A Speech Given By Simon Sinek - 1489 Words

Recently, there has been debates on the topics of millennials and technology. When it comes to these topics, one side says that it is making the younger generation addicted to them or that millennials are lazy, entitled, and narcissistic. In the other side, we have others saying that technology has helped become more advanced or that millennials are, in fact, beneficial to society as they changed the workplace and such. In a speech given by Simon Sinek, titled â€Å"Millennials in the Workplace,† he argues that due to how millennials were brought up, it affected their way of responding to challenges in their lives, such as stressors, and how they functioned in the workplace. My own view is that due to the way millennials were raised and the†¦show more content†¦Another point Sinek (2016) mentions is about how technology is a source of dopamine for these millennials, backing up his reasoning with a study done by Harvard research scientist. He states, â€Å"†¦an e ntire generation now has access to an addictive, numbing chemical called dopamine, through cell phones and social media, while they are going through the high stress of adolescence†¦Ã¢â‚¬  (2017, 4:31). In other words, due to devices being sources of dopamine, it is easy to become addicted to them as dopamine is the same chemical that released when smoking or drinking. As Sinek (2016) also said, â€Å"what’s happening is because we’re out allowing unfettered access to the dopamine producing devices and media. Basically, it’s becoming hardwired and what we’re seeing is, as they grow older, too many kids don’t know how to form deep, meaningful relationships. Their words, not mine,† (5:33). The essence of Sinek’s point is that, as he would hear others say, due to growing up with unrestricted access to devices and social media, kids do not know how to form true friendships and deep relationships with others. They end up not having r elationships or friendships where they can rely on the support of their partner or friend, as Sinek (2016) addresses. Due to using technology as a way to cope with stress, the relationship people have with others aroundShow MoreRelatedMillennials And Technology1194 Words   |  5 Pageschanged the workplace and such. In a speech given by Simon Sinek, titled â€Å"Millennials in the Workplace,† he argues that due to how millennials were brought up, it affected their way of responding to challenges in their lives, such as stressors, and how they functioned in the workplace. My own view is that due to the way millennials were raised and the environment we have around us, it truly affects how we work and function in the real world. In his speech, Simon Sinek (2016) addresses four pieces thatRead MoreSimon Sinek Speech1560 Words   |  7 PagesIn Simon Sinek speech â€Å"Millennials in the workplace interview† Simon humorously explains using past and personal experiences that millennials are a great and fantastic generation. They have become an addictive generation because of bad parenting, technology, impatience, and the environment and the only way to change this generation is if they are given help to balance physical and social lives. I would agree with this because I too suffer from an unbalanced physical and social life. At the startRead MoreSimon Sinek - How Great Leaders Inspire Action3157 Words   |  13 PagesSIMON SINEK – How Great Leaders Inspire Action How do you explain when  things don t go as we assume?  Or better, how do you explain when others are able to achieve things  that seem to defy all of the assumptions?  For example:  Why is Apple so innovative?  Year after year, after year, after year,  they re more innovative than all their competition.  And yet, they re just a computer company.  They re just like everyone else.  They have the same access to the same talent,  the same agencies, the same

Footnote to Youth Free Essays

Short story of how my brother leon brought home a wife? An Award Winning Publisher Looking for New Writers www. RaiderPublishing. com How my brother Leon brought home a wife is a short story by author Manuel E. We will write a custom essay sample on Footnote to Youth or any similar topic only for you Order Now Arguilla. Manuel E. Arguilla was well known for his short stories such as this story and many of his works were published throughout the 1940s especially. Arguilla lived between 1911 and 1944, at which point he was captured, tortured and killed by the Japanese army. The story ‘How my brother Leon brought home a wife’ is perhaps the most successful and popular of Arguilla’s short stories. The story is written from the point of view of a young boy called Baldo and his recollections of the night that he met his brother’s wife, Maria, for the first time. The story is descriptive and eloquently written and makes you feel as though you were there yourself. The story starts with Baldo meeting Leon and Maria and how he took them on a ride home through the fields near their home on a cart pulled by their family bull. The story describes the smell, look and feel of the fields and the surrounding areas and speaks well of Maria, describing her as gentle and full of laughter. It becomes apparent that Leon is taking Maria to meet his