Tuesday, December 31, 2019

Changes Brewing For African American History - 1708 Words

Changes Brewing for African Americans in 1950s Determined to write a play about African American experience in the United States for every decade during the 20th century, Wilson has written many plays representing each of these decades. Fences is one of such plays about African American in the 1950 s. It began in 1957 and ended in 1965; however, the 1950s marks the time period when the struggle against segregation and racial discrimination became strong in the mainstream of American life, showing that the wind of change was blowing. Bringing to consciousness events taking place prior to civil right movement in fences, Wilson s characters attest to the fact that the United States†¦show more content†¦This setting is noteworthy because of the industrial importance of the north to African Americans in the decades preceding civil war. According to Richard, Troy Maxson’s father – a sharecropper – â€Å"was frustrated by the fact that every crop took him further into depth† (1018). Richard means tha t economical state of the south was not favorable for sharecroppers and mostly backs. During that period, poverty, racial discrimination and savage conditions in the south caused many blacks including Troy and other men to migrate to the industrial north in search of a means of livelihood, but these men were met with utter disappointment. With no infrastructure or resources to live on, men like Troy and Bono resorted to living in shacks, committing crimes and ending up in jail. Wilson clearly shows a relationship between the freeing of the slaves and disproportionate number of African American men in jail as well as in low income occupations by contending that the majority of unequipped, resource-less and homeless group released into a competitive and financed society will find it difficult surviving lawfully in such a society. Wilson s characters attest to the fact that the United States failed African American after Abraham Lincoln ended slavery and that the United Statesâ€℠¢ failure, legalized through Jim Crow laws and other measures taken lawfully to ensure inequality, continues to affect many black lives. Wilson depicts the 1950s as a time period when new doors of

Monday, December 23, 2019

The Rapid Depletion Of Conventional Energy Sources And...

Abstract The rapid depletion of conventional energy sources and scarcity of fossil fuels are the major energy concerns. The renewable energy such as solar powered energy can be harnessed by using solar flat plate collector. A solar flat plate collector collects heat by absorbing heat from solar radiation. The performance of solar flat plate collector mainly depends upon the characteristics of working fluid. Conventional solar flat plate collector uses water as heat transfer fluid but it gives lower thermal efficiency. Nanofluids have superior thermal and optical properties that can be used to increase heat transfer rate. So our aim is to design and develop solar flat plate collector using Nanofluid as heat transfer fluid. 1. Introduction 1.1. (a) Introduction - Flat Plate Collector A solar thermal collector collects heat by absorbing heat from sunlight. A collector is a device for capturing solar radiation. Flat plate collector consists of: 1) a dark flat-plate absorber, 2) a transparent cover that reduces heat losses, 3) a heat-transport fluid (air, antifreeze or water) to remove heat from the absorber, and 4) a heat insulating backing. In water heat panels, fluid is usually circulated through tubing to transfer heat from the absorber to an insulated water tank. This may be achieved directly or through a heat exchanger. 1.1 (b) Introduction of Nanofluid A Nanofluid is a fluid containing nanometer-sized particles, called Nanoparticles. These fluids are engineeredShow MoreRelatedRenewable Energy in America Essays1573 Words   |  7 PagesAmerica is the dilemma of alternative forms of energy. While all forms of energy have various pros and cons, some are much more favorable than other depending on renewability, reliability and cost. Some are extremely energy renewable, some are much cheaper than others, some are much more reliable and some take up a lot less space than others. 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Energy Resources: Increasing energy needs, Renewable/ non renewable, Use of Alternate energy sources, Case studies f. Land resources: Land as a resource, land degradation, man-induced land-slides, soil erosion and desertification. 