Things Fall Apart By Chinua Achebe - 1557 Words

Chinua Achebe, author of Things Fall Apart, once said: â€Å"A man who makes trouble for others is also making troubles for himself†. This concept can be seen in the development of Okonkwo as a character throughout the book. Creating plenty of trouble for others, but ultimately creating the most trouble for himself is possibly the plot for the entire book. Generally, the creation of trouble is not a value that is appreciated in any culture, especially in Umuofia. Okonkwo breaks many of the boundaries and social norms within his culture; his tendency to be immature and unaccountable combined with being very self-concerned and the defiance of elders creates an interesting mix adjacent to the cultural standards. Okonkwo rarely takes ownership for†¦show more content†¦After a village elder had found what crime Okonkwo committed, he told Okonkwo that, â€Å"you are not a stranger in Umuofia. You know as well as I that our forefathers ordained that before we plant any crops in the earth, we should observe a week of peace in which a man does not say a harsh word to his neighbor† (30). The elder proceeded to give Okonkwo instructions on how to attempt amends with the goddess. After a single action was taken, his proceeding efforts were nearly non-existent. Any attempt to fix the situation were minimal, as were efforts to learn from his mistakes. Furthermore, Okonkwo advances to partaking in the death of Ikemefuna. The relationship between the two is complicated, but is closest description is that of a boy and his step-father. Killing Ikemefuna is not an evil against the earth, as beating a wife during the week of peace was, but a crime against himself. He is unhappy with himself, and still does nothing to fix his ways, continuing on to single handedly killing a boy at a funeral. Although accidental, Okonkwo was still the man behind the gun. â€Å"It was a crime against the earth goddess to kill a clansman, and a man who committed it must flee from the land†¦.he could return to the clan after seven years† (124). Okonkwo had no choice but to leave for the seven years, perhaps upon his return

Men and Eating Disorders - 874 Words

Protruding rib cages, frail bones, and thin hair, these symptoms often come to mind for many physicians and therapists alike when they think of someone suffering from an eating disorder. What about overly health conscience, extreme muscle mass, and obsessively exercising? New disorders like Muscle Dysmorphia are being discovered in males that have not been brought to the forefront of news today. The male population is severely under calculated and usually passed over when people cover statistics and findings for eating disorders. This stigma and stance that people have while thinking only females suffer from eating disorders only makes it more difficult for males to admit they have a problem and seek treatment for it before it gets too†¦show more content†¦He covers the struggle of multiple men within his article starting with how they developed the disorder to how difficult it was for them to receive help for their problem. Like women, male eating disorder victims usually d o not want to seek help but unlike their female counterparts, males typically have a hard time finding recovery facilities with people like them that focuses on treating just males. Since males are not typical patients they are usually the only man receiving treatment and are secluded or feel out of place when in inpatient recovery. Anyone getting help for an eating disorder should be able to feel comfortable and males do not generally get that opportunity. Many other popular source authors today are concurring with Penn and Daly views and are attempting to call more awareness to the raising deadly situation. In her October 2013 piece, â€Å"Mens eating disorders get increased attention for the San Francisco Gate Kristen Brown keys in on the vitality of accepting and treating males with eating disorders. Like Penn and Daly she includes some â€Å"Ignoring the prevalence of disorders among men creates a stigma that may prevent them from seeking help and a bias that might prevent clinicians or family members from recognizing a disorder in men, resulting in more of those men slipping under the radar.