family for the first time, and she is nervous about meeting them, his father especially. As the story continues Baldo, Leon (who is called Noel in the story as this is Maria’s nickname for him, Baldo presumes that this is because Noel is Leon backwards) and Maria all arrive at the family home. The story ends with the three of them entering the father’s room upstairs and they begin talking to him. If you would like to read the story yourself you can follow this link to read the story yourself. Analysis Footnote To Youth Footnote to Youth By Jose Garcia Villa 1. Explain the title. In what way is it suitable to the story? Footnote to youth is the title of the story. It is said that it is a footnote to youth because it is abrief reminder for the Filipinos especially the youth of what a real life could be today. It also indicatesthe sources or the causes why youth act this way. It furthermore adds comment, whether it is apositive or negative, on today’s generation. Yes it is suitable to the story because it gives a warningfor those apathetic youth that ones committed mistake because of their stubbornness. . What is the predominant element in the story- plot, theme, character, and setting? Explain. The predominant element on this story is the character and the setting. The setting has a greatimpact because the story definitely empathizes the situations of a Filipino person and it is appealingfor us because we are at the poverty line. The setting is most likely the same setting as today. Alsothe ch aracters, because characters had their own definite description, their conversation is differentfrom one another, and they act as unique as their personality it enhances the story even more. Theact of the characters seems to bring up the whole story. 3. Who is the single main character about whom the story centers? Explain. The story centers at the character of Dodong. Dodong is the one who represents the typicalyouth that experiencing a lot of uncertainties in life that make him realize that he sacrifice his youthjust for the sake of proving himself that he can manage his own life because he is matured enough toface this life’s challenges. 4. What sort of conflict confronts the leading character or characters? Explain. Internal conflict confronts the leading character. Internal character in a way that he wasstruggling if he can managed himself to have a family because he knows that he is in the legal agethat he can be independent and can definitely choose the right from wrong. But†¦ â€Å"Footnote to Youth† was written by Jose Garcia Villa. Story: The sun was salmon and hazy in the west. Dodong thought to himself he would tell his father about Teang when he got home, after he had unhitched the carabao from the plow, and let it to its shed and fed it. He was hesitant about saying it, but he wanted his father to know. What he had to say was of serious import as it would mark a climacteric in his life. Dodong finally decided to tell it, at a thought came to him his father might refuse to consider it. His father was silent hard-working farmer who chewed areca nut, which he had learned to do from his mother, Dodong’s grandmother. I will tell it to him. I will tell it to him. The ground was broken up into many fresh wounds and fragrant with a sweetish earthy smell. Many slender soft worms emerged from the furrows and then burrowed again deeper into the soil. A short colorless worm marched blindly to Dodong’s foot and crawled calmly over it. Dodong go tickled and jerked his foot, flinging the worm into the air. Dodong did not bother to look where it fell, but thought of his age, seventeen, and he said to himself he was not young any more. Dodong unhitched the carabao leisurely and gave it a healthy tap on the hip. The beast turned its head to look at him with dumb faithful eyes. Dodong gave it a slight push and the animal walked alongside him to its shed. He placed bundles of grass before it land the carabao began to eat. Dodong looked at it without interests. Dodong started homeward, thinking how he would break his news to his father. He wanted to marry, Dodong did. He was seventeen, he had pimples on his face, the down on his upper lip already was dark-these meant he was no longer a boy. He was growing into a man–he was a man. Dodong felt insolent and big at the thought of it although he was by nature low in statue. Thinking himself a man grown Dodong felt he could do anything. He walked faster, prodded by the thought of his virility. A small angled stone bled his foot, but he dismissed it cursorily. He lifted his leg and looked at the hurt toe and then went on walking. In the cool sundown he thought wild you dreams of himself and Teang. Teang, his girl. She had a small brown face and small black eyes and straightglossy hair. How desirable she was to him. She made him dream even during the day. Dodong tensed with desire and looked at the muscles of his arms. Dirty. This field work was healthy, invigorating but it begrimed you, smudged you terribly. He turned back the way he had come, then marched obliquely to a creek. Dodong stripped himself and laid his clothes, a gray undershirt and red kundiman shorts, on the grass. The he went into the water, wet his body over, and rubbed at it vigorously. He