35 48 2.3 ROLE OF AN INDIVIDUAL IN CONSERVATION OF NATURAL RESOURCESRead MoreChinas model7412 Words   |  30 Pagesmanufacturing and industrialization after Mao s age. Dang made the effective plans of modernization of that promoting agricultural sector, industrialization sector and technology standards and enhancing the military strength.Its role is become vivid as its rapid rise in the aspects of other nation. Its geography is harmony with agriculture and so the citizen are mainly depends on the agriculture.Promoting agriculture is the main core of the strategic reforms.The machine are applied to do agriculture for fasterRead MoreUS Intelligence Sees Cyber Threats Eclipsing Terrorism: An Analysis6653 Words   |  27 Pagesterrorist groups. Non-conventional terrorism is a rather new term in the glossary of international relations. It makes the connection between terrorism and unconventional warfare or techniques. While there is still a lack of consensus over the term of terrorism, unconventional terrorism often implies the use of chemical, nuclear or biological weapons in terrorist attacks. In my opinion the nuclear weapon is the most dangerous and at the same time easy to use non-conventional weapon in terrorist attacksRead MorePower and Energy Crisis of Bangladesh13714 Words   |  55 Pagesmaintained her pride among the developing countries for more than 40 years. The power and energy sector of Bangladesh may not be strong like other countries but it has been more than enough to provide for the fellow residents and also for exporting abroad. But for how long can Bangladesh maintain this? It has recently been seen that we are facing various types of problems and shortages in the power and energy sector of our country. It has also been predicted that sometime in the near future all theRead MoreSustainable Urban Development in India7190 Words   |  29 Pagesprotecting the environment for present and future generations. It also maintained that natural resources of the earth must be safeguarded for the benefit of present and future generations. About a decade later, to address the issues concerning continuing depletion of natural resources and unsustainable development, the World Commission on Environment and Development was created in1983. 2 Popularly known as Brundtland Commission (1983) , it described sustainable development as â€Å"development that meets theRead MoreOne Significant Change That Has Occurred in the World Between 1900 and 2005. Explain the Impact This Change Has Made on Our Lives and Why It Is an Important Change.163893 Words   |  656 Pagesthat era, not only from those proceeding it but from the rest of human history altogether. The essay by Gabrielle Hecht and Paul Edwards provides a nuanced interweaving of analyses of the nuclear arms race, debates over nuclear power as a major energy source, and the communications revolution made possible by computer technologies that did so much to shape the cold war standoff between the Soviet and American superpowers and the transition to a new century and millennium. Hecht and Edwards underscore

Saturday, December 14, 2019

The effect of motivation on behavior Free Essays

In everyday conversation, the question â€Å"What motivated you to do that?† is a way of asking, â€Å"What caused your behavior?   Why did you act that way?†Ã‚   To psychologists, a motivation is a need or desire that serves to energize behavior and to direct it toward a goal.   Psychologists consider motivation as a hypothetical concept.   Hence, they infer motivation from behaviors observe. We will write a custom essay sample on The effect of motivation on behavior or any similar topic only for you Order Now But in a broader sense, motivation pertains to the purpose for responding.   The term comes from the Latin verb movere, which means, â€Å"to move,† and it is what causes movement (behavior) that concerns this paper.   The idea of movement is reflected in such commonsense ideas about motivation as something that gets us going, keep us moving, and helps us get jobs done.   Conversely, a person is not motivated when s/he cannot seem to get out of bed or off the sofa (Pintrich, 2001). Despite these commonly held ideas, definitions of motivation are numerous and varied, and there is much disagreement over the precise nature of motivation.   Motivation has been conceived of in such varied terms as involving inner forces, enduring traits, behavioral responses tom stimuli, and sets of beliefs and affects (Schunk, D.H. 2003). Although motivation has many facets, psychologists have been especially concerned with those influences that energize and direct responses.   Simply stated, motivation determines how strong a behavior will be and the form it will take.   Moreover, much of what is known about motivational processes comes from research on how people respond to the difficulties, problems, failures, and setbacks encountered as individuals pursue goals over time.  Ã‚   Various theories contend that motivation underlies much human behavior (Weiner, 2005). Psychologists have different theoretical perspectives on motivation.   At present, there are four motivational strategies that are influential on how psychologists have understood  motivation, namely, flow theory, stress and coping theory, and intrinsic and extrinsic theory. Flow theory Csikszentmihalyi (2005) studied individuals who engaged in intrinsically motivating activities and found that their experiences reflected complete involvement with the activities. This involvement, is known as the flow theory, and is defined as â€Å"the holistic sensation that people feel when they act with total involvement† (Csikszentmihalyi, 2005). According to Csikszentmihalyi, the flow is very much related to other human motives and has shown that the dimensions in this two-by-two classification are closed-versus open-system goals and intra- versus interindividual processes.   