Task Two Cathy Ann Wilson-Bates Western Governors

Task Two Cathy Ann Wilson-Bates Western Governors University EVIDENCE-BASED PRACTICE & APPLIED NURSING RESEARCH EBP 1 Brenda Luther, PhD, RN January 25, 2012 Task Two Introduction: What I have learned about working with children in a chronic healthcare setting like dialysis is that they are resilient beings with the propensity for rapid changes in their medical condition. Children almost always surprise me in their unique description of symptoms and pain. Depending on their age, they may not be able to describe the symptoms they feel or tell me â€Å"where it hurts†.A simple ear ache may be described as a â€Å"drum in my ear† or may be observed with non verbal cues like tugging on the ear. Acute Otitis Media is seen quite often during the cold and flu season. Recent clinical guidelines suggest waiting twenty four to seventy two hours before beginning antibiotic therapy. Parents of children with symptoms of otitis media are accustomed to receiving a prescription for ant ibiotics before they leave the medical office. Adults as well are preconditioned for the little white slip of paper from their physician. You can read also Coronary Artery Disease Nursing Care PlanWaiting twenty four to seventy two hours to evaluate the need for antibiotics will definitely reduce the over-prescription of antibiotics as well as their efficacy. The waiting and watching of several days may seem like an eternity to a parent caring for a sick and crying child. Educating parents during routine visits to the physician office about the risks of over-prescribing antibiotics will help when the physician needs to discuss the possibility of waiting and evaluating before prescribing antibiotics.Providing a list of comfort measures parents can follow may help relieve the anxiety they have in caring for a sick child. Any comfort measure taken to reduce crying is helpful to the parent of a sick child, but mostly to the child. The following table and paragraphs will share the results of how one group of nurses at an outpatient clinic used clinical evidence to manage this situation. Source |Type of Resource |Source appr opriate or |Type of Research | | |general information, |inappropriate |primary research evidence, | | |filtered, or unfiltered | |evidence summary, evidence-based | | | | |guideline, or none of these | |American Academy of Pediatrics and American Academy of|Filtered |Appropriate |Evidence-based guideline | |Family Physicians. Clinical practice guideline: | | | | |Diagnosis and management of acute otitis media. | | | |Causative pathogens, antibiotic resistance and |Unfiltered |Appropriate |Evidence-based guideline | |therapeutic considerations in acute otitis media. | | | | |Pediatric Infectious Disease Journal. | | | | |Ear, nose, and Throat, Current pediatric diagnosis and|General |Inappropriate |None of these | |treatment. | | | | |Treatment of acute otitis media in an era of |Filtered |Appropriate |Evidence –based guideline | |increasing microbial resistance.Pediatric Infectious| | | | |Disease Journal | | | | |Results from interviews with parents who have brought |Unfilte red |Appropriate |Primary research evidence | |their children into the clinic for acute otitis media. | | | | | | | | | Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 13 No 5 1451-1465. This article is an evidence-based clinical guideline. It is a systematic review making it a filtered resource which is very appropriate for this situation. The article describes the current, (as of 2004) recommendations for the diagnosis and management of Acute Otitis Media (Subcommittee on Management of Acute Otitis Media, 2004). These guidelines show several different ways to treat acute otitis media depending on the symptoms of the child. It states that sometimes waiting to give antibiotics is good and sometimes waiting to give antibiotics is not good. This article is appropriate and provides clarity on the topic. Block, S. L. (1997).Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media. The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. This article discusses antibiotic resistance and describes the bacterial pathogens which are responsible for infections causing acute otitis media. This article is appropriate. It contains a comparison of studies performed based on the different types of bacteria which cause acute otitis media. It stresses the importance of identifying the bacteria causing the infection before giving antibiotics so that number one the bacteria can be eradicated and other bacteria will not become resistant (Block, 1997).PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lang. This textbook source contains general information on the ear, nose and throat. There is much more information here regarding basic anatomy and physiology as well as characteristics of the ear nose and throat. The information regarding otitis media is basic and not an appropriate source of