Insanity In Hamlet Essay - 975 Words

Questioning the Sanity of Hamlet In Hamlet by William Shakespeare, Hamlet’s sanity is questionable throughout the play. Insanity is defined as the â€Å"unsoundness of mind or lack of the ability to understand† (Merriam-Webster). In the play, Hamlet’s father, King Hamlet, is murdered by Claudius, Hamlet’s uncle, in secrecy. To make matter’s worse, Claudius then continues on to get married in an inscetuous relationship with Hamlet’s mother, the queen. Emotions are heightened when Hamlet then see’s a ghost that claim’s to be King Hamlet. The Ghost tells Hamlet that Claudius is the murderer and that Hamlet must seek revenge for his father’s death. In order to protect himself of being accused for treason, Hamlet decides he will act insane as an†¦show more content†¦Hamlet displays intelligence in the pursuit of avenging his father’s death. Hamlet again displays critical thinking when he does not blindly kill but first proves to himself that Claudius is, in fact, guilty. To do this, Hamlet requests a player to perform a play that Hamlet had edited to mimic King Hamlet’s murder. If Claudius â€Å"do blench, I know my course† (Shakespeare, II.ii.626-627), the course being murdering Claudius. By having a reaction to the play, Claudius is inadvertently admitting to Hamlet that he is guilty of murder. Some think that this is not enough evidence to commit treason, however, later in the play the readers learn that Claudius admits to murder in the secrecy of the church; â€Å"my offense is rank, it smells to the heavens; It hath the primal eldest curse upon ‘t, A brother’s murder† (Shakespeare, III.iii.40-42). By admitting his guilt it is know Hamlet is not insane, rather is justified in his pursuit of revenge. It is near impossible for Hamlet to prove Claudius guilty, and the play is the best way he can. It is irrefutable that the play is better than nothing, and this is a clear exhibit of critical thinking a quality insane people cannot posses. During the second appearance of the ghost, Hamlet is the only one who can see it. Many argue this is a sign the ghost is false, and Hamlet is crazy because he can see it. While having a conversation with his mother, Queen Gertrude, Hamlet sees the ghost and converses withShow MoreRelatedInsanity In Hamlet Essay1038 Words   |  5 PagesShakespeare’s tragedy, Hamlet, the protagonist, Prince Hamlet, is an inconsolable young man who struggles with the death of his father, King Hamlet. Hamlet is confronted by the ghost of his father in the first act and discovers the truth of his father’s death. The Prince is horrified at the disclosure that his Uncle, King Claudius has murdered his father. He also finds himself outraged by his mother’s hasty remarriage; however, the Ghost forbids him to cause her any harm. Hamlet promises to avenge hisRead MoreHamlet Insanity Essay1199 Words   |  5 PagesHamlet’s Insanity Hamlets actions display something of a madman. Hamlet’s madness contributes to the many examples that his insanity in fact seemed real. Few people believe his insanity seemed faked or feigned. Nevertheless Hamlets actions can get confusing, since he could be deeply in love one minute, then talking and screaming to himself the next. These events that have occurred may have altered Hamlets life, by leaving him horribly troubled, and in a state of madness. In the book HAMLET a deviceRead MoreInsanity In Hamlet Essay972 Words   |  4 PagesHamlet’s insanity has always been a controversial topic within literary analysis. Many individuals believe Hamlet has always been insane, while others believe that his insanity was an act he played the whole time. Ultimately however, throughout the play, Hamlet becomes legitimately insane due to the events that occur, the primary factor being the death of King Hamlet, his father. Seeing the ghost of King Hamlet is the beginning of his descent into insanity. Soon afterwards his mother marries ClaudiusRead MoreInsanity In Hamlet Essay1555 Words   |  7 PagesIn the play Hamlet, written by Shakespeare, the protagonist, Hamlet shows a state of instability which eventually leads to his irreversible actions. Many events have led to Hamlets insanity including his father’s death and his own mother marrying his uncle, the new king. This sets his enmity towards his uncle and results in his des ire of killing him. On top of this, Hamlet has suicidal thoughts. The big question here, is whether or not Hamlet should be charged with homicide, manslaughter or neitherRead More Madness and Insanity in Shakespeares Hamlet Essay3091 Words   |  13 PagesHamlet and Insanity      Ã‚  Ã‚   William Shakespeare’s creation of the character of Hamlet within the tragedy of that name left open the question of whether the madness of the protagonist is entirely feigned or not. This essay will treat this aspect of the drama.    