was not long in bathing, then he marched homeward again. The bath made him feel cool. It was dusk when he reached home. The petroleum lamp on the ceiling already was lighted and the low unvarnished square table was set for supper. His parents and he sat down on the floor around the table to eat. They had fried fresh-water fish, rice, bananas, and caked sugar. Dodong ate fish and rice, but didnot partake of the fruit. The bananas were overripe and when one held them they felt more fluid than solid. Dodong broke off a piece of the cakes sugar, dipped it in his glass of water and ate it. He got another piece and wanted some more, but he thought of leaving the remainder for his parents. Dodong’s mother removed the dishes when they were through and went out to the batalan to wash them. She walked with slow careful steps and Dodong wanted to help her carry the dishes out, but he was tired and now felt lazy. He wished as he looked at her that he had a sister who could help his mother in the housework. He pitied her, doing all the housework alone. His father remained in the room, sucking a diseased tooth. It was paining him again, Dodong knew. Dodong had told him often and again to let the town dentist pull it out, but he was afraid, his father was. He did not tell that to Dodong, but Dodong guessed it. Afterward Dodong himself thought that if he had a decayed tooth he would be afraid to go to the dentist; he would not be any bolder than his father. Dodong said while his mother was out that he was going to marry Teang. There it was out, what he had to say, and over which he had done so much thinking. He had said it without any effort at all and without self-consciousness. Dodong felt relieved and looked at his father expectantly. A decrescent moon outside shed its feeble light into the window, graying the still black temples of his father. His father looked old now. â€Å"I am going to marry Teang,† Dodong said. His father looked at him silently and stopped sucking the broken tooth. The silence became intense and cruel, and Dodong wished his father would suck that troublous tooth again. Dodong was uncomfortable and then became angry because his father kept looking at him without uttering anything. â€Å"I will marry Teang,† Dodong repeated. â€Å"I will marry Teang. † His father kept gazing at him in inflexible silence and Dodong fidgeted on his seat. â€Å"I asked her last night to marry me and she said†¦ yes. I want your permission. I†¦ want†¦ it†¦. † There was impatient clamor in his voice, an exacting protest at this coldness, this indifference. Dodong looked at his father sourly. He cracked his knuckles one by one, and the little sounds it made broke dully the night stillness. â€Å"Must you marry, Dodong? † Dodong resented his father’s questions; his father himself had married. Dodong made a quick impassioned easy in his mind about selfishness, but later he got confused. â€Å"You are very young, Dodong. † â€Å"I’m†¦ seventeen. † â€Å"That’s very young to get married at. † â€Å"I†¦ I want to marry†¦ Teang’s good girl. † â€Å"Tell your mother,† his father said. â€Å"You tell her, tatay. † â€Å"Dodong, you tell your inay. † â€Å"You tell her. † â€Å"All right, Dodong. † â€Å"You will let me marry Teang? â€Å"Son, if that is your wish†¦ of course†¦ † There was a strange helpless light in his father’s eyes. Dodong did not read it, too absorbed was he in himself. Dodong was immensel y glad he had asserted himself. He lost his resentment for his father. For a while he even felt sorry for him about the diseased tooth. Then he confined his mind to dreaming of Teang and himself. Sweet young dream†¦. Dodong stood in the sweltering noon heat, sweating profusely, so that his camiseta was damp. He was still like a tree and his thoughts were confused. His mother had told him not to leave the house, but he had left. He had wanted to get out of it without clear reason at all. He was afraid, he felt. Afraid of the house. It had seemed to cage him, to compares his thoughts with severe tyranny. Afraid also of Teang. Teang was giving birth in the house; she gave screams that chilled his blood. He did not want her to scream like that, he seemed to be rebuking him. He began to wonder madly if the process of childbirth was really painful. Some women, when they gave birth, did not cry. In a few moments he would be a father. â€Å"Father, father,† he whispered the word with awe, with strangeness. He was young, he realized now, contradicting himself of nine months comfortable†¦ â€Å"Your son,† people would soon be telling him. â€Å"Your son, Dodong. † Dodong felt tired standing. He sat down on a saw horse with his feet close together. He looked at his callused toes. Suppose he had ten children†¦ What made him think that? What was the matter with him? God! He heard his mother’s voice from the house: â€Å"Come up, Dodong. It is over. † Of a sudden he felt terribly embarrassed as he looked at her. Somehow he was ashamed to his mother of his youthful paternity. It made him feel guilty, as if he had taken something no properly his. He dropped his eyes and pretended to dust dirt off his kundiman shorts. â€Å"Dodong,† his mother called again. â€Å"Dodong. † He turned to look again and this time saw his father beside his mother. â€Å"It