jayson williams is guilty essays

jayson williams is blameworthy expositions Previous NBA player Jayson Williams, 36, is completely answerable for the February fourteenth (2002) shooting of Costas Christofi. Christofi, 55, had been recruited to drive Williams' companions from a Bethlehem, Pa. good cause occasion back to his bequest. Williams shot Christofi while giving his home visitors a voyage through his Hunterdon County home following a night out. Williams' sibling, and eleven different visitors, including four players from the Harlem Globetrotters, were at the house the evening of the shooting. As per the observers who affirmed at the preliminary, while Williams was indicating his visitors around his main room, he snatched a twelve-measure shotgun from his weapon bureau, opened it, and afterward yanked it shut. At the point when the firearm shut, it terminated, striking Christofi in the chest. He was discovered shot to death in the main room. Williams was accused of murder and different charges which incorporate blocking trepidation, proof altering, witn ess altering, creating physical proof and trick to impede the law for the passing of his limousine driver (Free Press). What is difficult to comprehend is the reason Williams even removed the shotgun from his weapon bureau. Something which is considerably increasingly hard to comprehend is the means by which he was unable to understand the shotgun was stacked. On the off chance that he realized it was stacked, might he be able to really be that wild to mess with it. Likewise, for what reason was the weapon in any event, confronting Christofi? There is no uncertainty that he did nott intend to execute Christofi, however how might he be so crazy? The way that he shot Christofi isn't even the upsetting part. Christofi's demise was at first revealed as a self destruction, however it was later governed a murder after a dissection affirmed it. A 911 tape really uncovers Williams saying that a man ended it all in his home. Williams advised his visitors to concede to stating that Christofi executed himself. During the time wherein Christofi was fired, Williams cleaned down the weapon and afterward attempted to t... <!

A Separate Peace Character Analysis Essay Example For Students

A Separate Peace Character Analysis Essay A Separate Peace is a transitioning novel around two young men at life experience school and their companionship during World War II. There are three huge scenes of viciousness that happen in the novel; in any case, the center of the plot depends on one. The first and most strong is where Gene, the storyteller, shakes the tree limb while he and Phineas, his closest companion, are getting ready to bounce, causing Phineas to fall and break his leg. The following scene of viciousness is when Quackenbush considers Gene a weak and Gene drives him into the water. In conclusion, Gene pushes Leper out of his seat while visiting him after he is blamed for causing Phineas injury. These events add to the general importance of the work. One of the peaks of A Separate Peace occurs at the principal scene of savagery. Until this scene, the peruser is unconscious of Genes fiendish side. He is so surpassed by his desire and fury toward Phineas that he surrenders to his feelings and causes Finny to tumble off of the tree limb. This shows the juvenile, infantile side of the characters. Not exclusively are they climbing trees, which is a conduct generally rehearsed among kids, however youngsters likewise don't have the foggiest idea how to deal with sentiments and feelings, and normally respond with brutality. Quality at that point continues to jump off of the branch like nothing occurred, obviously happy with his accomplishment; demonstrating the peruser that, similar to a youngster, there is almost no regret for ones activities. The following scene of brutality, where Gene responds to Quackenbush, is brought about by Quackenbushs referral to Gene as a faltering for choosing to be a team chief as opposed to going out for a game. This is after Phineas mishap, which Gene feels answerable for; and he thinks about the affront literally. Qualities response to the affront shows the peruser the real closeness among Gene and Phineas. By taking the affront to such an individual level, the peruser can see how Gene and Finny have become nearly as one individual. Quality feels just as he is disabled himself on account of the snugness of the bond among them, and the blame he feels for Finnys injury. The subject of development likewise turns out to be clear, as Gene feels substantial loaded down with blame and obligation regarding the choice he made to bump the branch. The last vicious scene likewise delineates Genes battle among development and adolescence. He causes Lepers seat to fall over when blamed for making Finny tumble from the tree. On one hand, the youngster like characteristic of depending on savagery when gone up against with outrage and humiliation is appeared. He knows Leper knows reality, yet is reluctant to confront it. Be that as it may, then again, by losing control and protective in any case, Gene shows he is repentant and liable for his activities. Savagery in some structure is a piece of practically every keeps an eye on youth, and it can even be resembled to the battling happening in Europe around then. Despite the fact that the fierce scenes in A Separate Peace are not many, they contain extraordinary reason and are noteworthy supporters of the novel all in all. Every occasion is representative to the soul changing experience went by Gene and his friends, not just turning out to be men battling for a harmony inside, yet warriors battling for a tranquility of countries.