George Lyman Kittredge in the Introduction to The Tragedy of Hamlet, Prince of Denmark, explains the lack of success with Hamlet’s pretended insanity, and in so doing he implies that the madness is entirely feigned and not real:Read More Insanity in Shakespeares Hamlet - The Madness of Hamlet Essay2270 Words   |  10 PagesThe Madness of Hamlet    William Shakespeare, in the tragedy Hamlet, designed two characters who exhibit symptoms of madness: Ophelia and the prince. Hamlet states his own madness as intentional, purposeful, for the carrying out of the ghost’s admonition. But does Hamlet’s pretended insanity actually touch on real, actual insanity from time to time, or is it consistent? Phyllis Abrahms and Alan Brody in â€Å"Hamlet and the Elizabethan Revenge Tragedy Formula† consider the madness of the heroRead More Madness and Insanity in Shakespeares Hamlet Essay1390 Words   |  6 Pages     Ã‚  Ã‚  Ã‚   In Shakespeares Hamlet, there are two characters that display qualities of insanity.   They are Hamlet and Ophelia.   Although they both appear to be mad at times, their downfall (or supposed downfall) is quite different.   Ophelias crazed characteristics show up and intensify quite rapidly, until she is ultimately led to suicide.   Her madness seems definite, and it is never questioned.   The insanity or sanity of the main character is an arguable question.   The issue can be discussed bothRead More Use of Insanity and Madness in Hamlet Essay1141 Words   |  5 Pages It is or is it not true that Hamlet was faking his insanity? I’m not saying Hamlet was faking the whole thing. The meaning for insanity on Dictionary.com is â€Å"a permanent disorder of the mind.† I dont think Hamlet had a permanent disorder of the mind he knew what he was doing and even planned the majority of the events that happened. Most of the time anyway. Having your father die is bad enough, but to have your mother marry your uncle, within a few weeks of your father’s death? Then to seeRead More Madness and Insanity in Shakespeares Hamlet Essay964 Words   |  4 PagesHamlet - A Question of Madness      Ã‚   Hamlets public persona is a facade he has created to carry out his ulterior motives. The outside worlds perception of him as being mad is of his own design. Hamlet is deciding what he wants others to think about him. Polonius, a close confidant of the King, is the leading person responsible for the publics knowledge of Hamlets madness. The idea that Hamlet is mad centers around the fact that he talks to the ghost of his dead father. He communicates withRead MoreEssay on hamlet: sanity vs insanity842 Words   |  4 Pages when he starts to carry out those actions, its it possible to say at what point the stops pretending and starts actually being crazy?†. In Hamlet by William Shakespeare, the way others interpret Hamlet’s behavior is different from the way Hamlet views himself. nbsp;nbsp;nbsp;nbsp;nbsp;Hamlet is in a situation where his sanity is turning into insanity. He is like one of those people who tell so many lies that they start believing their own lies. Hamlet’s acting is so vivid to him that, unconsciously

Should We Sell Our Privacy For Convenience Essay

Have we sold our privacy for convenience? Smart refrigerators snap pictures of their innards, letting us know it’s time to buy milk †¦ while we shop. On a chilly winter’s day shopping, we text home telling our connected thermostat and coffeemaker to welcome us back to a warm home, and hot cup of java. Our internet equipped car navigates our way home while keeping everyone entertained, from which we activate our WiFi enabled Christmas lights, and unlock or WiFi enabled home door locks, shortly before arrival. Once home, we cue up the Xbox and kill some zombies. Later, we update our Facebook status with a smart TV, as we collapse on the couch from a hard day shopping. Any, and all of these members of the, internet of things, can, or do, spy on us. Whether it be a hacker trying to steal from us, a company gathering personal information for profit, or big brother, our interconnected devices of convenience leaves our physical things, and possibly worse, our perso nal identity, vulnerable. What price have we chosen to pay for these conveniences? In 2013, a first of its kind global internet spam attack, took place. What differentiated this attack from a myriad of others, was an unexpectedly new, and surprising conspirator; smart appliances. Yes †¦ smart TVs, smart coffeemakers, and smart refrigerators, were perpetrators in a first of its kind, cyber-attack. After investigations concluded, the security firm Proofpoint stated â€Å"About 25% of the messages seen by ProofpointShow MoreRelatedEssay On Internet Privacy1658 Words   |  7 PagesInternet Privacy: An introduction (Mike Campbell) A famous and often misunderstood quote from Benjamin Franklin says that those who would give up an essential liberty to purchase a small, temporary safety, deserve neither the liberty nor the safety (Wittes, 2015) . This quote is usually used in the opposite of its original intent, according to historical context (Wittes, 2015) but it’s easy to see why it may be misused. The sentiment we likely draw from it is that sacrificing privacy for safetyRead MoreThe Privacy Of A Young