An Approach to Productive Feedback for Teachers Essay

An Approach to Productive Feedback for Teachers - Essay Example First and foremost, Krissia Martinez started her article by presenting the struggle that teachers face, of which after an observation, became a required part of their evaluation systems in many states and districts. The author believes that there is a relationship between feedback and conversations, potentially the related coaching and teacher’s performance evaluations. In addition, the author believes that the relationship makes teachers weary and anxious, feeling threatened during classroom observations. Of course, anyone could feel the same if the observations are based on a certain area with no clear protocols, useful feedback or coaching ways with no helpful information and professional support (Martinez, 1). Also, Krissia Martinez explained the reasons that make teachers struggle during classroom observations. Then, she provides strategies to enhance the post-observation feedback conversation by The Carnegie Foundation, which is the key point of her article. The various strategies include an individual starting a conversation with a positive statement; good listening skills, addressing teacher’s concerns, co-developing next steps, and sequencing the conversation into a predictable format (Martinez,

Feasibility study of mobile pizza trucks Research Paper

Feasibility study of mobile pizza trucks - Research Paper Example The document also allows flexibility to change various project parameters to suit the needs of the entrepreneur. Feasibility study is very important for a business. It makes an analysis of all the aspects of a business- the external factors influencing it and also the internal factors. It also analyzes all the costs associated with the project and how the material would be sourced. On the other hand, it will also make an estimate of how much sales are to be expected and what profits would the project make. If the results of the feasibility study are favorable, it is logical to proceed with it. On the other hand, if the results are not favorable no businessman will take a risk on it. Executive Summary 1.1 Background It has always been the researcher’s dream to open his own business-but what type of business he wasn’t sure about. At the end of his years long study in Business Management and Innovations he finally made up his mind-he wanted to run a pizza parlor that would give Papa John’s and Dominos Pizza a run for their money. The pizza industry is a very competitive market. However, in 2010 he decided to go forward with an idea that was brought forward to him by a very close friend-mobile pizza trucks. At first, it sounded like a typical and stupid idea, but when he actually thought about it; it might be just what New York needs-its favorite fast food on wheels. New York has vast amount pizzeria outlets to choose from with 75% of the market being privately owned and the remaining 25% of the market remaining to the franchising pizza making moguls such as Pizza Hut, Papa John’s and Domino’s. The researcher then decided to go into a partnership with someone else who has had extensive amount of experience in the pizza making industry-Jacob Miller. Both researchers decided to call the enterprise Buck’s Mobile Pizzas and their main aim was to bring a twist to the pizza industry. There will be a definite market for a mobile p izza restaurant as there is none in New York and there is a definite demand for pizzas in New York. 1.2 Product and Service Buck’s Mobile Pizzas is a newly established company scheduled to start operations on the 23rd of September 2011 out of the Bronx, New York. As the name suggests ‘Buck’s Mobile Pizzas has no set physical location or space to conduct business and it requires no land. Instead Buck’s Mobile is a customized truck known as the ‘Buck’s Mobile’ that is making America’s favorite deliciously tasting pizzas daily with the most succulent toppings such as; pepperoni pizza, triple meat pizza, Greek style pizza, caramelized onion, Hawaiian pizza, Chicago style pizza, Californian and Mexican style pizzas. Buck’s Pizzas understand and believe in the habits of eating healthy as such our pizzas are being made fresh with wholesome products including; imported cheeses, organic vegetables, and top-shelf meats. The product will also be developed to enhance presentation. Customer service will be Buck’s Pizzas primary priority because considering its current competition it is important to attract new but keep repeat customers.  Buck’s Pizzas is appealing to a wide clientele through the use of its mobility, customer service and affordable pizzas. Buck’s mobility will sure give it an edge over its competitors. Buck’s mobility will make the possibilities endless when gaining market share. The Buck’s mobile will be there to take care of the burning

Respons Essay Example | Topics and Well Written Essays - 1000 words

