphasized her equanimity in treating the elderly with dignity. The terms history reaches to the 17th Century, with public servant and private diarist Samuel Pepys using our word in much the same way we would today. If the term has fallen out of favor, I wonder if equanimity itself has waned? That virtue, as well as its signifier, deserve better. Nominate a word by e-mailing me (jessid -at- richmond -dot- edu) or leaving a comment below. See all of our Words of the Week here. Image of Samuel Pepys courtesy of Wikipedia Commons.

The Case of the Missing Italics

In a column by Boston Globe journalist Ellen Goodman, this odd-looking sentence caught my eye: Lets go back to a McCain op-ed that did run in The New York Times before the invasion. Funny, but Id seen this sort of thing before—in a George Will column (from May 2007) that appeared in the online edition of The New York Post: This citys taxi cartel is offering an audacious new rationalization for corporate welfare, asserting a right -- a (BEG ITAL)constitutional(END ITAL) right, (BEG ITAL)in perpetuity(END ITAL) -- to revenues it would have received if Minneapolis City Council had not ended the cartel that never should have existed. Obviously, the parenthetical remarks are computer-speak for begin and end italics—a message that in these two cases had been improperly coded, transmitted, or received. Not an especially newsworthy matter, perhaps, but the question arises: why do newspapers still experience such problems with italics? An answer, of sorts, can be found in The Associated Press Stylebook, the (American) journalists bible: Italic type face cannot be sent through AP computers. Turning for amplification to Ask the Editor at APStylebook.com, we find a number of inquiries pertaining to italics--all of them answered patiently by David Minthorn in more or less the same way: Is it correct to italicize car names, for example, would Prius in Toyota Prius be in italics? - from Pasadena, California on Wed, Jul 30, 2008Italics arent used for car names or anything else in AP news stories. Dont be confused by italicized examples in the AP Stylebook.What is the rule for the title of academic journals? Should they be italicized or put in quotation marks? - from Little Rock, AR on Wed, Jul 09, 2008AP uses straight type for titles of academic and other journals, no quotation marks or italics, principal words capitalized.Us Magazine (entire thing ital) or Us magazine (no ital on magazine)? - on Tue, Jun 03, 2008 Us Weekly . . . AP doesnt use italics in news stories.What is the correct style for the New England Journal of Medicine? Italics or quotation marks? Thanks in advance. - from Washington DC on Tue, May 06, 2008No quotes or italics for titles of publications, so its correct as written.Boat/Ship names should be italicized, but in the instance of USS Arizona, wo uld USS also be italicized? - on Tue, Apr 22, 2008The AP Stylebook would only use USS Arizona in italics as an example, to differentiate from a definition. In AP news stories, italics arent used because the typeface doesnt transmit through all computers. Were left to wonder which model of Kaypro computer the AP still relies on. Most style guides (those without AP in the name) advocate the use of italics for emphasis and with titles of complete works—books, plays, movies, magazines, CDs, television series, and works of art. But then, if you subscribe to The AP Stylebook, theres really nothing left to learn about italics. More About Online Resources for Writers: Top Three Grammar and Usage Advice SitesTop 10 Blogs for Writers, Editors, Teachers of WritingTop Five Business Writing Sites

Calculate Concentration of Ions in Solution

This worked example problem illustrates the steps necessary to calculate the concentration of ions in an aqueous solution in terms of molarity.  Molarity is one of the most common units of concentration. Molarity is measured in  number of moles  of a substance per unit volume.   Question a. State the concentration, in moles per liter, of each ion in 1.0 mol Al(NO3)3.b. State the concentration, in moles per liter, of each ion in 0.20 mol K2CrO4. Solution Part a.  Dissolving 1 mol of Al(NO3)3 in water dissociates into 1 mol Al3 and 3 mol NO3- by the reaction: Al(NO3)3(s) → Al3(aq) 3 NO3-(aq) Therefore: concentration of Al3 1.0 Mconcentration of NO3- 3.0 M Part b.  K2CrO4 dissociates in water by the reaction: K2CrO4 → 2 K(aq) CrO42- One mol of K2CrO4 produces 2 mol of K and 1 mol of CrO42-. Therefore, for a 0.20 M solution: concentration of CrO42- 0.20 Mconcentration of K 2Ãâ€"(0.20 M) 0.40 M Answer Part a.Concentration of Al3 1.0 MConcentration of NO3- 3.0 M Part b.Concentration of CrO42- 0.20 MConcentration of K 0.40 M

Honda (a) Free Essays

