Economics Health Care Essay

Many skilled nursing facilities have used a modified functional nursing structure, with a registered nurse leading in care planning and supervision, a licensed vocational nurse giving medication and some treatments, and nursing assistants performing hygienic and activities-of-daily-living tasks. With a new emphasis on rehabilitation of their changing and ever more acutely client population, they have developed new roles for the nursing assistants. One such role is that of the restorative aide. These individuals receive additional supervision and training related to range of motion, transfers, and other activities and may work in team with physical and occupational therapists. In some states, nursing assistants in long-term care or residential facilities receive additional training to administer oral medications under the supervision of a registered nurse, who evaluates the medication regimen and determines whether the medications should be administered as planned. This function is carefully regulated. Conversations with state board of nursing officials in several states reveal that this practice has been quite effective to date and reflects a trend. Some extended facilities that use many nursing assistants have developed the role of team leaded. These experienced, skilled assistants have exhibited additional leadership potential and are able to help the registered nurse train, mentor and evaluate the tasks completed by orientees. Since this group of assistants often exhibits a fair amount of turnover, the creation of this position has also become a means to develop and recognize highly competent, tenured employees (Hansten, 2004). Recent Labor Market Conditions Shifts or changes in the supply and demand for the labor of any occupational or professional group can have a significant impact on both the short-term employment opportunities and long-term career paths of workers over time. A general level, when the supply of new entrants (measured in actual numbers of graduates and numbers of new licenses or registrations) is maintained at moderate levels while labor demand is high, workers who meet the skill requirements of employers can reap substantial benefits. In such labor market situations, unemployment will be low, and workers will be in a strong position to demand higher levels of compensation and benefits of all forms. Conversely, when the demand for labor is reduced, due to economic downturn, system restructuring, or other factors, while the labor pool or supply continues to grow or remain stable, severe problems of unemployment and underemployment can develop. As with any other professional or occupational group, the nursing profession has been affected by significant changes in the supply and demand forces in the labor market. In particular, the nursing profession has been vulnerable to the dramatic shifts in demand for nursing personnel in the recent years (Hiscott, 1998). Nursing Assistants in the Heath Care Team While the job of nursing aide has existed almost since the beginning of the modern hospital, the position is becoming more formalized as a certified part of the health care hierarchy. This formalization is co-emergent with the growth of nursing homes, which already account for the majority of jobs in this rapidly growing field. Currently, nearly 1. 5 million nursing assistants work in the United States, and the Occupational Outlook Handbooks (1980-81) predicts 94,000 annual openings at least through the next decade, almost all of which will be in nursing homes. One trend in this development is the requirements for certification prior to work. In order to do this work, one must first be certified through a state approved training program as a certified nursing assistant (a title now replaces nursing aides). In classified newspaper columns throughout the country, there are advertisements for vocational schools that offer such training. The schools get many applicants, mostly poor women, who are attracted to the relatively good prospects for employment, the caring-oriented duties of the job, and the possibility – however remote – of moving in the ranks of the nursing profession. Unless one is formally trained in nursing (many foreign-trained nurses work as nurses aides), this certification procedure is required (Abel & Nelson, 1990). Long-Term Care There are currently 12 million people living in long-term care facilities in the United States, and the demand for such care is increasing. The $96.2 billion a year nursing home industry, providing long-term care for people who need medical as well as personal assistance, is expanding particularly rapidly, in part because the population is aging and in part because hospitals increasingly are discharging patients before they can care for themselves at home. But the ranks of nurse aides- most of them women, often immigrant or minority women, who typically provide some 80 to 90 percent of the direct care in these facilities – are thinning. More than forty states report critical shortages of nurse aides and other paraprofessional nursing-home workers. One major reason is money. The average starting wage for nurse aides in nursing homes is $6. 70 per hour, yielding an annual income of $14,000 for full-time workers, most often without benefits. The average wage for all nurse aides working in nursing homes is $10. 12, suggesting relatively small increases for seniority. A study of job leavers by the National Network for Career Nursing Assistants found that even those who like their work often leave because they cannot support their families on these wages. Exact rates of staff turnover at nursing homes are difficult to determine because method of calculation differ, but most sources place the annual rate for certified nurse assistants (CNAs) at between 80 and 100 percent. Such high rates of turnover, combined with cost cutting, mean that most nursing homes are understaffed most of the time. A recently released report of the Centers for Medicare and Medicaid Services found that more than 90 percent of the nation’s nursing homes are seriously understaffed. Indeed, the total amount of direct care given per resident per day in nursing homes averages only 3. 2 hours, well below the recommendations of professional organizations. And time studies conducted by the National Network of Career Nursing Assistants show that in an eight-hour shift it is impossible for CNAs to perform their five main responsibilities – bathing, feeding, toileting, dressing and walking patients – for caseload of twenty patients, not an uncommon assignment (Fitzgerald, 2006). Major Factors Influencing Health Care A range of influences, both external and internal, are greatly affecting the future of the profession for both pharmacists and technicians. External influences such as structural change in the health care economy, the growth of managed care, changes in health care financing, telecommunication and automated technologies, and breakthroughs in drug research and biotechnology are only a few of the forces that will undoubtedly shape the environment of pharmacy practice. Research into the molecular basis of disease and its treatment, multiple disease morbidity and chronicity in an aging population, and the critical nature of interdisciplinary health care relationships and collaboration will impose major challenges that will change our sense of purpose as professionals. Another influence on the profession may well be the heightened expectations of an increasingly informed and demanding public. Many of these external influences may be beyond our control. On the other hand, certain factors may have even more influence over our destiny. These factors include internal forces such as competency expectations and assessments, continuous education, training and retraining, the differentiated nature of pharmacy practice and growth of specialization, and the achievement of the mission and vision of pharmaceutical care (Durgin & Hanan, 1999). Economic Influences A wide array of economic and market influences continue to shape the direction and nature of the health care delivery sector. Market – driven Reforms Glacial yet profoundly fundamental changes have been occurring in health care since the mid-1980s. The Executive Summary of Third Report of the Pew Health Professions Commission poignantly describes the fact that, since 1990, the financial, organizational, and legal framework of American health care has been undergoing a transformation to systems of integrated care combining primary, specialty, and hospital services. The failure of the federal government and political system to successfully enact comprehensive health care reform legislation has given way to de fact of market-driven reforms energized by consumer and employer demands for more services and more intense technology. This problem is further compounded by a growing market trend of health care payers (public and private) refusing to pay the true and full economic costs of health care. Cost Containment A continuing focus on cost containment in health care delivery has led to a fiercely competitive marketplace. In some instances, the vision of success through providing care at the lowest possible cost may well be outpacing the quest for quality outcomes in health care. The continued market penetration of managed care and consolidation and integration of health care provider systems may well result in a survival of the fittest scenario in which only those systems that can produce the expected stakeholder results will survive. Public Demand for Health Care Services Heightened public demand for a broader and improved spectrum of health care continues unabatedly as a result of availability of consumer-focused education and the virtually instantaneous world of information access through telecommunications and the personal computer. As more information about health-related issues, breakthroughs in science and technology, and disease treatment advance, public demand spirals upward. Although health care’s future will ultimately be defined by public expectations, it will at the same time mandate the health care providers continually and systematically assess, ensure, and improve the quality and effectiveness of services provided. Hospital Reorganization The 1990s have ushered in a frenetic pace of price-driven competition among hospitals for the business of third-party payers, managed care organizations, and large employers for the services of physicians, and other hospital services. Hospitals must now compete on the basis of providing levels of care and services at predetermined prices. Financial risk continues to be shifted providers of health care as opposed to those that pay for such care. Much of this shift is a result of the growth of managed care and its impact on exposing excess hospital capacity. As a result of such trends, some hospitals that have not planned effectively or failed to recognize impending change have been forced to close. Hospital closures and consolidations are expected to continue into the next century. Unquestionably, the successful evolution of integrated health care will be determined economically. Yet, the health care industry must not lose sight of its mission to satisfy the needs of patients in the process. The interests of cost and profit cannot be allowed to supersede optimal patient outcomes. In the final analysis, demand for health care services will be satisfied at the price its consumers are willing to pay. Nursing assistants in this case, must market themselves to remain a part of such demand structure and ultimately demonstrate their roles in optimizing patient care outcomes and value (Abel & Nelson, 1990; Durgin & Hanan, 1999). The Future For nursing aides, the employment forecast is excellent. Four hundred thousand new jobs for nursing should open up in the next 5 years, according to the US Department of Labor, which ranks nursing aides as the tenth fastest growing occupation requiring a high school diploma or less in the coming decade. Salaries should increase as well. Many of the reasons for this growth are the same as those that are spurring demand for more home care aides and many other types of direct caregivers; our population is growing, it is growing older, and long-term care facilities and programs for the chronically ill are expanding. Specifically, employment opportunities for nursing aides should increase in nursing homes and other long-term care facilities and decrease in general hospitals which, increasingly, are focusing only on the seriously ill who require high-technology medical care (Swanson, 2000).