is a boy,† his father said. He beckoned Dodong to come up. Dodong felt more embarrassed and did not move. What a moment for him. His parents’ eyes seemed to pierce him through and he felt limp. He wanted to hide from them, to run away. â€Å"Dodong, you come up. You come up,† he mother said. Dodong did not want to come up and stayed in the sun. â€Å"Dodong. Dodong. † â€Å"I’ll†¦ come up. † Dodong traced tremulous steps on the dry parched yard. He ascended the bamboo steps slowly. His heart pounded mercilessly in him. Within, he avoided his parents eyes. He walked ahead of them so that they should not see his face. He felt guilty and untrue. He felt like crying. His eyes smarted and his chest wanted to burst. He wanted to turn back, to go back to the yard. He wanted somebody to punish him. His father thrust his hand in his and gripped it gently. â€Å"Son,† his father said. And his mother: â€Å"Dodong†¦ † How kind were their voices. They flowed into him, making him strong. â€Å"Teang? † Dodong said. â€Å"She’s sleeping. But you go in†¦ His father led him into the small sawali room. Dodong saw Teang, his girl wife, asleep on the papag with her black hair soft around her face. He did not want her to look that pale†¦ Dodong wanted to touch her, to push away that stray wisp of hair that touched her lips, but again that feeling of embarrassment came over him and before his parents h e did not want to be demonstrative. The hilot was wrapping the child, Dodong heart it cry. The thin voice pierced him queerly. He could not control the swelling of happiness in him. You give him to me. You give him to me,† Dodong said. * * * Blas was not Dodong’s child. Many more children came. For six successive years a new child came along. Dodong did not want any more children, but they came. It seemed the coming of children could not be helped. Dodong got angry with himself sometimes. Teang did not complain, but the bearing of children told on her. She was shapeless and thin now, even if she was young. There was interminable work to be done. Cooking. Laundering. The house. The children. She cried sometimes, wishing she had not married. She did not tell Dodong this, not wishing him to dislike her. Yet she wished she had not married. Not even Dodong, whom she loved. There has been another suitor, Lucio, older than Dodong by nine years, and that was why she had chosen Dodong. Young Dodong. Seventeen. Lucio had married another after her marriage to Dodong, but he was childless until now. She wondered if she had married Lucio, would she have borne him children. Maybe not either. That was a better lot. But she loved Dodong†¦ Dodong whom life had made ugly. One night, as he lay beside his wife, he roe and went out of the house. He stood in the moonlight, tired and querulous. He wanted to ask questions and somebody to answer him. He w anted to be wise about many things. One of them was why life did not fulfill all of Youth’s dreams. Why it must be so. Why one was forsaken†¦ after Love. Dodong would not find the answer. Maybe the question was not to be answered. It must be so to make Youth. Youth. Youth must be dreamfully sweet. Dreamfully sweet. Dodong returned to the house humiliated by himself. He had wanted to know a little wisdom but was denied it. * * * When Blas was eighteen he came home one night very flustered and happy. It was late at night and Teang and the other children were asleep. Dodong heard Blas’s steps, for he could not sleep well of nights. He watched Blas undress in the dark and lie down softly. Blas was restless on his mat and could not sleep. Dodong called him name and asked why he did not sleep. Blas said he could not sleep. â€Å"You better go to sleep. It is late,† Dodong said. Blas raised himself on his elbow and muttered something in a low fluttering voice. Dodong did not answer and tried to sleep. â€Å"Itay †¦ ,† Blas called softly. Dodong stirred and asked him what was it. â€Å"I am going to marry Tena. She accepted me tonight. † Dodong lay on the red pillow without moving. â€Å"Itay, you think it over. † Dodong lay silent. â€Å"I love Tena and†¦ I want her. † Dodong rose f ROM his mat and told Blas to follow him. They descended to the yard, where everything was still and quiet. The moonlight was cold and white. â€Å"You want to marry Tena,† Dodong said. He did not want Blas to marry yet. Blas was very young. The life that would follow marriage would be heard†¦ â€Å"Yes. † â€Å"Must you marry? † Blas’s voice stilled with resentment. â€Å"I will marry Tena. † Dodong kept silent, hurt. â€Å"You have objections, Itay? † Blas asked acridly. â€Å"Son†¦ n-none†¦ † (But truly, God, I don’t want Blas to marry yet†¦ not yet. I don’t want Blas to marry yet†¦. But he was helpless. He could not do anything. Youth must triumph†¦ now. Love must triumph†¦ now. Afterwards†¦ it will be life. As long ago Youth and Love did triumph for Dodong†¦ and then Life. Dodong looked wistfully at his young son in the moonlight. He felt e xtremely sad and sorry for him. Characters: 1. Dodong – main character of the story who got married at the age of 17 2. Teang – regretted marrying at an early age 3. Lucio – Teang’s other suitor who got married after she did and who’s childless until now 4. Blas – Dodong and Teang’s oldest