† These ideas have not just been secluded to magazines butShow MoreRelatedMen and Eating Disorders1453 Words   |  6 Pagessomeone suffering from an eating disorder. What about overly health conscience, extreme muscle mass, and obsessively exercising? New disorders like Muscle Dysmorphia are being discovered in males that have not been brought to the forefront of news today. The male population is severely under calculated and usually passed over when people cover statistics and finding s for eating disorders. This stigma and stance that people have while thinking only females suffer from eating disorders only makes it moreRead MoreMen and Eating Disorders Essay1182 Words   |  5 PagesMen and Eating Disorders About seven million women across the country suffer from eating disorders including anorexia nervosa and bulimia and, as a result most research involving these disorders have only been conducted on females. However, as many as a million men may also suffer from these same disorders. Women are not the only people prone to disliking what they see when they look into the mirror. Now a days more men are worried about their body shape. Clinical reports tell us that oneRead MoreEating Disorders : A Common Phenomenon Among Men2622 Words   |  11 PagesEating disorders have been a common phenomenon among men, and it is no longer considered niche topic. According to Gerbasi et al. (2014), males who are suffering from this disorder have been faced with immense stigmatization in an attempt to overcome it, and they have been neglected in the treatment process. There are numerous stereotypes associated with eating disorders that have inhibited the evidence-based treatment among males and it ha s mitigated effectiveness in the management of problems thatRead MoreShould Supplements Be A Type Of Eating Disorder Among Men? Essay905 Words   |  4 Pagespresented evidence that consuming great amount of supplement is considered a type of eating disorder among men since overusing supplements can also lead to malnutrition and psychological problem. Researchers conducted a survey questioning 195 men between ages 18 and 35 about their diet, their training, and how they view themselves physically in order to observe if supplements have a relationship with eating disorders. The results of the type fitness supplements that the majority of the participantsRead MoreAnorexia Nervosa Is A Serious Eating Disorder That Affects Women And Men Of All Ages2104 Words   |  9 Pagesâ€Å"Anorexia nervosa is a serious eating disorder that affects women and men of all ages. It’s characterized by three key features: refusal to maintain a healthy body weight, an intense fear of gaining we ight, a distorted body image† (Smith Segal, 2016). Individuals with this disorder do not have healthy eating habits, most often not eating at all. They will starve themselves, excessively exercise, eat very little, purge at random times, and/or throw up their food following their â€Å"meal†. AnorexiaRead More Eating Disorders in Males Essay examples1362 Words   |  6 PagesEating Disorders in Males Eating disorders are largely considered to be a female disease. Statistics seem to validate this perception – of the estimated five million-plus adults in the United States who have an eating disorder, only ten percent are thought to be male ((1)). Many professionals, however, hold the opinion that these numbers are incorrect – it is impossible to base the statistics on anything other than the number of adults diagnosed with eating disorders, and men are much lessRead MoreEating Disorders, Body Image Gender Essay1721 Words   |  7 PagesRIGHTS (HE6) ASSIGNMENT EATING DISORDERS, BODY IMAGE GENDER Submitted to: Dr. Sivakami Muthusamy Centre for Health and Social Sciences School of Health Systems Studies, TISS, Mumbai. Submitted by: Pallavi Muraleedharan Enrollment Number: M2015HE018 Master of Health Administration (2015-17) Tata Institute of Social Sciences, Mumbai Date: 16/08/2016 INTRODUCTION Eating disorders, body image and gender remain as a very complex interlinked web. Eating disorders affect people from all demographicsRead MoreIncrease in Eating Disorder Victims Essay1623 Words   |  7 PagesIncrease in Eating Disorder Victims There are a number of eating disorders which many people suffer from, and most people may not even be aware that the way they eat could be classed as an eating disorder. Amongst the many disorders are the four most notable; binge eating, anorexia, bulimia and obesity. Another disorder vastly approaching the media limelight is bigorexia. The Eating Disorders Association defines this condition as à ¢Ã¢â€š ¬Ã‚ ¦outward signs of inner emotionalRead MoreFacts About Eating Disorders And Gender Socialization846 Words   |  4 PagesFacts About Eating Disorders †¢ What is socialization? Socialization is a process in which we learn and internalize attitudes, values, beliefs, and norms of our culture and develop a sense of self. †¢ Gender Roles Gender Roles are complex clusters of ways males and females are expected to behave †¢ Gender roles Socialization Gender socialization is a process of learning social expectations and attitudes associated with one s sex. Gender socialization is explained with why human males and femalesRead MoreEating, Bipolar and Anxiety Disorders1145 Words   |  5 PagesIn 2010, eating disorders had a reported 7,000 deaths each year. Not only this, but 3%-5% of children under the age of 18 have an anxiety disorder. Also 15% of all bipolar disorder patients have committed suicide. Eating disorders, anxiety disorders, and bipolar disorders are all prevalent today throughout all ages. Even middle schoolers. Eating Disorders Eating disorders are abnormal eating habits that usually involve eating too little or too much food to the harmful point of both physical and