Closed goals are those that determined by genetics (needs, hunger, thirst, safety, optimal activation) or socialization; open goals develop as a result of experience and cannot be explained by pre-existing factors.   Interindividual processes are social in nature, whereas intraindividual processes refer to the person.   Flow is a personal process and reflects open systemic goals (Csikszentmihalyi Rathunde, 2003). Moreover, individuals experiencing flow are so intensely involved with a task that they may lose awareness of time and space.   They also seek a flow experience for itself rather than for anticipated rewards.   Although flow can be experienced with any activity, it is more likely to occur with activities that allow for free expression and creativity such as games, play, and art.   De Charm’s origin state shares many elements with flow.   In extreme form, individuals forsake a traditional lifestyle and most contingent material rewards to engage in activities that provide flow (de Charms, 1996). There are a number of researches on the flow theory.   These researches have proven that despite being nebulous, the flow theory makes intuitive sense.   Csikszentmihalyi (2002)  describes a research study in which the Experience Sampling Method was employed.   Adults carried beepers that sounded several times a week, at which time subjects rated themselves on two dependent variables:   Affect (comprising items â€Å"happy,† â€Å"cheerful,† â€Å"sociable†) and activation (comprising â€Å"active,† â€Å"alert,† â€Å"strong†). Subjects also judged their situation for challenges present and skills available.   The amount of time individuals judged themselves to be in flow (defined as challenges and skills present and equal to one another) was related positively to affect and activation (Csikszentmihalyi,2002). Mayers (reported in Csikszentmihalyi, 2002) had high school students’ rate school subjects and activities on challenge and skill.   Favorite activities fell into the flow are (challenge= skill): TV and music listening (low on each); friends (moderate); and arts, such as drama or ballet, and sports (high on each).   Skills were judged to exceed challenges in humanities and social sciences, resulting in boredom.   Challenges were rated as exceeding skills in mathematics and the sciences, resulting in anxiety. Other research compared the flow experiences of three groups of adolescents.   One group attended a select public school in Italy, a second group attended a typical suburban high school near Chicago, and a third group comprised talented math students from a top Chicago public school.   Students used the Experience sampling Method.   The Italian teens reported more flow experiences than U.S. teens, especially those talented in math.   Among the U.S. teens, those attending the typical school reported the most amounts of boredom (skills exceed challenges) and anxiety (challenges exceed skills). Interestingly, the talented group scored significantly lower than the other two samples in apathy, defined as skills and challenges in sync but below average (e.g., watching TV, listening to music).   In sum, experiences are comparable for average and above average students across cultures, whereas for talented U.S. teens, flow and apathy are rarer and boredom and anxiety are common (.Csikszentmihalyi, 1995) These researches implied that motivation affects the behavior of people.   The flow theory concluded that there is a state of equilibrium between the amount of challenge in activities and an individual’s capabilities.   People feel bored when their perceived skills exceed their opportunities for using them; they become anxious when they believe that challenges exceed capabilities.   Flow can vary intensity, with the critical variable being the ratio of challenge to skill.   The portrayed relations presumably hold for peak as well as everyday experiences (Csikszentmihalyi, 2003). Intrinsic and Extrinsic theory Deci Ryan believes that intrinsic and extrinsic motivational forces govern behavior.   Extrinsic forces are preprogrammed biologically (e.g., food, sleep) or derive from the reward structure in which the individual is socialized (money, prestige).   Intrinsic forces grow out of the individual’s belief that a given outcome is worth striving for (Deci Ryan, 2001). Deci and his colleagues (Rigby, Deci, Patrick, Ryan, 2002) have recently conceptualized motivation along both intrinsic and extrinsic dimensions.   Intrinsic motivation concerns activities that are autotelic – engaged in for their own sake – which by definition are self-determined.   Extrinsic motivation involves a progression from behaviors that originally were extrinsically motivated but became internalized and now are self-determined.   