Respons - Essay Example I agree with the author because using phone while walking is dangerous as it distracts a person from external environment and causes accidents and even death. Many a times, people underestimate the negative consequences of using a cell phone while walking or driving. For instance, last week while I was walking along the side way, I saw a young man talking on the phone and crossing the road. In a second, I could here is scream as he was hit by a car and injured his leg. Here Matt Ritchell is right in focusing on multi – tasking while on phone as it is a very dangerous act. The use of cell- phone can have many adverse effect including legal penalties .It is seen that many times children use cell phone at schools which can get them punishment. Last month, one of my neighbor’s kid was thrown out of class due the use of cell phone during class hours. Even at work, excessive use of cell phone can result in harmful consequences. Few days back my friend’s brother was fired from work due to his excessive texting at work. In the article â€Å"Behavior: Imitation of Film: Heres Smoking at You, Kid† Nicholas Bakalar claims of the imitation of smoking behavior in children due to watching smoking in movies. Generally children have a high tendency to imitate, and smoking is the most easily imitated behavior from movies. According to a study conducted with 6522 children nationwide it was revealed that children exposed to smoking in movies had two and half times chance to start smoking. I agree with the author here as it is a proven fact that children exposed to smoking through movies have a high tendency to end up as smokers in future. It is usually observed that parents and government authorities ignore the effect of smoking in movies on young children. When last time I visited movies, I have noticed bunch of young children smoking outside the theatre.It could be that these children were regular visitor to

Behaviorists Essay Example | Topics and Well Written Essays - 500 words

Behaviorists - Essay Example According to Guthrie such change could be achieved if a person is determined to replace the old behavior with something new instead. This could be achieved employing his suggested methods to include the threshold means, exhaustion, and incompatible response approach. Guthrie’s idea of threshold adjustment states that behavior of a person can change if the stimulus is weak or could be tolerated. For instance, people who smoke may not be elicited to puff a cigarette if he can indulge reducing the number of sticks a day until eventually he would endure not to smoke. The threshold method is further reinforced through sidetracking. This is avoiding the cues that may compel undesirable behavior (Olson & Hergenhahn, 2009) such as avoiding friends who smoke. Another helpful strategy is adopting the exhaustion mechanism which suggests repetition of the habit until the person feels the anguish of fatigue. An example would be to let the person smoke until he coughs or get sick. Such reac tion to smoking habit enables him to ultimately give up the habit. Equally important strategy is the use of incompatible response. Allowing the person to chew gum helps forge the link between the habit to smoke and the relief from smoking. Despite the proposed methods above, habits are hard to break. This is attributed to the familiar neural pathways involved.

Respons Essay Example | Topics and Well Written Essays - 1000 words

Respons - Essay Example I agree with the author because using phone while walking is dangerous as it distracts a person from external environment and causes accidents and even death. Many a times, people underestimate the negative consequences of using a cell phone while walking or driving. For instance, last week while I was walking along the side way, I saw a young man talking on the phone and crossing the road. In a second, I could here is scream as he was hit by a car and injured his leg. Here Matt Ritchell is right in focusing on multi – tasking while on phone as it is a very dangerous act. The use of cell- phone can have many adverse effect including legal penalties .It is seen that many times children use cell phone at schools which can get them punishment. Last month, one of my neighbor’s kid was thrown out of class due the use of cell phone during class hours. Even at work, excessive use of cell phone can result in harmful consequences. Few days back my friend’s brother was fired from work due to his excessive texting at work. In the article â€Å"Behavior: Imitation of Film: Heres Smoking at You, Kid† Nicholas Bakalar claims of the imitation of smoking behavior in children due to watching smoking in movies. Generally children have a high tendency to imitate, and smoking is the most easily imitated behavior from movies. According to a study conducted with 6522 children nationwide it was revealed that children exposed to smoking in movies had two and half times chance to start smoking. I agree with the author here as it is a proven fact that children exposed to smoking through movies have a high tendency to end up as smokers in future. It is usually observed that parents and government authorities ignore the effect of smoking in movies on young children. When last time I visited movies, I have noticed bunch of young children smoking outside the theatre.It could be that these children were regular visitor to

Pride and Prejudice Essay Example for Free