Dow Pbb Free Essays

Dow Chemical By Kai Draaisma Laurens de Blij Diedrik Oost Eva Sloff Lesley Flohil 13-11-2012 Duisenberg School of Finance Executive summary 1. Summary of Facts. With an annual revenue of $20. We will write a custom essay sample on Dow Pbb or any similar topic only for you Order Now 2 billion Dow held the leading market position worldwide in ethylene and polyethylene (exhibit 1b). To consolidate all of Bahia Blanca’s polyethylene activity under Dow’s control a three-stage plan was developed. The first stage involved taking control of PBB, the second stage involved acquiring Polisur’s two polyethylene plants, and the third stage involved building a new ethylene cracker. To determine a proper risk premium Dow had to consider possible country risks. Currency and government policy risk may have had an impact because of possible future crises and changing government policies relevant to foreign investments. Furthermore, because of the ending of the convertibility law Dow also had to consider a possible exchange-rate risk. Dow created a holding company, Dow Investment Argentina, to invest in the project, then they had to decide whether they will use general corporate funds or raise debt for the PBB bid. 2. Statement of problem . 1General analysis Rational for Acquisition of PBB Dow Chemical’s corporate strategy is to look for horizontal- and vertical integration, achieve technological leadership and gain international presence. Dow will benefit from a more integrated production process by lowering their cost of production. PBB will also create stable supplies of ethane for Dow allowing them to achieve operating rates near 100%. Cracking ethane in the region will result in lower operating risk for Dow meaning the supply/input risk for the production of Polyethylene. An increase in the production output of Dow will allow them to benefit from economies of scale. Overall Dow will gain technology leadership and operational excellence from adding PBB to their company and enhance them with a costleader position in the market required to compete with the government-subsidized chemical complexes. Risk measurement In this section we provide a brief risk analysis. Table 1 is designed to give a compact overview of the different risks, possible mitigating actions and whether the risks are integrated in the cash flow or discount rate. Not every risk was applicable in the acquisition of PBB. The risk that influenced our cash flows the most is the currency risk caused by a possible liquidity crisis in Argentina. Argentina has experienced eight major currency crises (tijd/reference)and there is a risk of a new currency crisis in the future. When this happens, Dow will not be able to sell its output to the home country and will have to increase its export. Revenue de We have also taken into account that the convertibility law that now provides stability could eventually stop. This will also have a significant impact on inflation. Operating risk is the second risk with a large impact on projected cash flows. This is mostly the risk of not meeting the full operating capacity. For the first 3 years we keep the operating rate of the plant at 65% and from 1995 we increase the operating rate by 5% each year. Other risks had less of an impact on our cash flows. Information risk was less of an issue because Dow was already present in Argentina and PBB was important to the government of Argentina. Corporate Governance risk in Argentina is not expected to have a significant additional impact on cash flows. This risk is already included in the discount rate for similar projects in the US. Table 1: Risk overview| Risk| Mitigating actions| Cash Flow (CF) or Discount rate (DR)| Corruption risk| 1. Have a large bank loan from a national bank. 2. Government stake of 49% here is a mitigating factor | DR| Expropriation risk| Same actions as for corruption risk| CF (tax wil increase 5%)| Operating risk (only post/ completion risks )| n/a| CF| Sovereign risk| Through the convertibility law, the peso has been anchored to the USD to prevent hyperinflation. | DR| Currency/ Foreign exchange risk| 1. Dow is a well diversified investor, therefore this should be mitigated. 