The first level includes what Deci and his colleagues call external regulation.   In their research, they cited the example that students initially may not want to work on math but do to obtain teacher rewards and avoid punishment. There is very little self-determination in this situation.   At the next level of extrinsic motivation, students may engage in a task (e.g., study for an exam).   Deci and his colleagues call this introjected regulation because the source of motivation is internal (feelings of â€Å"should,† â€Å"ought,† guilt) to the person but not self-determined since these feelings seem to be controlling the person.   The third level is called identified regulation and here individuals engage in the activity because it is personally important to them. The example they cited is that, a student may study hours for a test in order to get good grades to be accepted into college.   This behavior represents the student’s own goal, although the goal has more utility value (Wigfield Eccles, 2002) than intrinsic value such as learning.   The final level of extrinsic is integrated regulation, whereby individuals can integrate various internal and external sources of information into their own self-schema and engage in behavior because of its importance to their sense of self. This final level is still instrumental, rather than autotelic as in intrinsic motivation, but integrated regulation does represent a form of self- determination and autonomy.   As such, both intrinsic motivation and integrated regulation will result in more cognitive engagement and learning than external or introjected regulation (Rigby et al., 2002). Deci and his colleagues` (Rigby et al., 2002) position is thought –provoking, has generated much research, and has important implications for the field.   Many points in the self-determination model are not clearly specified, but researchers increasingly are conducting studies that are adding to the understanding of how this theory explains how behavior changes through motivation. Stress and Coping Theory Richard Lazarus` stress and coping theory was developed from his several research on stress and its effects to humans, and it emphasizes psychological variables, namely, the cognitive processes of perception and thought.   Lazarus   (1976, 1982, 1996) argues that it is neither the process (e.g. stressor) nor the response that best defines motivation.   Rather, it is the individual’s perception and appraisal of the situation that is a significant determinant of whether or not motivation will be experienced.   He cited that an individual may enjoy public speaking, whereas another individual finds it terrifying.   According to Lazarus, events in and of themselves do not produce motivation; it is the individual’s appraisal of the event that creates the motivation (Lazarus, 2001). Lazarus` theory of motivation states that when an individual is confronted with challenge, primary appraisal occurs.   During primary appraisal the individual attempts to determine how the event will affect her or his behavior.   Some events are perceived as positive and beneficial and thus are likely to create a motivation.   However, other events are viewed negatively and thus are perceived as harmful or threatening such as stress.   This appraisal of the event also generates different coping emotions such as fear, anger, or excitement (Lazarus, 1995). The next stage, secondary appraisal, involves determining whether one’s coping capacities are sufficient to meet the demands of a potentially harmful event.   An important part of this stage is a review and analysis of the response alternatives available to the individual.   This secondary appraisal can also lead to the acquisition of new coping responses (Lazarus, 2002). Although the two models of stress and coping theory of motivation are quite different, they are not necessarily antagonistic.   It is easy to see how a biological system to cope with stress would have obvious evolutionary advantages in enhancing survival.   Yet the nature of the human cerebral cortex allows for decisional process in dealing with stress, rather than autonomic biological reactions that are characteristic of lower organisms.   A synthesis of this theory provides for an immediate, probably nonspecific, preparation for dealing with stressors; it is followed by an intelligent appraisal of the situation that may redirect the physiological reactions and institute motivation.  Ã‚   It is because humans have behavioral options, even though they may not always make intelligent decisions in dealing with stressors (Lazarus, 2001). In conclusion, motivation is an important quality that affects all behavior because the different theories presented have proven that it can influence both learning of new behaviors and performance of previously learned behaviors.   Behavior is related in a reciprocal fashion to motivation because how one behaves can be changed through one’s subsequent task motivation. References Csikszentmihalyi, M. (2002).   Emergent motivation and the evolution of the self.   