son who followed their footsteps in the end. Blas contemplated to marry Tona when he was 18 5. Tona – woman whom Blas wants to marry. Summary: Dodong wanted to marry Teang and asked his father’s permission. Thinking that since they are young, their love would be short, he allowed them to get married. After nine months, Teang gave birth to a child named Blas. For six consecutive years, a new child came along. Teang did not complain even thought she secretly regretted being married at an early age. Sometimes she even wondered if she would have the same life if Lucio, her other suitor who was nine years older than Dodong, was the one she married. Lucio has had no children since the time he married. When Teang and Dodong were twenty they looked like they were fifty. When Blas was 18, he told his father that he would marry Tona. Dodong did not object, but tried to make Blas think twice before rushing to marriage – because Dodong doesn’t want Blas to end up like him. *** It simply tells the story of an older person who made a mistake in the past who ended up with a not so pleasurable life. Then he had a son who is like him when he was young. His son is hasty in making the decision to get married, just like he was when he was 17. Despite this, Dodong did not – and How to cite Footnote to Youth, Papers

Neuroscience Nursing Subarachnoid Hemorrhage

Question: Discuss about theNeuroscience Nursing: Subarachnoid Hemorrhage. Answer: Rupture of the Middle Cerebral Artery aneurysm with a Subarachnoid Hemorrhage Rupture of the Middle Cerebral Artery aneurysm results in the development of approximately 80% of the cases of subarachnoid hemorrhage that are non-traumatic. These aneurysms predominantly develop at the branching points or vessel bifurcations. Middle cerebral artery aneurysm is a type of intracranial aneurysm (also known as berry aneurysms) and most of these occur near or within the circle of Willis (Wen et al. 2012, pp.688-699). However, the most common location of the intracranial aneurysms is at the anterior communicating artery and the middle cerebral artery bifurcation and collectively constitutes about 60% of the overall aneurysms. 10 20% of the aneurysms develop at the basilar and vertebral arteries (Zanaty et al. 2014, pp.381-387). Subarachnoid hemorrhage is responsible for about 6% of the cases of strokes and affects about 6 to 9 people in a population of 100,000. About 85% of the patients suffer bleeding due to intracranial aneurysms and 10% from the non-aneurysmal and pr ei-mesencephalic hemorrhage (Pierot et al. 2013, pp.27-35). 5% of the bleeding is attributed to the vascular abnormalities that include vasculitis, arteriovenous malformation and tumor-associated abnormal blood vessels. The mean age of occurrence is 50 years, affects the younger population and women are at a higher risk compared to men for subarachnoid hemorrhage (Kalani et al. 2013, pp.428-436). Furthermore, numerous researches have been carried out till date on subarachnoid hemorrhage however, limited study has been conducted to explain the neurosurgical interventions of middle cerebral artery aneurysm with a subarachnoid hemorrhage. In this assignment, the researcher will carry out an extensive literature review to determine the neurological interventions of middle cerebral artery aneurysm with a subarachnoid hemorrhage from the primary sources. Diringer (2009, p.432) carried out a study to demonstrate the management of the subarachnoid hemorrhage due to the rupture of the intracranial aneurysm. The article has demonstrated a detailed encounter of the pathological condition with the prevailing consequences and the required interventions. Neurological interventions presented in this article included neurological function assessment with angiography preparation. Neurological deterioration has been identified as the chief symptom of the disorder with seizures. This article was beneficial in understanding the condition from the neurological aspect however, much attention was not given to the management of the disease from the neurological perspectives with a deeper understanding of the various parameters of intervention. Similarly, The complications of the disease and their management have been well discussed with provision of the early clinical care management with common pharmacological interventions The main arguments raised by the article stated that blood vessels get constricted because of the pathological changes, relaxation of the intracranial arteries are impaired followed by the narrowing of the lumen and thickening of the wall. These results in a decrease in the cerebral blood flow that causes infarction and ischemia. The article has well explained the pathophysiology that was well supported by the medical intervention which stated that catheter angiography and transcranial Doppler can be employed for measuring the velocities of blood flow. On the other hand, the management can be done by several prophylactic measures and nimodipine is the preferred pharmacological intervention for vasospasm. Lumbar CSF draining has been the proposed non-pharmacological intervention for preventing the accumulation of blood in the subarachnoid space and reduces the risk of occurrence of vasospasm. In contrast