2. Buy put options on the Arg peso. | CF| Corporate Governance risk| Give shares to management to align incentives. | DR| Repatriation risk| Current political climate is stable, not likely that Arg will impose limits on fund outflows. | DR| Information Risk| Dow Chemical already has presence in Argentina, therefore are more likely to receive high quality information. | n/a| Adjusted discount rate All risks that are not used for adjusting cash flows are integrated in the adjusted discount rate. These risks include but are not limited to corruption risk, information risk, hyperinflation, sovereign risk, repatriation risk and other residual risks. These risks are partly mitigated, however all the different risks combined constitute a premium which we will add on to the the given discount rate for similar projects in the US of 8%-10%. A reasonable assumption for the combined premium will be [ ]. The auumed premium results in a discount rate of [ ] which we will use in our further valuation. 4. Recommendation Bidding decision Competing bidders need to comply with certain covenants (exhibit 6). Competitors Perez Companc S. A. and Copesul do not comply with the requirements of having a statement of net worth of at least 5 billion. Even if the two companies would merge they do not meet the the requirements. This makes Dow the sole bidder for PBB. This has a profound impact on the internal valuation. Appendix 1 Risk Information risk. When you are doing a cross-border valuation you have to take into account that there may be information risk. This includes the risk of outside investors getting the wrong information because of poor disclosure in the financial statements. However since Dow entered Argentina in 1957 we assume they are familiar with the market and accounting rules, therefore information risk for this project is low as Dow chemical has already collected country experience in Argentina via Dow Quimica. Because this is difficult to quantify we have taken this into account in our discount rate. Corruptionrisk. The risk of corruption includes the illegal payments and favors outside the rule of law. Corruption exists to some extent in all countries, but there are large differences across countries. According to the Global Corruption Index by Transparancy international, the level of corruption for Argentina in 1995 was given a 5. 24 out of a possible score of 10. This gave them a ranking of 24 out of 42 countries surveyed. All of which were assumed to be developed countries. However, Dow somehow secured itself thanks to PBB’s importance and the Argentine government’s intention to keeps 49% which is an advantage and not a disadvantage. The Argentine government will also appreciate the jobs being created in the later project stages, if successful, and a good relationship with the government willlikely also be beneficial when discussing with YPF about long-term ethane supply. Mitigation: Part of this risk can be mitigated by taking a loan in Argentina to finance the project as the government will not want Dow to default on their debt resulting in an overall bad outcome for Argentina’s economic situation. Furthermore part of this risk is mitigated as the government has a stake in the company so it is also in their interest to keep the company strong. Currency risk: As Argentina has experienced 8 major currency crises in the past there is the risk of a new currency crisis occuring in the future. Even though the convertibility law took away some of the risk, Dow will still have to bear in mind that when a crises happen, they will not be able to sell their output to the home country and will have to increase its export. This risk is taken into account in the cashflows. Expropriation risk. Political instability or expropriation is small as they company has had a stable democratic government past 12 years. However, changes in the policy of the government will cause a risk for Dow and their foreign investments. At that moment there were no restrictions on borrowing abroad and there were no limits imposed on payments of foreign loan principal and interest. If something changes in this regulations it may have an effect on the acquisition of Dow. For this reason we will also include this risk in our discount rate. Furthermore the government has no limits on cash flows going out of their country but can eventually decide to do so. We consider the risk of the government taking over the company to be low as the production of polyethylene and deriving ethylene from hydrocarbon crackers is complex. This is a process for skilled people and not just anyone can therefore run the company properly. The risk of expropriation is therefore low. As the production of ethylene and derivatives such as polythylene is a