Employee Relationship Administration ( Crm ) - 1480 Words

1. Main CRM systems available in B2B context Stay-in-Front B2B: Stay-in-Front B2b is business to business client relationship administration which is intended to expand business adequacy and help the organizations to change their business transform around their clients and it likewise gives them different approaches to collaborate with clients. The primary peculiarities of Stay-in-Front are quick arrangement, simple to utilize instruments and rich usefulness. It has been conveying its administrations from 20 years to commercial enterprises, for example, chemicals, producing, media, telecom, tourism and utilities. NetSuite It is the main programming cloud station that conveys a 360- degree perspective of your client. NetSuite CRM gives a†¦show more content†¦C2 CRM: C2crm is a program based Customer Relationship Management arrangement created by Clear C2 Inc. C2CRM is intended to help fair sized organizations expand profit, lessen operational expenses, expanding deals and income, and to increase more trust of clients. C2 CRM gives continuous data with respect to leads, figures and customers. It tracks which advertising activities are the best and offers the most complete client administration data. Workbooks CRM: Workbooks CRM programming can be effectively gotten to from any web program and it is intended to give SME signed up methodology which can help to expand profit and execution at exceptionally productive rate. Workbooks CRM programming help to build deals and clients can get to information from any areas. Workbooks CRM dissimilar to other conventional programming its usefulness stretches out to incorporate Sales Order method, Purchase Order Procedures, Invoicing and Credit Notes furthermore the administration of agreement, without the necessity for outsider arrangements. Major objectives of the CRM systems: The primary target of CRM frameworks is to help the organization to examine the conduct of its clients and their quality. As the name proposes client, connection and administration of relationship, it records and stays informed concerning client s information which is useful for the organization to make

Why People Want to Study in My University Free Essays

Why people want to study at FMI Plovdiv University Essay People study in Plovdiv University for many different reasons. I think the most important reason is to gain more knowledge and develop their skills in an area. Of course, there are also many other reasons that people study in the university such as to get more friends. We will write a custom essay sample on Why People Want to Study in My University or any similar topic only for you Order Now These days, most jobs require people who are educated and have good job skills. Therefore, the people who want a good job have to study hard and at least graduate with a high education. I think that Plovdiv University is the right place to acquire an increased knowledge, especially professional knowledge for a particular job. The new, valuable experiences people get while studying at Plovdiv University are another good reason. Going to the university is so much different from high school, it’s like living in a new environment. For many students away from their home and family, the university is the new home where they’ll have an independent life. This is where they get’ll get to know new people, experience new things and prepare for the life in the future. So, besides the knowledge, people want to study here because they want to see what it’s like living in the real world. Plovdiv, as a big city, offers lots of new experiences and opportunities, especially for people coming from small cities. People want to study in Plovdiv university because of the variety of courses they can choose from, the quality of education they get, and the opportunities the big city (Plovdiv) offers after graduation. How to cite Why People Want to Study in My University, Essay examples

The Three Questions free essay sample

three questions by Leo Tolstoy brings questions that we as human beings have all asked ourselves. What is the best time to do each thing? Who are the most important people to work with? What is the most important thing to do at all times. The main character, the king tries to figure out these questions by rewarding anyone who could give him a reasonable answer. Not happy with the responses he is getting, the king visits the wise hermit to try and get some help. Tolstoy makes us question ourselves while reading this short story. He is trying to tell us that the answers to these questions are not as hard we think, but rather simple. He uses parts in his story to help us understand his simple points. What is the best time to do things? The best time to do things is now, during the present time. We have so much power over things right at the moment. We will write a custom essay sample on The Three Questions or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Why worry about the future that cannot be controlled when we should be thinking about what is in front of us. It is time to live in the moment, and stop worrying about the rest. Worry about other things when it is time to do so. An example of the king learning this can be seen when the Hermit is explaining to the king that if he did not spot the hermits weakness in digging the beds, and not helped him, then man who wanted to kill the king would have been successful. But, because the king helped, the man grew impatient and was attacked himself by the kings bodyguards. Another example of the most important time being now in the present was when the bleeding man came running towards the hermit and the king. The king noticed he was bleeding and tended to his wounds. If the king had not acted in that moment and helped the man then he would have probably died. Who are the most important to work with? The story explains that the most important people are those we are with at the moment. No one knows if that could potentially be the last person we see or they see. Cherish the moment you have with anyone you are with, because you do not know if you will have that moment again. The time the king spent with the dying man, he cherished the moment with him and took care of his wounds, that way he would not have died. The king could have been the last person the man saw if he did not make that man important in that moment, then his wounds would have not been tended to. What is the most important thing to do at all times? According to the story, the most important thing to do at all times is to treat each and every man well. It is the reason why man was sent into the world, to do good for others. The king learned that the man was someone who swore his revenge on him for the death of his brother. The king heard this and made peace with enemy by forgiving him. He was good to the man and promised to return his stolen property. If we as people can live buy these simple rules then life would be a lot easier on us.

Psychological trauma free essay sample

Your essay should include an introduction, body, and conclusion, and should use information from both the article (citing your source correctly) and your own insight and experience. . Be sure to take a clear stand and discuss it appropriately. 4. Support your opinions by using the article and your own ideas to strengthen your main points. 5. When you are finished, look over your essay and correct any errors before you turn it in. 6. You will have a total of 50 minutes to complete your essay.Essay Question: A trigger, in the context of academia, is any course material that initiates (or triggers) a stressful reaction in students who have sun. ivied a traumatic situation. Oberlin College recently instituted a trigger-varying policy for heir faculty, which advised professors to [u]understand triggers, avoid unnecessary triggers, and provide trigger warnings. Should GUCCI implement a similar trigger-warning policy to protect students from potentially upsetting course material? Why or why not?Article: Trigger Unhappy April 14, 2014 By Colleen Flattery Trigger* warnings, which have begun to appear on college and university syllabuses, are supposed to signal to readers that forthcoming material may be uncomfortable or upsetting. We will write a custom essay sample on Psychological trauma or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Trigger warned-subject matter in literature, films or other texts usually relates to sexual assault and other kinds of lenience, racism, and the like, and advocates say students have a right to know Of sensitive material in advance. But some critics of trigger warnings say that higher education is rooted in confronting uncomfortable ideas and experiences. And more practically, critics say, its nearly impossible in classes with students with differing sensibilities to define what deserves a trigger warning. Given the lack of consensus on trigger warnings in the classroom, it was perhaps unsurprising that the extensive trigger warning policy Oberlin College published in its Sexual Offense Resource Guide proved controversial earlier this academic ear. Faculty members criticized the policy from within, saying it had been drafted largely without their input, even though they stood on the front lines of such a policy.

How sleep deprivation affects your productivity

How sleep deprivation affects your productivity Did you know sleeping can boost your powers of productivity along with refreshing your brain? Yup, a good night’s sleep can make a huge difference in your ability to be productive at work. From generating new ideas to thinking of ingenious solutions to problems, sleeping well can bring enormous changes to your life. The American Academy of Sleep Medicine emphasizes the importance of seven to eight hours of sleep for an average adult for optimum utilization of their cognitive functions and overall performance. Some of the major problems that emerge out of sleep deprivation are a decline in cognitive performance, impaired memory, lack of spatial awareness, poor decision-making and slowed reaction time. These are some of the short-term problems that emerge out of sleep deprivation. However, studies show that prolonged sleep deprivation can have adverse long-term effects like reduction in immunity and lifespan, negative impact on learning and memory and symptoms of ADHD.Hereâ€⠄¢s how a lack of sleep can affect your performance at work†¦Impaired decision makingWhen you lack sleep, you are deprived of a sound mind which fuels the abilities to evaluate scenarios and pass judgment based on those assessments. These abilities are crucial to the execution of any task that requires logical reasoning from complex cognition. Without an adequate grasp of a sound mind, you may be more prone to making mistakes at work due to an increased tendency to make impulsive and poorly thought-out decisions or merely slowing down work progress in the more difficult attempt to prevent the former.Limited learning and memory capacitiesThe process of learning, retaining and improving skills and abilities heavily rely on your working memory capacity, one which determines the performance of your cognitive online (real-time) processing. Research suggests that while you are asleep, your memory systems are still active and sleeping significantly strengthens existing memories.   D uring Rapid Eye Movement (REM) sleep, your brain also cuts off unnecessary neuron connections while maintaining others; meaning sleep improves your memory by selectively both strengthening and eliminating formed neural connections. In a state of sleep deprivation, your capacity for efficient memory retention is substantially disrupted, hindering productive growth.Toxicity towards physical and emotional healthHealth implications of insomnia, while never usually the priority, should never be trivialized. Sleep plays an essential role in your physical health by both reinforcing your immune system against infections via boosting protective cytokine production and lowering your risk of diabetes, obesity, and cardiovascular diseases. Insufficient sleep will positively contribute to a decline in your physiological state, negatively impacting your work performance. It has been found that sleep deprivation can compromise your cognitive processing and amplify the smallest amount of emotional turmoil, making you more irritable and erratic. This impedes your executive functions, rendering you less productive.Not getting enough sleep or poor quality of sleep affects your ability to deliver in almost all facets of life. Be it work or home, insomnia or not sleeping well can make things really difficult for you. But getting a proper sleep can undoubtedly solve all your issues and can improve your ability to be productive. An abnormal sleep cycle is associated with mild depression and anxiety disorder, especially in people who are facing emotional battles. Snoring can also be a reason for abnormal sleep, different snoring solutions can ultimately save you from this serious disorder.We’ve covered what can happen with a poor night’s sleep, but all of these functions can improve with a solid 7-8 hours. Here’s how a good night’s sleep can help you become more productive†¦It makes you energeticThis seems obvious but it’s a known fact that get ting a good night’s sleep can give you lots of energy and a mood boost. It relaxes your body and mind and prepares you for the next day. From improving your job performance to helping you stay productive at home, sleeping well can also optimize your health.Boosts memoryRemember when we talked about what happens during REM sleep? The brain removes unnecessary neural connections and strengthens the cognitive bonds building your memories while you snooze. Go too many nights without REM sleep and your memories become hazy. With a consistent night’s sleep, you actually have a chance of remembering that report you’re supposed to submit at 9 AM.It makes you a faster learnerLearning new things comes naturally to a fresh mind. Your brain becomes stronger and works faster. So whether you’re at work or in class, never compromise your quality of sleep. With a strong body and sound mind, you’ll open the doors of opportunity.While we constantly focus on how we c an intensify our workload to pump up production, we often jeopardize our health to get it all done. Remember that sufficient sleep is paramount to a successful life.Sleep tight, everyone!About the Author: Katherine Dilworth is a wife, mother, and blogger on caseydilworth.com,  a blog that focuses on providing snoring solutions for everyone.