Pride and Prejudice Essay Elizabeth seems to represent something of a departure form the conventional image of women of her time By Comparing Jane Austens characterisation of Elizabeth with that of the other female characters in the novel, and by examining its social context, discuss this verdict in the heroine of Pride and Prejudice. The novel Pride and Prejudice is about a fascinating love between Elizabeth and Mr. Darcy who have to overcome a lot of difficulties and social prejudices to be together. Some readers may be amazed by the way Jane Austen builds her female characters, especially the main heroine Elizabeth Bennet who is an energetic, quick-witted, sharp- tongued, bold and intelligent girl. Everyone soon realizes that she is the most distinguished and unique character in the novel because of her strong-willed and eager mind. Jane Austen lived in a historical time of social and political changes all over the world but she focused on the middle-class, narrow-minded life in England in which womens social status was established by marrying a prosperous man who would be able to provide them and their family with good security for life, very similar to Mrs. Bennets desires. However a majority of central female characters in Austens works are strong-natured and they promote womens freedom on marriage. Elizabeth is a highly unconventional woman of her time. Her mannerisms and thoughts seem to be different to other characters in the novel. Elizabeth is the second of five daughters in the Bennet family. However, unlike her mother and her siblings whose childishness and narrow-mindedness always showed themselves poorly in public, Elizabeth is quite smart and has a fast tongue. This is the reason for her being the most favourite daughter of her father and the least one of her mother. Mr. Bennet, an intelligent man with a cynical sense of humour, has made an unwise marriage with a simple minded and ill-mannered woman, Mrs. Bennet, and when he realizes this, he has a tendency to hide in his study rather than take part in the social and family activities with his wife. Being her fathers confidante almost portrays Elizabeth as the son of the family. Throughout the novel, it is recognizable that Mr. Bennet always gives Elizabeth a unique interest as he sees in her in a different way from her sisters and other girls. While Mrs. Bennet has little value for Elizabeths intelligence and wit: Lizzy is not a bit better than the others; and I am sure she is not half so handsome as Jane, nor half so good humoured as Lydia, Mr. Bennet has a high regard for these qualities: They have none of them much to recommend them, they are all silly and ignorant like other girls; but Lizzy has something more of quickness than her sisters. (Chapter 1) Mr. B. believes that his Elizabeth is more sensible and shrewd than her sisters so he frequently offers her advice, supports her and trusts her in all that she does. For example when Elizabeth rejects Mr. Collinss proposal due to the fact that she does not want to marry such a pompous man, Mrs Bennet is outraged however Mr. Bennet is not livid about her decision at all and instead he supports her. Your mother will never see you again if you do not marry Mr. Collins, and I will never see you again if you do. (Chapter 20). This shows that Mr Bennet is humouring his wife and is joking with Elizabeth. Refusing this marriage with Mr. Collins, which would highly benefit the Bennet family, seems unusual in Elizabeths time. Any other women would be delighted to marry a man of Mr. Collins standard. In addition to the quickness of her mind, Elizabeth also shares good humour with her father. She likes taking ironic enjoyment at others silliness and hypocrisies and is quick to mock them exclusive of her mother and her younger sisters though she is sometimes humiliated by their ludicrous behaviour. In the novel, she is portrayed as having a lively, playful disposition, which delighted in anything ridiculous. (Chapter 3). Elizabeth does not care to join her family in the balls and finds her familys behaviour unusual. In fact she finds humour in the way her family conducts themselves. She is completely in contrast to Lydia one of her younger sisters. This is uncommon in females in that society, partaking in balls and getting excited about them was one of the many things women were expected to do. Again this shows Elizabeths uniqueness. At the first encounter between Elizabeth and Mr. Darcy at the Meryton ball, Darcy callously turns down the offer to dance with Elizabeth and insults her by saying she is tolerable; but not handsome enough to tempt me (Chapter3). Such a remark on a girl, particularly in a dance party is very impolite and offensive and it makes Elizabeth slightly annoyed. However, rather than being humiliated and hiding her embarrassment, she retells this incident to her friends in a teasing and sardonic way. I think that her reaction is wise and rare as not often can a woman behave as calmly as her in a situation like this. She laughs at what Mr. Darcy says about her appearance and changes the fact of being insulted from her to Mr. Darcy. Furthermore, in her discussions with Miss. Bingley and Mr. Darcy at Netherfield Park, Elizabeth herself admits that I dearly love a laugh but I never ridicule what is wise or good. Follies and nonsense, whims and inconsistencies do divert me, I own, and I laugh at them whenever I can. (Chapter11). Being a person who has an exceptional mind, Elizabeth knows what she should or shouldnt make a joke about and she states this point of view clearly and frankly. In other words, only follies and vanities of others can delight her and she is good at creating laughter from these enough to make her conversation become attracting and amusing. Everybody is drawn towards her because of her quick mind and excellent sense of humour. Finding humour in things that would seem rude at the time seems eccentric of women of that time. Elizabeth should be insulted and angry at Mr. Darcy, yet she seems to laugh at how ridiculous his thoughts. This shows that Elizabeth does not care about her appearance to people in society and she is content with being herself. Elizabeth shows that she is unconventional, when she meets Lady