highly complicated process, requiring large captial investment and a high operating leverage, not many companies will be able and willing to take over the business. Furthermore as Polythylene is a commodity product that trades globally with a narrow price range. Mitigation:Dow can decrease the risk exposure by taking on a loan in Argentina to finance their project. This will decrease the risk exposure as Dow can only default on their debt when the government decides to raise taxes, which will not lead to a company default. Foreign Exchange Rate Risk. Foreign Exhange rate risk will be low because of Dow Chemical’s international presence and the assumption that shareholders are sufficiently diversified. The convertibility law which ensured a fixed Argentine peso and U. S. dollar at exactly one already decrease the foreign exchange rate risk. However we need to take into account the risk that the convertibility law might come to an end. Mitigation: The risk can be decreased by setting up binding financial contracts with the governmetn to make sure the deal will happen. Furthermore Dow could decide to place a put option on the peso to protect themselves when the peso collapses. Operating risk Pre-completion: as the project is already completed there is no risk concerning the technology risks or other completion risk. Post-completion: we have included the post-completion risk in our cashflows as we run the risk of not meeting the full operating capacity. For the first 3 years we keep the operating rate of the plant at 65% and from 1995 we increase the operating rate by 5% each year. As the company provides their own input this risk does not need to be taken into account. Operating risk would likely matter but we handled that risk by adjsuting down our casfhlows in stage 1 so we do not take it into account for adjusting our cost of capital Sovereign risk Politcal events suchs as wars, labor strikes, terrorism and changes in laws can happen in any country you work with and therefore needs to be taken into account. Since it is hard to quantify this risk we have handled it through the discount rate. Appendix 2 | | Source: Erb, Harvey Viskanta, ‘Poltical risk,Economic risk and Financial risk’, Fuqua School of Business Working Paper No. 9606, 1996. | ——————————————– [ 1 ]. For broader explanation of the different risks see Appendix 1 [ 2 ]. According to the Global Corruption Index by Transparancy international the level of corruption for Argentina in 1995 was given a 5. 24 out of a possible score of 10. This gave them a ranking of 24 out of 42 countries surveyed. All of which were developed countries more or less. Source: http://archive. transparency. org/policy_research/surveys_indices/cpi/previous_cpi [ 3 ]. See Appendix 1 for an explanation of the mitigating factors of the before mentioned risks [ 4 ]. This conclusion was reached byTaking the ‘total assets’ as net worth on the financial statements of Perez on Copesul (exhibit 8a 8b). How to cite Dow Pbb, Essay examples

Sexually Transmitted Infection of Justin †MyAssignmenthelp.com

Question: Discuss about the Sexually Transmitted Infection of Justin. Answer: Introduction The paper deals with the case study of Justin. On placement in a students health clinic at a local university, a 24 year old male student, named Justin is presented. He notices some worrying symptoms including blisters on his penis. The patient has not experienced these symptoms in the past. Upon investigation, the client revealed that the he had sex including oral sex three times in last 24 hours. The patient reported that he had not used condoms as his partner informed him that the STD screen was clean for everything. In response to the case study, the assignment discusses the sexually transmitted infection (STI) that Justin is highly likely to suffer. In the context of the STI chosen the assignment will address the pathophysiology of this STI, the assessment and management of this STI, ethico-legal issues that may arise with the diagnosis of an STI. Further, the assignment will discuss the role of the sexual health team members involved in the management of Justin. Lastly, the ed ucation needs for Justin to prevent further STIs are outlined. STI Justin has been practicing unsafe sex and is experimenting with his sexuality. Because of his unsafe sex practices, he is at risk of developing Genital herpes. It is one of the most common STIs. Pathophysiology of this STI Genital herpes is caused by the Herpes simplex virus (HSV) and in most cases HSV type 2 is responsible for the disease. HSV-1 is often the cause of fever blisters or cold sores (Garland Steben, 2014). However, the patient denies the history of cold sores on his mouth or sore around his genitals before. His case history