In D.A. Kleiber M.L. Maehr (Eds.), Advances in motivation and achievement (Vol. 4, pp. 93-98).   Greenwich, CT: JAI Press. Csikszentmihalyi, M. (2003). Intrinsic rewards and emergent motivation.   In M.R. Lepper D. Greene (Eds.), The hidden costs of reward:   New perspectives on the psychology of  human motivation (pp. 205-206).   Hillsdale, NY:Erlbaum. Csikszentmihalyi, M., Rathunde, K. (2003).   The measurement of flow in everyday life:   Toward a theory of emergent motivation.   In J.E. Jacobs 9Ed.), Nebraska symposium on  Ã‚  motivation 1992 (Vol. 40, pp. 57-97).   Lincoln: University of Nebraska Press. Csikszentmihalyi, M. (2005).   Toward a psychology of optimal experience.   In L. Wheeler (Ed.), Review of personality and social psychology   (Vol. 3, pp. 13-16).   Beverly Hills,  CA:Sage. Csikszentmihalyi, M. (2005).   Beyond boredom and anxiety.   San Francisco: Jossey-Bass.  de Charms, R. (1996).   Enhancing motivation.   New York: Irvington.   Deci, E.L. (1995). Intrinsic motivation.   New York: Plenum.  Deci, E.L. (2000). The psychology of self-determination.   Lexington, MA: D.C. Heath.  Deci, E.L., Ryan, R.M. (2001).   Intrinsic motivation and self-determination in human  behavior.   New York: Plenum. Deci, E.L., Ryan, R.M. (2002).   The support of autonomy and the control of behavior.   Journal of Personality and Social Psychology, 53, 1024-1027. Deci, E.L., Ryan, R.M. (2003). A motivational approach to self: Integration in personality.   In R.A. Dienstbier (Ed.) Nebraska symposium on motivation 1990(Vol. 38, pp.237-238.  Lincoln:University of Nebraska Press. Lazarus, R.S. (1996).   Psychological stress and the coping process.   New York: McGraw-Hill.  Ã‚  Lazarus, R.S. (1995).   Thoughts on the relation between emotion and cognition.   American Psychologist, 37, 109-111. Lazarus, R.S. (2001).   Emotion and adaptation.   Oxford: Oxford University Press. Lazarus, R.S. (2002).   Little hassles can be hazardous to your health. Psychology Today,  pp.82-85. Pintrich, P.R. (2001).   Current issues and new directions in motivational theory and research.   Ã‚  Educational Psychologist, 26,199-201. Rigby et al., (2002).   Beyond the intrinsic –extrinsic dichotomy: Self-determination and  learning.   Motivation and Emotion, 16, 165-167.  Rigby, Deci, Patrick, Ryan, (2002).   Beyond the intrinsic –extrinsic dichotomy: Self- determination and learning.   Motivation and Emotion, 16, 165-167. Schunk, D.H. (2003).   Goal difficulty and attainment information:   Effects on children’s Achievement behavior.   Human Learning, 2, 107-117. Weiner, B. (2005).   Human motivation.   New York: Springer-Verlag. Wigfield, A. Eccles, J. (2002).   Expectancy-value theory of motivation: A developmental perspective.   Educational Psychology Review, 6, 49-52. How to cite The effect of motivation on behavior, Essay examples

Friday, December 6, 2019

Adaptive Support Ventilation Inappropriate Mechanical

Question: Discuss about the Adaptive Support Ventilation for Inappropriate Mechanical. Answer: Introduction: Obesity ventilation syndrome is mainly characterized by the daytime hypercapnia, obesity and disordered in the breathing while sleep due to the absence of a vital lung or the disease related to the respiratory muscle (Leader et al., 2013). In the case of Michael Anderson, obesity is the reason for the increase in the type 2 diabetes mellitus. The obesity etiology is supplementary complex than merely an imbalance between energy output and energy intake.The most vital factor which influences the rate of the obesity is the changes in the consumption of food with the changes in the dietary habits (Leader et al., 2013). The case history of the Michael clears that he is not only suffering from the physical issues but is also mentally disturbed and socially isolated himself from the society due to the increased weight which resulted in an increased hypertension and depression among him from the last three months (Leader et al., 2013). To support Michael in such situations of the poorly controlled diabetes, obesity ventilation syndrome and sleep apnoea chronic illness factors such as the care, family relationships, technology, developmental level, beliefs, cultural values, economics need, and communication is to be measured. A thoughtful of how such factors affects the chronic illness can make possible the suitable development and commencement of options for the illness adaptation (Leader et al., 2013). Effectiveness of nursing interventions: The chronic illness encounters the patients with the range of needs that is required by the patients to change the behavior and get involved in such activities that results in promoting the psychological and the physical well-being, to work together with the community healthcare providers and hold on to healing regimens, monitoring the status of health and to take the decisions associated with the care, and managing the illness impact on psychological, physical and social functioning with the coordination of the health care providers (You, Dunt, Doyle, 2015). The management related to the community care of the patients suffering