ABBOTT Surname Meaning and Origin

ABBOTT Surname Meaning and Origin The Abbott surname means abbot or priest, from the Old English abbod or Old French abet, which in turn derive from the Late Latin or Greek abbas, from the Aramaic abba, meaning father. Abbott generally originated as an occupational name for the chief ruler or priest of an abbey, or for someone employed in the household or on the grounds of an abbot (since celibate clergy usually didnt have descendants to carry on the family name). According to a Dictionary of American Family Names it may also have been a nickname bestowed on a sanctimonious person thought to resemble an abbot. The Abbott surname is also common in Scotland, where it may be of English origin, or possibly a translation of MacNab, from the Gaelic Mac an Abbadh, meaning son of the abbott. Surname Origin: English, Scottish Alternate Surname Spellings:  ABBOT, ABBE, ABBIE, ABBOTTS, ABBETT, ABBET, ABIT, ABBIT, ABOTT Where in the World is the ABBOTT Surname Found? The Abbott surname is now most commonly found in Canada, especially in the province of Ontario,   according to WorldNames PublicProfiler. Within the United Kingdom, the name is most common in East Anglia. The name is also fairly common in the U.S. state of Maine.  Forebears surname distribution data places the Abbott surname with the greatest frequency in the former British Caribbean colonies, such as Antigua and Burbuda, where it is the 51st most common last name. It is next most commonly found in England, followed by Australia, Wales, New Zealand and Canada. Famous People with the Last Name ABBOTT Berenice Abbott - American photographer and sculptorGrace Abbott - American social worker best known for her work improving rights of immigrants and advancing child welfareEdith Abbott - American social work pioneer; sister of Grace AbbottSir John Abbott - former prime minister of CanadaJeremy Abbott - U.S. national figure skating championGeorge Abbott - American director, producer and playwrightBud Abbott -  comedian best known for playing the straight man of Abbott and Costello   Genealogy Resources for the Surname ABBOTT Abbott DNA ProjectIndividuals with the Abbott surname or any of its variations are invited to join this Y-DNA surname project of Abbott researchers working to combine traditional family history research with DNA testing to determine common ancestors. The Abbott Family GenealogyThis site compiled and written by Ernest James Abbott collects information on primarily Americans with the Abbott surname, and includes sections on authors, occupations, famous descendants, courses, and Abbotts in the military and ministry. Abbott Family Genealogy ForumSearch this popular genealogy forum for the Abbott surname to find others who might be researching your ancestors, or post your own Abbott query. FamilySearch - ABBOTT GenealogyExplore over 1.7 million historical records and lineage-linked family trees posted for the Abbott surname and its variations on the free FamilySearch website, hosted by the Church of Jesus Christ of Latter-day Saints. ABBOTT Surname Family Mailing ListsRootsWeb hosts a free mailing list for researchers of the Abbott surname around the world. DistantCousin.com - ABBOTT Genealogy Family HistoryExplore free databases and genealogy links for the last name Abbott. The Abbott Genealogy and Family Tree PageBrowse genealogy records and links to genealogical and historical records for individuals with the common Abbott last name from the website of Genealogy Today. Looking for the meaning of a given name? Check out First Name Meanings Cant find your last name listed? Suggest a surname to be added to the Glossary of Surname Meanings Origins. - References: Surname Meanings Origins Cottle, Basil. Penguin Dictionary of Surnames. Baltimore, MD: Penguin Books, 1967. Menk, Lars. A Dictionary of German Jewish Surnames. Avotaynu, 2005. Beider, Alexander. A Dictionary of Jewish Surnames from Galicia. Avotaynu, 2004. Hanks, Patrick and Flavia Hodges. A Dictionary of Surnames. Oxford University Press, 1989. Hanks, Patrick. Dictionary of American Family Names. Oxford University Press, 2003. Smith, Elsdon C. American Surnames. Genealogical Publishing Company, 1997. Back to Glossary of Surname Meanings Origins

Station Nightclub fire Research Paper Example | Topics and Well Written Essays - 1500 words

Station Nightclub fire - Research Paper Example The building that constitutes the Station Nightclub was conceived in 1949 when it comprised a restaurant, a tavern and a nightclub. Back in 1972, a fire hit the building due to which it was kept closed until 1974. In 1974, it was re-opened as a restaurant however it saw an ownership change in 1985 when it was again re-opened as a pub. The interiors and the roofs were made out of wood and the pub was divided into a bar and a club. The wall at the western side of the club constituted a raised platform which was used by the bands to perform. The walls as well as the platform were insulated with polyurethane foam to control the volume of the music. There were four exits in the room, out of which only one of them was used by the crowd to regress. This was the main front door of the club. Fire alarms and heat detectors were also present but there was no mechanism to sync them with any nearby fire station. (Duval 2006). There were many other incidents similar to the station nightclub fire that took place prior to this one. Rhythm Club fire 1940, Coconut Groove Boston 1942 and Beverley Hills Supper Club South Gate 1977 are the three major nightclub fires that had occurred during the century (Duval 2006). These accidents paved way for different codes that were designed for the safety of people. The paper will aim at analyzing the affectivity of these codes at the same time discussing the extent to which these codes were followed in the construction of this night club. Furthermore, the new codes were conceived as a result of this incident that took away the lives of many people. Moreover, different suggestions and recommendations will be proposed by the end of the paper. A timeline of the events has been specified by the NIST investigation department, according to which the band took its place and lights were dimmed 11:07 PM that night. Soon after that, four pyrotechnics present at the stage

Similarities and differences between action research and audit Essay

Similarities and differences between action research and audit - Essay Example Concerning functions and applications, they have their distinct objectives, techniques and responsibilities.An interesting fact concerning these two disciplines is that action research of audit improves auditing, and auditing of action research helps to remove the dross and improve the quality of the research. (CAFWAA).From immemorial times monarchs and other rulers have rewarded groups and individuals for research and development purposes. The wise rulers and elders possessed the gracious disposition which caused them to provide rewards and incentives to encourage discoveries, inventions, and improvements for the betterment of human life and society.Men and women convinced in the belief that there were better ways of doing things immersed themselves in understanding systems and theories, and harnessed nature and elements to refine methods and structures. They zealously pursued their goals, at times against heavy odds, bequeathing their posterity a rich legacy of healthier and happie r living conditions. (Action Research).Action Research is based on clear vision, mission and guiding principles seeking to reveal the truth about any subject, thesis or situation. It also undertakes tasks of finding ways and means on improving existing systems and methodologies. It does so by meticulously going through existing systems and technologies, scrutinizing their efficacy, relevance and alternatives, and conducting experiments with new hypotheses and integrations. (What is Action Research) Audit Audit is the statutory study, scrutiny and verification of financial statements and management systems maintained by institutions, corporations and individuals. It provides the status and track record of the entity as required by law for general information or specific purposes like diversifications and investment strategies. Audit is done internally and by external professionals. (Audit, Credit Suisse). Audit helps to shape and reshape policies and procedures and improve efficiency and output. It refurbishes the entire organization to provide better quality and services. (Acacia Research Corporation). Auditing is highly responsible and demanding task. It is also time consuming and meticulous. It is a teamwork pursuance endowed with highly skilled technical expertise and adept at critical evaluations of diverse disciplines. It follows the highest order of professional and statutory standards and ethics. (Audit). Similarities between Action Research and Audit One ostentatious similarity between action research and audit is that both rely on data and facts to serve their aims and objectives. They base their conclusions on fundamental principles and sound judgment. They source their data and methodologies from well-established, credible sources only. Their similarities also match in the highly professional and all-pervasive approach to their area of activities. Action research is based on examination and improvement wherever possible of relevant, well-documented data and facts. Audit is based on the examination of financial statements made up of facts and figures, and their certification and approval along with suggestions for improvements and rectifications. Both action research and auditing is done by experienced, well-qualified, and highly skilled professionals. (Catherine Wylie). Differences between Action Research and Audit Action research is an age old phenomena which has existed for a very long time. Audit is comparatively new and came