research in this situation for three reasons. Number one, the information is very basic, number two, it does not give any up to date information on how to treat this type of infection, and number three there is too much non-relevant information.McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. This article is a review of the known etiologies that may cause acute otitis media. The article gives up to date information on therapeutic approaches when selecting an appropriate antibiotic therapy. We don’t practice â€Å"cookie cutter† medicine. The same prescription is not always right for all patients or all communities where some bacteria’s may be more prevalent than others (McCracken, 1998). This is appropriate information f or this group of people or community. media, P. o. (n. d. ).Interviews. (C. nurses, Interviewer) This set of interviews is simply raw data. General information can however provide great insight as to what is happening out in the community. For example, this information might shed light on the fact that if the parents are willing to hold off on antibiotics for example, would they be more likely to follow up and come back into the clinic when asked? The reaction of parents is dependent upon other several basic factors like finances, a belief system and possibly the ability to obtain transportation. Knowing how the community is going to respond to their choice may have a great effect on the decisions they make.When evaluating the findings of these sources cumulatively, one must first determine the causative pathogens infecting patients in this given community with acute otitis media. After pathogen determination we can determine which antibiotics may be most useful in eradicating the g iven bacteria. Careful selection of antibiotic therapy will reduce the propensity for antibiotic resistance. Watchful waiting may be a good thing from the perspective of increasing microbial resistance however we must always evaluate patients on their individual needs or on a patient by patient case. One size doesn’t always fit all. Patient education is the key to keeping the public informed of current practice.Physicians and Nurses need to be consistent in the lesson plan shared with patients and remain true to our scope of practice. Communication is essential between the physician, nurse and other multidisciplinary team members in order to provide the best care. There are many considerations in assessing if patients are able to withstand the waiting and evaluation period. Low income families are one example of how the waiting and watching method might not work. Parents may have to take time off work to come to clinic with a sick child. They might struggle finding money for the additional return trip to the clinic and may risk losing their job if they take more time off work.Many low income families may have already waited before seeking help thus creating their own watchful waiting period. They also may not be able to afford antibiotics and as a result may not give the full dose if symptoms have subsided. The perception is that they will save the medication for the next time symptoms arise. Confidentiality might be an issue in smaller communities. People tend to be concerned about neighbors and co-workers and some may not care to share their experience with others. This may be an issue for parents who don’t share custody as in the case of divorce. It is a greater issue when parents or partners don’t share the same fundamental values, especially those related to healthcare. Conclusion:Watchful waiting like the nurses in this clinic are looking at may be useful for some of the patients, but not all. Again, a one size fits all philosophy is not always appropriate in healthcare. Tools like algorithms may be helpful in determining the appropriateness for watching and waiting versus immediate action as determined by physical findings and social circumstances like parental adherence for follow up and ability to afford treatment. Whatever course you choose, watchful waiting or immediate antibiotics the best practice remains a plan of care based on the individual needs of our patients. References Block, S. L. (1997). Causative pathogens, antibiotic resistance and therapeutic considerations in acute otitis media.The Pediatric Infectious disease Journal , Volume 16 (4) pp 449-456. McCracken, G. H. (1998). Treatment of acute otitis media in an era of increasing microbial resistance. The Pediatric Infectious Disease Journal , Volume 17(6) pp576-579. media, P. o. (n. d. ). Interviews. (C. nurses, Interviewer) PE Kelley, N. F. (2006). Ear, Nose and. In M. L. W. W. Hay, Current Pediatric Diagnoisis and Treatment (pp. 459-492). Lan g. Subcommittee on Management of Acute Otitis Media. (2004). American Academy of Pediatrics and American Academy of Family Physicians. Clinical Practice Guidelines: Diagnosis and Manegment of Acute Otitis Media. American Academy of Pediatrics , Vol. 113 No 5 1451-1465.