Adolescent Sexuality

SEXUALITY OVERVIEW Most teens and pre-teens have a lot of questions about sex and sexuality. This is normal and natural. It also is normal to feel shy or embarrassed about raising these issues with adults or healthcare providers. Sexual development is an important part of health, similar to other measures of physical growth, such as height and weight. Sexual behavior, which is related to sexual development, has important health implications for everyone, and especially for teens. It is particularly important that to be well informed about all aspects of sex and sexual health. Some basic information on sex and sexuality is provided in this review, which may answer some questions and raise others. Find an adult you feel comfortable with — perhaps a healthcare provider, parent, or teacher — to discuss any questions or concerns you may have. SEXUALITY: WHAT IS IT? Human sexuality is more than just whether you are male or female, and it is more than just the act of sex. It is a complex idea that involves your physical make-up, how you think about yourself, and how you feel about others and the society you live in. Here are some of the things that contribute to sexuality: Anatomic sex — Anatomic sex refers to the sex organs with which you were born. That is, you are either a boy (with a penis and testicles) or a girl (with breasts, a uterus, vagina, and ovaries). Occasionally, a baby is born with sex organs that are not normally developed and/or may appear to resemble both sexes; these individuals are said to have ambiguous genitalia or to be intersex. Anatomic sex is only one component of sexuality. Gender identity — Gender identity relates to how you feel inside, and whether you â€Å"feel† like a boy or a girl. Most people have a combination of feelings, including some that are thought of as â€Å"male† or â€Å"masculine† and some that are thought of as â€Å"female† or â€Å"feminine†. In most cases, someone feels mostly like a boy or mostly like a girl. Gender identity and anatomic sex sometimes do not match. For example, a person can be born as a boy but feel like a girl. This is sometimes referred to as transgender. Sexual orientation — Once you begin puberty, you are likely to begin to have strong physical and emotional attractions to others. Sexual orientation refers to whether you are primarily attracted to people of the opposite sex (heterosexual), the same sex as you (homosexual, gay, or lesbian), or both (bisexual). Sexual orientation is influenced by many factors, including your anatomic sex, your gender identity, the society you live in, and other factors, some of which are not completely understood. Sexual orientation is believed to exist on a continuum. That is, you may feel mostly attracted to people of the same sex as you but still have some feelings for people of the opposite sex, or vice versa. These feelings are normal and may change throughout life. ADOLESCENT SEXUAL DEVELOPMENT Sexual development begins in the pre-teen years and continues into adulthood. The body produces hormones that cause outward changes, including breast development in girls, the appearance of facial hair in boys, and growth of hair under the arms and in the genital area of both boys and girls. However, puberty is more than physical changes. As your body grows into adulthood, your way of thinking, emotions, and wants and needs will change as well. The factors discussed above (your anatomic sex, your gender identity, and your sexual orientation) will all become a part of how these changes affect you as a person. You will probably start to feel strong attractions toward others. Sometimes these feelings include developing friendships with other teenagers. Other feelings include wanting to be physically close to another person. You may find yourself attracted to someone of the opposite sex, someone of the same sex, or both. It's important to remember that these physical attractions can shift and change and that they develop at different times in different people. You may find you are attracted to someone of the same sex for a time, then find stronger attractions to someone of the opposite sex. Alternately, the reverse could occur. Over time, most teens will come to identify themselves as primarily heterosexual, homosexual, or bisexual. However, you should not be surprised if you feel confused about some of these issues during your teen years. This time of life may be troubling for teens who begin to identify themselves as homosexual or bisexual, especially if these ideas are not openly accepted by family members, friends, or the society in which they live. In this case, it is especially important for the teen to find a trusted adult and friends with whom he or she can talk openly. Several of the online resources listed below can also be of benefit (see ‘Where to get more information' below. It also is important to know that in the early years of puberty, it's normal to want to experiment with sexual activity. This often happens before a teenager is fully aware of how this activity might affect his or herself or others. As teens continue to grow and mature, they are better able to make choices about intimacy and physical relationships that will enhance their lives, rather than making choices that will cause problems for themselves or others. Adults generally recommend that teens not rush into sexual activity too soon, but rather wait until they are more mature. (See ‘Health issues related to sex' below. ) When you are sexually mature, you'll have a more developed sense of your preferences and desires. You will understand the possible consequences of having sexual relationships with others, and you will be ready to take responsibility for whatever occurs. You will be more ready to engage in the satisfying, intimate relationships that are an important part of life. SEXUAL ACTIVITY: THE FACTS There are many ways to express intimacy. Spending time with another person, holding hands, and kissing are all ways to show affection and begin to explore physical intimacy. As you develop attractions toward others, you will probably want to explore these and other types of physical intimacy. What might this involve? Most teens have questions about sex and sex acts. Here are some basic facts and definitions, including some important information about sexual boundaries; that is, what is and what is not OK as part of a sexual relationship. Genitals — Genitals are the external sex organs that are sensitive to and stimulated by being touched, which typically occurs during sexual activity. The male external organs are the penis and scrotum, which holds the testicles (figure 1). The female external organs are the vulva, clitoris, and the opening to the vagina (figure 2). Petting — Petting is feeling parts of another person's body. This usually refers to touching the genitals or other sexually sensitive areas, such as breasts. Orgasm — Orgasm is an intensely pleasurable release of tension felt in the genital area and elsewhere in the body. It usually results from stimulation of the genitals. In men and boys, orgasm is associated with the release of semen (called ejaculation), which contains sperm. The term â€Å"come† is a slang word for orgasm. Sexual intercourse — In general, this refers to sex involving a man's penis being placed inside a woman's vagina. When the man ejaculates during sexual intercourse, this semen is released into the woman's vagina. Pregnancy occurs if sperm, contained in the semen, are able to fertilize the egg released by a woman's ovary. However, semen can be released even if the man does not have an orgasm. Oral sex — Oral sex involves using the mouth and/or tongue to stimulate the genitals. Oral sex can occur between a man and a woman, between two men, or between two women. Anal sex — Anal sex is sexual activity involving penetration of the anus (the opening where bowel movements leave the body). A penis or another object is inserted into the anus during anal sex. Both men and women are able to engage in anal sex. Masturbation — Masturbation involves using the hands, or sometimes a device such as a vibrator or other sex toy, to stimulate one's own or someone else's genitals. Some people believe â€Å"having sex† only means sexual intercourse. But other activities, including oral sex, anal sex, or masturbation can also be considered as â€Å"having sex†. Even things like kissing or petting are considered to be sexual activity because they are part of how one person responds sexually to another person. Sexual boundaries — The only kind of sexual activity that is OK is activity that occurs between people who want to have sex with each other. Activity that occurs when a person is alone, such as masturbation, is also OK. If two people are having sex, both of them must be old enough and mature enough to participate without feeling pressured to prove something or try something new. If a sex act is forced upon a person who does not want to participate, this is called rape. Rape is a serious crime that can result in being arrested, spending time in jail, and having a permanent criminal record. Having sex with someone who is not sure they want to have sex can also be called rape. For teens, feelings about sex can be new and confusing. For example, sometimes a person begins kissing or petting but then changes their mind and wants to stop. The other person must always listen, even if it is very difficult to stop. It is not harmful to stop sex before orgasm occurs. Teens sometimes get into difficult situations if they are drinking or using drugs and having sex. In these cases, someone may seem to want sex, but they may be too drunk or high to know what they are doing. Later, the sex can be called rape. Teens may be lured into having sex with an adult. It is never OK for an adult to behave in this way. If an adult wants to engage in any type of sexual activity (kissing, petting, oral sex, intercourse), the teen should talk to a parent, healthcare provider, law officer, or other trusted adult at once. Even if you feel like you have done something to cause the adult to be attracted or have sexual feelings, the adult is responsible for controlling his or her behavior, regardless of the circumstances. Certain state laws, which vary from state to state, impose certain regulations or rules on sexual activity, even among teens. As discussed above, it is always a crime for anyone to force or coerce you into having sex against your wishes, no matter if it is an adult or someone around your own age. However, in some states, sex between teens below a certain age may also be illegal, even if both people want to have sex. Rules may depend upon the age of both partners and upon the sex of your other partner(s). Before deciding to have sex, speak to