Religious and Ethnic Groups Essay Example for Free

Religious and Ethnic Groups Essay According to Encyclopedia Britannica, Orthodox Judaism is a â€Å"the religion of those Jews who adhere most strictly to traditional beliefs and practices. † (Britannica, 2013) Differentiating from Christianity, Orthodox Jews adhere to daily worship, traditional prayers and holidays, and how and when a child goes through adulthood. While in a synagogue, men and women are separated, which is unlike many religions presented in our society. Orthodox Jews are often looked at as very strict and traditional. The dress garments are used to make them stand out from the world around them as well as to preserve the traditions. For women, pants are not permitted; all clothing must cover the chest to the neck and the arms to at least the elbows and fall below the knees. As a sign of modesty, married women hide their hair with a covering that may be a wig over a shorn head (in the most extreme cases), a wig over hair, a scarf, or a hat. † (Worldmark Encyclopedia of Religious Practices, 2006) For this reason, today’s society seems to have viewed Orthodox Jews as weird, segregated and just different. Our society sees lots of skin and very few modest women. Jewish people have contributed to American culture for their fight for rights equality. In 1965, in the march from Selma to Montgomery Alabama, you found â€Å"Rabbi Abraham Heschel and African American leader Martin Luther King Jr. joining arms and leading a group of hundreds of protestors in the action against discriminatory voting rights policies (Heschel. )† (Brown, 2010) Though Heschel was not an Orthodox Jew, he still fought for the rights of his people, all Jews, as well as the rights that every American deserves, regardless of race or skin color. Even in our society today you will see camaraderie between an African American and a Jew. Because they fought side by side with African Americans for equal rights, Jewish men and women will forever have an impact on our country. Throughout the history of the world, Jews have been discriminated against, and persecuted. Adolf Hitler sought to â€Å"exterminate† them from our society. Hitler killed around six million Jewish men, women, and children during the Holocaust. He not only discriminated against Jews, but anyone who could be a Jew, just based on their physical appearance. I think that learning more of their culture and religion has helped me better understand their group. I was curious of many things regarding Orthodox Jews and their Hasidic practices. For instance, I was unaware that the Torah is the first five books of the Holy Bible. Knowing that they dress in such traditional and modest clothing to adhere to their traditions is something that all American’s should look up to. Having such a devout faith to have no regard for the culture around you and being so devoted to your faith, or any cause, is something that I think is an admirable quality. South American Hispanics differ not only from White Americans, Asians or African Americans, but also, in part, to other Hispanics. Brazil does not speak Spanish as other Hispanic and Latino countries do. Brazilians speak Portuguese. Not all Hispanics from South America speak this language, but Brazilians, in their own right, have their own little corner if Hispania. South Americans also tend to have a harbored feud with other Hispanics. Brazilians do not want to be mistaken for Colombian; Columbian do not want to be mistaken for Chilean; and so on. In America, Hispanics also tend to be clumped together. Since the closest Hispanic country to the American border is Mexico, many American’s classify all Hispanic people as Mexican. This also becomes an issue among White American’s as well as Hispanics. Again, each group of Hispanics does not like to be classified as another, causing tension when being addressed as such, is most likely unbeknownst to the person who improperly identified the person or group of people. Hispanics have contributed a great deal to America. Through food, music and language, or nation has grown in leaps and bounds with the help of Hispanic people. There are many Mexican, Brazilian, Columbian and Chilean restaurants to be found in major cities across the U. S. A popular dancing style is the Salsa; which is a very sensual Hispanic dance. America’s unofficial second language is Spanish. There are many immigrants in the United States that are strictly Spanish speaking individuals. There are even classes called ESL, or English as a Second Language. Many employers often seek employees who are bilingual, speaking both English and Spanish. Hispanics, throughout History, have experienced uch discrimination, prejudice and are subject to stereotypes. Everyone is guilty, as there is no one group of people to be had as guilty or innocent. Even other Hispanics discriminate against each other. For example, Hispanics are often thought of as poorly educated, illegal immigrants with a very large family. Because these stereotypes have been so prevalent in our society, Hispanics are also thought to be a major factor in the unemployment rat e. Many Americans think that all Hispanics are here illegally taking their jobs and working for less money. This image hurts the Hispanic community, just as it would hurt any other racial or ethnic group. To say that they are poorly educated, therefore do not know how to fight to earn more money is stereotyping and just plain rude. I think that because I am of Hispanic descent, specifically Central America, and have experienced some of these discriminatory factors from both White Americans as well as other Hispanics, I understand where Brazilians, Mexicans, and all other Hispanic groups feel. To earn your way into a country and then to be looked down upon is a hard pill to swallow. It can often be difficult to take the high road and ignore the ignorance, but in the end, it is the most rewarding. Conclusion The discrimination experienced by Orthodox Jews as well as Hispanics is very similar. Both groups have fought for equal rights as American’s, regardless of race. Both groups receive looks and whispers behind their backs regarding their culture and beliefs. However, they are different in the fact that Orthodox Jews appear to be White American’s; whereas Hispanics tend to have a darker skin tone, which makes it easier to infer their ethnicity. I think that Orthodox Jews are more discriminated against because of their religious beliefs, the clothing that they were and their nonmoving stance on their religion. Hispanics are discriminated against, most often, because of their skin color, the way the talk or their country of origin. I believe that discrimination has many faces. There is no one set of rules for discrimination. Too often, society discriminates against what they do not know. People tend to fear the unknown. By shunning and discriminating against a religious group, a race or ethnicity, or a sexual orientation, people show that they are ignorant on the subject. I think that children are the greatest teachers to the negative minded discriminators. Babies are not born to know color or race or hate. They know people; they know love and compassion. I think the world would be better off if we listened to our children tell the tales of their adventures at school with â€Å"the kid who has skin that looks like chocolate,† as my niece once said.

Maligning Women in Shakespeares Macbeth :: Free Essay Writer

Women in Macbeth      Ã‚  Ã‚   Why did the playwright include only one noteworthy woman in Shakespeare's tragedy Macbeth? This essay will not answer this question, but rather tell about this one woman - Lady Macbeth, with lesser consideration of the magical weird sisters.    In Fools of Time: Studies in Shakespearean Tragedy, Northrop Frye shows that a lady is the actual driving force in the play:    That Macbeth is being hurried into a premature act by his wife is a point unlikely to escape the most listless member of the audience, but Macbeth comes to regret the instant of fatal delay in murdering Macduff, and draws the moral that    The flighty purpose never is o'ertook Unless the deed go with it. From this moment The very firstlings of my heart shall be The firstlings of my hand.    That is, in future he will try to attain the successful ruler's spontaneous rhythm of action. (91)    L.C. Knights in the essay "Macbeth" describes the unnaturalness in the thoughts and words of the plays dominant female force, Lady Macbeth:    Thus the sense of the unnaturalness of evil is evoked not only be repeated explicit references ("nature's mischief," "nature seems dead," " 'Tis unnatural, even like the deed that's done," and so on) but by the expression of unnatural sentiments and an unnatural violence of tone in such things as Lady Macbeth's invocation of the "spirits" who will "unsex" her, and her affirmation that she would murder the babe at her breast if she had sworn to do it. (95)    Clark and Wright in their Introduction to The Complete Works of William Shakespeare contradict the impression that the female protagonist is all strength:    Lady Macbeth is of a finer and more delicate nature. Having fixed her eye upon the end - the attainment for her husband of Duncan's crown - she accepts the inevitable means; she nerves herself for the terrible night's work by artificial stimulants; yet she cannot strike the sleeping king who resembles her father. Having sustained her weaker husband, her own strength gives way; and in sleep, when her will cannot control her thoughts, she is piteously afflicted by the memory of one stain of blood upon her little hand.   (792)    In "Macbeth as the Imitation of an Action" Francis Fergusson enlightens the reader concerning the fears weakening Lady Macbeth:

Analysis: “How much Land does a Man need” by Leo Tolstoy Essay

As Humans, we have desires that make us take possession on something more than what we have to benefit us. In this short story, Leo Tolstoy delivers the message that greed, in the end brings us nothing but death itself. This story tells us that even if we have enough that we can get by the odds of becoming wealthier is so seductive to us that we are ready to loose everything we love. Tolstoy starts his story with two women and their argument in whose life is better. Is is a life with or without ownership? As they continue, the owner of the house, Pahom, joins and agrees that life without possessions is better hence the fact that they will have no temptations towards wealth and not fear the devil. In this story, devil is greed. But he, himself thinks about having land of his own so he wouldn’t fear the devil. From the beginning, Pahom is a hardworking man, but he makes the mistake in thinking that more land would give him a better life. He says it himself: â€Å"If I had plenty of land, I shouldn’t fear the devil himself!† When he gets the shot at buying his own land, he jumps into the chance with the mentally prepared mind that will be happy with more land. Even if he had a lot or fertile land to grow crops on and not pay fines for his animals, he was not satisfied. â€Å"Pahom was well-content and everything would have been right if the nei ghboring peasants would not have trespassed on his cornfields and meadows†, so even if had more than enough land, he looked up fo more land. This reflects the characters greed. Pahom would be fine and happy with the extended land but the human instincts made him get greedier and greedier as time went by. As the story progresses, Pahom’s behavior reflects the message that greed has no line. As Pahom’s land expanded, he got into many riots with his neighbors which led him to move to different and larger land. Whenever he got into riots like this with his new neighbors, he moves into new land to satisfy himself; reflecting the greed in him growing. Once, a tradesman passing by told him about a lot of land sold for less money. â€Å"If I take it out there, I can get more than ten times as much for the money† so, he abandoned everything that he worked so hard on and left for inspection on that land. The land was obviously just the way the tradesman described. His greed just got out of control and it took over him. He was exhausted walking all day and he tried making it back to his meeting place before the day was over. But, due to his weak body, he was defeated, and made one last battle wondering, â€Å"there is plenty of land but, will God let me live on it†. He had taken this journey too much and died in the process. Throughout this story, Tolstoy was trying to tell us that human nature pushes us for more than what we need. Many of us think that having ownership makes us happy, in fact it does, but we need to understand that once the process starts, there is no end until the death. That was Tolstoy was reflecting, in the end all he needed was a piece of land.