with the previous article, another similar article by Connolly et al. (2012, pp.1711-1737) took the argument forward for narrowing the gaps from the previous study by stating the guidelines related to the management of the aneurismal subarachnoid hemorrhage. One of the neurological interventions discussed in this article is cerebral angiography and it has been identified as a widely used technique for the condition. Although it has been accepted that computed tomographic angiography is the best intervention process for the treatment of aneurysm with surgical clipping, it is still a controversy to determine whether its usage is suitable in cases where endovascular therapy can be an alternative. The authors carried out an exceptionally detailed identification of the various technological specifications of the instruments and concluded that 3-dimensional cerebral angiography was found to be more effective and sensitive than its 2-dimensional counterpart. The article did a th orough discussion of the treatment of the cerebral aneurysms by pharmacological and non-pharmacological interventions. Medical measures should be adopted for the early treatment for reducing the risk of re-bleeding due to ruptured middle cerebral artery aneurysm. For this, acute hypertension resulting out of aneurismal subarachnoid hemorrhage has to be controlled with medications like nicardipine as it provides smoother control of blood pressure over sodium nitroprusside and labetalol. Antifibrinolytic therapy has also been found to be effective in reducing aneurysm re-bleeding in case of delayed aneurysm obliteration. Endovascular and surgical methods for the treatment of ruptured middle cerebral artery aneurysm includes microsurgical clip obliteration and the article provided sufficient evidence to support the efficacy of this method. Furthermore, arguments have been placed by the author stating that aneurysm recurrence and incomplete occlusion is critically dependent on the dome size and the neck diameter. Increasing the rate of complete obliteration is possible by the inclusion of high porosity stent, it should be supported with dual-antiplatelet periprocedural therapy for the prevention of the arterial thromboembolism. Microsurgical approaches with pure platinum coils are the method of choice for the current endovascular technology. It is difficult to treat middle cerebral artery aneurysm by the method of coil embolization and therefore, surgical treatment is the best possible option for its treatment. This article was very informative but lacked in several other aspects of nursing intervention for the treatment of the condition. An argument was put forward by Mery, Amin-Hanjani and Charbel (2008, pp.979-982) stated that the ICG (intraoperative indocyanine green) video angiography for the confirmation of aneurysm obliteration is not secure and there have been cases reporting rupture and growth of the angiographically obliterated aneurysms. ICG video angiography is a valuable tool that is employed when the features of aneurysms are complex and direct clipping becomes challenging. Its efficacy can also be compared with catheter intraoperative angiography. However, the study demonstrated that ICG had a false indication of the aneurysm obliteration and applies to the catheter angiography. Therefore, follow up on a long term basis is recommended with angiographic evaluation with cerebral angiogram for the securing of aneurysm. To discuss on the management of subarachnoid bleeding with special focus on normalizing cerebral perfusion pressure, a research work was conducted by Umamaheswara Rao (2007, p.12) to demonstrate the pharmacological management of traumatic brain injury based on cerebral perfusion pressure. The author demonstrated cerebral perfusion pressure as the difference between the intracranial pressure and the mean arterial pressure. Subarachnoid hemorrhage due to middle cerebral artery aneurysm is a form of brain injury and its management includes drainage of cerebrospinal fluid through ventriculostomy, systemic vasopressor and vascular expansion. On the other hand, pharmacological interventions include mannitol in the dose of 0.5-1.0g/kg for maintaining the cerebral perfusion pressure at 70mmHg and albumin infusions for mobilization of the extracellular water into the intravascular compartment. Norephinephrine or phenylephrine without or with dopamine is used for achieving the required mean ar terial pressure.. However, the non-pharmacological interventions were missing in this article and to research further on this aspect, the literature search was carried on. For carrying forward the argument, a similar study was carried out by (Meyer et al. 2010, pp.706-721) suggested some other pharmacological interventions for improving the neural recovery after the aneurysmal subarachnoid hemorrhage. The other pharmacological interventions include midazolam, opioids, barbiturates, propofol, and hypertonic saline. However, the researchers argued that the cannabinoids were found to be ineffective and the corticosteroids were reported to be contraindicated in the treatment of the condition. Similarly, the long term benefits from these interventions rarely resulted in the improved and long-term outcomes for