Catherine De Bough. During the conversation, Lady Catherine puts a series of questions to Elizabeth concerning the upbringing of her sisters and expects to receive the normative and easy on the ear answers from her. Yet, Elizabeths responses cannot make the Lady satisfied as she thinks. Why did not you all learn? (Chapter 29 )Elizabeth is open in expressing her own ideas and her replies to the impolite and rude questions of Lady Catherine are quite cold and frank. For example, when being asked about personal information, Elizabeth does not hesitate to hold back the answer regardless of the old womans feelings. In other words, it is a signal of rebellion against the social principals that an inferior such as herself should challenge a very wealthy and important woman like Lady Catherine. Her brave and admirable reaction to this situation impresses me and I respect her for being able to do that. It is irregular for someone of Elizabeths position to talk and conduct herself in the way she did to someone like Lady Catherine who was inferior to her in both age and wealth. She should have respected her and agreed with everything she said. She should have said very little as Mrs Jenkinson and Sir William said. Others such as Mr. Collins, who had been much acquainted with Lady Catherine De Bourgh, behaved in a more appropriate way, as it would have been expected. When playing Cards with Lady Catherine he would agreeing to everything her Ladyship said, thanking her for every fish he won, and apologising if he thought he won too many. Unlike most of the other characters in the novel and the conventional women of her time, Elizabeth is a strong woman who is capable of harmoniously balancing reason and emotion in dealing with every incident. She does and says whatever she believes to be right without paying attention to the external forces. The determination in her character really makes her become the most admired and praiseworthy woman. For example when Jane becomes ill, Elizabeth is determined to go meet her. She is also stubborn about walking there rather than taking horse and carriage. Mrs. Bennet is afraid that Elizabeths visiting to Netherfield would make Jane recover from illness quickly and she would not stay there as long as her mother wants. Moreover, the appearance of a girl as the result of walking three miles through the mud is surely not expected to see and the girls social image may be affected. Nevertheless, Elizabeth pays attention to nothing of it. Her only concern is Jane and her health so she does not have intention of changing her initial decision. Her answers to her parents are full of willpower and resolution. Her look with weary ankles, dirty stockings, and a face glowing with the warmth of exercise when arriving at Netherfield is a great surprise to the people here but she appears unworried about their comments and views on her. Nothing can make her flinch from difficulties. In a society like Elizabeths appearance is everything and by arriving to Netherfield as she did would ruin her familys social image. However Elizabeth paid no attention to this and this shows that she is an unconventional woman of her time. She was more concerned for her sister Jane than her familys reputation. Moreover, Elizabeth is really a woman of action who once decides to do something will do it no matter how hard it is. She is very unwavering, particularly shown by her treatment of Darcy when she believes him to have done wrong. As we know, at their first meeting, Darcy was impolite and insulted words on Elizabeths beauty making her think so badly of him. At the evening at Longbourn, Sir William Lucas intends to introduce Elizabeth to Mr. Darcy as a very desirable partner to dance. However, she immediately refuses this offer and does not change her mind no matter how Sir William tries to persuade her. Even though when Mr. Darcy himself elegantly asks for her hand, she only smiles and turns away. Later on, when she hears about the fake story that Wickham makes up to leave a stain on Mr. Darcys reputation she increasingly believes he is a terrible and cruel man. That is the reason for her indifferent and harsh attitudes to Mr. Darcy whenever they meet (but this changes after Elizabeth knows the truth of the two men). I can say that it actually takes a great strength of character and resolution to confront such a power man as Mr. Darcy who should be treated with respect and courtesy because of his wealth and social status. However, it is a part of Elizabeths personality that attracts Mr. Darcy as well as the readers of Pride and Prejudice. Rejecting to dance with a man of such high standard as Mr. Darcy takes a lot of strength and this strength was uncommon in women of Elizabeths time. Elizabeth should have disregarded what Mr. Darcy had said before and quietly and obediently dance with him, and do as she was told. She should have conducted herself in a respectable manner. The opening line of Pride and Prejudice is It is a truth universally acknowledged, that a single man in possession of a good fortune must be in want of a wife implies that the only way for women to ensure themselves a stable life is through marriage. Marriage to some certain extent is like a business transaction. In the novel, Jane Austen uses the character Charlotte Lucas to illustrate this point and contrast with Elizabeths views on love and marriage. Charlotte is also a smart and well-educated woman like Elizabeth so it really makes Elizabeth surprised when hearing her friends decision to wed