Generals Die in Bed †Plot Essay

When he thought war contained glory and glamour, he finds himself wrong when his comrades start to die, beginning with Brown. A while later, he is emotionally affected when he kills a German with his bayonet. His emotional status worsens when another of his friend dies. The narrator then goes on leave for 10 days in England, where a prostitute makes him forget about the war. When he comes back, an attempt to raid the Germans takes place where the rest of his friends, except Broadbent dies. The general tells the new team that the Germans sank a hospital ship, and organizes another raid, this time to kill everyone. The narrator has wounded his foot, and discover that Broadbent was mortally wounded too. Broadbent’s leg is hanging by a string of flesh, but then dies by blood loss. Then the war is over. The recruits are told that the general lied, the Germans didn’t sink a hospital ship. It was a ship filled with weapons. He then realizes war is basically a chess game for the generals, and the soldiers are just young boys, listening to the orders, with meaningless ideals Wikipedia

History of jazz Essay

Jazz is a form of American music which began in the 20th century though it has some of the elements of songs which had evolved in the late 19th century. It originated from the African Americans who were living in the southern parts of United States. Jazz is a combination of African and European traditions of music. Jazz developed mainly due to the cultural experiences which were being experienced by the African American as a result of slavery. Jazz is believed to have originated from the slave songs which the African Americans used to sing while working on the plantations. Music marked an important part of the lives of the African Americans and greatly influenced the American music industry to this day. The rhythms of ragtime were expressions of perseverance and the passion for the African Americans or the slaves to get freedom. During this period, also blues had been introduced which were songs that reflected the tribulations and trials of slavery live. Cultural experiences that the African Americans went through formed the themes of most of the songs . A brief history of African music In the African culture, music is highly esteemed and forms part of the daily life of a native African. The rhythm used in African songs and the pitch makes the African language sophisticated especially for accurate translation by non Africans. Music in African culture since time immemorial was and is still widely used in ceremonies and celebrations. Songs are sung by clapping, dancing and singing natural responses. Most of the African songs are call and response songs and this is done on varying degrees thus resulting to hetrophonic results. Unlike in western music which is characterized by complexity and polyrhythm and also polymeters, African music often evokes response of physical movement and at times calling for conscious response altering. Africans adopted the European 2 and 4 bar format beats which led to the evolution of syncopation. This syncopation made the audiences to clap their hands, dance and even tap their feet with such emotion which had not been experienced before in American music. The African music transformed the American music industry to this day . Roots of jazz music In the wake of 16th century, Europeans were using African slaves as laborers as well as their servants. Europeans had settled in the western hemisphere where they were setting up shops. They had also settled in the south and central parts of America as well as the northern parts which were commonly referred as new word (today’s United States). Slaves were mostly situated at the Caribbean where they got exposure to the music styles of the European music and also the western instruments which were being used in those areas. The culture of South Americans also influenced greatly the African slaves who were spending most of their time in the islands waiting to be bought and taken to the Caribbean islands . During the 16th century, slave trade had not reached the northern parts of America but in 1610, the first group of slaves was taken to North America through New Orleans ports. In Orleans, the slaves were taken to the southern plantations while some of the wealthy Orleans purchased some of the slaves. In south Orleans, Christianity had taken root with Catholic Church being dominant. This gave the slaves exposure to the Christian activities and immediately a chord was formed between the slaves and the church. This was mainly influenced by the similarities which existed between the African ritual and the Catholic Church practices. It is also believed that the call and response known as the Gregorian chants used by the catholic church also contributed greatly to the form of music that developed among the African slaves. Exposure to the western music and their instruments and also the Catholic Church practices and the experiences the slaves were undergoing in the foreign land led to the evolution of a homogenized cultural music. The songs were used by the African slaves to ease the pain they were going through while in slavery . Slaves also used music to tell stories of their ordeals, to celebrate and also as a means of looking for relief in God. The resulting culturization of the slave music formed the basis for their songs of the already settled Americans which they marked as their â€Å"own new music†. Work songs, spiritual songs and hollers became the starting point of gospel music which was mainly extracted from the New Testament. Story telling blues were also formulated during this period and these are believed to be the roots of the jazz music. The blues consisted of soulful flatted notes and a syncopated rhythm which evolved to be the ragtime music. This form of music was becoming popular mostly in America during the period. The freeing of slaves after the civil war led to public awareness of the existence of blues as well as jazz music which had the origin of the African slaves thus a black culture. However, before this time, slaves who were living in New Orleans used to meet at Congo square where they used to do and dance to music and also to compete musically. The band which won the weekly competition was given sponsorship to an establishment which was organized by the black musicians. These bands formed the initial origin of jazz in the northern America. Due to their influence in New Orleans, the black musicians were offered jobs in whore houses in story Ville which ensured they obtained a living in this place . Though after the civil war most of the African slaves were freed and allowed limited access to education, finding a decent job was difficult since the rate of discrimination was still very high. New Orleans provided a working environment for the musicians which could be termed as being â€Å"supportive† which made this place to become the hot spot for music such as blues and jazz. Increasing awareness of this forms of music also formed the center for the â€Å"American† music especially in the United States. During this period, cheap pianos were being sold thus the black musicians had access to them mostly in the whore house especially in New Orleans. The pianos