Pregnant Teen1651 Words   |  7 Pagesconquered the privacy of a young pregnant teen, causing emotional stress to her parents, because they were unaware of her pregnancy. She started searching for baby-items online and Target assumed she was pregnant. So, they sent offers to her mailbox and her parents’ found out and eventually realized what their daughter has been up to. Target has unapologetically invaded the privacy of this young teen. It’s starting to become very common nowadays. We give Target the right to charge our cards, whichRead MorePrivacy And The Era Of Big Data Essay1449 Words   |  6 PagesPrivacy in the Era of Big Data One day, you go shopping in Times Square. When you are passing by an underwear shop, what do you feel if the store assistant who is standing out of the door promotes to you that: â€Å"Morning Ilarie. We have got several this season’s new models of your size, 66 D. And your boyfriend will also like them because they are pink and cute and right to his taste†¦Ã¢â‚¬  Could you tell me your feeling? Happy? Surprised? Or you’re scared? I think most of the people might feel offendedRead MoreThe Privacy Of The Patriot Act906 Words   |  4 PagesPrivacy The misuse of our personal information collected by private and public institutions has made privacy, or the lack of it, a major societal concern today. One of the biggest reasons privacy has become such an issue is the enactment of the â€Å"Patriot Act†, signed into law in reaction to the attacks on 9/11/2001. This act broadened the ability for the US government to collect surveillance on people in order to protect against terrorism inside the US. Critiques say it violates our civil libertiesRead MoreInternet Privacy And The Internet954 Words   |  4 Pagesoffice, how would we get our candy crush reminders, or write a five page essays for an English final. Major programs like the ones I’ve stated may not have been possible without hackers. Hackers are people who gain access to unauthorized information using a computer. I know, it sounds bad that people are gaining unauthorized information by computer, but they actually make the internet a safer place. With the gr owth of the internet comes the growth of hackers and internet privacy. New laws that wouldRead MoreEthics in Technology Essay1555 Words   |  7 Pagesethical issues relating to computer technology and cyber technology is undeniable in today’s society. Computer technology plays a crucial role in all aspects of our daily lives. Different forms of computer technology provide unique functionalities that allow people to perform daily activities effectively and efficiently. In modern society, we use computer and cyber technology to communicate with friends and family via social networking sites, participate in business transactions, and get current newsRead MoreHipaa Compliant Mobile App Development Requirements1308 Words   |  6 PagesRequirements HIPAA compliance issues affect medical practices, insurance companies and eCommerce companies that sell medical devices, equipment and increasingly popular fitness apps that measure key health and fitness functions. HIPAA, an acronym that stands for the Health Insurance Portability and Accountability Act, was passed in 1996 and took effect in 2003. The act mandates privacy protection for confidential health records including written and oral disclosures and digital electronic healthRead MoreInformation About Lelong.Com Presentation1610 Words   |  7 Pagesas Alexa.com, Google.com, Bing.com and Yahoo.com. I also consider other criteria such as simple design, user friendly, popularity and hassle free payment. 1. Lelong.my  - popular local auction amp; online shopping. 2. eBay Malaysia  -  buy or sell practically anything on eBay, the worlds online marketplace. 3. Zalora.com.my  - online shopping for shoes amp; fashion on Zalora Malaysia, simplified. 4. Lazada.com.my  - largest selection of the worlds most popular brands at best prices toRead MoreThe United States Healthcare System1742 Words   |  7 PagesThe world as we know it has changed drastically in the past three decades, we are slowly but surely morphing into a worldwide community dependent upon computer technology. More specifically we rely on the Internet heavily for everything in our day to day lives. The benefits of expediency and the convenience afforded to those who utilize information systems their business dynamics is undeniable. This paper will discuss the various threats and vulnerabilities related to the United States healthcareRead MoreThe Security Of Your Own Home2510 Words   |  11 Pagesstill a reasonable expectation to the right to privacy when you are in the security of your own home. Even if you rent, a landlord cannot install a listening device to monitor the activities in your bedroom without violating your right to privacy (Scruggs, 2016). Established as it may be that a landlord spying on you in your bedroom is illegal, technology companies and their spread of big data appear to be getting a pass on the privacy front. Before the Xbox One was released back in November of