highlights that he rarely practices the safe sex, thus the blisters on penis in such situations is mainly caused by the genital herpes. Genital herpes is easily transmitted through sexual contact and may happen even if the concerned person is containing virus without exhibiting the related signs or symptoms (Schiffer Corey,2014). As the virus enters the skin it travels along the nerve path, where it can become dormant and persist there indefinitely. Both HSV 1 and HSV 2 infections occur by contacting the infectitious secretions on oral, anal and genital mucosal surfaces. Contacting other anatomical site such as eyes, non-mucosal surfaces, such as lesions on the butto cks and trunk can also cause genital herpes. In this type of viral infection, the symptoms may appear months after the initial exposure. The mucous membrane lines the opening of the body, which is the door to the viruses. The primary infection is characterised with the small blisters on genital areas that may burst to leave open sores. Genital herpes mainly affect genitals, mouth, and anal region (Johnston Corey, 2016). Assessment and management of this STI Diagnosis of genital herpes includes several tests. PCR blood tests are used to look for pieces of viral DNA. This is most common test and is accurate. The health care providers may collect sample from sores for cell culture and can be observed under microscope for HSV (Liu et al., 2015). Both the tests have a chance of giving false results, if the patient has started to recover recently. Antibodies against HSV do not show up until several weeks and it is difficult to identify the time of exposure or noticeable exposure. With the help of the direct fluorescent antibody testing, it is easy to detect the glowing antibodies that stick to the viral antigens in the sample. This testing is useful to differentiate between the HSV 1 and HSV 2. Overall, the clinical diagnosis has low sensitivity and specificity (LeGoff et al. 2014). Nurses can asses for impaired skin integrity that is related to skin inflammation, vesicles and crusting. Further assessments include hyperthermia indicating increased hypothalamic set point, fatigue due to decrease in energy source and risk of imbalanced nutrition pertaining to appetite down and lastly acute pain that may be caused by the infection in pain neurons. Based on the assessment HSV is diagnosed (Posavad e al., 2017). According to Fife et al. (2015), daily suppressive treatment with valaciclovir can reduce HSV-2transmission. This drug was investigated among HSV-2 discordant heterosexual couples. The infection was reduced by 75%, for clinical disease and reduces the acquisition (measured by serology) by 48%. Development of vaccine effective against this disease is not been found. Antiviral treatment is helpful and commonly prescribed medication include- Zovirax, Famvir, Valtrex, which are known to prevent outbreak. Antiviral medicine should be taken daily and it makes the living easier. These medicines can be taken as pill. According to the guidelines of WHO for adolescents with a first clinical episode of genital HSV infection, a standard dose of aciclovir over valaciclovir or famciclovir is recommended (Sands-Lincoln Goldmann, 2016). The dosages are as follows- aciclovir 400 mg orally thrice daily for 10 days aciclovir 200 mg orally five times daily for 10 days valaciclovir 500 mg orally twice daily for 10 days famciclovir 250 mg orally thrice daily for 10 days Intermittent therapy can consist of antiviral therapy for five or ten days. Suppressive treatment for recurrent infections includes taking the antiviral drugs everyday and is given for six outbreaks a year (Bibbins-Domingo et al., 2016). Therefore, the dosage may be like- aciclovir 400mg orally thrice daily for 5 days 800mg twice daily for 5 days, 800mg thrice daily for 2 days Legal and/or ethical issues that may arise with a diagnosis of an STI Diagnosing and management of HSV involves use of several medical equipments and processes. The circumstances under which it is conducted may raise ethical or legal concerns. The ethical issues that may arise in this case are the patient safety, informed consent, and confidentiality. The care providers must strictly follow the four principles of ethics such as beneficence, maleficence, social justice and respect for autonomy (Scott, 2014). Administering the patients with medicines that are not examined may lead to adverse outcomes and may be as fatal as death. Breaking the protocol of patient safety may cause ethical issues particularly in Expedited Partner Therapy. This act may cause legal consequences on the ground of professional negligence. It may lead to legal lawsuit against the hospital, claiming for compensation for heath loss. If the patient