Q1. What’s the strategy that allowed Honda to be so successful in the US market? It is a fact that Honda had experienced a remarkable success during the period from the late 50’s to the end of the 70’s. This success is a result of the strategy the company developed at that stage of its lifecycle. We will write a custom essay sample on Honda (a) or any similar topic only for you Order Now This strategy in principle is a technologically based strategy; where Honda established Honda Technical Research Institute (HTRI) in 1946. In the meantime, Honda developed manufacturing expertise to become fully integrated producer of motorbikes components. In order to minimize the associated risk, Honda offered a multiproduct line, taking leadership in product innovation through the HTRI and exploiting opportunities for economies of mass production by gearing design to production objectives. How is possible that Honda’s many expensive investments lead to lower costs? The company achieved a significant product advantage through a heavy commitment to RD and advanced manufacturing techniques. Honda used its productivity-based cost advantage and RD capability to introduce new models to the market very quickly and at prices below those of competitive machines. Over time, Honda had smoothly descending real prices. This price reduction is experience-based which means that as long as more experience is acquired, Honda is capable to develop new methodologies to produce motorcycles at lower cost. This was mainly due to high production volume and improved productivity of the Japanese labor. Q2. How did Honda come to have this strategy? Honda’s strategy was a result of Honda’s underlying philosophy which is a marketing philosophy; i. e. grapping more market share and increasing the sales volume. Selling and Distribution system was a tool to implement this philosophy. What evidence do we have of forethought and planning in the company approach to production? Honda built a manufacturing plant with a capacity 10 times in excess of demand at the time of construction in 1958. Honda developed manufacturing expertise to become fully integrated producer of motorbikes components. Honda minimized risk through: offering a multiproduct line, taking leadership in product innovation through the HTRI and exploiting opportunities for economies of mass production by gearing design to production objectives. Marketing? In the 1958 Honda’s market research identified a large untapped market segment seeking a small, unintimidating motorcycle that could be used by small motorcycle business for local deliveries. Honda advertizing concerted to change the image of motorcyclist through heavy campaigning towards middle class consumers. Distribution? Honda followed a policy of developing the market region by region beginning with the west coast and moving eastward. Design? Honda designed the lightweight motors to match the market research results. In general, Products are updated or redesigned whenever a market threat or opportunity is perceived, prices are set at levels to achieve market share targets and will be cut if necessary, effective marketing systems are set up in all markets where serious competition is intended – regardless – of short term cost and finally plans and objectives look to long term payoff. Q3. To what degree was the US entry strategy thought out in advance? Honda was already the world’s largest motorcycle producer. Honda established a US subsidiary and began its push in the market by offering very small lightweight motorcycles. Honda followed a policy of developing the market region by region beginning with the west coast and moving eastward until it established the largest dealership network in the US. How to cite Honda (a), Papers Honda (a) Free Essays Q1. What’s the strategy that allowed Honda to be so successful in the US market? It is a fact that Honda had experienced a remarkable success during the period from the late 50’s to the end of the 70’s. This success is a result of the strategy the company developed at that stage of its lifecycle. We will write a custom essay sample on Honda (a) or any similar topic only for you Order Now This strategy in principle is a technologically based strategy; where Honda established Honda Technical Research Institute (HTRI) in 1946. In the meantime, Honda developed manufacturing expertise to become fully integrated producer of motorbikes components. In order to minimize the associated risk, Honda offered a multiproduct line, taking leadership in product innovation through the HTRI and exploiting opportunities for economies of mass production by gearing design to production objectives. How is possible that Honda’s many expensive investments lead to lower costs? The company achieved a significant product advantage through a heavy commitment to RD and advanced manufacturing techniques. Honda used its productivity-based cost advantage and RD capability to introduce new models to the market very quickly and at prices below those of competitive machines. Over time, Honda had smoothly descending real prices. This price reduction is experience-based which means that as long as more experience is acquired, Honda is capable to develop new methodologies