Sir Gawains Shield and the Green Night A Semiotic Analysis

In the poem Sir Gawain and the Green Knight, Sir Gawain must go on a quest to find the Green Knight from whom he accepted a challenge a year earlier. Because Gawain lives the chivalric code, he must keep his promise to the Green Knight and let him get one swing of the axe one year and a day after he swung the axe on him. Before leaving for this quest, Gawain was given amazing armor and a descriptive shield. This shield was more than just a shield; it had a much greater meaning like many other items and actions throughout the poem. The shield is the most important symbol in Sir Gawain and the Green Knight, as it reaffirms the importance of both the chivalric code and Christianity to the people of the Middle Ages. Sir Gawain was given†¦show more content†¦The back of the shield has the image of Mary painted on it to help Gawain mentally when he was losing faith and hope. During his journey, Gawain loses hope to the point that he knows the only way he can survive is with t he help of Mary. With little hope left, â€Å"Sir Gawain, at that tide, / To Mary made his prayer, / For fain he was to ride / Where he might shelter share† (Weston, II. x. 24-27). When he has finished praying, he finds up ahead of him a large, two mile wide castle that was not there before. Without Mary, Gawain would most likely have not been able to make it to the Green Chapel, and all of the Knights of the Round Table would be known as cowards. Because of this, Gawain is made to realize that he is but human and fallible and that the ways of the world make it difficult to be sure of not falling from grace in some way. It is only the protection of Mary that helps him keep to the difficult line between clannes and cortaysye and the trap or at least dilemma into which he falls is an extremely insidious one for a man who might regard the offered girdle as a gift of a divinely ordered fate (Evans). Chivalry was relevant in many ways in the Middle Ages. High expecta tions of virtuous and noble behavior on behalf of God, the church, and those the church marked as worthy of protection were the Christianized form of chivalry (Gregory-Abbott). â€Å"The ideal chivalric knight was brave, loyal, and determined as well as compassionate, just,

Charge To Fly For Much Longer Distances †Myassignmenthelp.Com

Question: Discuss About The Charge To Fly For Much Longer Distances? Answer: Introduction Drones can be defined as an unmanned aerial vehicle which is commonly known as UAV.' That means that the aircraft flies by itself without passengers and the help of a pilot. Military and commercial drones usually have longer ranges than any of those simple hobbyist planes (Kala, 2016). These two type of drones can be controlled from a much longer distance unlike the R/C craft which can only be flown based on the visual ranges of the pilot. They can also use a single charge to fly for much longer distances. Today, the growing usage of drones has increased and so is their application areas (Roma, 2017). Commercial designed drones are used for delivering packages, and most notably drones have been highly used in surveillance where they are used to monitor and record scenes from the sky (Pappot and de Boer, 2015). Background to Transport Industry Ground transport Ground transport is also referred to as transportation by road or land transportation. It is the movement or shipment of goods and people from one location to another. Road transport is highly used in Australia because of the low population density. Most importantly almost every household in Australia owns a car. This shows how important road transport is for the Australian population. Water Shipping This involves shipment of goods and people across water bodies such as seas, lakes, oceans, and rivers through use of vessels such as boats and ships. Transportation through water plays a significant role in the Australian economy as the majority of industrial enterprises are situated along the east of Australian seaboard. Some of the major industry participants are New South Wales and Queensland which provide a destination for cruises. Aerial-Blimps A blimp is a dirigible balloon or airship or a steerable aircraft what can easily float because of the gases that are inflated in them which are usually lighter than air. They have no internal structure. When the gas is let out, a blimp losses its way. In Australia and the world, blimps are mostly used in advertising because of the great commanding attentions that they possess. The Hindenburg Disaster The Hindenburg disaster occurred on May 6, 1937, at Lakehurst. The disaster led to the death of more than 35 persons. Miraculously, about 62 passengers survived the deadliest disaster. Hindenburg provided a fast means of traveling from Europe to South and North America. It provided luxurious to the passengers, and it used half time of the fastest ocean liners of the time. After research about the cause of the accidents, multiple reports concluded that the crash