from the OHS needs the multidisciplinary access which combines the various surgical and medical subspecialties. The affected subjects need the contribution from endocrinologists and internists regarding diabetes mellitus, hyperlipidemia, hypertension, failure of the heart. In the case the main focus of the nursing care is to control the morbid obesity as this is the main cause of all the chronic diseases in the patient (You, Dunt, Doyle, 2015). Hence, nursing care priority in such case scenario is to implement the hypothyroidism therapy; a dietician is required for the planning the diet which will result in the weight reduction; a respirologist which will help in the management of the issues related to the respiratory failure and the surgeon is required at the time of need for the potential bariatric surgery (LAM, MAK and IP, 2012). Care priority one: The community care services provides management for controlling the increased proportions of the risk related to the morbid obesity and also the advice related to the preventive lifestyle advice (Wilson, Ramelet, Zuiderduyn, 2010). The focus of the community care providers is on the strategies of intervening in the lifestyle changes with increased healthy behavior in the patients and controlling all the physiological variables that are responsible for the onset of such chronic disease. In the case, reduction in the body weight may lead to the improvement in the functions and the pulmonary physiology which can be evidenced in the patient with the improved expiratory volume and vital capacity (Ramelet, Gill, 2012). Weight loss will further results into the reduction of the desaturation severity and hypopnea or apnea index. It is obvious that the care management related to the issues will be guided as per the severe conditions and acute presentation and hence the care management inclu des the need of different care such as the requirement of the reduction in the weight, positive pressure ventilation, oxygen therapy, tracheostomy, pharmacotherapy, and management of the complicated and comorbid illness (Wilson, Ramelet, Zuiderduyn, 2010). The plan for the dietary alteration which shall support the weight reduction including the emotional readiness in order to address such issues requires evaluation (Riha, 2009).Motivation to take part in the exercise as well as the activity in spite of returning to ordinary sedentary TV watching also shall be significant. The proper enhancement and development of the chart which allows to properly mapping of the plan in order to maintain recovery with the sense of timely progress may promote regular participation in developing his ability in order to support the ADLs individually again (Madigan, Vanderboom, 2005). Proper and timely review of the efforts so as to enhance mobility should be regularly done. Care priority two: The second strategy which is to be implemented by the community care is the multidisciplinary care and will normally involve the expansion of treatment plans customized to the psychosocial, medical and the financial requirements of the patients. The community care utilizes a wider range of the social and medical support personnel which includes the physicians, pharmacists, nurses, social workers, dieticians and others to facilitating transition from the inpatient acute care to the long term management of the disease (Blackwood, Albarran, Latour, 2010). Sleep apnea is very harmful and dangerous as if it is untreated, may lead to very high blood pressure plus is also closely associated with an increased possibility of abnormal heart rhythms, heart attack, and also heart failures (LAM, MAK and IP, 2012). The community care supported the treatment with the intravenous antibiotics, and was placed on the reduced salt with low-calorie diet; in support to this he was also given complete physical therapy. The community care will also focus on the social behavior, exercise with healthy diet and complete sleeps are considered as vital to lose weight (Hooper, 2010). As OHS may be brought into use for the treatment of the hilarious health problems, thus at times surgery is also required (e.g. gastric surgery) to assist with the weight loss. Serious obesity is also refractory to the flooding management with and also without the drug or the behavioral therapies; thus in such cases, the bariatric surgery has been considered to be the best and also the most effective modality of durable and reliable treatment refer the severe obesity (Dongelmans and Schultz, 2010). The main decision to referring the patients for proper bariatric surgery at times is not at all easy as such patients do suffer at the exact same time from the important comorbid illnesses thus keeping them at much comparative higher risk for any kind of general anesthesia plus the postoperative complications (Dongelmans and Schultz, 2010). As per the guidelines which have been issued by National Institutes of Health, all of the patients with a BMI that is comparatively higher than around 35kg/m2plus an obesity that is related to the comorbid condition or such