a trusted adult about these important issues. HEALTH ISSUES RELATED TO SEX The main reason it is important to postpone sexual activity until you are mature is that sexual activity affects both the physical and emotional health of the people involved. Here are some facts. Sexually transmitted infections (STIs) — There are a number of infections that can be spread during sexual activity. Infections can be spread through sexual intercourse, anal sex, oral sex, and using fingers, other body parts, or sex toys that have come in contact with another person's genitals or body fluids. These diseases are called sexually transmitted infections, or STIs (often called sexually transmitted diseases, or STDs). Common places STIs can occur are the genital organs, anus, and throat. Research has shown that young people are at an increased risk of developing STIs. The reasons for this are not completely understood. However, the younger you are when you start having sex, the more likely it is that you will get an STI. Also, having one STI can make it easier to acquire other STIs at the same time. In many cases, you can get an STI and not know it. This is because STIs often do not have any noticeable signs or symptoms. All of the STIs can have serious consequences for future health. For example, a woman who gets an STI may have difficulty becoming pregnant later in life or may be more prone to developing certain types of cancer, such as cervical cancer. Some of the most important STIs are: HIV — HIV (Human Immunodeficiency Virus) is the virus that causes AIDS (Acquired Immune Deficiency Syndrome). AIDS is a serious, incurable disease of the immune system. Until recently, everyone who developed AIDS died. Although new treatments are now helping many people with HIV infection live longer, there is still no cure for this serious disease or vaccine to prevent it. Many people still die each year from AIDS. Each year, between 40,000 and 80,000 people are newly infected with HIV. Half of these new infections are in people younger than 25 years old. New recommendations call for those who have been sexually active to be tested routinely for HIV infection. The earlier HIV is detected, the sooner a person can obtain treatment and the better their chances are of survival. Speak to your healthcare provider about HIV testing. (See â€Å"Patient information: Testing for HIV†. ) Human papillomavirus — Human papillomavirus (HPV) is the most common STI in adolescents. Most people who get HPV do not know they have it. Some types of HPV cause genital warts. Other types of HPV cause cervical cancer in woman, penile cancer in men, and anal cancer in either sex. A Pap smear is one important way your healthcare provider can screen for cervical cancer associated with HPV. (See â€Å"Patient information: Condyloma (genital warts) in women† and â€Å"Patient information: Cervical cancer screening†. ) In addition, there is a vaccine for girls age 9 to 26 years to protect against four common types of HPV. Speak to your healthcare provider about this important vaccine. (See â€Å"Patient information: Human papillomavirus (HPV) vaccine†. ) Gonorrhea and chlamydia — These are serious bacterial infections of the genital tract. They can lead to pelvic inflammatory disease (PID) in women, which can cause severe pain and can lead to infertility (inability to become pregnant). Both gonorrhea and chlamydia can be cured with antibiotics. It is important to be screened for these infections if you have had sex, because you may not always have symptoms. (See â€Å"Patient information: Gonorrhea† and â€Å"Patient information: Chlamydia†. ) Herpes simplex virus — This is a viral infection that causes painful or itchy sores or blisters in the genital area. The sores heal but can reappear at any point later in life. There is no cure. The virus can be spread even when there are no blisters present. Medications are available from your healthcare provider to shorten the length of time the blisters last and decrease your risk of repeat outbreaks. (See â€Å"Patient information: Genital herpes†. ) Hepatitis B virus — This is a viral infection that can cause liver disease. In most cases, the disease resolves after the initial illness. But in some people, serious liver damage or liver failure can occur. Most children and adolescents are being vaccinated against this infection with a series of three shots. You should speak to your healthcare provider if you are not sure if you have had this vaccine. (See â€Å"Patient information: Hepatitis B†. ) Syphilis — This is an infection caused by a small organism called a spirochete (/SPY-ro-keet/), which can cause an ulcer on a person's genitals or anus. It is fairly uncommon in teens but more common in certain populations. Sometimes you may not notice the ulcer, because it does not usually cause pain or may be on the inside of the vagina (in females) or anus (in both sexes). It is important to see your healthcare provider right away if you notice any sores or ulcers. The sore usually heals but can cause important long-term problems if untreated. Trichomonas — Trichomonas (â€Å"trich†) is a common infection caused by a tiny parasite that can cause itching and/or a discharge from a person's genital organs. Females notice symptoms far more often than males, although both sexes can be affected and require treatment by a healthcare provider. This infection can be cured with antibiotics. PREVENTING AND SCREENING FOR STIS The only way to be sure you will not get an STI is to not have sex. STIs can be transmitted through sexual intercourse, oral sex, anal sex, and using fingers, other body parts, or sex toys that have come in contact with another person's genitals or body fluids. STIs can be transmitted between a male and a female, between two females, and between two males who have sex. It is not possible to tell by looking at someone whether he or she has an STI. Even if the other person tells you they do not have an STI or says they are â€Å"clean†, you cannot be sure this is true. That is because the person may not know if they are infected. Also, it is common for teens to not be completely truthful about many things in relationships, including whether they may have been exposed to an STI. Condom use — People who are sexually active can reduce their risk of getting an STI by using a latex or polyurethane condom every time they have sex. Male condoms are worn on the penis, helping to prevent body fluids from passing to another person. Female condoms are also available, and can be placed in the vagina to help prevent fluids from passing from one person to another. (If a male and female are having sex, only one should wear a condom. If both the male and female wear a condom, the condoms could rub together and move out of place. ) Dental dams are another barrier device that can be used when performing oral sex on a female. (See â€Å"Patient information: Barrier methods of birth control†. ) Condoms and dental dams reduce the risk of getting an STI, but they do not take away the risk completely. Condoms can break or leak, allowing passage of body fluids and transmission of infection. In addition, condoms do not completely cover all of the skin that is exposed during sex; herpes and HPV can be passed by skin-to-skin contact. Other birth control methods do not reduce the risk of STIs. You can reduce the risk that a male condom will break or slip off in two ways. First, make sure the penis is completely hard before putting on the condom. Also, be sure to squeeze and hold the tip of the condom as you roll the rest of it down the penis, making sure there is no air pocket (like a small balloon) at the end of the penis. Immunizations — Another way to reduce the risk of two specific STIs (HPV and hepatitis B) is to talk to a healthcare provider about immunizations. As previously mentioned, most children and adolescents are routinely immunized against hepatitis B in the United States. The HPV vaccine is now available to females aged nine years and older. Check ups — Regular check-ups by your healthcare provider are important to all adolescents, but it is particularly important to speak with a healthcare provider if you decide to have sex. This talk should include ways to prevent pregnancy and STIs, as well as the need for regular testing for STIs, including HIV. Since STIs can occur in different body sites (genital organs, anus, and throat) and may have no symptoms, it is important to speak honestly with the provider about sexual behavior to get appropriate testing. If your healthcare provider is not comfortable or able to screen you for STIs, ask for a referral to a provider who can. Pregnancy and birth control — Pregnancy is a serious consequence of sexual activity between males and females. Each year in the United States, about 1 million adolescents become pregnant. Pregnancy in teens has serious health consequences. Pregnant teens are more likely to have babies who are premature or sick. A pregnant adolescent is more likely to drop out of school and live in poverty. Although some teens who become pregnant choose to have an abortion, this choice also carries risks. As with STIs, the only way a young woman can be sure she will not become pregnant is to not have sexual intercourse. There is no reliable way to determine a â€Å"safe† time when she will not become pregnant; menstrual cycles at this age can be irregular. Teens should know that pregnancy is possible each time they have sexual intercourse, including the first time and during the menstrual period. Birth control methods are available that can reduce the risk of pregnancy. However, birth control methods other than condoms do not reduce the risk of STIs. The most reliable methods (other than abstinence) must be prescribed by a doctor or nurse. These include birth control pills, patches, and injections. Other newer options for females include a vaginal ring that is worn in the vagina or a small device that must be inserted under the skin by a healthcare provider. (See â€Å"Patient information: Hormonal methods of birth control†. ) Some methods, such as condoms and contraceptive foam, can be purchased without a prescription. A condom should be used every time you have sex, even if another method is used to prevent pregnancy. (See â€Å"Patient information: Barrier methods of birth control†. ) If you use birth control but have an accident (the condom breaks, you forget a pill), you can take a â€Å"morning after pill† to reduce the risk of pregnancy. (See â€Å"Patient information: Emergency contraception (morning after pill)†. ) Teens who engage in sexual activity must be sure they have accurate information about the available birth control options. The best time to decide on a method of birth control is before you start having sex.