fails to provide informed consent regarding the choice of the treatment then the care provider fails to make clinical decision. Initiating treatment without taking informed consent may have adverse complications. It is considered the breach of patents autonomy, respect and dignity. Patients should be informed about availability of testing of HSV, treatment and lack of sensitivity and specificity of antiviral drugs. In Australia, federal government sets regulations on use of blood tests and genetic tests using human subjects (Todres, 2017). In case one the partners visits the clinic together and the infection of one of them is revealed, the relationship may be compromised. If the partner hides the information, it may lead to ethical and legal issues. Lawsuits are obvious when the potential partner allegedly gives them the herpes. Leaking the patients health information to third party may involve legal consequences as it may involve defamation and social stigmatisation. In case one partner does not want the information to be shared by the other partner, and if the request is denied it may lead to compromising of confidentiality and the patient may resort to legal help. Partners can also file lawsuits that their opposite consorts have given them herpes (Caulfield Willis, 2016)). Role of the sexual health team members involved in the management of Justin Nursing management include keeping the affected area clean and dry to keep away other infections. Sexual contact must be avoided until the sores are gone. Home care for management for Justin includes bathing in warm water, keep the area clean and wear comfortable clothing (Whitehead, 2017). Counselling the infected patients is best way to manage the disease. Justin must be counselled along with his potential partner to cope up with the infection. It will help prevent the sexual and perinatal transmission. Counselling is based on the natural sources of disease and asymptomatic shedding, first episode and recent infection, information pertaining to antiretroviral therapy and its impacts, successive therapy with recurrent infections. The patient should be educated about the side effects of the medicines. The rationale for counselling is to break the cycle of recurrent infections. It can be possible only if the patient has knowledge of the infection, and daily antiviral therapy (Davis et al., 2016). Management of the genital herpes not only involves dealing with the physical symptoms but also the psychological concerns. Patients often feel anxiety due to uncertainty related to disease and its curability. Anxiety related to denial and refusal from potential partners is the main cause of concern. Therefore, the sexual health team members should address the psychological concerns in this manner. Intervention for mental distress, anxiety and depression due to STI may include patient centered care and therapies such as Acceptance and commitment therapy or psychodynamic therapy. Justin can be engaged in relaxing or recreational activities such as exercise, sports or anything that can calm his mind (Jayasuriya et al., 2015). Education needs for Justin to prevent further STI's The patient must be educated about safe sex and severe disorders associated with the genital herpes. The rationale for the education is to prevent the recurrent infections. The consequences are worst when the infection is spread to mouth, eye and central nervous system. Justin must be aware of the fact that the risk of HIV infection is doubled in the people diagnosed with genital herpes (HSV 2). The use of condoms can prevent the herpes virus infection. Justin must be informed to use condoms when meeting new partners. The patient should be instructed to avoid sex during the lesions or prodromal symptoms. Most people are unaware of the HSV infection and those with history of STDs are highly likely to have genital herpes. It is because genital herpes are hard to spot. Therefore, Justin must learn to communicate with his partner about history of STDs and sexual history. Limiting the sexual partners is advisable for Justin, as it will reduce the risk of exposure to HSV and other STIs. As the patient has multiple sex partners, he should ensure that she is tested for genital herpes (Davis et al., 2016). Justin should be aware of consequences of sexual contact with partner who has genital sores. Oral sex is risky as the oral herpes may pass to the genitals through the process. Oral herpes causes sores are known to cause cold sores of fever blisters. Since, Justin frequently engages in orals sex he may be at high risk of future infection and he should be advised to receive oral sex from partners with cold sores. The patient may never have an outbreak but may be highly contagious to the sexual