to produce motorcycles at lower cost. This was mainly due to high production volume and improved productivity of the Japanese labor. Q2. How did Honda come to have this strategy? Honda’s strategy was a result of Honda’s underlying philosophy which is a marketing philosophy; i. e. grapping more market share and increasing the sales volume. Selling and Distribution system was a tool to implement this philosophy. What evidence do we have of forethought and planning in the company approach to production? Honda built a manufacturing plant with a capacity 10 times in excess of demand at the time of construction in 1958. Honda developed manufacturing expertise to become fully integrated producer of motorbikes components. Honda minimized risk through: offering a multiproduct line, taking leadership in product innovation through the HTRI and exploiting opportunities for economies of mass production by gearing design to production objectives. Marketing? In the 1958 Honda’s market research identified a large untapped market segment seeking a small, unintimidating motorcycle that could be used by small motorcycle business for local deliveries. Honda advertizing concerted to change the image of motorcyclist through heavy campaigning towards middle class consumers. Distribution? Honda followed a policy of developing the market region by region beginning with the west coast and moving eastward. Design? Honda designed the lightweight motors to match the market research results. In general, Products are updated or redesigned whenever a market threat or opportunity is perceived, prices are set at levels to achieve market share targets and will be cut if necessary, effective marketing systems are set up in all markets where serious competition is intended – regardless – of short term cost and finally plans and objectives look to long term payoff. Q3. To what degree was the US entry strategy thought out in advance? Honda was already the world’s largest motorcycle producer. Honda established a US subsidiary and began its push in the market by offering very small lightweight motorcycles. Honda followed a policy of developing the market region by region beginning with the west coast and moving eastward until it established the largest dealership network in the US. How to cite Honda (a), Essay examples

Nursing Care and Management for Elderly Patient Sample for Students

Questions: 1.Identify and Prioritise the Most Important Nursing Care Issues for a Client2. Identify the Influences Impacting on the Older Person and their level of Function and Levett-Jones Clinical Reasoning Cycle as the tool to drive the Process of Identifying and Assessing, Implementing and Evaluating Care. Answer: 1.Introduction Risk of geriatric syndromes, functional decline, and chronic illness, are a threat to older adults' well being. 43% of Medicare beneficiaries report having more than three chronic conditions including heart disease, cancer, and arthritis (Federal Interagency Forum on Age Related Statistics, 2010). Reports from surveys also indicate that 42% of persons above 65years of age live with a functional limitation. In one study, the results showed that one or multiple geriatric syndromes are reported in 25% of the older population (Lee, Cigolle Blaum, 2008). Additionally, older adults spend less of their time communicating and socializing as they advance in age (Federal Interagency Forum on Age Related Statistics, 2010). This results in an accumulation of the functional decline and interaction impairments which exacerbates the person's vulnerability (Innouye, Studenski, Tinetti, Kuchel, 2007). This report will analyze the functional consequences in relation to Barbra's current medical situa tion (Hunter, 2016) and utilize clinical reasoning to map a plan toward her wellness and recovery (Levett-Jones, 2013). Patient's Description Name: Barbra Green Age: 89 Years Marital Status: Widow Barbara experiences joint stiffness; enlarged joints and swollen feet; pain in joints especially the back, hip, fingers, and knee; limited movement on the joints; constipation; dry macular degeneration; occasional dizziness; constipation, and weight loss. Her functionality has deteriorated which has resulted in decreased social functioning, poor living conditions, and also poor eating habits. She is likely to be non-adherent to her medications. The age related changes include the visual deficit due to dry macular degeneration (Boyd, 2017) and constipation (Schuster, Kosar, Kamrul, 2015). The risk factors include poor diet, use of some specific multiple medication (polypharmacy) and diminished physical activity which are known causes of constipation among the elderly (Neri, Basilisco, Corazziari, 2014). Caucasians are at a higher risk of macular degeneration than Hispanics or Africans (National Eye Institute, 2016) Poor diet and failure to exercise also causes fast progression of early macular degeneration. The negative consequences of the symptoms the patient