Sunset Grill at Blue Analysis Essay Example | Topics and Well Written Essays - 250 words

Sunset Grill at Blue Analysis - Essay Example igger issue to the management and thus prompted analysis SWOT analysis on Sunset at Blue to identify the exact genesis of the problem (Fitzsimmons & Brordoloi, 2014). To help this organization improve the service delivery and customer satisfaction, the concepts of gap model Gap Model was applied to benefit Sunset at Blue. The restaurant management was pleased with performance as they realized high customers and sales particularly on its first year of operations and had earned business of the year in the countries of Simcoe and Grey. However, the management had to device a new strategy to combat a problem that was increasingly building up at the restaurant, and could affect the performance in terms of customer satisfaction (Cheng, 2012). Even though sun set at blue restaurant provided healthy food to customers, the management had a problem of constant long queues of customers especially on Sunday (Fitzsimmons & Brordoloi, 2014). For instance, the servers were only two attending to the customer orders; this could be corrected using Gap model should be applied by the management. This concept entails bridging the gap between consumers in terms of their expectation and management perception that occurs when the management does not correctly perceive the customers want. The fourth in the gap model is directly important in this scenario as it arises between service delivery from the providers and external communication (Reitzel et al., 2014). The gap arises when customer’s expectations are not fully met the time of service delivery as in the case of Sunset at Blue. Due to inadequacy in terms of enough servers, the management of the Sunset at Blue should hire three more servers to ensure quick attendance to the customers’ orders (Fitzsimmons & Brordoloi, 2014). In addition, the management should provide more seats on at the weighting bay for the customers to feel comfortable as they await their service (Rachel et al, 2013). Cheng, C. (2012). Service quality

Landfill Gas Essay Example | Topics and Well Written Essays - 250 words

Landfill Gas - Essay Example One hazard of the production of LFG, particularly methane, is the possibility of the occurrence of gas explosion in areas where there is high concentration (ASTDR, 2001). With this kind of hazard and possible health risks of those exposed to LFG, methane has been considered to be captured and recycled for more beneficial purposes (EPA, 2014). One of the most productive uses of methane is its collection in landfills and processed to be converted to energy, like what is done in some areas of California. Removal of water from LFG makes it allowable for use in reciprocating engines. Further clean-up processes make it usable in manufacturing industries and gas turbines. Gas recovery facilities in California have produced approximately 246 megawatts of electricity since 1995. This amount of electricity came from the recycling of LFG, mostly methane (California Energy Commission, n.d.). Landfill gases have initially posed harm to humans and the environment, but with the continuous study of the processes involved in the production of landfill gases, the government has taken part in promoting its collection. The recycling of methane from landfills is the most productive because it has provided a source of renewable electricity. Through this processes and collection facilities, lower emissions of methane can escape into the atmosphere. The benefit that humans get from methane through conversion to electricity also benefits the environment by minimizing the greenhouse gas that causes global

Strategic management Essay Example | Topics and Well Written Essays - 2000 words - 19

Strategic management - Essay Example People of Stockholm are relatively proactive when they are charged to pay fees for using the roads because of their awareness over increasing degree of emissions. The same cannot be said to be true for the people of Delhi. A topic becomes interesting when it is on a burning issue of interest to all stakeholders. Increasing degree of emissions in the air has reached threatening levels from the increasing vehicular traffic and emissions of gases, harmful for all human beings. When a comparison is made between such cities, which are not parallel in the matter of advancement, the topic becomes more interesting and relevant. Although Delhi is the capital city of India and one of the leading developed cities in the matter of infrastructure development, yet its comparison with Stockholm, the capital as well as the largest city of Sweden, is inclined to show gaps in transport policies, adopted by these two cities’ governments. The major theme of this topic, as acknowledged by the authors, is that more than planning and functioning of the sophistication in transport means, the politics of sustainable transport plays a decisive role on the urban planning of these two cities and to highlight the differenc es of major transport functions and operations in these two cities, although similarities also exist in both cities’ urban development projects. The introduction includes two tables at the outset. Both the tables analyse the data of the two cities on the parameters of population, area, population density, household size and gross per capita income. One thing that comes to sharp notice is the time period of the data that begins from the year 2003 although the article print year is 2010. When it comes to statistical comparison of data, in my view, data should not be older than five years for the writing of such articles. One gets a blurred view when Delhi is

Culture, End of Life and Evidence Based Practice Assignment

Culture, End of Life and Evidence Based Practice - Assignment Example We also use scientific theories to support our hypothesis. Using their findings, we tend to explore and add evidences to tailor their needs or the clinical problem. It is not easy to find research findings that would be of clinical significance to your study. Critical thinking skill is very much essential in finding the best evidence that would support your study. In addition, the researcher in evidence based practice always work on what they think would be of the best interests of the patient. They also used their clinical judgment in applying evidence to patient care. 2. Discuss the process of how current evidence is used to make clinical decisions. In using current evidence to make clinical decisions, evidence based practice follows a distinct process which are different from nursing research process or research utilization. First, researchers observe, recognize, and identify clinical problem. After identification of the clinical problem, researchers will gather researches that ar e of clinical significance to the present situations. When we speak of clinical significance, we can say that related literatures or studies the researchers have gathered came from the experts and have used scientific theories. Using their critical thinking, the researcher will synthesize all the evidence and will integrate all the findings from the expert to the patient input or current situation. ... PICO stands for Population, Intervention being tested, Comparison, and Outcome (Gerrish & Lacey, 2010, 69). PICO could be illustrated in the question that follows: â€Å"In an adult population, does taking virgin coconut oil (compared to not taking one) increase the level of good cholesterol?† The population is the adult population, taking virgin coconut oil is the intervention, comparison set-up are those adults who are not taking virgin coconut oil, while the projected outcome is the increased levels of good cholesterol. 4. Identify common complementary and alternative therapies used by clients based on culture. The use of complementary and alternative therapies has increased dramatically for the past decades. Complementary therapies refer to treatment approaches that can be used in conjunction with conventional medical therapies whereas; alternative therapies are treatment approaches that are not accepted by medical practice (Daniels, 2004, 812). The used of complementary-a lternative modalities (CAM) depend upon the culture of an individual. Sometimes, those therapies of Western origin are called complementary while those who do not are called alternative. For instance, the Ancient Greek culture viewed health as the balance of in all the dimensions of life and healing is administered primarily by trained priest-healers. In Chinese, Japanese, and Indian culture, health is viewed as the balance between mind, body, and spirit. They have this concept called â€Å"energy force† which is deeply rooted on their religious beliefs; examples of which include the Tao healing in Chinese and the Ayurveda in Hindu culture. Aside from religious affiliations, one can observe the emergence of Shaman

Information Management Research Paper Example | Topics and Well Written Essays - 1000 words

Information Management - Research Paper Example Business field has experienced many transformations in developed countries over time. One major change is the use of information technology in order to achieve better communication. Written forms of communication for example e-mails, blogs and letters play significant roles in organizations. They enable execution of business issues in a more convenient manner because tasks such as accounting and employee appraisals are effectively undertaken. This paper offers analysis and critique of the association between information science, written communication genres and business aims; furthermore, it addresses issues affected by written communication.Analysis and Critique According to Demarco (2011), information technology is a critical pillar in advancing business operations in current competitive economic world. Critically, organizations who seek to leverage their business performance should comprehensively adopt sound technological methods in daily business transactions. These technological-enabled systems facilitate effective development of customer base through mutual networking and exchange of noble business ideals. For example, most organizations have designed definite e-mail and blog network systems through which communication with clientele is established. The clientele establishment has enhanced productivity and financial growth in most business settings, which has remained a potential element

Managing for Competitive Advantage Essay Example | Topics and Well Written Essays - 2500 words - 1

Managing for Competitive Advantage - Essay Example They introduce only two fabric and two garments innovations per year (2003, p8). A growth of .7% means nothing in the industry. They wanted to change many things at once in an effort to regain the lost market but in the process, they ended up losing core customers. The new team, M&R, believed in a selected range, high quality merchandise at reasonable prices with high value (2005, p4). They cut down the product line in clothing as well as in food sector. According to them, too many sub-brands had diluted the main brand. Your M&S helped to draw the brand together. They removed the slow lines and simplified the range (2005, p5). Their concentration was product, service and store environment (2005, p4). Reducing product line enhances the shopping experience they felt. V&H widened the price band by lowering the opening prices in some product lines and believed that they offered best value for money. They wanted to appeal to everyone so had all price ranges and catered to all ages. They wanted to attract the under 35 while M&R felt their core customers belonged to the 35-55 age group (2005, p4). M&R had sharper, very competitive opening prices (2005, p4) while V&H had inconsistent price architecture (2005, p4). V&H used press advertising to appeal to the younger customers. They introduced samples in stores and felt this boosted sales. They changed their products too often, and their designs were complicated (2004, part3, p9), which according to the new team, made the customer feel confused (2006, p5). It was also difficult to find the product they were looking for. M&R thus de-cluttered and simplified the store layouts while V&H constantly tried to change the displays at stores (2005, p5). V&R was not quick to recognize shift in customer demand and could not move fast enough to meet aspirations (2004, part3, p6). This could possibly be due to wide