Mr. Collins. However, in a society where women are expected to marry a well-off man even though they are not in love with him was common. Their main reason was gaining financial security, or else facing homelessness and poverty. Therefore Charlottes actions were understandable. Compared with Elizabeth, Charlotte is older, plainer and more desperate to find a husband so Mr. Collins proposal is the rare opportunity to save her from the unpleasant reality, I am not romantic, you know. I never was. I ask only a comfortable home; and considering Mr. Collinss character, connections, and situation in life, I am convinced that my chance of happiness with him is as fair as most people can boast on entering the marriage state. (Chapter 22). Charlotte is constrained by the fact that all she desires is wealth and stability and it can be achieved just through marrying to Mr. Collins. In her thought, love is not a real concern in marriage. To her closest friends choice, Elizabeth exclaims: Engaged to Mr. Collins! My dear Charlotte impossible! She completely astonished at seeing Charlotte marrying without affection and it is their opposite points of view on this matter that makes them never be close as before. In Elizabeths time marriage was like a business transaction. All that was necessary was for the man to have money. Love had no importance. This meant that Elizabeths views on marriage were highly unusual and were irregular of her time. However Elizabeth also shows conventional features of women of her time. Firstly she marries someone of a higher status, and has more wealth than herself. This was typical of women in her time. In fact Mrs Bennet was happy declaring Ten thousand a year! Oh Lord what will become of me. (Chapter 59). She was delighted in knowing that her daughter has married an accomplished, rich man. Elizabeth Bennet marries Mr. Darcy, providing her family and herself financial security, as a woman of her time desired and aimed for. Her story ends very similar to Jane, a typically conventional woman, showing her regularity. Another conventional aspect of Elizabeth Bennet is that she plays the piano forte She has a very good notion of fingering (Chapter 31). Elizabeth also partakes in dancing in the Meryton balls. So much so that she is said to be an excellent dancer. You excel so much in the dance Miss Eliza (Chapter6). When Mr. Darcy talks of accomplished women he says that an accomplished women is one who add something more substantial, in the improvement of her mind by extensive reading (Chapter 8). Elizabeth Bennet also reads regularly showing she is an accomplished and conventional woman. Traditionally a woman of Elizabeths time would be experienced in reading, playing the pianoforte, partaking in local balls, all aspects which Elizabeth Bennet has. In conclusion Elizabeth Bennet is not entirely an unconventional woman. She possesses mainly conventional aspects such as playing the piano. However I believe that it is her mind and thoughts that are unconventional. Elizabeth has been blessed with wit and intelligence. This comes through in her mannerisms and this is what forces her to seem unconventional. Through her thoughts, words and actions, no one can deny the fact that Elizabeth is an intelligent girl who possesses a humorous sense as well as a keen capability of observation. In the novel, she is described as a beauty and has especially expressive eyes, but what everybody notices about her is her spirited wit and quick responses. Elizabeth is not only smart but she also has a strong character. She is very brave to confront with the people who are far more powerful and superior than herself like Lady Catherine and Mr. Darcy. Elizabeth is quite determined and independent in her actions and opinions. She is ready to refuse the marriages that could provide her with a comfortable life and a high standing in the society just because she finds that man does not suit her in terms of intellect and personality. In Pride and Prejudice, Jane Austen uses Elizabeth Bennet as a literary device to represent her values and attitudes on the importance of marrying for love. The heroine dares to go against the social conventions that women should marry for their economic benefits. She only weds the man she really loves and respects. This makes the young free-spirited woman differ substantially from the other female characters of the novel. Although the novel was written a vast amount of time ago and Jane Austen is no longer with us, the distance of time could not fade away the image of Elizabeth as a complex young woman with sparkling intelligence and a strong personality. Although Elizabeth makes some mistakes, for example she has been driven by her pride and prejudice for a long time leading to the misjudgements between Wickham and Mr. Mr. Darcy, the striking features she possesses still overweigh these weaknesses. She is not perfect but is an idealized woman. That is possibly the message Jane Austen was trying to get across, that there is no perfect woman, but then who is. In modern times, Elizabeth would be the opposite of unconventional. Now women are free to express their opinions and are encourage speaking their minds. In this way I think Jane Austen has predicted the future of women through Elizabeth. I believe Jane Austen has been accurate in her prediction and she has succeeded in producing more Elizabeths throughout the world. I admire Elizabeth Bennet and I believe that she is an ideal women. Particularly when it comes to her strength of mind and her courage.