Nicu Nursing Care Plan

A  Neonatal Intensive Care Unit  (NICU) is an  intensive care unit  specializing in the care of ill or  premature  newborn  infants. Neonates who need to go to the unit are often admitted within the first 24 hours after birth. Newborns may be sent to the NICU if: †¢ they're born  prematurely †¢ difficulties occur during their delivery †¢ they show signs of a problem in the first few days of life (sepsis/infection, congenital defects, cardiac / respiratory abnormalities, low birth weight) NICU EQUIPMENT: †¢ BLOOD PRESSURE MONITOR  may be a smaller version of the blood pressure cuff used  on older children and adults.Or  an  ARTERIAL CATHETER  (tiny tube inserted in an artery) may be used to monitor blood pressure. †¢ CARDIORESPIRATORY MONITOR  keeps track of the baby’s heartbeat and breathing †¢ CPAP (continuous positive airway pressure) machine  delivers air or oxygen through tubes in the nostrils. It uses low, contin uous pressure to keep the lungs inflated. †¢ ENDOTRACHEAL TUBE (ETT)   used with a respirator or ventilator to send air directly to the lungs. †¢ FEEDING TUBE (ALSO CALLED A GAVAGE TUBE) †¢ INCUBATOR used when newborn is relatively stable but still premature or requiring intravenous fluids or other special attention.The incubator keeps the newborn warm with moistened air in a clean environment, and helps to protect the baby from noise, drafts, infection, and excess handling †¢ INTRAVENOUS LINE (IV) †¢ PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) OR A PERCUTANEOUS CENTRAL VENOUS CATHETER (PCVC)  may be inserted in a central (large) vein. This catheter is used to give the fluids, nutrition, and medication. †¢ PHOTOTHERAPY LIGHTS, OR â€Å"BILI LIGHTS,† are used when neonates have jaundice †¢ PULSE OXIMETER  measures the level of oxygen in the baby’s blood.It’s attached to the skin with a sensor taped to the baby’s h and or foot. It works by shining a light through the baby’s hand or foot RADIANT WARMERS used for very unstable or extremely premature newborns †¢ RESPIRATOR OR VENTILATOR   used to help the baby breathe. These machines are attached to an ETT. †¢ TEMPERATURE PROBE †¢ UMBILICAL ARTERIAL CATHETER (UAC) OR UMBILICAL VENOUS CATHETER (UVC)- catheter is placed in the artery or vein at the stump of the umbilical cord. It’s used to give the medications, fluids, and nutrition. It’s also used to draw blood for lab tests. WEIGHING SCALE COMMON NICU TESTS: †¢ help determine the neonate’s problems and how they should be treated †¢ monitor newborn’s progress. If the neonate needs a major test, the doctor will ask the parents or legal guardian to sign a consent form before the test is done. BLOOD TESTS-provide crucial information on the potential and present problems of the neonate †¢ Bilirubin levels, blood sugar, blood chemistry, electrolytes, CBC, blood C/S, blood gas COMPUTED TOMOGRAPHY (CAT OR CT SCAN)-produce a more precise image of tissue than an X-ray or ultrasound examination.ECHOCARDIOGRAM- detects structural problems (heart defects) and problems with how the heart works. HEARING TEST-A tiny earphone will be placed in her ear to deliver sound. Small sensors, which are taped to the baby's head, will relay information to a machine that measures the electrical activity in her brain in response to sound. MAGNETIC RESONANCE IMAGING (MRI)-The MRI gives a more detailed view than a CT scan NEWBORN SCREENING TEST- tests babies for serious hereditary disorders.RETINOPATHY OF PREMATURITY (ROP) EXAMINATION-This test usually is done for newborns born at or before 28 weeks of gestation or weighing less than 1,500 grams (3 1/3 pounds). The test is generally performed about 4 to 6 weeks after birth, or when your newborn reaches 31 to 33 weeks gestational age (weeks since the mother's last menstrual period). ULTRASO UND-routine test to diagnose bleeding in the brain. URINE TESTS- determine how well the kidneys are functioning, and whether neonate has an infection.WEIGHING-routine exam, especially for premature and low birth weight newborns X-RAYS- provide pictures of neonate’s lungs and other internal organs. NURSING CARE PLAN: 1. Hyperthermia NDx:  Hyperthermia related to inflammatory process/ hypermetabolic state as evidenced by an increase in body temperature, warm skin and tachycardia 2. Fluid Volume Deficit NDx:  Fluid volume deficit related to failure of regulatory mechanism |Bucayu, Michael | |Cabulay, Lei-Ann Jessica | |Rodriguez, Kristel Angela | |Talosig, Janica Marie | Nicu Nursing Care Plan A  Neonatal Intensive Care Unit  (NICU) is an  intensive care unit  specializing in the care of ill or  premature  newborn  infants. Neonates who need to go to the unit are often admitted within the first 24 hours after birth. Newborns may be sent to the NICU if: †¢ they're born  prematurely †¢ difficulties occur during their delivery †¢ they show signs of a problem in the first few days of life (sepsis/infection, congenital defects, cardiac / respiratory abnormalities, low birth weight) NICU EQUIPMENT: †¢ BLOOD PRESSURE MONITOR  may be a smaller version of the blood pressure cuff used  on older children and adults.Or  an  ARTERIAL CATHETER  (tiny tube inserted in an artery) may be used to monitor blood pressure. †¢ CARDIORESPIRATORY MONITOR  keeps track of the baby’s heartbeat and breathing †¢ CPAP (continuous positive airway pressure) machine  delivers air or oxygen through tubes in the nostrils. It uses low, contin uous pressure to keep the lungs inflated. †¢ ENDOTRACHEAL TUBE (ETT)   used with a respirator or ventilator to send air directly to the lungs. †¢ FEEDING TUBE (ALSO CALLED A GAVAGE TUBE) †¢ INCUBATOR used when newborn is relatively stable but still premature or requiring intravenous fluids or other special attention.The incubator keeps the newborn warm with moistened air in a clean environment, and helps to protect the baby from noise, drafts, infection, and excess handling †¢ INTRAVENOUS LINE (IV) †¢ PERIPHERALLY INSERTED CENTRAL CATHETER (PICC) OR A PERCUTANEOUS CENTRAL VENOUS CATHETER (PCVC)  may be inserted in a central (large) vein. This catheter is used to give the fluids, nutrition, and medication. †¢ PHOTOTHERAPY LIGHTS, OR â€Å"BILI LIGHTS,† are used when neonates have jaundice †¢ PULSE OXIMETER  measures the level of oxygen in the baby’s blood.It’s attached to the skin with a sensor taped to the baby’s h and or foot. It works by shining a light through the baby’s hand or foot RADIANT WARMERS used for very unstable or extremely premature newborns †¢ RESPIRATOR OR VENTILATOR   used to help the baby breathe. These machines are attached to an ETT. †¢ TEMPERATURE PROBE †¢ UMBILICAL ARTERIAL CATHETER (UAC) OR UMBILICAL VENOUS CATHETER (UVC)- catheter is placed in the artery or vein at the stump of the umbilical cord. It’s used to give the medications, fluids, and nutrition. It’s also used to draw blood for lab tests. WEIGHING SCALE COMMON NICU TESTS: †¢ help determine the neonate’s problems and how they should be treated †¢ monitor newborn’s progress. If the neonate needs a major test, the doctor will ask the parents or legal guardian to sign a consent form before the test is done. BLOOD TESTS-provide crucial information on the potential and present problems of the neonate †¢ Bilirubin levels, blood sugar, blood chemistry, electrolytes, CBC, blood C/S, blood gas COMPUTED TOMOGRAPHY (CAT OR CT SCAN)-produce a more precise image of tissue than an X-ray or ultrasound examination.ECHOCARDIOGRAM- detects structural problems (heart defects) and problems with how the heart works. HEARING TEST-A tiny earphone will be placed in her ear to deliver sound. Small sensors, which are taped to the baby's head, will relay information to a machine that measures the electrical activity in her brain in response to sound. MAGNETIC RESONANCE IMAGING (MRI)-The MRI gives a more detailed view than a CT scan NEWBORN SCREENING TEST- tests babies for serious hereditary disorders.RETINOPATHY OF PREMATURITY (ROP) EXAMINATION-This test usually is done for newborns born at or before 28 weeks of gestation or weighing less than 1,500 grams (3 1/3 pounds). The test is generally performed about 4 to 6 weeks after birth, or when your newborn reaches 31 to 33 weeks gestational age (weeks since the mother's last menstrual period). ULTRASO UND-routine test to diagnose bleeding in the brain. URINE TESTS- determine how well the kidneys are functioning, and whether neonate has an infection.WEIGHING-routine exam, especially for premature and low birth weight newborns X-RAYS- provide pictures of neonate’s lungs and other internal organs. NURSING CARE PLAN: 1. Hyperthermia NDx:  Hyperthermia related to inflammatory process/ hypermetabolic state as evidenced by an increase in body temperature, warm skin and tachycardia 2. Fluid Volume Deficit NDx:  Fluid volume deficit related to failure of regulatory mechanism |Bucayu, Michael | |Cabulay, Lei-Ann Jessica | |Rodriguez, Kristel Angela | |Talosig, Janica Marie |

Chasing Amy essays

Chasing Amy essays Chasing Amy: Exposing the Deceit While it appears to be an open-minded exploration into the complexities of sexuality and gender, Chasing Amy is in actuality little more than a cover-up for the set of myths that encompass the plot. In this article, I will first uncover these myths, then reveal the truths that expose them. On its face, the film is about two young comic book artists who fall in love. The subtext of the movie, though, is about something far more political, and far more disturbing. Lesbian: Disgruntled Straight Woman Myth: Any lesbian can be straightened out if only she were to meet the right guy. Womens sexuality should be subject to male desires; what women really need, especially those stubborn lesbians, is some serious male domination. Banky: Whatd I tell you - she just needs the right guy. All every woman really wants - be it mother, senator, nun - is some serious deep-dicking. Myth: Every woman can love either men or women; there is no common ground. When Holden proclaims his love for Alyssa, she screams about how difficult it would be for her to make the switch: Holden: But thats every relationship! Theres always going to be a period of adjustment. Alyssa: Period of adjustment?!? THERES NO PERIOD OF ADJUSTMENT! IM FUCKING GAY! THATS WHO I AM! AND YOU ASSUME I CAN TURN ALL THAT AROUND JUST BECAUSE YOU HAVE A FUCKING CRUSH? The strange thing is, she turns around and changes to a heterosexual anyway, just to be with him. Myth: What constitutes a normal couple is a man, no matter what his sexual past, and a sexually kept woman. Throughout the film, Alyssas character is constructed as seemingly outlandish, unconventional, and not given to accepting tradition without question. As the plot unfolds, we learn of her wild sexual past, which includes a few threesomes and some ...

A Study On Sharing The Wealth Philosophy Essay

A Study On Sharing The Wealth Philosophy Essay There are many people in the world who are currently living in horrible conditions that include malnutrition, hunger, and polluted drinking water. While these people are living in such horrible conditions, I am living a comfortable life and have a habit of taking advantage of certain luxuries that are available to me, but not to someone living in such unfortunate conditions. If a global tax was instated in an attempt to end hunger by contributing a mere one dollar a week, then I would be more than willing to support this movement. There are some others who would agree to and support this tax, but there are also some who disagree with this tax. Different individuals who would have varying opinions on this idea for a global tax are Thomas Pogge, John McMillian, Peter Singer, and Garrett Hardin. Thomas Pogge, as shown in his essay, â€Å"World Poverty and Human Rights,† would seem to agree with the notion of a global tax to help aid those in need. He writes that we have duties, â€Å"not to expose people to life-threatening poverty and duties to shield them from harms for which we would be actively responsible† (Pogge 319). In other words, he believes that those who live in wealthier nations should not allow other people to fall to illnesses if they can afford not to. This would include leaving people to just starve when one can contribute a small portion of our funds to them. Pogge also discusses the topic of how richer countries, such as the United States, strip these poorer areas of their own natural resources. He does mention that these countries to pay for it, but there is a problem with this payment. â€Å"The payments we make for resource imports go to the rulers of the resource-rich countries, with no concern about whether they are democratically elected or at least minimally attentive to the needs to the people they rule† (Pogge 320). Although the richer nations may be paying for the resources they take away, they are paying to leade rs who may not share this payment fairly with those that they rule. With this idea in mind, perhaps Pogge would be even more supportive of this global tax if it could be guaranteed that the funds from the tax would be placed in the correct hands and those who need it will actually receive it. Peter Singer is another person who would agree to this notion of a global tax– to an extent. In his essay, â€Å"World Poverty and Hunger,† he states that, â€Å"I (Singer) begin with the assumption that suffering and death from lack of food, shelter, and medical care are bad† (Singer 332). It would be an obvious conclusion to come to from this that he would agree that everyone (who can afford to do so) contributing something to people who are suffering from those things would be a good thing. This is ratified when he states that, â€Å"if it is in our power to prevent something bad from happening, with-out thereby sacrificing anything of comparable moral importance, we ou ght, morally, to do it† (Singer 332). Again, this would lead to the conclusion that he would be in favor of this tax.