The Great Depression of the 1930's Research Paper

The Great Depression of the 1930's - Research Paper Example The depression not only resulted in loss of jobs, but also resulted in psychological crisis which was attributed to loss of income and property, and the resultant sense of gloom which was endured by the country during those tragic years. Such events put the government and the Federal Reserve under great pressure to safeguard the rapidly deteriorating economy from worsening further and eliminate the social and commercial crisis faced by its people (Campbell, 2008). The exact reasons which led to the great depression are highly complicated in nature, and have been the subject of various debates among historians. Initially during the beginning of 1920s, the nation’s economy was relatively strong and consumer-oriented, with a booming automobile and consumer goods industry which produced products in large numbers to cater to the wide market. This could be substantiated with the presence of large companies such as General Motors and General Electric, which were not only successful i n the consumer goods market but also a major source of investments in the New York Stock Exchange along with other financial markets. The stock markets and financial institutions prospered greatly during those years, which led to a huge investment in those sectors, leading to an unprecedented rise in stock prices. The government concern increased, with the increase in stock prices, and the Federal Reserve along with the government began to introduce and develop policy measures to control the rising stock prices. Such measures taken by the government and the Federal Reserve paved way for the impending crash of the stock market, which began during October 1929. Although historians so far, have failed to pinpoint one single event which led to the collapse of the stock markets, and the resultant economic downturn that followed, resulting in billions of dollars worth of loss, large scale unemployment, failure of banks, and years of economic and social unrest. Timeline history of the peri od Year Events 1929 Feb 2 Federal Reserve Bank bans bank loans for margin trades June 15 - August Agricultural Marketing Act passed, Economic expansion peaks Sept, 3 Stock prices peak Oct 24, Oct 29 Black Thursday, sales of stocks was recorded at an all time high of 12,895,000, and 16,410,000 respectively resulting in a record forty points drop in the New York Times index Nov 13 Stock prices record a new low 1930 October Unemployment rises, Committee for unemployment relief formed Dec 2 Government funds a $150 million public works program. By the end of 1930, nearly 1350 banks suspend their operations 1931 Official report suggests that nearly 4-5 million people were unemployed Oct 16 New York Federal Bank increases its discount rate from 1.5 per cent to 2.5 per cent Oct 23 New York Federal Bank once again increases its discount rate from 2.5 per cent to 3.5 per cent Dec 11 New York Bank collapses. By the end of the year nearly 2293 banks shut down Lack of economic safeguards During the depression there was large scale unemployment, various banking and other financial institutions failed and had to shut down, and there was a sharp decline in the GNP leading to disastrous outcomes. Such widespread and negative repercussions were mainly as a result of lack

The Information Technology skills Essay Example for Free

The Information Technology skills Essay It is clear to me how University of Phoenix’ convenient and efficient educational program designed for working professionals, has helped me grow. I see tremendous change and development in myself. I have not only matured personally and professionally, but have also grown to believe in orderly goals and motives with respect to my existence. My life has been organized and I see greater potential for my progress. The outlook of the entire university, dedicated to the success of its students, may be viewed now in who I am as compared to who I was before joining the BS of Information Technology program. When I started the program at University of Phoenix, my professional attitude was unseasoned. I was an unsure person, someone who had not matured. My humble and uninformed self did not allow me to think much of my career. I had briefly dreamt of becoming a graphic designer. However, I had wrongly imagined that I would not go too far. My mind was set at thinking that I might have to do with unsuitable jobs. What else are high school graduates supposed to do? I did not aspire to be great or hold lofty goals for my career. My goals were in fact, not many. I only desired to keep myself employed. My knowledge base was limited. I was raw. To that end, I am absolutely honest to claim that I knew little or nothing about the things I have learned at the University of Phoenix. Knowledge has been added on to my life at a rapid pace with this great program. Before this, life could seem sluggish to me as an unaware person. At work, I did not consider myself a professional. I did not even present myself as such. I was simply working; holding a job because one has to do that in this uncertain world. I would describe my writing skills before the program as ranging from bad to good. This is one of the areas where I have experienced drastic change. Besides, I now have extremely different views about myself and my career. My verbal communication skills before the program may also be described as varying from bad to good. With less confidence, the way I presented myself was obviously poor. I did not grasp at the time that professionally, one must appear assertive and proficient to get the work done. At present, I like to view myself as a thorough professional. My critical thinking skills before the program were good. All the same, my â€Å"Critical Thinking† (PHL/251) general education course worked wonders to polish my skills. It was for this reason that I had chosen the course. I believe that my decision was absolutely correct. After all, critical thinking is crucial in both personal and professional life. My interpersonal skills were always excellent, according to my opinion. This is because I believe in people, trust them, and wish to know more about them in order to be of assistance to them. I chose the general education course called â€Å"U. S. History to 1865† (HIS/110) because I was deeply interested in understanding the mechanics of human relationships, as well as the causes and effects of human decisions. Learning about U. S. history was essential, seeing that the people I share my space with do also share the same history. Hence, I believed unconsciously that I would be able to improve myself in my relations with others if I studied human history. Once again, my decision to opt for this general education course was correct, seeing that I now deal even more effectively in my personal and professional relationships. The most important core courses with respect to my employment were â€Å"Critical Thinking: Strategies in Decision Making† (MGT/350) and â€Å"Project Planning and Implementation† (CMGT/410). I opted for these courses because I believe that professionals who know the functions of management are always more successful than the rest. Furthermore, these courses helped me to assimilate my ideas about team projects as well as leadership. I further believe that all professionals must be armed with knowledge of management, even if this knowledge is specialized in terms of Information Technology. What is more, decision makers, project planners and implementers must always bear in mind the people connected with the decisions and projects. Indeed, this idea connected with my love for people and interest in human relations. Moreover, I now connect better with the people at my workplace, and truly understand more about the mechanics of decision making and project planning as well as implementation. One of the terminal objectives of my program was, of course, for me to mature into a successful individual in my professional life. Even at my current organization – General Mills, where I presently work as a Network Engineer – development and innovation are priorities as well as major targets. Hence, both the University of Phoenix and General Mills have contributed to my current upsurge or growth. But the job without the education at University of Phoenix would definitely not be as good as it is at present. At this time, however, my job is a huge part of who I am and who I want to be. The program at University of Phoenix has really been a great source of inspiration for me. Employment may have helped me go on living. But the education here has helped me to live life fully, to enjoy my work and to be proper in all respects. It has shown me the way to live life in a way that is better, not just to live as I may have heard others living. Life does not just drag on anymore. It is full of enthusiasm and anticipation for a bright present and future. I am applying the tools that I have learned through the University of Phoenix, and there is hope to use them in better ways to achieve higher goals. I am eager to learn even more of that which would help me along. Learning should be a life-long process so that one’s intellectual powers do not rust. Before the program, it was as though I, as a resource, was underutilized. Now I feel fully functional. Just as General Mills thrives on research and development, I see myself flourishing with an increase in my knowledge base and the utilization of my mental resources to their fullest capacity. The Information Technology skills learned by me through the program at University of Phoenix are incomparable to anything I have ever been taught. I feel more grown-up now because of what this program has done for me. I have been shown much of my potential. It seems that I have learned a lot and there is excitement in me now to know more. Life does not seem like dreary employment anymore. I enjoy my personal and professional life much more now that I have been a part of the University of Phoenix. As far as my ethical outlook is concerned, I see no change between the past and the present, and I do not see it changing either. My values have not changed. My self-esteem has increased because the way I see myself has changed. Whereas I may have been covered by darkness in my mind, I now see myself in the light, capable of doing much, maintaining goals, and wanting to do all that is good. I certainly have become advanced in my professional attitude. With regards to my personal attitude, I even walk more confidently now and that has a serious affect upon my professionalism too. At work, I have to be responsible, knowing and showing that I can make it right and to the top. It is as though I have been cultivated and I know what I am doing now. My career views have changed so much that whereas I had seen myself doing basic jobs and not going too far in my professional life before I joined University of Phoenix, now I feel confident and able to be the leader at work. I feel that the axiom ‘the sky is the limit’ is working in my life now. Earlier I may have thought that it is impossible to have such an attitude unless one’s performance was really marvelous. But this program has been about trying to do one’s best and fulfilling one’s potential. It has made me open my eyes and view the world out there full of possibilities for a bright human being wanting to do more and wanting to do what is excellent. I feel capable of reaching the top of my company now. Furthermore, now that I have had a glimpse of my highest potential, I also feel self-assured and competent enough to be at the top of another organization, if not my present company. A part of this newly found confidence in me is a result of observation. Even so, the knowledge that has been imparted to me with the wonderful Information Technology program takes most of the credit for my motivation today. Resonant with my new goals is the fact that my knowledge base has grown impressively. I now know not only that which is taught at undergraduate level in my field, but I am also seen by others as a better professional. My professional sense is increasing, signaling that I must continue trying to do better. I do not see the way down now. What is more, I am now able to hold professional presentations and meetings with high level professionals at General Mills. I am also more interested in my work at present. Over the next five years, my professional and personal attitudes may become more refined. I hope to become more mature and confident. I now understand how learning more can make one grow. I do not only want to continue learning, but I also want to continue growing until I can become a self-actualized individual. I wish to develop my ability to move to higher levels in my career through greater productivity. My goal is to be my best and also to be the very best in others’ opinion. I would like to attend a graduate program. I have so greatly and positively been influenced by the undergraduate program at University of Phoenix that I hunger for more of education. I understand to an extent how much it can do for me. Before the program, I did not think much of education besides the fact that it is necessary to a certain level. But because I have been working and noticing the changes that education brings into my professional life, I long to gather more knowledge. Education is directly related to success. I love the changes higher education has brought to my life and I welcome this fantastic transformation on an ongoing basis. Thinking is the basis of our actions, and if the undergraduate program at University of Phoenix could do so much for my life and attitudes, I cannot yet imagine where a graduate program might put me with regards to my professional position. I need more guidance for the future though, to be specific about what I would really do. I see the possibilities laid open before me, but which way do I really go? Many ways seem important. Perhaps I would settle for an MBA. In any case, I would have liked the University of Phoenix to better assist me in getting to the right place at the right time in future. To get a clearer sense of my educational goal at present, I may have to go for education counseling. I would like to recommend at this point that the University of Phoenix should incorporate an extensive education counseling program for its students. Over the next five years, I wish to grow to have more business sense. This may happen through higher education and additional years of experience at work. In point of fact, I would like to improve in all spheres of my life, and in the areas of my being that are good now, I would like to keep a balance whereby I do not drift to the low side of things. With my new outlook, I feel ready to take responsibility to add value to the world, even if it is solely by way of doing my job well and showing others that honesty, hard work and learning can go a long way. I feel worthwhile now and am prepared to continue struggling through life with zeal. When life gets slothful, I know what I must do to change that and to be promoted learn. I must continue learning.