the patient. This suggested that further investigation is required to identify the non-pharmacological interventions for the management. As a support and continuation to the previous study, Meyer et al. (2010, pp.694-705) carried out a review to determine the non-pharmacological interventions for managing and maintaining cerebral perfusion pressure and blood pressure. This study demonstrated the non-pharmacological interventions in alignment with the findings from the previous study and was a conglomeration of the findings from several other studies. The nursing interventions proposed in this study include adjustment of the head posture, rotation of the body position, hyperbaric oxygen, hypothermia and hyperventilation. Elevation of the head over the heart level reduces intracranial pressure by the facilitation of the venous outflow without adjusting the cardiac output and cerebral perfusion pressure. Therapy of continuous is used for avoiding the complications due to immobilization that includes pulmonary emboli, deep vein thrombosis and bedsores. Prone position increases cerebral perfusion pressure and oxygenation i n the patients with acute respiratory insufficiency. Hyperventilation causes cerebral vasoconstriction that leads to the reduction in cerebral blood volume and cerebral blood flow. Hypothermia is regarded as a neuro-protective strategy used for reducing cerebral damage due to aneurysm and it exerts the effects of neuro-protection by the reduction of neuronal metabolism. Subarachnoid hemorrhage might cause hypoxia and brain hypoperfusion and hyperbaric oxygen increases the partial pressure of oxygen that enters the brain for reducing the deleterious effects of hypoxia. On the other hand, two of the invasive procedures discussed in the study are decompressive craniectomy and cerebrospinal fluid drainage. Cerebral perfusion pressure is maintained by decompressive craniectomy by managing the elevated pressure through surgical removal of a section of the skull and limits the damage. Elevated cerebral perfusion pressure and blood pressure is controlled by ventricular cerebrospinal fluid d rainage and it is done with the insertion of catheters in the brain. Analyzing both the studies for pharmacological and non-pharmacological interventions, it can be stated that the different regions of the brain requires different cerebral perfusion pressure levels at different points of time after the rupture of the middle cerebral artery aneurysm with subarachnoid hemorrhage. Optimal cerebral perfusion pressure is an imaginary concept and the techniques of brain monitoring like cerebral microdialysis, monitoring of oxygen tension in brain tissues and jugular venous oximetry provides specific and complimentary information. Based on this, the best cerebral perfusion pressure and blood pressure is selected for maintenance for a patient over the time. The feasibility of the previous study was established by critically appraising the research work carried out by Damkliang et al. (2015, pp. 3365-3373) which stated that evidence-based care bundle could be an effective nursing intervention for the management of the aneurysmal subarachnoid hemorrhage. The non-pharmacological interventions learnt from this article were monitoring of end-tidal carbon dioxide, assessment frequency of blood pressure, respiratory rate and pulse rate and patient positioning. This argument was further carried over by Abd-Elsayed, Wehby and Farag (2014, pp.418-425) where the researchers stated that anesthetic management of intracranial aneurysm is possible to prevent hemorrhagic stroke. High blood pressure should be avoided to prevent aneurysm rupture and further damage and low blood pressure must be avoided to reduce the cerebral perfusion pressure. Similarly, the preferred colloid is albumin and erythropoietin has been effective in lowering the vasospasm incidence and delaying cerebral ischemia. For a patient suffering from ruptured middle cerebral artery aneurysm with subarachnoid hemorrhage, fluid and electrolyte management is another crucial intervention that forms a part of the neurosurgical management of the condition. To elaborate this fact, DSouza (2015, p.222) carried out a study on aneurysmal subarachnoid hemorrhage and its management through various interventions. Patients are likely to suffer from the fluid and electrolyte abnormalities in case of intracranial aneurysm as a part of neuroendocrine abnormalities. On the other hand, hyponatremia is a more common occurrence under such circumstances while hypernatremia is a lesser occurring sequence. Hyponatremia is a condition that co-exists due to two factors which includes syndrome of inappropriate antidiuretic hormone secretion and the syndrome of cerebral salt washing. Its etiology is has been considered as multifactorial and includes the elevated levels of natriuretic peptides, angiotensin-II, renin and hypoaldos teronism. Hypernatremia is also seen in the patients suffering from subarachnoid hemorrhage and is considered to be iatrogenic that is secondary to hypertonic saline or mannitol infusion. While hyponatremia is not associated with mortality, hypernatremia is associated with it. Solutions containing glucose should be avoided as hyperglycemia