helped in providing rhythmic and also harmonic basis for bands to perform spontaneously for their clients. A single musician could also sing using the piano thus increasing the popularity of African jazz and blues. Solo artists were performing for the saloons and also bordellos . The first recognized and accepted form of jazz style to be performed in the United States was done by the small black marching bands which were from New Orleans which was later branded the Dixieland. This jazz style was used in funeral marches. This music was based on the western music beat structure which was mixed with traditional marching using brass brand instruments. The black musicians then broke into solos which were improvised around a theme which was melodic and this was done simultaneously. Joyous celebrations then followed the burial as they celebrated the new life of the deceased. The improvised polytonality belonging to the native Africans was widely recognized in the structures of the population of the whites in the United States. During this festival or burial march, coronet, trombone, trumpet, drums and clarinet instruments were being used. Another instrument which was used was the banjo which the Americans had adopted from the instruments of native Africans. As such, almost all of the American music was rooted or has its originality from the Africans who were mostly slaves. African culture provided a rich music background which was easily and quickly adapted by the Americans. Jazz was one of the most predominant forms of music which the population of the United States imitated from the Native Africans . Despite the wide acceptance of jazz in New Orleans, it was not regarded as legitimate music especially by the music industry in Chicago and New York among other parts in the United States. During the 19th century and early 20th century, the center for fine arts in United States was located in New York and it was supporting only the highly educated and widely traveled musicians. This â€Å"high society† usually considered musicians and artists from Europeans music school. However, during the civil war era, black influence in the music industry started to creep slowly to the entertainment scene in New York. This was aided by the formation of minstrel show elements like the vaudeville and others. Ragtime was introduced in the United States which combined the blue tones and syncopation utilization but it was resisted. The â€Å"polite† society highly resisted this form of music terming it to be vulgar, suggestive and filthy. It was refereed to as African belly dance and was dismissed as the edition of orgies from Africa. These people also viewed it as a sex dance thus increasing their resistance and they advocated for its banishment from a society which was â€Å"polite† . During this period, most of the blacks were migrating to New York City thus increasing the influence of ragtime and dance hall music and the shows as well. A recording industry was also introduced in this city where most of the black musicians were migrating to record their songs. This place was later named Harlem and it opened the stage which led to an upheaval in the music industry of New York as well as the whole world. This formed a major historic part of the music industry in the United States and the origin of jazz music in New York City and the larger United States. In some parts of the east coast, jazz and blues were not recognized as being legitimate despite its influence in New Orleans. This place like the New York was inhabited by the high society people of the east coast. A group of whites citing the name original Dixieland jazz band recorded the first jazz in New York in the year 1917. Being white, the band tried to commercialize the viability of jazz music and in so doing; they visited Europe with their new format of Dixieland. This group is today credited for the spread of jazz to most parts of the world. However, despite their visit to Europe in 1917, jazz music had entered Europe in 1914 through black musicians. Europeans were less discriminatory on racial basis and were paying the black musicians better than in the United States. The black migration to Europe led to the establishment of the â€Å"hot club† which was located in Paris. African musicians thus contributed greatly to the history and evolution of music industry in Europe as well as in Americas . In 1924, jazz was presented to the high society of New York during a contest. The performance of the jazz band was stunning to the American people although it was criticized by one of the personality known as Martin Williams who was highly respected and a jazz critic. This performance made jazz to be more accepted in America broadly than during the first attempt. The era of post First World War led to high migration of most black musicians to Mississippi from the South and they went up to Chicago. This led to Chicago becoming a jazz’s and blues center in United States in the 1920’s. The south side of Chicago was mostly occupied by blacks some of them musicians who had migrated form south. During this time, the whites who were living in the northern parts of Chicago learned about jazz sounds thus there was competition between the northern white jazz musicians and the southern side black musicians. This competition was usually supportive and friendly. These musicians were also given exposure through the advent of commercial radio and a recording industry. Afro American influence had also been made valid thus giving the musicians a wider scope for their careers. However, there was a segregation system in the United States which was unfair to the blacks. Despite this segregation system, the music of the blacks and the whites reduced the boundaries which had existed before and this ultimately led to the development of Chicago blue scenes in the 1930’s. This also led to development of urban blues in some parts of the United States. Jazz music which was originally from the African slaves and the later migration to various parts of the United States helped in the establishment and growth of the music industry in this country as well as the whole world . Conclusion African music had a great influence and it formed the foundation of most of the Americas music. Slavery and the later migration were some of the major factors which contributed to the development and the spread of jazz music as well as other forms of music like blues. The rich African culture and music background combined with their experiences while in slavery as well as the influence of western culture and their instruments gave rise to the introduction of jazz music which has continued to be one of the most sought music. Apart from the influence that African Americans had on the American music, this music also changed the entire music industry in America and in most parts of the world. Introduction of jazz music and other African styles led to a complete overhaul in the music industry in America and also in Europe. Furthermore, jazz music helped in bridging the gap between the blacks and the white especially in Chicago. African American music has played a major role in the music industry in the United States and is credited as being the root of most of the music styles in this country.