Advantages and Disadvantages of Plastic Surgery

Advantages and Disadvantages of Plastic Surgery When the goal is to make yourself look better in any form, the first option that would strike your mind would perhaps be plastic surgery. Like everything, plastic surgery also involves many pros and cons. And when it comes to advantages and disadvantages, you need to plan things before you make up your mind to go for plastic surgery. Although there are many disadvantages associated with plastic surgery the advantages of plastic surgery will definitely outweigh the disadvantages of plastic surgery. Teasing and taunting by someone about your features will take their toll on a persons emotional and mental well-being. Not only years of teasing cause emotional scars but a person who is dissatisfied about something in them will be equally affected. Well in this case even a small procedure that would affect your self-esteem positively can work wonders for such persons. Plastic surgery is a procedure to change ourselves not only to look better but to feel better as well. Disadvantages of Plastic Surgery The obvious risk of plastic surgery is that it not only involves complications but also the risk of receiving bad work. This is for sure, no one wants to spend substantial amount money to look even worse that before or to be affected by side effects involved in plastic surgery. In order to clarify all the possibilities of plastic surgery, whether good or bad, you should consult your doctor before you plan any surgery for you. This will assist you in knowing the risks involved and to get prior knowledge of the medications to which your body reacts unpredictably. With cosmetic surgeries, results may be unrealistic, not up to the expectations of the person undergoing surgery. Advantage of Plastic Surgery The advantages of plastic surgery are no doubt dramatic, like the ability to use a hand, remove skin cancer or close an open wound, or subtle like cosmetic or skin surgery or rhinoplasty for a young woman etc. Cosmetic surgery has become one of the most common events in the lives of people of all age groups, after all everyone takes due advantage from this processes. The motive behind the surgery can be any, removing birth marks or unattractive looking scars, re-scaling of noses, get rid of enlarged breasts or any other problem. The sole purpose behind plastic surgery is to get a good appearance and therefore to enhance self-confidence. While doing all this, you should not forget that these surgical procedures can prove to be fatal and has a lot of risks involved in it. Taking decision in favour of plastic surgery is like putting yourself under testing as there is no guarantee of the results in the surgical treatments. Another important thing that you should keep in your mind is that, the surgeon who will perform the surgery is certified and has been qualified for conducting such kind of surgery. Do not risk yourself just to enhance your outwardly appearance to get mental pleasure. The factors that will affect you if you undergo should not be overlooked but the problems should be considered and rectified.

government paper :: essays research papers

The Democratic Parties beliefs include Fight the influence of giant corporations and powerful moneyed interests, which have diluted the power of the people, Empower grass roots Democrats by the establishment of greater democracy in the Democratic Party at all levels of Party structure and processes, Achieve greater democracy and empowerment of individuals in all governmental structures and processes, promote election reform and increased access to the political process, and preserve the integrity of voting rights and political processes, Increase the participation and empowerment of persons of low income in our Party and our government, Terminate Patriot Act I and reject Patriot Act II The United States should enact a new foreign policy based on respect for human rights and other governments, and they want to end the policy of pre-emptive first strike, and work instead to lead global efforts to dismantle nuclear weapons and other weapons of mass destruction. The Democratic Party is very large in the U.S it and the Republican Party are the biggest in the U.S. Members of the Democratic Party include John Kerry who was the Democratic Party presidential candidate of 2004. he did well and almost won but bush has too many zombie followers. Another member of the party is Bob Clinton he was president for 8 years and during his presidency the economy of the nation was doing well and we weren’t at war. He did however cheat on his wife but honestly after looking at his wife who could blame him, also it was way to publicized because I know the people want to know about there president but him and his wife need privacy just like any other marrage. I myself agree with most of the party’s beliefs they want to give more power to the people and a lot of them are non violent which is a good thing most people just want to destroy every country because there is a chance they might have nuclear weapons, but we’ve always had nuclear weapons and what gives us the natural born right to be the world’s dictator. I for one believe in pro-choice even though I generally support the Democratic Party I can’t agree with every thing they believe but in general I like how democrats think.

Why Creationism Should Not Be Taught in Public Schools Essay examples -

A hotly debated topic concerning public schools centers on the origin of life. Now more than ever, science and religion are butting heads. What should public schools teach to their students? Alex Rainert reasons that both â€Å"science and religion are engaged in the same project, to discover the origin of life† (141). In short, one could better describe the debate as a crusade between evolutionists and creationists; both sides have their well-founded arguments, but when one looks at the decisions of the courts, clearly only one side may win the battle when deciding biology curriculum in schools. Despite an overwhelming number of individuals in favor of teaching creationism in public education, science classes should refrain from becoming a discussion of religious belief. In 2004, Sharpes and Peramas report that â€Å"nearly two-thirds of all Americans surveyed favored teaching creationism together with evolution in schools,† according to a poll organized by CBS Broadcasting (qtd. in Costley and Killins 5). Thus, it seems as if the public has bought into the fair play argument proposed by creationists. After all, creationists contend, why not have a place to teach equally credible theories of the origin of life in schools? (Eldredge 634). Chet Raymo, a noted science professor of physics and astronomy at Stonehill College, rejects this notion, stating, â€Å"one might as well give equal billing to those who believe the Earth is flat† since creationism stands on little factual ground (156). At any rate, the U.S. Supreme Court illustrates that teaching creationism puts pressure on minorities to conform to the obviously favored religion when the power of the government backs up the theory (qtd. in Anti-Defamation League 143). Therefore, if s cho... ...nd Religion Will Transform Your Life and Our World. New York: Penguin Group, 2007. Print. Eldredge, Niles. â€Å"Creationism Isn’t Science.† The Conscious Reader. 6th ed. Ed. D. Anthony English and Eben Ludlow. Needham Heights: Simon & Schuster, 1995. 633-638. Print. Hickman, Cleveland Pendleton. Integrated Principles of Zoology, sixth edition. St. Louis: The C. V. Mosby Company, 1979. Print. "Of Darwin, Dover and (un)intelligent design: scholar says the future of science— and Church-State separation--are at stake in the creationism/evolution conflict." Church & State 62.2 (2009): 10+. General OneFile. Web. 23 Feb. 2012. Rainert, Alex. â€Å"Creationism V. Evolutionism in America’s Public Schools.† Cooke 138-41. Print. Raymo, Chet. Skeptics and True Believers: The Exhilarating Connection Between Science and Religion. Walker Publishing Company, Inc., 1998. Print.