gets aggravates global and focal transient cerebral ischemia. Therefore, proper balance of fluid and electrolytes is essential in case of subarachnoid hemorrhage. In context to the neurological assessment and risk of aneurysmal subarachnoid hemorrhage, Taki et al. (2011, pp. 437-445) carried out a study to examine the poor outcomes of the treatment of the ruptured aneurysms with either endovascular treatment or microsurgery. It was a cohort study which demonstrated that the ischemic and thromboembolic events are the well known risks during the process of coiling. The other complications found were post coiling ischemic complications and post-clipping hemorrhagic complications that had an independent and significant impact on the poor outcome after the aneurysmal subarachnoid hemorrhage. Larger size of the aneurysms is associated with increased complication risks by modality and smaller aneurysms are difficult to treat with the application of coiling. The commonly used neurological assessments for aneurysmal subarachnoid hemorrhage are TCD (Transcranial Doppler) and NIRS (Near-Infrared Spectroscopy). It is difficult to perform neurological asse ssment in the patients who are in a state of unconsciousness (Budohoski et al. 2012, pp. 3230). To further progress the research, Guida et al. (2012, p.59) carried out a study to demonstrate that pregnancy is a risk factor in case of aneurysmal subarachnoid hemorrhage. It can be devastating for both the child and the mother if the condition occurs in times of pregnancy. Appropriate treatment and early diagnosis are the only ways to survive and therefore, in case of pregnant women presenting with acute headache, seizures, palsy or nuchal rigidity, the gynecologists and obstetricians should be familiar with these nosocomial entity. Involvement of a neuroradiologist and neurosurgeon will play an exceptionally crucial role in the management of aneurysmal subarachnoid hemorrhage in pregnant women. In such cases, endovascular coiling is most effective for reducing bleeding. Vasospasm is a major complication in case of aneurysmal subarachnoid hemorrhage and to explore the management of the condition, Gump and Laskowitz (2008, pp.354-360) carried out a study to identify and manage this post-hemorrhagic complication. Identification of vasospasms is carried out angiographically, by clinical signs of regional or focal ischemia and by significant reduction that is visible in the diameters of arterial lumen. The common risk factor for the development of vasospasm includes distribution and volume of the subarachnoid blood and the preventive measures are not effective. The treatment strategies adopted for the management of vasospasm includes angioplasty, hyperdynamic therapy and the intra-arterial injection of the vasodilators. However, the strategies of novel treatment focus on protection of the cerebrum, identification of the genetic factors that are predisposed towards vasospasm and targeting the inflammatory cascade components. This finding was further argued by Schmidt et al. (2010, pp.895-902) who proposed pharmacological management of vasospasm in case of post-aneurysmal subarachnoid hemorrhage. The researchers found that the intraarterial administration of milrinone and nicardipine requires using vasopressors for maintaining the arterial blood pressure. It was proved from the findings that even with higher doses of the vasoconstrictors, the mortality rate was low and systemic acidosis or the end organ ischemic damage was minimal. It also improved the efficiency of the cerebral vessels that were affected by vasospasm. From the review of the literatures, it is evident that ruptured middle cerebral artery aneurysm with subarachnoid hemorrhage is a global health burden with permanent disability and higher fatality rates. Considering the death rate and global burden of the disease from the past decade, there has been an increase in the routine mortality data that went on to include one-third of the population of the world. The overall prognosis is dependent on the volume of the delayed cerebral ischemia, rebleeding and initial bleed. Neurogenic pulmonary edema and cardiac manifestations are the severity of the condition (Miura et al. 2013, pp.519-521). Although extensive research has been done to investigate the identification and management of the condition, more research is needed for investigating the preventive measures for the occurrence of intracranial aneurysms and aneurysmal subarachnoid hemorrhages. Although appropriate neurological interventions are available, the mortality and morbidity rat es are high with multifactorial pathophysiology that is not yet understood (Rodrguez-Hernndez et al. 2013, pp.415-427). The body of evidence for the management of the condition is gradually expanding and several trials are ongoing that might bring about results for enhancing and improving the short term and long term patient outcomes. References Abd-Elsayed, A.A., Wehby, A.S. and Farag, E., 2014. Anesthetic management of patients with intracranial aneurysms.The Ochsner Journal,14(3), pp.418-425. Budohoski, K.P., Czosnyka, M., Smielewski, P., Kasprowicz, M., Helmy, A., Bulters, D., Pickard, J.D. 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