Small business managment Essay Example | Topics and Well Written Essays - 250 words

Small business managment - Essay Example These problems are all caused by having unmotivated employees who will jump, at any chance, to leave the company. In addition, the major fact that supports this is the high employee turnover rate (Robertson 316). Solutions include the downsizing of staff to reduce company expenses, closing down irrelevant divisions that are not performing well, consolidating positions and restructuring the staff (Robertson 316). All the above stated solutions are all solutions that can save a company at the edge of closure, but the best solution is that which includes increasing the motivation of the workers since they are the simple factors that can make or break a company. (Robertson 317) The C.E.O of Intermatic Inc. Miller proved beyond a reasonable doubt that a company may employ many tactics to save itself from failure, but the only best solution is to make the employees happy and comfortable and that will lead to success, and profitability of the

Analysis three macroeconomic factors in the UK and how do they affect Essay

Analysis three macroeconomic factors in the UK and how do they affect the profitability of Sainsbury company - Essay Example It can be stated that the GDP growth will positively impact towards improving the profitability of Sainsbury’s. GDP also positively impacts upon public spending which is a crucial aspect for a retail organisation such as Sainsbury’s as it can enable them to garner more profit. Though, slower growth of GDP can create unemployment, which can in turn affect Sainsbury’s profitability as new recruitment can be stopped by the organisation along with investing in any new purchases until the economy gets better (Economy Watch, 2009). Interest Rate and Inflation Rate UK interest rate in March’ 2011 had been registered at 0.5% which is a record low (BBC, 2011). In February 2011, inflation rate of UK rose to 4.4% (BBC, 2011). Interest rate has a major impact on time value of money. Changes in case of inflation rate generally result in alterations in the interest rate. These two factors are the key decision making factors for making any investment decision since these factors have a straight impact upon the ‘investment yield’. In case of the UK, the record low interest rate will support the investment on shares. Rising interest rates slows down the inflation.