resulted from an electrostatic discharge that leads to leaking of hydrogen gas (Bain1 and Van, 1999). Drones Technologically, drones are unmanned aircraft which are mostly referred as UAV unmanned aerial vehicles. In the past drones were highly associated with the military as weapon platforms and for intelligence gathering (Boyle, 2015). However, drones are nowadays used even by civilians in many roles such as traffic monitoring, photography and for business purpose. Ground drones This is unmanned ground vehicle UGV which operates while in contact with the ground and does not require a human controller. They are designed to work in dangerous environments that are unsuitable for human operators Shipping drones These are unmanned aerial vehicles that are used to deliver good and small packages from one place to another. Increased commercial use of drones has facilitated the increase of drones in this industry. Some organization such as Amazon has invested heavily in this drones to deliver small packages to customers faster and safely. Aerial drones These are Unmanned Aerial Vehicle UAV which are aircraft without a pilot. These drones can be controlled remotely by a controller in control station, or they can also fly autonomously on their own (Aerial drone, 2016). These drones have many areas of application, they can be used by the military to launch attacks, and delivery drones are used in delivering goods like they are employed by Amazon. Drone threats to transport industry The increased demand and usage of drones can be thought as a threat to the industry of carriage because of the impacts the drones will have to transportation companies which have inadequate capital to invest in drones (Haidari, Brown and Ambikapathi, 2016). However, drones have had an enormous impact on almost all modes of transport. In ocean carrier by use of ships and ferries is not flexible as ports are required for ships to anchor but if drones are used, they can provide more reliable transportation and automatically updating the transportation management system (Tavana, Khalili-Damghani and Santos-Arteaga, 2017). Drones have also taken over the delivery of small packages. Entrances before Drones Before drone in Aerial technology unmanned balloons were used. The earliest form of an unmanned vehicle was reported in 1849 when Venice Italian city was attacked by Austrians. Later in 1927-1929 pilotless aircraft was tested which lead to the development of radio controlled target. The radio controlled target let to the development of drones. In the ground-based technology unmanned car were used. The car was controlled wirelessly using a radio. Later on, the gun-armed tank was developed and was remotely controlled. The shipping drones is a new technology that is under development and testing, and most of the organizations have not implemented these drones. Drones have been developed to be used to patrol storage site for example MDARS which are used to sense and detect intruders. Political and Legal Factors These two environments are the most important aspects of drone industry. They could legalize or ban the use of drones. These two elements are controlled by the government of the particular countries. In the US laws have been developed to prohibit some companies from using drones The transport industry has become very competitive, and many companies are trying to increase their competitiveness by adopting drones. This is because they want to improve their customer satisfaction. Drones are no longer only used for military purposes but are also used by civilians for commercial purposes. Drones have less social forces since they are mostly used in businesses. Drones are left for use to the public which raises criticism about the privacy of the people (Rao, Gopi and Maione, 2016). There are laws to protect privacy. The availability of infrastructure and resources has facilitated the development of drones. Companies and universities have carried out research based on drone development. The developments on drones are expected to increase. Environmental factors that can affect drones include weather and climatic conditions. These changes in climate can be constructed may be from showers to understand the limits of the particular drones. Laws governing drones Some of the laws that guide the drone users not to fly beyond 400 feet, the drones should be flown within sight of the controller, drones are prohibited to be flown over groups of people such as stadiums. Ground based drones The laws prohibit the drone controllers from driving the drones at night. Drones should also not be controlled beyond the sight of the driver, and the drones should not violate the established ground regulations such as road regulations. Shipping Drones According to the proposed laws, people can only be allowed to fly only the registered drones, and they should not weigh beyond 25kgs. This means that the packages should not be large or should not weigh more. The controller should have a minimum of 17 years and should pass aeronautics test. International waters and International Airspace The term international waters apply where water bodies transcend international bounders such as oceans. A country has no sovereignty over international waters. All countries have rights and freedom of navigation (Vacca and Onishi, 2017). While international airspace is the airspace that is not restricted to territorial rules of any country. References Aerial drone., 2016. 