Women and the Fight for Reform :: essays papers

Women and the Fight for Reform Women in the late 19th century, except in the few western states where they could vote, were denied much of a role in the governing process. Nonetheless, educated the middle-class women saw themselves as a morally uplifting force and went on to be reformers. Jane Addams opened the social settlement of Hull House in 1889. It offered an array of services to help the poor deal with slum housing, disease, crowding, jobless, infant mortality, and environmental hazards. For women who held jobs, Hull House ran a day-car center and a boardinghouse. Addams was only one of many early reformers to take up social work. Jane Porter Barrett, an African American, founded the Locust Street Social Settlement in Hampton, Virginia, in 1890. Her settlement offered black women vital instruction in child care and in skills of a being a homemaker. Lillian Wald, a daughter of Jewish immigrants from New York City, began a visiting- nurse service to reach those too poor to pay for doctors and hospitals. Her Henry Street Settlement offered a host of vital services for immigrants and the poor. Wald suggested the formation of a Federal Children's Bureau. By the end of the 19th century, many women reformers focused on the need for state laws to restrict child labor. Young children from poor families had to work late hours in mines and mills and were exploited by plant managers. No state laws prevented the children from being overworked or abused. One of the first to challenge the exploitation of orphaned or dependent children was Sophie Loeb, a Jewish immigrant from Russia Once her father was deceased, she watched the desperation of her mother as the family slipped into poverty. As a journalist, Loeb campaigned for window's pensions when this was still a new idea. Helen Stuart Campbell, born in 1839 in New York, began her public career as an author of children's books. Then she used novels to expose slim life's damaging effect on women. In 1859 she wrote a novel about two women who break from their dependence on men and chart new lives. Campbell also wrote how easy it was fir women's lives to be ruined by poverty and despair. Some women went beyond advocating reform to promoting revolution. There are many other famous women who helped lead the fight to reform. Like Florence Kelley. In 1891 Kelley worked with Addams at Hull House and became an investigator for the Illinois Bureau of Labor, and then was appointed the U.

My First Day Essay Essay

My First Day†¦ As of today, August 30th, I, Blah blah blah, took the initiative to explore the entire campus. Today, the temperature could have possibly been right at about 93 degrees, and I decided to walk around this gigantic campus to waste time before my next class. During orientation week, I missed the campus tours because I was too busy sleeping my day away. So, what other way to compensate for lost time than to take my very own campus tour? Initially, I intended to look for the art buildings, but the best thing I discovered after my journey today happened to be the fact that the art buildings were being reconstructed. Just my luck. However, I did find the Knight Physics building which happens to be absolutely gorgeous. I also happened to stumble across the school’s arbortorium. I felt like I was walking through a jungle with my combat boots on and the leaves hovering above my head. I walked around in a circle and found my way to the school of law. The school of law is literally like its own kingdom within the campus. The students had their own law shirts, and the windows of the classroom even had curtains to block the sun out. I know curtains are a pretty simplistic observation, but I could not help but to find that fascinating! I have failed to sit in any classroom that had panels to block the sun. Only in the law school at the University of †¦. As I walked away from the law school, I made my way towards the UC area and back around towards the Rat. Passing the vivacious students lounging with their friends, I hiked around the lake under the scorching sun wishing that I had a bottle of water, a hat, and maybe even some sun glasses. The heat was pretty unbearable. Passing between the Hecht and Stanford towers, I ventured towards the school of architecture. That is one white building. I expected it to be more lavish in its exterior design seeing that it is the school of architecture. I walked past the school of architecture and head back towards Mahoney-Pearson. I know that area pretty well. †¦ is my new home for now. As I left the Mahoney-Pearson area, I circled around towards the UC area again and crossed the winding paths towards the Whitten Learning Center. There was approximately 10 minutes left to spare before class started, and the brightest idea that I came up with all day was†¦ to finally sit down!

Modern Technology Essay

When we look back to the history of human being in recent 200 years, we will be surprising what a huge change modern technology has brought us. Trains and planes enable us to travel to everywhere we want. Internet and televisions communicate news to everyone. New technologies provide us a new standard of living, and I state that they are creating a single world culture. Modern technology has shortened the distance between cultures, and made the world smaller. People can travel or migrate from one place to another very quickly. They see how people in other zones dress, speak and behave. The more exposure to other traditions and customs they do, the more likely they adopt to those. As a result, their own traditions and customs are replaced by a massive one. Another reason for the impact of modern technology on creating a similar world is that it makes possible for cultures to communicate with each other. When watching TV programmes, searching web and chatting through the Internet, people learn about foreign cultures and try to make some of those their own. The exchange of knowledge has had a great impact on their lives. The cafà © from Brazil, the scotch from Scotland, the cigars from Cuba, the wine from France, the American music, that appear and become well-known in many parts of the world are good examples of how modern technology influences people’s life and also creates a single world culture. With the rapid development of modern technology, people learn and come to appreciate foreign cultures. They recognize the value of variety. Therefore, in the near future, there will be many similarities in country’s cultures. Traditional cultures around the world may be more willing to join our call for a single world one.

SWOT analysis for Nurses and Health care environments Essay

Strengths, Weaknesses, Opportunities and Threats in a health care environment. SWOT – for management, mentoring and nursing Hospital nursing swot analysisA SWOT analysis is a tool that can provide prompts to the managers, clinical leads, nurse tutors, nurse mentors and staff involved in the analysis of what is effective and less effective in clinical systems and procedures, in preparation for a plan of some form (that could be an audit (CQC), assessments, quality checks etc.). In fact a SWOT can be used for any planning or analysis activity which could impact future finance, planning and management decisions. It can enable you (the management& clinical staff) to carry out a more comprehensive analysis. Definitions of SWOT †¢Strengths – Factors that are likely to have a positive effect on (or be an enabler to) achieving the clinic’s objectives †¢Weaknesses – Factors that are likely to have a negative effect on (or be a barrier to) achieving the clinic’s objectives †¢Opportunities – External Factors that are likely to have a positive effect on achieving or exceeding the clinic’s objectives, or goals not previously considered †¢Threats – External Factors and conditions that are likely to have a negative effect on achieving the clinic’s objectives, or making the objective redundant or un-achievable. Before starting any planning or analysis process you need to have a clear and SMART goal or objective. What is it that you need to achieve or solve? Ensure that all key stakeholders (relevant to the issue being explored) buy into this objective or goal. Then undertake a PESTLE analysis (or PESTLE in Clinics), this will provide you with the external factors (OT). Use the PRIMO-F model to ensure all internal factors are considered Conducting a SWOT analysis in a clinical environment One of the most effective ways to conduct a SWOT analysis is not in isolation, but with a team effort. When the goal is shared, then a brainstorming session can be run. Ensure than when running such a session it is facilitated by a person not involved with the content – this is best with an independent person. If budgets do not allow this – then talk to another establishments head, and arrange a contra deal. Do this activity in a number of phases: 1.Share the goal 2.Data collection (no filtering or comments – record verbatim) consider all areas of PRIMO-F 3.Take a break of at least 1 hr 4.Filter, sort and analyse into the 4 areas – SWOT – be critical and SMART avoid ambiguous statements or ideas at this stage 5.Prioritise the elements Have a second session where the planning phase takes this data and puts it into a realistic plan. IMPORTANT TIP – do not hide or underestimate threats or weaknesses – if you ignore them or underplay them now they will come back to haunt you at some stage – probably when they can do most damage! The goal of any session like this is not necessarily to neutralise any weakness or threat – that is impossible – but to have it on your radar – and where possible take avoiding action. To some extent it is all about risk. What sort of tasks and issues can this be used for? At its most complex and comprehensive, it can be used for business planning, however it is also of value to solving localised issues and challenges. An Example of a nursing based SWOT We will use an example of a nurse working within a primary care clinic who want to improve the relationship with their patients. TASK 1.Define the goal and measurable outcomes – i.e. to have less than 50% of patients spending one hour waiting for treatment 2.Consider the current activities you have in place to encourage patient-partnerships within your clinic. 3.Complete a SWOT analysis, identifying your current strengths and realistically appraising your current weaknesses. This can only be done involving other nurses, doctors, support staff and patients. 4.From the current analysis identify factors which could be improved 5.Identify opportunities that could be created 6.Put a plan and set of measures in place. The clinic identified the following objective: †¢To improve parent-partnership by encouraging patients to visit the clinic and become active members of the community. †¢Outcome – to have less than 50% of patients waiting more than one hour for treatment Currently, the clinic holds an open day once each year. It uses this as a way to encourage patients to visit the clinic and engage with clinic staff. The following is the initial SWOT Analysis. Strengths †¢Highly-skilled clinical staff. †¢History of successful Open day events †¢Clinic has a strong ethos of openness, sharing and commitment to increasing patient confidence †¢Patients wanting to get involved †¢Local charities willing to participate Weaknesses †¢Nurses not available to meet patients often enough †¢Current open days events not increasing voluntary activity †¢Not enough staff time to plan more events †¢Staff not clear of their role in the patient relationship †¢Narrow focus on open events not partnership activities †¢Services too stretched for additional activity Opportunities †¢Active volunteer committee willing to plan and organise events †¢Patients active in the clinic’s Patient Participation Project can be asked for their opinions and suggestions. †¢Head Nurse is willing flex clinic times to free up clinical staff time †¢Use patients to contribute to practice delivery Threats †¢Confidentiality is at risk †¢Patient coercion to do things they do not wish to do The next step is to develop a plan with interested stakeholders SWOT Analysis templates for Nursing, clinics & health care SWOT Analysis Template/ Worksheet – use these templates to start your SWOT process SWOT Analysis on ____________________ (organisation name or product/ service/ project)Clinic/ establishment/ organisation Background/ situation ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________(usual business partners, relationships, channels to market, assumptions etc†¦) Date PESTLE completed ____________________ Date of SWOT Analysis ____________________ ____________________v INTERNAL Under each of the PRIMO-Ffactors list the relevant strengths and weaknesses.List the Opportunities and threats from your PESTLE analysis below.Then considering the combination of these factors generate some options or alternative strategies for action. Strengths (PRIMO-F) †¢People (nurses, patients, CLINICAL GOVERNANCE TEAM etc) †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Resources †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Innovation & Ideas †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Marketing (communications) †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Operations (day to day running) †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Finance †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ Weaknesses (PRIMO-F) †¢People (nurses, patients, CLINICAL GOVERNANCE TEAM etc) †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Resources †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Innovation & Ideas †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Marketing(communications) †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Operations(day to day running) †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢Finance †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ E X T E R N A L Opportunities †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ SO Alternatives / Strategies †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ WO Alternatives / Strategies †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ Threats †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ ST Alternatives / Strategies †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ WT Alternatives / Strategies †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ †¢___________________ Try our organisational SWOT analysis tool for free NOW – Or return to our main SWOT analysis page SWOT Analysis Template / Worksheet for Nursing/ Clinical Environments 2 SWOT Analysis on ____________________ (Clinic/ establishment organisation name or product/ service/ project)Background/ situation__________________________________________________________________________________________________________________________________________________________________ __________________________________________________________________________________________ (usual operational partners, relationships, channels to market, assumptions etc†¦) Date PESTLE completed ____________________ Date of SWOT Analysis ____________________v INTERNAL Under each of the PRIMO-Ffactors list the relevant strengths and weaknesses.List the Opportunities and threats from your PESTLE analysis below.Then considering the combination of these factors generate some options or alternative strategies for action. Strengths Weaknesses E X T E R N A L Opportunities SO Alternatives / Strategies WO Alternatives / Strategies Threats ST Alternatives / Strategies WT Alternatives / Strategies Try our organisational SWOT analysis tool for free NOW – Or return to our main SWOT analysis page SWOT Analysis Template / Worksheet for Nursing/ Clinical Environments 3 SWOT analysis – Strengths, Weaknesses, Opportunities and threats Date Company/ Department name Internal Factors Our Strengths Ways to exploit Our Weaknesses Ways to reduce External factorsOur Opportunities Ways to exploit Our Threats Ways to reduce