Trade Analysis between Brazil and the USA Term Paper

Trade Analysis between Brazil and the USA - Term Paper Example creation of Southern Common Market and participated in the formation of the G-20 as a coalition to represent developing countries in the World trade organization negotiations. Brazil works bi-laterally with the U.S due to her influence in the trade groups. She also co-chairs the Free Trade Area of the Americas (FTAA) negotiations as with the U.S. Indeed for the two countries, closer ties serve advantageously both economically and politically. There is mutual benefit when there are good trade relations and the partners have stable political governance. Political stability of any country greatly determines the economic performance of the country. This is evident from the economic recession experienced by the two countries during the Word War II. Economic ties in the U.S and Brazil are much dependent on the two-way trade that is far much empowered by the World Trade Organization. Additional resources and economic growth are the direct benefits realized by the countries in relation to ex port-import trade relations (Schott, 2003, p 2). US recorded the highest imports from and exports to Brazil in the year 1997. However, a sharp decline was noted in 2002 due to the financial crisis experienced in Brazil. A contrast was sited as US imports from Brazil rose in 2002 than in 1997. Bilateral trade between U.S and Brazil has grown rapidly since 1992. The US had commendable trade surplus with Brazil between 1990’s and 2002 when she recorded a drastic merchandise trade deficit with Brazil. United States’ basic exports comprise of industrial manufactured goods such as electric machinery, air crafts and computers. On the other hand, she relies on imports from Brazil that comprise of steel, iron, footwear and mineral fuels. Approximately about 70% of United States’ exports to... In Brazil and the United States, closer ties majorly brought about by the trade relations serve both for economic and political reasons. The two countries have common objectives in trade. Opening markets is beneficial to both boosting innovation and competition. They both have a role to play in order to deepen their trade relations especially bilateral. The success of trade negotiation in WTO and in the hemisphere largely depends on them. An increment in trade and investment in both countries will lead to boosted employment and income. This would also lead to greater cooperation politically, culturally and economically in the hemisphere. Brazil and the U.S both share a role to play in order to deepen their bilateral relations. They have a challenge to ensure better results for their citizen and entire trading block partners (Schott, 2003, p22- 23). Free trade is an essential emerging aspect in these countries’ trade. However, Brazil is still a way off to understanding the benefits associated to the trade and thus is yet to open up her boundaries for the trade. Countries adopt trade policies at will and this explains the difference in trade liberalization between the United States and Brazil. Bilateral and regional trade agreements have put the United States at an advantage in trade relation to Brazil. Prospects are good over future trade relations going with the current signing of trade agreements to enhance mutual trade. It is also crucial that these two countries maintains and develops the already established trade partnership for the well being of the two economies.

Sales promotion portfolio Research Paper Example | Topics and Well Written Essays - 2500 words

Sales promotion portfolio - Research Paper Example Currently there are around 700 restaurants of Pizza Hut in UK with more than 154 stores of Pizza Hut owned by the franchisees (PizzaHut, 2011). The sales promotion helps the organization to change the perception of the customers towards their buying decision by offering them different incentives, which they are able to get eventually. This is the reason why Pizza Hut uses different sales promotion techniques because the company understands the significance of sampling and making a product trial during the marketing campaigns. The sales promotion strategies help Pizza Hut to increase its market share because these promotions entice the customers to switch their brand loyalty towards Pizza Hut. Another advantage that Pizza Hut gets with these promotional tools is the immediate result, which other IMC tools are not able to produce for the company (Pride et al., 2006). Sales Promotion Sales promotion can be defined as the activities which are planned by the organizations in order to impr ove the quality of the products or services and build a positive attitude of the customers towards their products or services (Bose, 2004). ... Since sales promotion influence the behavior of the customers, therefore Pizza Hut can analyze this theory in order to understand and change the behavior of the customers towards the deals and offers it is offering to the customers (Bose, 2004). Tools of Sales Promotion In order to understand the dynamics of sales promotional tools, it is important for the organizations to understand that these tools are different from other marketing and promotional methods, because these tools provide precise advantages for encouraging the customers to buy the product or services (Sagar, 1998). As compared to the sales promotions tools, other promotional techniques are used to attract the customers with help of an event or a program and they are not always designed for the direct purchase. Some of the most commonly used sales promotion tools are: Discounts and Coupons Free Samples Direct Mail Rebates Demonstrations Exhibits Point of Purchase Display Money Back Offers Mystery Rewards Branded Magnets and Pen Contests Gifts (Sagar, 1998) Promotional Strategies Used by Pizza Hut UK Pizza Hut uses different promotional tools for the increase share in the market, increase frequent buying, increase volume of sales and convince the customers for buying the product. The promotional mix of Pizza Hut consists of â€Å"Personal Selling, Advertising and Sales Promotion†. Since Pizza Hut uses Pull Strategy to fulfill its global objective, therefore many promotional tools are needed to implement this strategy successfully. The ‘Healthy Eating’ campaign is used to increase the awareness level of the customers, change their attitude towards pizza, motivate them to get involved in the product, and reduce risk for the product.