is experiencing include social isolation and difficulty in performing activities of daily living Information Cues Barbara lives in a one-story building. The joint pains especially on her knees have limited her movement and it is likely that she avoids climbing the stairs in her house which may be an unkempt house. The fact that she has a vision deficit and has stopped driving means that shopping trips to the grocery store are limited or none, especially because of the existing pains on her joints that discourage her to walk. The patient also expressed her loneliness because of the loss of her husband and also her lost contact with friends at the German Association. Information Process Osteoarthritis: Osteoarthritis is common in women than in men who are 45 years and above. The disease occurs when bone cartilage wears and tears and in severe cases, it leaves bones which friction against each other. The symptoms include: mild to acute pain in the joints as well as stiffness of joints. It affects the neck, low back, hands, weight bearing joints such as feet, hips, and knees (Antipuesto, 2010). Constipation: This is a common challenge among elderly persons with prevalence differing with settings (hospital or community). Among the population that is 65years and above and living in a community, 16% of men and 26% of women suffer from constipation (Gallegos-Orozco, Foxx-Orenstein, Sterler, Stoa, 2012). For persons that are 84 years and above, the rtes increase to 26% and 34% for men and women respectively. For patients in long term care, the rate increases by 80% (Fleming Wade, 2010) Vision Deficit: Macular degeneration that is age related occurs when the retinal macular is damaged resulting in loss of central vision but the peripheral vision remains normal. Dry macular degeneration is as a result of some parts of the macula getting thinner and drusen grows (Boyd, 2017). Assessment and Interventions Osteoarthritis Assessment Aching pain that is deep and which is more pronounced after exercise or weight bearing; pain is relieved by rest Joint deformity or swelling Joint stiffness that lasts Heberdens nodes on interphalangeal distal joints and Bouchards nodes on interphalangeal proximal joints. Diagnosis Chronic pain linked to deterioration of joints. Diagnostic Evaluation X-rays show sclerosis and narrowing of joint space in affected joints Radionuclide imaging shows increased uptake in the bones that are affected. Analysis of synovial fluid shows difference in osteoathritic and rheumatoid joints. Interventions Involved joints should be rested. Patient advised to avoid pain precipitating activities. Relieve stiffness and pain using heat applications Teach the patient body mechanics and posture that is correct Patient advised to relieve cervical pain by sleeping with a terry cloth that is rolled under the neck. When indicated, provide patient with cane, braes, or crutches, to minimize weight bearing stress on knees and hips. Advise patient to wear metatarsal support and corrective shoes. Teach patient simple motion exercises for joint mobility Assessment Patient should give an accurate symptoms history. Symptoms of constipation in the elderly include: abdominal pain, urinary retention, loss of appetite and nausea, overflow diarrhoea, and confusion. The risk factors include polypharmacy, alteration in fluid and nutritional intake, pre-existing diseases such as degenerative disease that affect functional and mobility status, difficulty in accessing washroom facilities (Gandel, Straus, Bundookwala, 2013) Intervention Patients should also be offered education and advice on managing their constipation. Simple lifestyle changes, such as an increase in fluid intake, regular exercise and fiber-rich food may be effective in managing constipation (Gandel, et al., 2013) Macular Degeneration Assessment Blurred vision Visual field has central blind spot Nursing Diagnosis visual impairment poor health maintenance due to lack of knowledge Injury risk due to poor vision Deficit in self care due to poor vision Nursing Management Once patient has a photodynamic therapy (PDT) session, she will be advised to avoid direct exposure to sunlight or any bright light for five days Watkins, (2010) 2.SMART GOAL Barbara will be able to walk short distances (which will be increased with time) without experiencing discomfort and pain. The distance will be increased by 300meters every week. The walks will serve as part of her exercise routine and will help with alleviating joint stiffens as well as constipation Barbara will be able to carry out her daily life activities with no assistance including preparing her own meals. Barbara will regain lost weight Taking Action A daily routine timetable will be created which will indicate what activates to do every hour of the day. The time table will include time allocation for short walks and reminders on when to sip on water and/or other fluids. It will also show the times that Barbara needs to take her