57. Retrieved from https://doi.org/10.1016/S0262-4079(16)31855-3 Bain, A. and Van Vorst, W.D., 1999. The Hindenburg tragedy revisited:: the fatal flaw found. International Journal of Hydrogen Energy, 24(5), pp.399-403. Retrieved from https://doi.org/10.1016/S0360-3199(98)00176-1 Boyle, M. J., 2015. The Race for Drones. Orbis, 59(1), 76-94. Haidari, Brown and Ambikapathi., 2016. The economic and operational value of using drones to transport vaccines. 4062-4067. Kala, R., 2016. 1 Introduction. 1-10. Retrieved from https://doi.org/10.1016/B978-0-12 803729-4.00001-5 Pappot and de Boer., 2015. The Integration of Drones in Today's Society. 54-63. Retrieved from https://doi.org/10.1016/j.proeng.2015.11.504 Rao, Gopi Maione. (2016). The societal impact of commercial drones. 83-90. Roma, A., 2017. Drones and popularisation of space. 23-30. Retrieved from ttps://doi.org/10.1016/j.spacepol.2017.01.001 Tavana, Khalili-Damghani and Santos-Arteaga., 2017. Drone shipping versus truck delivery in a cross-docking system with multiple fleets and products. 93-107. Vacca and Onishi., 2017. Drones. military weapons, surveillance or mapping tools for environmental monitoring? The need for legal framework is required, 51-62.

Nursing Annotated Bibliography for Morbidity and Self-Care

Question: Discuss about theNursing Annotated Bibliography for Morbidity and Self-Care. Answer: Annotated bibliography Strmberg, A., Mrtensson, J., Fridlund, B., Levin, L. ., Karlsson, J. E., Dahlstrm, U. (2003). Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: results from a prospective, randomised trial.European heart journal,24(11), 1014-1023, Doi: https://doi.org/10.1016/S0195-668X(03)00112-X A prospective randomized trial was done with hospitalized patient with heart failure to investigate about the impact of nurse-led heart failure clinic on mortality, morbidity and self-care behavior of participant. The research was conducted in one university hospital and two county hospitals in Sweden. It includes one intervention group and one control group and the criteria for blinding was fulfilled by computer generated list of random numbers and sealed envelopes. The intervention group at the nurse-led clinic was followed-up by experience cardiac nurse after 2-3 weeks and the activities done by nurses included status evaluation, education on heart failure and social support to patient. The control group received current clinical practice and follow-up in primary health care clinic. The data related to demographics and clinical details were collected from medical chart of patient and data on self-care was collected by means of a questionnaire tool. The primary outcome variable was all-cause mortality and hospital admission after one year and secondary variable includes self-care behavior, number of readmissions and number of days in hospital. The results of the study showed that intervention group had fewer deaths, fewer admission rates and higher self-score behavior. It was concluded that nurse-led follow after hospital can improve survival rate and self-care behavior of patients with heart failure. Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J., Dalal, H. M., Lough, F., ... Taylor, R. S. (2015). Exercise-based rehabilitation for heart failure: systematic review and meta-analysis.Open heart,2(1), e000163, https://dx.doi.org/10.1136/openhrt-2014-000163 A systematic review and meta-analysis of randomized controlled trial was done to evaluate the impact of exercise-based cardiac rehabilitation for heart failure. The data sources for the systematic review included databases like MEDLINE, EMBASE, CINAHL and PsycINFO and the sample population for the studies needed to include heart failure with preserve ejection fraction (HFPEF) or heart failure with reduced ejection fraction (HFREF) patient. Another criteria for study selection was that all participant must have reported about at least 6 months follow-up and they must all have received exercise training apart from other intervention. The outcome measure for studies were also considered and the criteria was to have outcome data related to mortality, hospital admission, health related quality of life and cost and cost-effectiveness. A total of 33 trials was found to fulfill the research criteria and the systematic review of these literatures indicated that exercise intervention reduced t he risk of heart failure and overall hospitalization rate. The data were independent of trial duration and dose of exercise. Overall, the study concluded that exercise based cardiac rehabilitation can lead to improvement in hospitalization and quality of life in patients