Corporate Social responsibility assignment Essay

Corporate Social responsibility assignment - Essay Example Triple Bottom Line Triple bottom line is a system that operates to ensure that corporate social responsibility is seen as a formal and an essential aspect of business entities. This is because it formalises the process of corporate social responsibilities and ensures that social responsibilities is included in an organisation at the strategic level. Triple bottom line is â€Å"... the necessity for a corporation to disclose information about its social and environmental performance in growing† (Sridhar and Jones, 2013 p92). This is because triple bottom line creates a situation where the environmental and social aspects of a business is carried out in a way that is appropriate and leads to the best interest for all entities. And more importantly, environmental and social matters are audited and accounted for through the triple bottom line system. This is because it integrates these two aspects into the business and the firm will not have to only care about profitability and ma king money for the shareholders but also, other stakeholders and provide valid evidence of how they are seeking and working towards the attainment of stakeholder interests. Triple bottom line involves the identification of sustainable corporate performance by integrating systems to attain and account for three aspects of a business: 1. Financial 2. Social and 3. Environmental (Fauzi et al, 2010). This is because triple bottom line provides a system to get an organisation to look beyond just financial reporting and financial targets. This is because it integrates the elements of sustainability into corporate reporting. In order to attain the standards of triple bottom line, a firm would have to set up a system for corporate financial, social and environmental strategy and reports (Jamali, 2006). This will ensure that an organisation will be able to integrate other important pointers of corporate social responsibility and report it and monitor it for a year-on-year improvement. Carol and Buchholtz (2012) identify that triple bottom line is a requirement for corporate control and corporate governance that focuses on stakeholders and other entities. This is because it involves setting goals in areas and aspects that affects other stakeholders and make it imperative for corporate entities to work towards the attainment of results over a broader scope than the traditional method. In the opening discussions of Carol and Buchholtz, they spell out that from the period of modern business after the Industrial Revolution in the early 1800s, firms and businesses focused excessively on the profit motive and sought to provide the best interests of the owners of the business only (2012). However, the growth of the Post-Second World War global order has sought to preserve the rights of individuals and other third parties and prevent the attainment of profits at the expense of other people who are connected to or affected by the business. Hence, the triple bottom line approach integrates the needs of stakeholders by ensuring that the needs of the society and the wider environment is integrated into the organisation and the organisation must demonstrate a strong tendency to protect the wider environment through sustainable practices and targets and also protect the environment. This is meant to promote the needs and expectations of other stakeholders, not just shareholders. Jackson et al

Golden Rule Essay Example | Topics and Well Written Essays - 2000 words

Golden Rule - Essay Example It was not meant as a guide to practical choice separate from all other principles of conduct. It has nothing to say about specific choices, nor does it vouch certain moral principles, ideals, or virtues. The golden rule relates, rather, to a perspective thought vital to the exercise of even the most basic morality: that of trying to put oneself in the place of those affected by one's actions, so as to counter the instinctive tendency to moral shortsightedness. It instructs listeners to treat others with the respect and understanding they themselves would wish to come across, and not to cause misfortunes on others that they would detest to have caused upon themselves. The golden rule put emphasis on the ethic of empathy: treat others as you would like them to treat you. Empathy relies on understanding that the other person senses pains as you do or will feel gladness as much as you do if they are properly dealt with. If another person is mourning, you feel his/her grief and offer consolation. If another is hurt, you go out of your way to extend help and you treat the injured person with support to prevent further suffering. Empathy, however, is not equally present among human beings, nor is any person incessantly empathetic for others. Some are deficient in empathy and are selfish, irresponsible and do harm to others with out feeling any remorse. The natural tendency is to treat only a number of other people, immediate members of a select group, and to be distrustful of and unreceptive to everyone else. Empathy can stimulate on in one circumstance and hold off in another situation. Once a particular group labels that non-members are threats, empathy is switched off and group members treat outsiders as though they were intruders. Actual situations may well affect how we relate the golden rule by looking at the practical significance of differences between experiences such as: observing another, how one would feel in the situation of another, what is the feeling of another, what is the world from the perception of the other, the impact of an action on the other, how the other would judged the fairness of another's act, and taking the other's viewpoint clearly into consideration in moral decision-making. Imagining oneself, however, in the situation of another is not plainly required by the golden rule, nor is it a requirement or adequate state for sound moral judgment. At times one acts it but stays unenlightened because of unawareness or self-deception, and occasionally one comprehends intuitively what is to be performed without any definite act of imagination. We normally presuppose that we understand others intuitively, that we empathize truly, that our expressions of sympathy are appropriate. Despite our usual dependence on empathy to enlighten us about another, our emphatic feeling of others often gives the wrong impression. The golden rule instructs us to treat others as we want others to treat us, thus implicitly advancing the assumption that there are important shared aims or similarities between the self and another. Over dependence on commonalities can dull receptiveness to dissimilarity just as much as being overly impressed with dissimilarity can make people blind to empathy. If the golden rule is to be understood as encouraging complacency about empathizing with others, then the rule would seem

Project Communication Plan Assignment Example | Topics and Well Written Essays - 500 words - 1

Project Communication Plan - Assignment Example Project managers should use the available tools of communication such as; letters, telephones, and video conferencing. A good communication plan is the most effective way of letting different end users of a project knows the effects a particular project to them. Project managers who have the responsibility of developing a communication plan should take into account a number of key components to ensure that they have a good communication plan. This will ensure that all the parties who are interested in a project are well served with the relevant information regarding the project. Audience forms a major component of a good communication. Campbell (2012) refers to this as the Stakeholder analysis. Different persons who are interested in the project cycle such as sponsors, stakeholders, and team members will require different information. A good communication plan should identify each audience with the aim of providing relevant information to them. The purpose of identifying audience is to see if we can determine how each audience is concerned. In addition to Audience, Content is the second component of a good communication plan.This component describes the kind of information that each audience needs. Such information may include the details about accomplishments and progress of the project. This information may be very relevant to the high level stakeholders (Biafore, & Stover, 2012). All these audience groups have unique interest in the whole project which the project manager will reflect up on when developing a communication plan. Method of communication is another important aspect of a good communication plan which project management should take into account. With a lot of technological advancements in the methods of communication, project managers have numerous methods of communication to the relevant audience (Heldman, 2011). Means of communication include; in person meetings, videoconferencing, telephone calls, email, and written