Acars Via Iridium

ACARS via Iridium Iridium is a large satellite constellation that consists of 66 low-earth orbiting (LEO), cross-linked satellites operating as a fully meshed network providing truly global coverage (including oceans, airways and polar regions). Iridium satellites are in a near-polar orbit at an altitude of 485 miles. The network is composed of 66 active satellites that fly in six orbital planes, each with 11 satellites per plane. Satellites circle the earth once every 100 minutes. ACARS is an Aircraft Communication Addressing and Reporting System otherwise known as Digital DataLink System.ACARS was first developed in the 1970’s. It is a point-to-point service that either sends air-to-ground messages or receives ground-to-air messages from the cockpit. ACARS via Iridium now gives Flight Departments the capability to communicate with the aircraft in their fleet all over the globe. ACARS is now a viable option via Iridium. Until now ACARS was only available by 2 different medium s. ACARS via Very High Frequency (VHF) communication is only available through line of site.ACARS via Inmarsat (Satcom) is only available over the populated continents and does not provide communications over polar routes. The cost of Iridium service is far less than that of Satcom and is available over oceans whereas VHF is not. This allows aircraft to access various services provided by ACARS Service Providers. Aircraft can now send a number of automatic reports (OOOI, engine oil pressure, position reports, fuel, and etc) using ACARS via Iridium. Pilots can request relevant information pertaining to flight safety and receive necessary in-flight updates.Some of the data services include: Text-based and Graphical Weather, Flight Planning and Clearances, Text Messaging, Position Reporting, Automatic Terminal Information Services (ATIS), Terminal Weather Information for Pilots (TWIP), and OOOI messages (Out of the gate, Off the ground, On the ground, and Into the gate). New flight saf ety services such as Controller Pilot Data Link Communications (CPDLC) and Future Air Navigation System messaging (FANS) are currently undergoing live tests to help improve flight times and routes for Air Transportation.Typical ACARS messages are only 100 to 200 characters in length. Such messages are made up of a one-block transmission from (or to) the aircraft, constrained to be no more than 220 characters within the body of the message. Iridium’s Short Burst Data Service (SBD) has the network transport capability to transmit short data messages between field equipment and a centralized host computing system. ACARS blocks are 238 bytes maximum; segmenting and distributing them across multiple SBD messages is not necessary. Each ACARS block is encapsulated in a unique SBD message.ACARS requires ARINC-429 Interface, compliant with ARINC 741 characteristics for satellite communication systems. Standardized nature of the ARINC 429 digital data bus allows Satcom Data Unit (SDU) to interface with wide variety of ACARS capable hardware. Air-to-ground messages are originated from the Control Display Unit (CDU), which is located in the cockpit of the aircraft. The pilot will initiate his request through the CDU, where the Data Management Unit (DMU) will pass the ACARS requested message onto the Iridium Satcom Data Unit (SDU).The SDU encapsulates each ACARS block into an SBD message and sends the SBD message to the Iridium gateway. The SBD messages are received by the Iridium gateway, converted back into ACARS blocks, then passed on to the chosen DataLink Service Provider (DSP) through the service provider gateway. Conversely, ground-to-air messages from the data provider are passed through the service provider gateway as ACARS message blocks. Once received by the Iridium gateway, they are encapsulated as SBD messages and delivered to the aircraft.Once the SDU has received an uplink SBD message, it removes SBD-specific information and passes the remaining data to the DMU as an ACARS message block via the ARINC 429 data bus. The DMU then interprets and displays the ACARS data via the CDU. ARINC (Aeronautical Radio, Incorporated) and SITA (Society of International Telecommunications Aeronautics) are the two DSPs available to the airlines. ACARS messaging allows the airlines to identify abnormal flight conditions and automatically send real-time messages to an airline, thereby enabling airlines to improve their aircraft performance.

Answer exam question1 Essay Example | Topics and Well Written Essays - 1000 words

Answer exam question1 - Essay Example It is a systematic approach, which entails various activities performed to get people’s performance to attain agency, group and individual goals, (Mitchell 2007, p.90). Staff appraisal is a strategy used to evaluate an employee’s job performance (based on job quantity, quality, cost and time) by the management. Staff appraisal is an aspect of guiding and career development management, and the process is used for obtaining, information recording and analyzing the relative value of a workers to the company. Staff performance appraisal analyzes the current achievements and limitations, individual limitations and strengths of an employees as well as qualification for additional training. Objectives and purposes in multinational organizations The main objective of performance management systems and staff appraisals is to connect the goals and strategies of an organization to personal and group performance to enhance effectiveness of an organization – increased product ivity and profitability. Multinational organizations require performance management systems to asses and ensure that their workforce is performing their duties as required in a satisfactory and efficient way that contributes to the overall organizational goals and target, (Aguinis, 2009, p.52). Performance is the actual test for marketplace survival, therefore, high performing workers contribute to excellent performance, giving the organization a competitive advantage – and their additional effort distinguishes exceptional organization from others organizations. Effective performance system encourages teamwork, effective communication and collaboration among employees, which is crucial for multinational organization to survive in competing market place. It is critical for companies to have the system in place to define, appreciate, rewards and maintain their best performers to attain sustainable growth as a survival mechanism. Appraisal performance, on the other hand, aims to enhance worker’s job performance by defining the limitations and strengths and creating channels of utilizing these strengths within the company and overcoming the weaknesses. How applicable are these techniques to non-western societies? The general inadequacy of management skills and expertise hinders complex structures development like systems of performance management in non-western societies. They thus focus on introducing and imitating systems and tools from western societies that are not applicable and suitable for local situations, (Harzing and Ruysseveldt, 1995, p.85). This poses a question of whether modern techniques such as performance management systems and staff appraisal are applicable for non-western societies. Yes, these techniques are applicable to non-western societies because poor management practices, inefficiencies in bureaucratic systems and reduced productivity force managers to adopt rapid and ready to implement western techniques. These techniques ar e crucial to non-western societies encourages teamwork, effective communication and collaboration among employees which is crucial for their survival in competing marketplace, (Mendenhall and ODdou, 2000, p.20). Performance management systems and staff appraisals is required to connect the goals and strategies of an non-western societies to personal and group performance to enhance effectiveness of the organizations. Conclusion The approach of performance ma

Lawrence v. Texas Essay Example | Topics and Well Written Essays - 1500 words

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