patients having BMI even greater than 40kg/m2may be referred to some special kind of surgical treatment (Dongelmans and Schultz, 2010). To properly treat the breathing disorder, one probably may require a (PAP) which stand for the positive airway pressure support that is explained in the ATS series on patient n the Obstructive Sleep Apnea refer grownups. The kinds of the positive airway pressure assistance include the (CPAP) that is Continuous PAP or the (BPAP) Bi-level PAP (Gylen, Anttalainen and Saaresranta, 2014). These both are devices which deliver air to Michael through a mask which she wears anytime while sleeping or even at the time of napping. Continuous PAP delivers the air at a continuous pressure at times when you breathe out and also when you breathe in (Blackstone, 2006). The BPAP, on the contrary, delivers much higher pressures when one breathes in, in comparison to when you breathes out. When the OSA is higher/severe, and is uncontrollable even with the PAP, a surgical hole in the back of the neck might be required to make sure that your sleep apnea is properly and completed treated (Gylen, Anttalainen and Saaresranta, 2014). In the health care of the Michael, the rationale is the continuous improvement with the long-term utilization of the PAP relics to be speculative and not active for acting via numerous mechanisms which ultimately leads to the daytime symptoms and improved nocturnal (Avram, 2002). Conclusion: Michael for the successful treatment of the syndrome is with the bi-level PAP system with decrease in weight. As increased weight is one of the major reasons for diabetes and sleep apnoea and can be cared to the great extent with the weight loss. Hence the priority of the care system is to regulate the diet of Michael with intake of rich protein and fewer calories. He is to be motivated towards such diet and physical exercises with the regular watch. The community caretaker must weigh the Michael body weight at regular intervals and motivate him for the reduction (Avram, 2002). The other care which is to observe in Michael is to deal with the sleep apnea which results in the breathing issue and is treated with the CPAP and the bi-level PAP which will allow the independent adjustment of the expiratory and the aspiratory PAP and is proved to be equivalent effective to improve the daytime hypercapnia (Avram, 2002). Hence, the proper care with routine medication will help Michael to impr ove his health and will result to live his routine life healthily. References Avram, A. (2002). Case Study: Necrotizing Fasciitis in a Patient With Obesity and Poorly Controlled Type 2 Diabetes.Clinical Diabetes,20(4), 198-200. Blackstone, R. (2006). Implications of the Medicare National Coverage Decision for Bariatric Surgery for Treatment of Morbid Obesity.Bariatric Nursing And Surgical Patient Care,1(3), 151-155. Blackwood, B., Albarran, J., Latour, J. (2010). Research priorities of adult intensive care nurses in 20 European countries: a Delphi study.Journal Of Advanced Nursing,67(3), 550-562. Dongelmans, D., Schultz, M. (2010). Adaptive Support Ventilation: An Inappropriate Mechanical Ventilation Strategy for Acute Respiratory Distress Syndrome?.Anesthesiology,112(5), 1295. Gylen, E., Anttalainen, U., Saaresranta, T. (2014). Relationship between habitual sleep duration, obesity and depressive symptoms in patients with sleep apnoea.Obesity Research Clinical Practice,8(5), e459-e465. Hooper, V. (2010). National Priorities Partnership: Palliative and End-of-Life Care.Journal Of Perianesthesia Nursing,25(2), 135-136. Lam, j., Mak, j., Ip, M. (2012). Obesity, obstructive sleep apnoea and metabolic syndrome.Respirology,17(2), 223-236. Leader, N., Ryan, L., Molyneaux, L., Yue, D. (2013). How best to use partial meal replacement in managing overweight or obese patients with poorly controlled type 2 diabetes.Obesity,21(2), 251-253. Madigan, E., Vanderboom, C. (2005). Home health care nursing research priorities.Applied Nursing Research,18(4), 221-225. Ramelet, A., Gill, F. (2012). A Delphi study on National PICU nursing research priorities in Australia and New Zealand.Australian Critical Care,25(1), 41-57. Rhodes, E., Fleischman,. (2009). Management of obesity, insulin resistance and type 2 diabetes in children: consensus and controversy.Diabetes, Metabolic Syndrome And Obesity: Targets And Therapy, 185. Riha, R. (2009). Genetic Aspects of the Obstructive Sleep Apnoea/Hypopnoea Syndrome ndash; Is There a Common Link with Obesity?.Respiration,78(1), 5-17. Wilson, S., Ramelet, A., Zuiderduyn, S. (2010). Research priorities for nursing care of infants, children and adolescents: a West Australian Delphi study.Journal Of Clinical Nursing,19(13-14), 1919-1928. You, E., Dunt, D., Doyle, C. (2015). How would case managers practice change in a consumer-directed care environment in Australia?.Health Social Care In The Community,25(1), 255-265. You, E., Dunt, D., Doyle, C. (2015). What is the role of a case manager in community aged care? A qualitative study in Australia.Health Social Care In The Community,24(4), 495-506.