Healthcare Training in Simulated Environments

Healthcare Training in Simulated Environments Simulation Introduction â€Å"Clinical simulation is pretending for the purpose of improving behaviors for someone elses benefit (Kyle Murray, 2008, p.xxiv).† All respiratory therapists are trained to manage the airway of an unconscious patient. Endotracheal intubation is the most effective method of securing the airway but is a complex psychomotor skill requiring much practice. Historically, endotracheal intubation had been taught on patients, cadavers or animals, but this was not ideal. Mannequin training is one of the best options for instructing large numbers of students in a variety of skills (Gaiser, 2000) therefore the Respiratory Therapy program at TRU has adopted training on mannequins as a core component of their courses. Intubation trainers have been used for over 30 years (Good, 2003) but there is little published information on the relative merits of the available airway and intubation trainers. A variety of airway trainers with differing features are now commercially available from the low fidelity, part task trainer, that TRU respiratory therapy program utilizes, to the high fidelity, whole patient simulator that is becoming increasingly popular today. Training health care practitioners in a simulated environment without actual patients is a potential method of teaching new skills and improving patient safety (Issenberg et al, 1999; Devitt et al, 2001; Lee et al, 2003). pt safety Simulations are defined as activities that mimic the reality of a clinical environment and are designed to demonstrate procedures, decision-making, and critical thinking through techniques such as role-playing and the use of devices such as interactive videos or mannequins. A simulation may be very detailed and closely simulate reality, or it can be a grouping of components that are combined to provide some resemblance of reality. (Jeffries, 2005) definition of simulation Computer based simulations and part-task training devices can provide a certain degree of real-world application. These focus on specific skills or selected areas of human anatomy. High-fidelity patient simulators can provide real physical inputs and real environmental interactivity. To recreate all elements of a clinical situation, a full-scale or high fidelity simulation would be used. Costs of simulators will vary widely depending on purchasing costs, salaries, how faculty time is accounted for, and other factors. (Jeffries, 2005) simulators, high fidelity, costs Modern technology, such as high fidelity simulation offers unique opportunities to provide the â€Å"hands-on† learning. High fidelity simulation offers the ideal venue to allow practice without risk and there are an infinite number of realistic scenarios that can be presented using this technology. As an example, life threatening cardiac arrhythmias can be simulated on a life like fully computerized mannequin. Mo nitors, identical to those used in the clinical situation can replicate the arrhythmia and corresponding changes in vital signs. The ‘patient can be fully and realistically resuscitated with technical and pharmacological interventions. Viewing of videotaped performances allows personal reflection on the effectiveness of the case management. Morgan et al, 2006 example of use of high fidelity sim. High fidelity simulation provides a venue to teach and learn in a realistic yet risk free environment. The ‘patient is represented by a computer-controlled mannequin who incorporates a variety of physiological functions (e.g. heart and breath sounds, pulse, end-tidal carbon dioxide). An instrumentation computer network can replicate situations likely to be encountered in an emergency room, critical care environment or operating room. A second person controls the mannequin and the monitors. The simulator mannequin will respond on an accurate way to induced physiologic or pharmacologic interventions. The ‘patient will respond according to pre-set physiological characteristics (e.g. a young healthy adult or a geriatric patient with severe emphysema). In addition, the ‘patient has the ability to speak, move his arm, and open and close his eyes and has pupils that can dilate and constrict. The simulation room can be set up to appropriately reflect the environment, either an emergency room, a recovery room, or a fully equipped operating room. Attached monitors respond to a medical intervention. Feedback from participants in the simulated environment has attested to the ‘realism of the environment (Morgan Cleave-Hogg, 2000). Morgan et al, 2006 set up of HPS A simulator replicates a task environment with enough realism to serve a desired purpose and the simulation of critical events has been used instructionally by pilots, astronauts, the military and nuclear power plant personnel (Gaba, 2004). The fidelity, or the â€Å"realness†, of simulations can vary in many ways, such as the use of simple case studies, utilization of human actors to present clinical scenarios, computer-based simulations, and the use of high-fidelity patient simulators that respond to real-world inputs realistically (Jeffries, 2005; Laerdal, 2008; Seropian, 2003). Recently, literature has described that using full-sized, patient simulators are a way of creating â€Å"life-like† clinical situations (Fallacaro Crosby, 2000; Hotchkiss Mendoza, 2001; Long, 2005; Parr Sweeney, 2006). While simulation has been used by the aviation industry with flight training for years (Gaba, 2004), the use of a rudimentary human patient simulator in the health care fiel d was first introduced in 1969 to assist anesthesia residents in learning the skill of endotracheal intubation (Abrahamson, Denson, Wolf, 1969; Gaba DeAnda, 1988). The more realistic human patient simulators were not created until 1988 and were used primarily to train anesthesiologists (Gaba, 2004). Defining simulation in health care education The literature on human patient simulation has tried to define several of the terms used in this study. However, there is no general consensus on many of these terms, including a debate on whether the simulator is a mannequin or a manikin (Gaba, 2006). One key term that requires specific definition for this study is high-fidelity mannequin-based patient simulator. The term â€Å"fidelity† is used to designate how true to life the teaching experience must be to accomplish its objectives (Maran Glavin, 2003). Using this definition, fidelity becomes a scale where if given the objectives, a single piece of medical simulation equipment may be able to provide a â€Å"high-fidelity† experience for one objective but be â€Å"low-fidelity† for another objective. An example would be the insertion of a radial arterial catheter. If the objective were to only teach the psychomotor skills required for inserting the catheter, a relatively simple arterial blood gas access arm, part-task simulator would be adequate and provide a high-fidelity experience. But if the objective were expanded to include communication with the patient and members of the health care team, then the same device would suddenly become low-fidelity, as there is no feedback being delivered with catheter insertion and communication with the patient is not possible. Beaubien Baker (2004) noted that the term ‘fidelity is frequently documented as a one-dimensional term that forces a static classification of simulation devices. Individuals with this view would have difficulty agreeing with the use of the terms as explained in the previous paragraph. Maran and Glavin (2003) offered this definition: â€Å"Fidelity is the extent to which the appearance and behaviors of the simulator/simulation match the appearance and behaviors of the simulated system (p.23).† Yaeger et al (2004) broke fidelity down into three general classifications: low-medium-and high-fidelity and explained that low-fidelity simulators are focused on single skills and permit learners to practice in isolation while medium fidelity simulators provide more realism but lack sufficient cues for the learner to be fully immersed in the situation. High-fidelity simulators, on the other hand, provide adequate cues to allow for full immersion and respond to treatment interventions. For the purposes of this study, the following definitions will be used: 1. High-fidelity patient simulator A full-bodied mannequin that replicates human body anatomy and physiology, is able to respond to treatment interventions, and is able to supply objective data regarding student actions through debriefing software. 2. Low-fidelity simulator A part task trainer or a full-bodied mannequin that replicates human anatomy, but does not have physiologic functions (including spontaneous breathing, palpable pulses, heart and lung sounds, and voice capabilities), does not have a physiologic response to treatment interventions, and does not have a debriefing software system. Use the next two statements at the beginning of other sections on simulation: * â€Å"Simulation is a training and feedback method in which learners practice tasks and processes in lifelike circumstances using models or virtual reality, with feedback from observers, peers, actor-patients, and video cameras to assist improvement in skills (Eder-Van Hook, 2004, p.4).† * â€Å"Simulation is a technique†¦.to replace or amplify real experiences with guided experiences that evoke or replicate substantial aspects of the real world in a fully interactive manner (Gaba, 2004, p.i2).† When we are looking at the use of high-fidelity patient simulators in health professions education, we have to be aware of and not confuse the simulator with the simulation. As Gaba (2004) described, â€Å"Simulation is a technique not a technology (i2).† The mannequins or other devices are only part of the simulation. Dutta, Gaba and Krummel (2006) noted a gap in the research literature, stating, â€Å"A fundamental problem in determining the effectiveness of surgical simulation has been an inability to frame the correct research question. Are the authors assessing simulation or simulators (p.301)?† Simulation has many applications. The teaching of psychomotor skills seems an obvious use for simulation but there are other areas that simulation can be utilized effectively. Rauen (2004) listed several areas in addition to psychomotor skill training where simulation has been used. Her list included teaching theory, use of technology, patient assessment and pharmacology. Rauen (2004) notes that the â€Å"emphasis in simulation is often on the application and integration of knowledge, skills, and critical thinking (para 3).† History and Development of Simulation in Healthcare education The history of simulation in healthcare has been well documented by several authors including Bradley (2006), Cooper and Taquito (2004), Gaba (2004) and Rosen (2004) and began with the use of models to help students learn about anatomical structures. Although the use of mannequins as the simulation model is relatively new (Bradley, 2006), simulation using animals as models dates back over 2000 years. Mannequins were utilized as models in obstetrical care as early as the 16th century (Ziv, Wolpe, Small, Glick, 2003). The more modern medical simulators originated in the 1950s with the development of a part-task trainer called ‘Resusci-Anne that revolutionized resuscitation training (Bradley, 2006; Gaba, 2004). Part-task trainers are meant to represent only a part of the human anatomy and will often consist of a limb or body part or structure. These low fidelity modesl were developed to aid in the technical, procedural, or psychomotor skills, such as venipuncture, catheterization and intubation (Kim, 2005), allowing the learner to focus on an isolated task. Some models provide feedback (visual, auditory or printed) to the learner on the quality of their performance (Bradley, 2006; Good, 2003). Another general classification of patient simulators that combines some of the elements of both three-dimensional models and task-specific simulators is partial or part task simulators (Kyle Murray, 2008). Issenberg, Gordon, Gordon Safford, and Hart (2001) used the term procedure skills simulator for this type of device. Maran and Glavin (2003) stated, â€Å"part-task trainers are designed to replicate only part of the environment (p.24).† and replicate anatomy and physiology of a single portion of the human body. As described by Beubien and Baker (2004), the skills taught with part task simulators â€Å"segment a complex task into its main components (p. i53).† Rather than creating complex scenarios commonly done with high fidelity patient simulation, part task trainers permit students to focus on individual skills instead of more comprehensive situations. Examples would be an arm with vascular structure to teach arterial blood gas procedures or a head with upper airw ay anatomy to practice advanced difficult airway procedures. The second wave of modern simulation, with the development of full-scale, computer controlled, mannequin based patient simulators started in the 1960s with the development of Sim One (Bradley, 2006; Gaba, 2004; Good, 2003). SimOne had many of the features found on the high-fidelity mannequin-based patient simulators used today. SimOne was quite lifelike, and fitted with a blood pressure cuff and intravenous port. SimOne was able to breath, it had a heartbeat, temporal and carotid pulse and a blood pressure (Abrahamson, 1997). Patient simulators have become very sophisticated over the years and now allow a wide range of invasive and non-invasive procedures to be performed on them, as well as enabling teamwork training (Davis, Buono, Ford, Paulson, Koenig and Carrison, 2006). When they are set up in a simulated and realistic environment, they are often referred to as high-fidelity simulation platforms (HFSP) or human patient simulators (HPS) (Kim, 2005). Components of the human patient simulator (HPS) include a mannequin and computer hardware and software. The HPS has characteristics expected in patients such as a pulse, heart and lung sounds, and blinking eyes with reactive pupils. The mannequin also supports invasive procedures, such as airway management, thoracentesis, pericardiocentesis and catheterization of the bladder (Laerdal, n.d.). Medical Education Technologies, Inc. (METI) introduced the Human Patient Simulator (HPS) in 1996. It has subsequently followed with PediaSim in 1999, a simulator utilizing the HPS software but scaled down to mimic a child. In 2005, BabySim was introduced. While being the first to enter the market with a full-bodied mannequin for patient simulation purposes in resuscitation with the Resusci Anne in 1960, Laerdal Medical did not introduce a high-fidelity patient simulator until 2000 with the introduction of SimMan. This device does not possess all the high-level functionality of METI HPS, but does provide adequate fidelity for many medical emergency situations. The Laerdal Medical SimMan also differs from the others in that it does not operate on mathematical models for simulator responses. Instead, it operates on instructor controls combined with script-based control logics. The Laerdal Medical SimMan patient simulator is the device to be used in this study. Details of the simulators functions are found in appendix ____. Aside from high-fidelity mannequin based patient simulators, there are many other types of simulation used in healthcare provider education and training. Collins and Harden (1998), Issenberg, Gordon, Gordon, Safford, and Hart (2001), and Ziv, Small and Wolpe (2000) discussed several other forms of simulation. The list includes animal models, human cadavers, written simulations, audio simulations, video-based simulations, three dimensional or static models, task specific simulators and virtual reality simulation. (Add VR reference?) Perhaps the next step in the evolution of health care teaching modalities is virtual reality (VR) simulation. Commercial VR simulators now exist to teach various trauma skills (Kaufman Liu, 2001). In a study of the effectiveness of using a VR bronchoscopy simulator, students quickly learned the skills needed to perform a diagnostic bronchoscopy at a level that was equal to those who had several years of experience (Colt et al, 2001). Simulation has been used for many years in the aviation and nuclear power industries and other highly complex working environments in which the consequences of error are costly (Bradley, 2006). A simulator designed to mimic the anesthesia patient was first developed in 1988, and since then, the number of hospitals and universities buying simulators for educational purposes is increasing (Henrichs, Rule, Grady and Ellis, 2002). The human patient simulator is used in health care education because it is a high-fidelity instrument that provides both educators and students with a realistic clinical environment and an interactive â€Å"patient† (Feingold, Calaluce and Kallen, 2004). The cost of simulation is related to the level of fidelity and the technology being used. For high fidelity patient simulators, purchase costs can range from $30,000 for the Laerdal Medical SimMan or the METI ECS to over $200,000 for the METI HPS. Optional equipment available for these simulators can make the purchase costs even higher. In addition to the simulator, it is important to create a learning environment that replicates real-world settings, complete with appropriate medical equipment. Halamek et al. (2000) stated, â€Å"The key to effective simulation-based training is achieving suspension of disbelief on the part of the subjects undergoing training, ie, subjects must be made to think and feel as though they are functioning within a real environment (para 15).