with cardiac failure. Faris, R., Flather, M. D., Purcell, H., Poole-Wilson, P. A., Coats, A. J. (2006). Diuretics for heart failure.Cochrane Database Syst Rev,1. Doi: 10.1002/14651858.CD003838.pub2 A systematic review of randomized controlled trial was done to evaluate the harm and benefits for chronic heart failure in patients with chronic heart failure. The main rational for this aim was to evaluate how diuretics can control disease progression and improve survival rate in patient. Relevant research articles were taken from EMBASE databases and the main research design was meta-analysis of randomized controlled studies. The criteria for study participants in the selected studies included patient with chronic heart failure and those with symptoms of breathlessness and fatigue. The intervention for all studies should involve all type of diuretic drugs. The primary outcome measures include mortality and morbidity and the secondary measures included effect of diuretic on symptoms, quality of life and worsening of heart failure. From the review of research studies on the basis of above mentioned criteria, a total of 28 studies were found relevant to the study objective. Different studies covered different range of outcome measures. Overall, the review of findings from different studies showed that diuretic is the conventional treatment for patient with chronic heart failure and it is effective in reducing the risk of death in patient with heart failure. In comparison to control group, intervention group also had improved exercise capacity. Justification for the choice of references The above three evidence has been selected in response to the case scenario of Charlie, a 75 year old overweight who has been diagnosed with chronic heart failure and find out the best evidence to manage Charlies condition. The main symptoms observed in Charlie were breathlessness, visible peripheral edema and tachycardia. The evidence by Strmberg et al. (2003) was found suitable for the management of Charlies condition because it proved the effectiveness of follow-up at nurse-led heart failure clinic. This evidence has been chosen because the study considered challenges in the management of heart failure patent and showed that poor-follow and low patient education about self-care behavior also leads to poor patient outcome. Focusing on self-care behavior and follow-up care is necessary because many times poor awareness about self-care behavior also result in non-compliance to medication and increase in hospital readmissions rate. The study by Ruppar et al. (2016) proved poor adheren ce to medication results in exacerbation of heart failure symptoms, poor physical function and high risk of admission in patients with heart failure. Strmberg et al. (2003) showed that nurse-led heart failure can address management problem like poor compliance to medication and this is evident from the study outcome. The study showed that implementation of intervention related to education about heart failure to patient, psychosocial support and appropriate follow-up with heart failure patient significantly improved self-care score for patient and reduced the admission rates and length of hospital stay. The research evidence is also selected for Charlies because of the quality and credibility of the work. The researcher adopted randomized controlled trial method and considered the requirement for blinding. This eliminated selection biases in studies. The credibility and generalisability of the work was also enhanced by conducting research in three different setting. The study gave the clinical implication that improving the process needed for follow-up is necessary for management of heart failure patient as it is a cost-effective approach to diagnosis and treatment of the condition. Unverzagt et al. (2016) also confirmed that regular follow-up visits and self-care programs improves adherence to medication in heart failure patient. The study by Sagar et al. (2015) has been selected for the management of Charlies condition because the study explained about the effectiveness of exercise-based cardiac rehabilitation (CR) for reducing overall risk of complication and heart failure specific hospitalization. As Charlie is an obese patient, he is at higher risk of exacerbation of symptom related to heart failure (Parto, Lavie and Ventura 2016). The evidence by Sagar et al. (2015) has been considered because of the positive benefits of exercise-based rehabilitation on health related quality of life, mortality and hospital admissions rate in patient (Taylor et al., 2014). The study proved that exercise CR improves health related quality of life and improves hospitalization rate in patient with heart failure. The research was done by means of systematic review and meta-analysis method, however the factor that improves the quality of the evidence is that it includes only randomized controlled trial (RCT) for analysis. As RCTs come under top level under the hierarchy of evidence, the results from the study is reliable. This study