medication. Barbara will need to purchase a 1Liter water/juice bottle. She will be required to fill it twice a day with water and after she is through sipping it, she will need to fill it with blended fruit juice. The 1l of juice and 1lof water need to be taken on a daily basis. Home safety: Request Tracy to help in rearranging the furniture in Barbra's house to create more clear pathways to avoid any incidences of injury. Limit use of area rugs. Have the window curtains pulled all the way back to create more light. Get a talking clock. Place things that Barbara uses regularly in the same place: toothbrush, slippers, keys, shoes etc. Evaluation Barbara is able to take short walks on a daily basis. She can walk up and down the stairs in her house without any pain discomfort. She is able to do daily living activities with no assistance. Her house is tidier and her refrigerator and kitchen cabinets are a reflection of healthier cooking and eating. Barbara reports no dizziness and constipation. She has gained 1-2 kg in 4-6 weeks. Reflection I have a clearer understanding on the need to include regular exercising and healthy eating habits in one's daily routine starting at an early age. By eating well and exercising, age related complications such as osteoarthritis, macular degeneration, and constipation are delayed. The next time I will enter appointment reminders in Barbara's mobile phone to ensure she comes in for checkups. I will also add a column in the timetable where the patient will need to put a star(s) after each activity to indicate her adherence. The timetable will also have incentives for each task completed. In addition, I should have given Tracy a copy of Barbara's timetable so that she can monitor Barbara's progress during her daily calls. Conclusion The care of elderly patients with osteoarthritis, macular degeneration, and constipation can be effectively done through lifestyle changes. The patient in this case was a widow who was living alone and had disconnected herself socially. The social isolation had resulted in poor eating habits causing her to lose weight, exacerbate her vision deficit, report slight dizziness spells, and constipation. By encouraging the patient to engage in regular exercises and healthier eating which includes daily intake of water and fiber rich fluids, the patient will be able to carry out her daily activities with minimal discomfort. She will also be able to return to her social life and reduce or completely eliminate feelings of loneliness and depression. Health promoting lifestyles including socializing, should be adopted at an early age to avoid late life complications such as discussed in this report. References Antipuesto, J.D (2010). Osteoathritis. https://nursingcrib.com/nursing-notes-reviewer/medical-surgical-nursing/osteoarthritis/ Accessed: 03rd April, 2017 Boyd, K (2017). What is Macular Degeneration? American Academy of Opthamology. https://www.aao.org/eye-health/diseases/amd-macular-degeneration. Accessed: 03rd April 2017 Federal Interagency Forum on Aging-Related Statistics.Federal Interagency Forum on Aging-Related Statistics.Washington DC: U.S. Government Printing Office; Jul, 2010. Older Americans 2010: Key Indicators of Well-Being. Fleming V, Wade WE. A review of laxative therapies for treatment of chronic constipation in older adults.Am J Geriatr Pharmacother.2010;8(6):51450Gallegos-Orozco JF, Foxx-Orenstein AE, Sterler SM, Stoa JM. Chronic constipation in the elderly.Am J Gastroenterol.2012;107(1):1825.Epub 2011 Oct 11 Gandell D, Straus SE, Bundookwala M, Tsui V, Alibhai SM. Treatment of constipation in older people.CMAJ.2013;185(8):66370.Epub 2013 Jan 28. Hunter, S. (Ed). (2016). Millers nursing for wellness in older adults (2 nd Australia and New Zealand ed.) North Ryde, NSW: Lippincott, Williams and Wilkins. Innouye SK, Studenski S, Tinetti ME, Kuchel GA. (2007). Geriatric syndromes: Clinical, research, and policy implications of a core geriatric concept.Journal of American Geriatrics Society.;55(5):780791. Lee PG, Cigolle C, Blaum C. (2009)The co-occurrence of chronic diseases and geriatric syndromes: The health and retirement study.Journal of the American Geriatrics Society.57(3):511516. Levett-Jones, T. (Ed.). (2013). Clinical reasoning: Learning to think like a nurse. Frenchs Forest, NSW: Pearson. National Eye Institute (2016). Facts About Age-Related Macular Degeneration. https://nei.nih.gov/health/maculardegen/armd_facts. Accessed: 03rd April, 2017. Neri L, Basilisco G, Corazziari E.(2014) Constipation severity is associated with productivity losses and healthcare utilization in patients with chronic constipation. United European Gastroenterol J. 2:13847. Schuster, B. G., Kosar, L., Kamrul, R. (2015). Constipation in older adults: Stepwise approach to keep things moving.Canadian Family Physician,61(2), 152158. Watkins, S (2010). Management of older people with dry and wet age-related macular degeneration. DOI: 10.7748/nop2010.06.22.5.21.c7793