Reflect on the physical and social factors of vulnerability

Reflect on the physical and social factors of vulnerability I have recently undertaken a student nurse placement in a community hospital in North Wales. I was mainly employed on the care of the older person ward. This ward dealt with older people awaiting or recovering from surgery or awaiting re-housing into care facilities or their own modified house. Many of the patients could be considered vulnerable. Normal aging, illness and life experiences had increased the vulnerability of many of the patients and the coping skills of many had been severely diminished. In this essay, I will examine one of the patients I came into contact with regularly. In accordance with the Nursing and Midwifery Code of Conduct (NMC 2008) all names and placement details will be concealed, and I will refer to the patient as Mr. A at all times. I will discuss Mr. As medical conditions and how and why these medical conditions have led Mr. A to be regarded as vulnerable, covering physical, social, psychological and environmental factors. Mr. A was a 67 year old gentleman who was morbidly obese. He had a BMI of over 40  kg/m2 and was bed bound. He also suffered with Aspergers Syndrome which is a type of autism mainly affecting social and communication skills. Both of these in addition with being an older person would have led to him to be vulnerable in various aspects. Vulnerability  is the susceptibility to physical or emotional injury or attack. Vulnerability refers to a persons state of being liable to succumb to  manipulation,  persuasion  or  temptation. (Bankoff, et al. 2004). A vulnerable adult is one who due to Age, Physical injury, Disability, Disease or Emotional or Developmental disorders is unlikely to be able to provide for their own basic necessities of life; they may also have an increased risk of harm or injury. This would include, but is not necessarily limited to adults who reside in long-term care facilities such as nursing homes, adult family homes, boarding homes, assisted living facilities or those who receive health care or other assistance in providing for the basic necessities of life while residing in their own home. Roper, Logan and Tierney(1980) published a nursing model outlining 12 activities of daily living that are crucial to a person basic needs, some of which are essential such as breathing, eating and drinking and others which enhance the quality of life such as work and play and expressing sexuality. When an individual becomes old, frail, ill and immobile they may be dependent on others to help them with the 12 ADLs. This can result in people feeling vulnerable. Fernandez LS et al (2002) states that impaired physical mobility, diminished sensory awareness, chronic health conditions, and social and economic limitations can result in vulnerability of the elderly to disasters such as falls or accidents. Frail elderly with serious physical, cognitive, economic, and psycho-social problems are at especially high risk. Mr. A was 67 and according to the Geriatric Pharmacology Research Group in Newcastle upon Tyne, The frail elderly are individuals, over 65 years of age, dependent on others for activities of daily living, and often in institutional care. As with Mr. A, he was 67 years old and was reliant on carers for many if not all of the Activities of Daily Living. He was also in institutional care for pressure sores. Due to all of these points Mr. A would be classed as frail elderly. Mr As problem with weight was the main cause of his hospitalisation, he stated he had weight consistently put on more and more weight over the years. He felt very responsible for his weight gain but was reluctant to do anything about it even though he was classed as morbidly obese. Obesity  is a  medical condition  in which excess  body fat  has accumulated to the extent that it may have an adverse effect on health, leading to reduced  life expectancy  and/or increased health problems.  Body mass index  (BMI), a measurement which compares  weight  and height, defines people as  overweight  when their BMI is between 25  kg/m2  and 30  kg/m2, and obese when it is greater than 30  kg/m2. Mr. As obesity led him to be largely bedbound and incapable of maintaining his health, his home or personal hygiene. When Mr A was living in his own home district nurses would regularly come in to tend to his pressure sores. Pressure sores are  lesions  to the skin caused by many factors such as unrelieved  pressure and friction. These pressure sores were the result of Mr A being unable to move so constantly having to stay in the same position and thus having unrelieved pressure on different parts of his body. As Mr. A was bedbound he could not tend to his own housekeeping and his house became so untidy the district nurses found it too hard care for him in the chaotic surroundings so referred him to a community hospital. While he was in a community hospital a council funded cleaning team organized his house in order for him to be discharged back to a manageable house. Another reason that district nurses were finding Mr. A hard to manage was that he suffered from Aspergers Syndrome and would often be aggressive with the district nurses. Aspergers syndrome  is a type of autism that is characterized by difficulties in social interaction, along with restricted and repetitive patterns of behaviour and interests. It differs from other autisms as sufferers linguistic  and  cognitive development are often fine and develop well. The exact  cause of Aspergers  is unknown.  