guides current practitioners to adapt exercise CR for management of heart failure patient as it gives consistent results irrespective of the type of CR programme. Haykowsky et al. (2016) also supported the fact that exercise-based CR improves muscles strength, physical function and quality of life of patient with heart failure. The third evidence by Faris et al. (2006) emphasized on the use of diuretic for heart failure patient. This evidence has been selected for management of Charlies condition because he was suffering from the symptom of breathlessness and diuretic drugs like furosemide are the first line of treatment for congestive heart failure and relieving symptoms of peripheral oedema in patient. The study used systematic review method to analyze the effectiveness of diuretic therapy on improving morbidity and mortality in patient. The quality of the study is high as it included only double-blinded randomized controlled trial for review and by this means, it eliminated all biases and confounding factors that influences study outcome. By the review of relevant research, the researcher proved that diuretic reduces the risk of death in patient. By such finding, it gave the clinical implication that new diuretic drugs should be considered for management of patient with heart failure. Buckley et al. (201 6) also explained that short course of IV diuretics is a safe and effective intervention for patient with heart failure. Recommendations for clinical practice: Based on the review of research evidence, it can be recommended that important criteria for management of patient with heart failure is to first achieve symptom improvement in patient and then focus on promoting self-care behavior and physical movement in patients like Charlie. This strategy has been proposed because the three interventions focus both on short and long trem health outcome of patient. As heart failure patients like Charlie experience symptom of breathlessness, pharmacological therapy by means of diuretic therapy is effective in reducing pulmonary congestion in patient (Johnson Oxberry, 2010). Secondly, finding provisions for adequate follow-up and improving patient-care behavior is also necessary because self-care is associated with increase in self-confidence of patient to manage risk. It is recommended that to improve the quality of life of patients with heart failure, clinicians or nurses should educate patient about self-care behaviors like following diet regimen t, having low-salt diet, being physically active, controlling weight and controlling symptoms of heart failure (Abotalebidariasari et al., 2016). In addition, clinicians should focus on exercise-based cardiac rehabilitation as regular exercise is associated with improved quality of life in patients with heart failure (Rajati et al., 2013). References: Abotalebidariasari, G., Memarian, R., Vanaki, Z., Kazemnejad, A., Naderi, N. (2016). Self-Care Motivation Among Patients With Heart Failure: A Qualitative Study Based on Orem's Theory.Research and theory for nursing practice,30(4), 320-332, doi:10.5681/jcs.2012.029 Buckley, L. F., Carter, D. M., Matta, L., Cheng, J. W., Stevens, C., Belenkiy, R. M., ... Stevenson, L. W. (2016). 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Reducing Heart Failure Risks in Obese Patients.Current Cardiovascular Risk Reports,10(4), p.15, Retrieved from: https://link.springer.com/article/10.1007/s12170-016-0498-1 Rajati, F., Mostafavi, F., Sharifirad, G., Sadeghi, M., Tavakol, K., Feizi, A., Pashaei, T. (2013). A theory-based exercise intervention in patients with heart failure: A protocol for randomized, controlled trial.Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences,18(8), 659, Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872604/ Ruppar, T. M., Cooper, P. S., Mehr, D. R., Delgado, J. M., Dunbar?Jacob, J. M. (2016). Medication adherence interventions improve heart failure mortality and readmission rates: systematic review and meta?analysis of controlled trials.Journal of the American Heart Association,5(6), e002606, Doi: 10.1161/JAHA.115.002606 Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J., Dalal, H. M., Lough, F., ... Taylor, R. S. (2015). Exercise-based rehabilitation for heart failure: systematic review and meta-analysis.Open heart,2(1), e000163, https://dx.doi.org/10.1136/openhrt-2014-000163 Strmberg, A., Mrtensson, J., Fridlund, B., Levin, L. ., Karlsson, J. E., Dahlstrm, U. (2003). Nurse-led heart failure clinics improve survival and self-care behaviour in patients with heart failure: results from a prospective, randomised trial.European heart journal,24(11), 1014-1023, Doi: https://doi.org/10.1016/S0195-668X(03)00112-X Taylor, R. S., Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J., Dalal, H., ... Singh, S. (2014). Exercise?based rehabilitation for heart failure.The Cochrane Library, doi: 10.1002/14651858.CD003331.pub4. Unverzagt, S., Meyer, G., Mittmann, S., Samos, F.A., Unverzagt, M. and Prondzinsky, R., 2016. 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