† Creating this environment adds additional costs to setting up a simulation-based medical education program. Advantages of using simulation in health care education Patient simulation of all types, including high-fidelity patient simulation, is becoming more common in many aspects and levels of healthcare provider education (Good, 2003; Issenberg, McGaghie et al., 1999; leblond, Russell, McDonald et al, 2005). The reasons behind the increased use of patient simulation include the advancement of medical knowledge, changes in medical education, patient safety and ethics. For new healthcare providers it is also important to consider the changing student demographic, as todays students are more comfortable with technology. Issenberg, McGaghie et al. (1999) pointed out several advantages to the use of patient simulators, stating â€Å"Unlike patients, simulators do not become embarrassed or stressed; have predictable behavior; are available at any time to fit the curriculum needs; can be programmed to simulate selected findings, conditions, situations, and complications; allow standardized experience for all trainees; can be used repeatedly with fid elity and reproducibility; and can be used to train both for procedures and difficult management situations. (p. 862)†. Advancement of medical knowledge Medical knowledge is continually growing with new tests, medications, and technologies that all bring about innovative understandings and expertise. The problem with educating health care providers with this new knowledge is that their curriculum is of a finite length therefore innovation in the curriculum is needed in order to prepare future health care providers. Issenberg, Gordon, Gordon, Stafford, and Hart (2001) made the following comments: â€Å"Over the past few decades, medical educators have been quick to embrace new technologies and pedagogical approaches†¦ in an effort to help students deal with the problem of the growing information overload. Medical knowledge, however, has advanced more rapidly than medical education†¦Simulation technologies are available today that have a positive impact on the acquisition and retention of clinical skills. (p.16) Changes in medical education Healthcare provider education has typically been taught using a lecture/apprenticeship model (McMahon, Monaghan, Falchuk, Gordon, Alexander, 2005) that relies on observation and repetition (Eder-Van Hook, 2004). Halamek et al. (2000) noted the traditional model of medical education has three components: the learner performs a reading of the literature, the learner observes others with greater experience, and then the learner develops hands-on experience. This is the traditional medical model of education that has been in use for over 2,000 years (Current state report on patient simulation in Canada, 2005). In relation to the traditional model, Issenberg, Gordon, Gordon, Stafford and Hart (2001) observed, â€Å"This process is inefficient and inevitably leads to considerable anxiety on the part of the learner, the mentor, and at times the patient (p. 19).† McMahon, Monaghan, Flachuk, Gordon, and Alexander (2005) stated this model â€Å"is inefficient in promoting the highest level of learned knowledge, as reflection and metacognition analysis occur independently, often without guidance and only after extended periods of time when students are able to piece together isolated experiences (p. 84-85).† Customarily, this format is often referred to as the â€Å"See one, do one, teach one† model of medical learning (Brindley, Suen Drummond, 2007; Eder-Van Hook, 2004; Gorman, Meier, Krummel, 2000; Yaeger et al., 2004). Halamek et al. (2000) identified several problems with the current medical education model which includes; 1. Reading of the literature does not produce competency. More active rather than passive participation in the learning experience is needed; 2. Learners may have difficulty determining if their model for observation is a good or poor model. Just because the model may be senior does not mean they are competent. 3. The variability of experiences in the apprenticeship model is high, therefore learners experiences will not be equal, and 4. Many training settings do not fully represent the complexity of the real world resulting in an inability of the learners to adequately practice their decision-making skills in a â€Å"real† environment. Yaeger et al (2004) reinforced these points stating that healthcare education rely on two fatally flawed assumptions. The first assumption is that all clinical role models are effective and skilled, and all behaviors demonstrated by these role models are worthy of replication. The second assumption is that the end of the training period implies that a trainee is competent in all the skills necessary for successful clinical practice (Yaeger et al, 2004). Yaeger (2004) also noted that in the apprenticeship model, there is a need for a preceptor but this preceptor may not have the necessary skills to be an effective educator. Patient safety A predominant theme in many discussions of high-fidelity simulation is the concept of patient safety. In the education of healthcare providers, there are sometimes conflicting goals. As Friedrich (2002) commented in quoting Atul Gawande, â€Å"medicine has long faced a conflict between ‘the imperative to give patients the best possible care and the needs to provide novices with experiences (p. 2808).† When looking at the broader topic of medical simulation, the concept of patient safety is a frequently mentioned subject (Bradley, 2006; Cleave-Hogg Morgan, 2002; Ziv, Ben-David, Ziv, 2005). Much of the incentive behind the focus on patient safety relates back to the Institute of Medicine 2000 report To Err is Human: Building a Safer Health system (Kohn, Corrigan, Donaldson, 2000). This study reported over 44,000 people and possibly up to 98,000 people die each year in United States hospitals from medical errors. The total annual cost of these errors is between $17 billion and $29 billion. Even more alarming is the fact that these findings represent only the hospital sector of the healthcare system. The number of lives affected would be even higher if other parts of the healthcare system were included such as long term care facilities and Emergency Medical Services. In its summary of recommendations, the report specifically mentions simulation as a possible remedy, stating â€Å"†¦establish interdisciplinary team training programs for providers that incorporate proven methods of team training, such as simulation (p.14).† In Canada, it was estimated there were 70,000 preventable adverse events in Canadian hospitals with an estimate of deaths associated with those errors ranging from 9,000 to 24,000 (Current state report on patient simulation in Canada, 2005). The Canadian Patient Safety Institute supports the use of simulation as a means of improving patient safety in Canadian hospitals. In the conclusion of its report on patient simulation, the institute stated: Growing awareness of adverse events in Canadian hospitals, combined with increasing emphasis on patient safety, has changed the traditional â€Å"learning by doing† approach to healthcare education. Anecdotal evidence reveals the promising potential of simulation to fundamentally change the way healthcare professionals practice and further hone their skills, interact across disciplines, and manage crisis situations. (Current state report on patient simulation in Canada, 2005, p.23) Ethical perspective One of the strongest statements made regarding the ethical perspective of simulations was presented by Ziv, Wolpe, Small and Click (2003). Under the title â€Å"Simulation-Based Medical Education: An Ethical Imperative†, the authors presented an argument that not using simulation was more than just an education issue, it was an ethical issue. As they report, there is often an over reliance on vulnerable patient populations to serve as teaching models when other resources exist that would provide adequate and possibly, more superior replacements. The education of healthcare providers requires a balancing act between providing the best in patient care while also providing learning opportunities for the healthcare professions student (Friedrich, 2002). To protect patient safety, actual patient contact is often withheld in the healthcare provider learning process to a later period in their education. One of the principle reasons patient simulation is being indicated as a partial remedy for the medical errors crisis is its ability to impact on a particularly vulnerable time in the learning process. As Patow (2005) cited, the â€Å"learning curve† faced by many healthcare professions students is a source of medical errors. He continued, stating that the realism of many of the currently available simulators is quite high and allows for procedures to be practiced to mastery prior to being tested on real patients. But simulations offer much more than just practice. Since medical errors often result from ineffective processes and communication, simulation allows teams â€Å"to reflect on their own performance in detailed debriefing sessions† (Patow, 2005, p.39). This opportunity to review, discuss, and learn from the simulation is an important step in the learning process. The use of patient simulation in the training of healthcare providers is not limited to new students. There is also a need to maintain education in the health professions and simulation can be utilized effectively in this area as well (Ziv, Small Wolpe, 2000). As in other reports, Ziv, Small and Wolpe (2000) restated the shortcomings of the traditional model and explained that simulation was not just for the beginner but also for the expert who is expected to â€Å"continuously acquire new knowledge and skills while treating live patients (p.489).† These authors feel simulation, when used across the range of health professions education, can make an impact on patient safety by removing patients from the risk of being practiced upon for learning purposes. Gaba (2004) pointed out there are also many indirect impacts of patient simulation on patient safety. These areas of impact include improvements in recruitment and retention of highly qualified healthcare providers, facilitating cultural change in an organization to one that is more patient safety focused, and enhancing quality and risk management activities. A final point on patient safety is the ability to let healthcare providers make mistakes in a safe environment. In real patients, preceptors step in prior to the mistake being beyond the point of recoverability or if the mistake occurs (particularly for those healthcare providers who are not longer students), there is a very limited instructive value to the case. Ziv, Ben-David, and Ziv (2005) stated, â€Å"Total prevention of mistakes, however, is not feasible because medicine is conducted by human beings who err†¦[Simulation Based Medical Education] may offer unique ways to cope with this challenge and can be regarded as a mistake-driven educational method (p.194).† They continued stating that Simulation Based Medical Education is a powerful learning experience for students and professionals where â€Å"students are permitted to make mistakes and are provided with the opportunity to practice and receive constructive feedback which, it is hoped, will prevent repetition of such mistakes in real-life patients. (p.194)†. Ethical Use of Simulation (incorporate these paragraphs into previous on pt safety) Health care educators, whether from nursing, respiratory therapy, or medicine, find themselves in similar situations in deciding how to teach patient management to their students. Bioethicists have long condemned the use of real patients as training tools for physicians (Lynoe, Sandlung, Westberg, Duchek, 1998). Unfortunately there have been times in which the student learning has occurred to the detriment of patients (Lynoe et al, 1998). However, with the advent of high-fidelity human patient simulation approaches to learning, it may be time to adopt this method of instruction in the development of interprofessional education. The Institute of Medicine (IOM) recently issued a report on medical errors and recommended the use of interactive simulation for the enhancement of technical, behavioural and social skills of physicians (Kohn, Corrigan Donaldson, 1999). Numerous accounts are found in the medical literature touting the use of human patient simulation in the education of health care personnel at all levels, from student to attending physicians. Patient simulation is used for training personnel in several areas of medical care such as trauma, critical care, surgery and anaesthesiology, mainly due to the extensive skill required to perform adequately the procedures and techniques relevant to these areas. Several researchers have demonstrated the effectiveness of simulation in the skill development of medical personnel (Morgan et al, 2003; Lee, Pardo, Gaba, Sowb, Dicker, Straus, et al., 2003; Hammond, Bermann, Chen Kushins, 2002). In areas with low technology, such as internal medicine and in acute care areas providing less procedural skills but greater decision making requirements, the use of simulation in the education of its clinicians has progressed (Ziv, Wolpe, Small Glick, 2003). Despite the growing support for the use of simulation in health care education, there is not yet enough evidence to support its use. Simulation Research in Medical Education In 1998, Ali, Cohen, Gana Al-Bedah studied the differences in performance of senior medical students in an Adult Trauma Life Support (ATLS) course. This course uses simulated scenarios to both teach and evaluate students performance in trauma situations. The students were divided into three groups; 32 medical students completed a standard ATLS course, 12 students audited the course (without participating in the sessions or taking the written exam) and a control group of 44 matched students who had no exposure to ATLS. Of note is that some participants from all three groups were doing clinical hours in trauma hospitals during this study while others were not. The participants were observed while managing the standardized (live) patient in simulated trauma and non-trauma scenarios. The participants management of the sessions was scored on