There is no single treatment but interventions are used to improve sufferers symptoms and functions. The main treatment used is  behavioural therapy, focusing on the specific insufficiency of the patient. These tend to consist of poor communication skills, obsessive or repetitive routines, and physical clumsiness.  Most individuals improve over time, but difficulties with communication, social adjustment and  independent living  can exist and continue into adulthood.  Some people with Aspergers syndrome may become angry and aggressive, either to themselves or to other people. Sometimes when a person with Aspergers feels angry, they cannot easily pause and think of alternative strategies to resolve the situation. The rapidity and intensity of anger, often in response to a relatively trivial event, can be extreme and can get so intense, they may go into a blind rage and unable to see the signals indicating that it would be appropriate to stop. (Attwood, 2006). At the community hospital Mr. A would often get aggressive or rude when more than one nurse would be in the room. If he felt he wasnt being listened to not being involved enough he would become very agitated and start shouting. The nurses took this into account and made sure Mr. A was involved at all times with anything going on in his room. I feel this condition may have led Mr. A to inadvertently isolate himself from people and people to him. When people do not understand something they can take a negative approach to it. Mr. As outbursts would have offended some people and cause them to detach themselves. This would quite possibly be due to the fact they did not understand or know about the condition and fear of the unknown leads to negativity in some cases. (Campbell, 2006) A person who is vulnerable to isolation or social pressure may be considered as suffering from social vulnerability. When people become isolated due to illness or reduced mobility they may find it difficult to access essential services. Mr. A had a job translating books from various foreign languages into English. He did this from his laptop every day and when he was transferred to hospital he left his laptop at home. This made his feel low all the time as he said he had no purpose to his day. The nursing staff through Multi Disciplinary Team meetings reviewed his situation and decided to let him have his laptop delivered to the hospital along with internet connection and had his mail transferred, this all to allow him to continue to work which elevated his mood greatly for the remainder of his stay. He reported he was much happier at the community hospital now that he could continue with his day to day life. Mr. A also said he felt isolated due to his obesity. As people age, they often become more vulnerable, their social circumstances particularly impact their health. As with Mr A, due to his obesity he was confined to his bed and this impacted on his social circumstances. It limited anything he wanted to do socially, for example, he could not venture out of the house, and could only find small ways of interacting with society. One of these ways was through his online job; this allowed him to interact through the internet without having to leave his bed. This had both a positive and negative side. Although it allowed Mr. A to interact with people, all be it virtually, which was important in developing his social skills it did however mean he did not have to move and so made little effort in changing his lifestyle. Mr. As lifestyle choices were undoubtedly the main cause of his hospitalization. He refused to try to diet at the hospital and stated he had always been this way, never wanting to diet. Family members would bring in unhealthy food for him; they were advised against doing this but made no attempt to stop. A dietician came to evaluate Mr. A and a plan was made but not stuck to by Mr. A. He was also offered physiotherapy in the form of help to start doing small movements with his arms and legs daily but he declined. This weight problem made him vulnerable to all sorts of illnesses; one in particular that was being managed at the hospital was his pressure sores. In hospital a special bed was required to accommodate his weight and relieve his pressure sores, along with bariatric chairs, wheelchairs and hoists. Mr. As weight and inability to move made him physically vulnerable. Many of the elderly are admitted to hospital due to something caused by a physical vulnerability. A physical vulnerability is when a person has an increased risk of injury. E.g. easily brakes bones, has reduced strength, reduced movement or dexterity. Many of the patients in the community hospital were there as a result of such vulnerability and had suffered injuries resulting from falls. Some had reduced mobility which meant they needed assistance in performing one or more daily tasks such as getting in and out of bed, preparing meals and eating them, doing housework, dressing, and performing personal hygiene. According to Holden and Smeeding sixteen percent