partner. Therefore, Justin should be advised to educate the same to his partners (Davis et al., 2016). According to McGregor et al. (2014) illicit drugs impairs judgment and lower inhibitions. During intoxication, people are less careful to practice safe sex, which may lead to adverse outcomes. Since, Justin is the regular, binge drinker he must be educated about adverse consequences of sex while intoxication. Conclusion Genital herpes is the significant public health issue as it can cause substantial morbidity if it is left untreated and undiagnosed. It is one of the most common STIs and is highly likely to occur in the people with unsafe sex practices. All the patients with ulcers in the genital area are suspected to have HSV. Overall, the clinical diagnosis has low sensitivity and specificity. Nursing assessment includes physical examination for the related symptoms. Although there is no exact cure for the illness, it can be effectively managed. The health care team must help the patient to cope up with the illness by education, counselling, medication and home care. In addition to the physical problems, the health care team must also deal with the psychological issues of the patient. Education and counselling will prevent of recurrent infections as well as risk of HIV. References Bibbins-Domingo, K., Grossman, D. C., Curry, S. J., Davidson, K. W., Epling, J. W., Garca, F. A., ... Mangione, C. M. (2016). Serologic screening for genital herpes infection: US preventive services task force recommendation statement.Jama,316(23), 2525-2530. Caulfield, P., Willis, D. (2016). Herpes simplex virus:to disclose or not to disclose.An exploration of the multi-disciplinary teams role in advising patients about disclosure when diagnosed with genital herpes simplex virus.International journal of STD AIDS, 0956462416665730. Davis, A., Roth, A., Brand, J. E., Zimet, G. D., Van Der Pol, B. (2016). Coping strategies and behavioural changes following a genital herpes diagnosis among an urban sample of underserved Midwestern women.International journal of STD AIDS,27(3), 207-212. Fife, K. H., Mugwanya, K., Thomas, K. K., Baeten, J. M., Celum, C., Bukusi, E., ... Lingappa, J. R. (2015). Transient Increase in Herpes Simplex Virus Type 2 (HSV-2)Associated Genital Ulcers Following Initiation of Antiretroviral Therapy in HIV/HSV-2Coinfected Individuals.The Journal of infectious diseases,213(10), 1573-1578. Garland, S. M., Steben, M. (2014). Genital herpes.Best Practice Research Clinical Obstetrics Gynaecology,28(7), 1098-1110. Jayasuriya, N. D. V., Sivayogan, S., Buddhakorale, K. (2015). Psychological impact due to genital herpes among Central STD Clinic attendees in Sri Lanka.Sri Lanka Journal of Venereology,5(1). Johnston, C., Corey, L. (2016). Current concepts for genital herpes simplex virus infection: diagnostics and pathogenesis of genital tract shedding.Clinical microbiology reviews,29(1), 149-161. LeGoff, J., Pr, H., Blec, L. (2014). Diagnosis of genital herpes simplex virus infection in the clinical laboratory.Virology journal,11(1), 83. Liu, J., Yi, Y., Chen, W., Si, S., Yin, M., Jin, H., ... Zhang, J. (2015). Development and evaluation of the quantitative real-time PCR assay in detection and typing of herpes simplex virus in swab specimens from patients with genital herpes.International journal of clinical and experimental medicine,8(10), 18758. McGregor, J. A., French, J. I., Jones, J., Perhach, M. (2014, June).crowdsourced analysis of gbs perinatal disease as a sexually transmissible infection (sti) underscores need for gbs vaccine and patient education regarding gbs as an sti to be able to make well-informed sexual practice choices. insexually transmitted diseases(vol. 41, pp. s147-s147). two commerce sq, 2001 market st, philadelphia, pa 19103 usa: lippincott williams wilkins. Posavad, C. M., Zhao, L., Dong, L., Jin, L., Stevens, C. E., Magaret, A. S., ... Koelle, D. M. (2017). Enrichment of herpes simplex virus type 2 (HSV-2) reactive mucosal T cells in the human female genital tract.Mucosal immunology. Sands-Lincoln, M., Goldmann, D. R. (2016). Antiviral Drugs to Prevent Clinical Recurrence in Patients with Genital Herpes.The American Journal of Medicine,129(12), 1264-1266. Schiffer, J. T., Corey, L. (2014). Herpes simplex virus. InMandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. Elsevier Inc.. Scott, P. A. (2014). Unsupervised self-testing as part public health screening for HIV in resource-poor environments: some ethical considerations.AIDS and Behavior,18(4), 438-444. Todres, J. (2017). Physician encounters with human trafficking: legal consequences and ethical considerations. Whitehead, L. (2017). First-episode genital herpes: interventions for men and women.Nursing Standard,31(22), 40-41.