The Childhood Obesity Epidemic in the United States :: Obesity in Children

There is an alarming rise in childhood obesity throughout the United States, making it an epidemic in our country. Obesity has become a threat to the health of many children. Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.(Childhood Obesity Facts, 2015) What is Obesity? Obesity is defined by Webster’s dictionary as increase body weight due to excessive accumulation of body fat. It is a condition or disease in which the â€Å"the natural energy reserve of humans or mammals, which is stored in fat tissue, is expanded far beyond usual levels to the point where it impairs health.† Obesity is most often measured by using the BMI (body mass index). BMI is calculated by dividing the weight in kilograms by the height squared in meters. A desirable BMI for children to sustain a healthy life is between 18.5 and 25. A child with a BMI over 25.0 kg/m 2 is considered overweight. A BMI over 30.0kg/m 2 is considered obese, and a BMI over 40 is morbid obesity. â€Å"An estimated 80% of overweight adolescents continue to be obese into adulthood, so the implications of childhood obesity on the nation’s health are huge†. (Survey on childhood obesity, 2014). Obesity is a chronic condition that develops as a result of genetic, behavioral and environmental factors. Causes of Childhood Obesity There are many factors that may influence the occurrence of obesity in children. These factors can be broad and may vary depending on the individual child. Research has shown the impact genetics has had on the development of obesity in children as well as unhealthy home environments. Other external factors may include the education system and the food industry, because of their promotion of unhealthy eating habits and physical inactivity in children. The Role of Genetics: Genetics can play a huge role in the development of obesity in children. Studies have shown that obesity can be inherited. A child’s chances of being overweight or obese are increased by 25 percent if their parents are overweight or obese. The Centers for Disease Control and Prevention (2015) states that â€Å"the latest study from Stanford University has found that having overweight parents is the biggest risk factor for childhood obesity†(para 1). The Childhood Obesity Epidemic in the United States :: Obesity in Children There is an alarming rise in childhood obesity throughout the United States, making it an epidemic in our country. Obesity has become a threat to the health of many children. Childhood obesity has more than doubled in children and quadrupled in adolescents in the past 30 years. The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2012. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to nearly 21% over the same period.(Childhood Obesity Facts, 2015) What is Obesity? Obesity is defined by Webster’s dictionary as increase body weight due to excessive accumulation of body fat. It is a condition or disease in which the â€Å"the natural energy reserve of humans or mammals, which is stored in fat tissue, is expanded far beyond usual levels to the point where it impairs health.† Obesity is most often measured by using the BMI (body mass index). BMI is calculated by dividing the weight in kilograms by the height squared in meters. A desirable BMI for children to sustain a healthy life is between 18.5 and 25. A child with a BMI over 25.0 kg/m 2 is considered overweight. A BMI over 30.0kg/m 2 is considered obese, and a BMI over 40 is morbid obesity. â€Å"An estimated 80% of overweight adolescents continue to be obese into adulthood, so the implications of childhood obesity on the nation’s health are huge†. (Survey on childhood obesity, 2014). Obesity is a chronic condition that develops as a result of genetic, behavioral and environmental factors. Causes of Childhood Obesity There are many factors that may influence the occurrence of obesity in children. These factors can be broad and may vary depending on the individual child. Research has shown the impact genetics has had on the development of obesity in children as well as unhealthy home environments. Other external factors may include the education system and the food industry, because of their promotion of unhealthy eating habits and physical inactivity in children. The Role of Genetics: Genetics can play a huge role in the development of obesity in children. Studies have shown that obesity can be inherited. A child’s chances of being overweight or obese are increased by 25 percent if their parents are overweight or obese. The Centers for Disease Control and Prevention (2015) states that â€Å"the latest study from Stanford University has found that having overweight parents is the biggest risk factor for childhood obesity†(para 1).

Single Parenting Stigma

Single-Parenting Families: Attached Stigmas The social deviance that interests me is single parenting, one who chose to have a child out of wed-lock. The stigma attached to being a single parent is rising anew. Many media commentators blame America's uptrend in violence and other social problems on family breakdown – on single parents. This stigma is based on myths and stereotypes that have been promoted by half-truths and, often, by prejudiced viewpoints. Many in our society still regard single parenthood as a unwelcome status.I as a single parent myself, I am often admired, but at the same time looked upon with pity, disgust, sympathy, and perhaps with uneasiness. In defense of single parent families I would argue to de-stigmatized single motherhood by society, in which the shifting of family type in single parent household is now normal and acceptable. One obvious identity is I am a woman and my hidden identities are I am a mother, unmarried, and parenting alone. A complex of set social and cultural stigma perceived as making a selfish or misguided decision to have a child and raise it on my own as a unmarried single mother.Growing up I was told by my parents the unwed mothers were bad girls who make mistakes and gotten pregnant, whom family, friends, and the community shamed and reject. There is a clear cultural, moral, and religious message of stigma. In my parents generation, it would highly scandalous of a single woman raising a child alone and never married. In those days it was expected for the man to do the honorable thing, and marry the woman who is carrying his child. It did not matter whether he love her or not, having a child out of wedlock is unacceptable and the child would be considered a bastard( child born to unmarried parents).I am a single parent. I never planned on being a single parent. Few do. I grew up with an ideal of parenting as something I would do with a husband, within a marriage. Choosing to parent alone was simply not a o ption in my household growing up. Unwed pregnancy was to be avoided at all costs! Divorce with children was quickly remedied with remarriage. The honored and supported single mothers without stigma is through the death of a husband is a widow. Today, nearly one-third of American families with children under the age eighteen are in single-parent families, and this has double the number less than two decades ago.Separation and divorce creates most single parent families, that accounts for twice as many single parent families (60%) as failure to marry (30 %), while the death of a parent creates less than (7 %) of such families. Single parent families are raised by single mothers are becoming the majority family type culturally in United States. However, there is still a powerful negative images associated with Black single mothers and rarely does the dominant culture identify individuals, but instead stigmatized the entire class of Black mothers.Many presume the color of the typical we lfare recipient is a Black mother and that is not entirely true, but Black mothers are disproportionately represented. I personally can not explain why single parent never been married families are far more prevalent in the Black communities than in the White communities. Marriage is the most common for all women and for most women the only way out of poverty. For Black women, however the economic gain of marriage is often few and far between due to the poor economic opportunities of Black men.Although, I am a single mother raising three sons. My children have not and will not suffer from the outcome of poverty, simple because I am a single parent. I am not poor. I am gainfully employed and I own my own home for the last fifteen years. There is a strong stigma attached to single mothers households are living below the poverty line. What are the critics saying about the single mothers? Stigmatizing the single parent families as part of the underclass, broken, and deviant. Their child ren are mostly to have emotional or behavioral problems.To have children out of wedlock, are more likely to have trouble in school, and likely to commit crimes. Therefore, because I chose to raise my children alone†¦Ã¢â‚¬ ¦society blames me for the decline in social order. The two parent families is still compared as the traditional family formation and contribute to a healthy and successful society. I recently saw on TV an interview with Ann Coulter on the talk show The View †¦. she blames many of society’s problems on single moms. She goes on to say that our jails are filled with the offspring of single moms.To accuse single moms of being responsible for all society’s problems is absolutely crazy. There are many reasons relationships end, and when there are kids involved usually the bulk – if not all – of the responsibility of raising the kids is assumed by the mom. We single moms should be applauded and not attacked for this. Sure, there are some women that decide to have a baby on their own with no man in the picture, but can you blame them?It is hard to find a decent man who also wants to raise a family. Even when you do there are no guarantees he will stick around for the long haul. Nevertheless, single fathers have biological link or legal status as a non-custodial parent. What that actually means is they are expected to pay child support for their children, but rarely do they have sole or joint custody of their children. Some men have this immature concept of fathering that expects men to separate from their children and their responsibility, if they do not maintain a connection to the children’s mother.There is a layer of stigma that is laid upon Black single mothers complete with highly fertile capacity( having many babies), being lazy and shiftless, and being in a relationship with uncaring and equally lazy black man. In which he is not willing to work, will not marry her, and will not support his family. This stereotype does not fit all single African American mothers and fathers. Unfortunately, those are the views of the dominant culture in our society of unwed African American single mothers. There are confronting stigmas and myths of single parenting as society continues to view that stigma as appropriate and justified.The first, single-parent families are poor and single parenting causes poverty and social problems. Second, single-parent families are physiologically unhealthy. Third, single-parent families are immoral. The religious standpoint the families are sinful because they lack the blessing and validation of marriage through the church. Finally, there is a underlying undertone of stigma attached to race and gender beliefs that further support the badge of social scorn and economic hardships. What I know about single mothers is far different from the myths that are circulating in society, resulting in powerful stigmatizing.The truth and reality is many single mother are r aising their children very successful alone, including myself. Parenting is the hardest job, that one will ever have. However, single parenting is even harder, but not impossible to be successful in providing for your family. Society must look at the parent and not the circumstances that lead to their being a single mom or dad. The first priority and full responsibility is towards the child, put the child first in every and all decisions. My personal story is I have always been there for my three sons and it is my job to take care of them, until they can take care of themselves.I have raised boys to men and at the sometime to be gentleman. In my household it is filled with love and support. Education was always instilled and valued in my home. My sons are very intelligent, respectful, good human beings and all because I took full responsibility for them and I took parenting very seriously. I can argue strongly that children need love, discipline, structured, boundaries, and guidance . Children who lack these exposures will perhaps become menace to society, but not from living in a single parent household. Two parent families can be dysfunctional, don’t place the blame solely on single parent families.The house with white picket fence is only a disguise, one can only guess what is truly going on behind closed doors. For the love that I had for my son’s father and yes, they have the same dad (a myth that African American single mothers children have different fathers). We drifted apart and we decided to separate and I focus on being a mom. In neither case was it my choice to be a SINGLE mom; my choice was to just be a MOM. Sorry to report that single mom bashing is nothing new. And, the â€Å"double standard† is nothing new, either.Single dad who pays his child support and see his kids on a regular basis is a hero! Single moms, on the other hand, seem to be held to nearly impossible standards. I can only suggest what has worked for me. I hold my head high, keep my decisions grounded in what's best for my sons , and ignore the small minded people. My sons are my blessings, they are beautiful, and I am very proud to be their mother. Being a single mom presents additional and unique challenges and experiences. I feel I can conquer the world, because being a mom is the toughest job there is.Life is never boring! These myths and stigmas can be confronted successfully and new strength can be found in the truth. As with so many aspects of single parenting, myself and other mothers rise to the challenge and become better people because of it. The myths are sometimes subtle and subconscious, but the more we examine them, the more clearly we take responsibility for our lives and the lives of our children. My deepest love and appreciation goes to my sons, who have taught me more than they will ever know. I love you†¦.. higher than the moon, wider than the sky.