of the elderly need help with at least one of these conditions. Elderly persons subject to two or more of the five they deemed insecure; those facing three or more were considered extremely insecure. Those people who are totally dependent on social services for survival are already economically and socially marginalized and require additional support at all times. Mr. A needed help with all physical activities, he was washed, dressed, fed, and cared for all by nurses and carers. He stated that because he could not do anything for himself he had no quality of life in the community hospital and although he was bedbound at home as well, he did have home comforts and had developed methods of reaching things he needed and wanted, such as a pik-stick. These new surroundings may have made Mr. A feel environmentally Vulnerable. Environmental vulnerability is when a person suffers reduced quality of life caused by external conditions and surroundings. The transfer to the community hospital was a major change of environment for Mr. A as he had to get used to new surroundings, new methods, and new people and as he has limited movement he stated he all the new goings on made him feel rather helpless as all he could do was press the bell and wait if he needed something. This was understandable and it was explained to Mr A in great detail the goings on, routines and layout of the hospital to try and overcome his worries. Brubaker (1987) tells of how having a major lifestyle change such as having to come to hospital for a long period of time can make the patient feel as though there dignity is being taken away from them. This was noticeable with Mr. A. When he was first admitted to hospital, he resisted being washed on many occasion. This may have been due to there being many new nurses and carers that he was not used to. He may have felt shy and undignified having to be washed in his hospital bed my many different workers. This was overcome by making sure his door was always closed, windows and curtains shut, nurses and carers would also introduce themselves, ask for consent and talk Mr. A through the procedure, all in order to make him feel more comfortable. This seemed to cease his worries and he started to allow the staff to wash him on a daily basis. One major concern of Mr. As was the time it took from when he pressed the bell in the hospital or the emergency bell in his house to the time a nurse or carer got to him. He would panic during this period and this impacted greatly on his psychological well being leaving him psychologically vulnerable. Psychological Vulnerability is when someone is vulnerable to emotional or behavioural harm. While Mr. A was in the community hospital calming and relaxation techniques were taught to him to try and overcome his anxiety. He was taught deep breathing techniques and stated he found this particularly beneficial. Every time he started to feel anxious and worried he could now use these new techniques which take his mind of the worry and keep him calm. While I was working at the hospital I saw a huge change in Mr. As behaviour in terms of anxiety. He became much less aggressive when having to wait for a nurse.   There were many elderly residents at the community hospital that suffered many different types of psychological vulnerability. Many of the frail elderly who had suffered falls lost their confidence completely. One female patient told me that she did not want to go home as she did not feel she could cope. She did not feel safe in her home but would not want to move to a residential home. This must be a very distressing time and it is hard to reassure patients in this mind set. Through the MDT meetings it was decided that Mr. A would have to go to a residential home as it would not be safe for him to go home. Mr. A felt he would not enjoy being in residential and was completely opposed to the idea. However, three workers from the residential home came to speak to Mr. A, he was taken to view the residential home and his room, the Doctors and Nurses at the community hospital spoke to Mr. A at length and gave him time to voice his questions and concerns. With time Mr. A seemed to come around to the idea and realise it was the best option for him and by the end of my student placement Mr. A told me he was looking forward to moving out of the community hospital and into the residential home. I have outlined Mr. As conditions and how he was affected by physical, psychological, sociological and environmental vulnerability. Over the seven weeks I was in the community hospital alot was done to conquer Mr As vulnerability and re-merge him into society. Community hospitals are designed to reduce the risks to people who are vulnerable to social, physical, environmental and psychological injury. Hospitals have special floors, showers, seats and beds. They have controlled heating, lighting, diets, they encourage interaction between patients and with visitors (at certain times during the day) thus reducing social isolation. Highly trained staff monitor and review patients regularly to ensure they are receiving the best care and the support needed to leave hospital and to prevent their return. This all minimises the risk of patients feeling vulnerable and helps them to have a fast recovery and rehabilitation.