The Benefits of Having Sex More Often

The Benefits of Having Sex More Often Relationships Spouses & Partners Print The Benefits of Having Sex More Often Emotional, Physical, and Relationship Benefits of Frequent Sex By Sheri Stritof Sheri Stritof has written about marriage and relationships for 20 years. Shes the co-author of The Everything Great Marriage Book. Learn about our editorial policy Sheri Stritof Medically reviewed by Medically reviewed by Carly Snyder, MD on November 20, 2019 facebook twitter linkedin Carly Snyder, MD is a reproductive and perinatal psychiatrist who combines traditional psychiatry with integrative medicine-based treatments.   Learn about our Medical Review Board Carly Snyder, MD on November 20, 2019 More in Relationships Spouses & Partners Marital Problems LGBTQ Violence and Abuse In This Article Table of Contents Expand Ideal Frequency Psychological Benefits Physical Benefits Relationship Benefits Challenges Tips View All Back To Top There are many reasons to have sex more often, at least when it comes to quality sex in a supportive relationship. More frequent sexual activity is linked to physical benefits, such as lower blood pressure, emotional perks, such as reduced stress, and relationship benefits, such as greater intimacy and a lower divorce rate.?? While there is not a magic number when it comes to the ideal frequency of sex, the results of a few studies can suggest a ballpark. Illustration by JR Bee, Verywell   Ideal Frequency As far as the ideal frequency, a 2015 study found that general well-being is associated with sexual frequency, but only up to a certain point.?? Relationship satisfaction improved progressively from having no sex up to having sex once a week but did not improve further (and actually decreased somewhat) beyond this point. This goal number is fairly consistent with the current average, but should be of concern with our increasingly busy lives. Looking at the frequency of sex in the 2010s, adults are now having sex nine times per year less than in the late 1990s.?? What Is the Average? Average adult: 54 times/year (about 1/week)Adults in their 20s: Around 80 times/yearAdults in their 60s: 20 times/yearAverages based on a 2017 study published in the Archives of Sexual Behavior. Even though the frequency often decreases with age, sexual activity in older adults remains very important to many people. Those who are married people tend to have sex more often than those who are not.?? Psychological Benefits There are many emotional and psychological benefits from making love that is strongly linked with overall quality of life. Some of these include: Happiness According to a 2015 study conducted in China, more sex and better quality sex increases happiness (though unwanted sex lowers happiness).?? Stress Relief That many people deal with chronic stress is a given and has been cited as a reason why adults are having sex less often. This may be a double whammy, as sex may be considered a stress management technique. Our bodies secrete cortisol and adrenaline (epinephrine) as part of the stress response. These hormones (the fight-or-flight response), can lead to fatigue, high blood pressure, and much more. Sex can reduce the level of these hormones, with effects that can last well into the next day.?? Improved Mood There are a number of chemicals our bodies release during sex that can affect how we feel. During sex, our brains release endorphinsâ€"feel good chemicals that can reduce irritability and feelings of depression. Another hormone, oxytocin (the hug drug), is released with nipple stimulation and other sexual activity.?? Similar to the effect it has on nursing mothers (oxytocin is responsible for the let down reflex in breastfeeding), oxytocin can create a sense of calmness and contentedness. Finally, orgasm leads to the release of yet another hormone, prolactin, that can aid in sleep.?? Improved Self-Image Sex can boost self-esteem and lower feelings of insecurity, leading to a more positive attitude. Physical Benefits Its fairly intuitive that sex would improve emotional health, but there are a number of physical benefits as well. Some of these include: Improved Physical Fitness Sex is a form of physical activity, and there are a number of studies linking exercise with better health. According to a statement from the American Heart Association, sexual activity is equivalent to moderate physical activities such as walking briskly or climbing two flights of stairs.?? The movements associated with sex can tighten and tone abdominal and pelvic muscles. For women, this improved muscle tone translates to better bladder control. The 200 calories burned in 30 minutes of sex,?? combined with the reduction in food cravings associated with the chemicals released during sex, are beneficial as well. Better Immune Function Being more sexually active also has positive effects on immune function.?? This translates to a lower likelihood of getting a cold or the flu. Reduced Pain The endorphins mentioned above do more than lead to a sense of well-being and calm, but appear to reduce pain (such as migraines and back pain) as well. Cardiac Effects Sexual activity (but not masturbation) has been linked with lower systolic blood pressure.?? Elevated blood pressure, in turn, is associated with an increased risk of heart disease, stroke, and more. Its thought that sexual activity helps dilate blood vessels, increasing the delivery of oxygen and nutrients to the cells of the body while reducing blood pressure. Its important to note that having sex can also promote a heart attack in those at risk, but having sex more often may help reduce this concern. While sex can precipitate a heart attack, and anyone at risk should talk to their doctor before having sex, a 2011 study published in JAMA, found that this risk is diminished in people who have high levels of regular sexual activity. In other words, and similar to other forms of physical activity such as running, infrequent activity could put a strain on the blood flow to the arteries supplying the heart, but regular activity may be protective.?? Brain Effects In the past, studies in rats found that more frequent intercourse was correlated both with better cognitive function and the growth of new brain cells. Researchers are now learning that the same may be true in humans. A 2018 study looking at over 6,000 adults found that having sex more often was associated with better memory performance in adults ages 50 and older.?? Sexual Effects Being more sexually active actually boosts libido and increases vaginal lubrication in women. Making love is more often associated with lighter menstrual periods and less bothersome period cramps. For men, while it was once thought that sex caused an increase in prostate cancer, a 2016 study found that men who had more ejaculations (21 or more per month) were less likely to develop the disease than men who had fewer (seven ejaculations or less per month). Since prostate cancer is the second leading cause of cancer-related deaths in men,?? this is worth noting. Other Physical Effects A number of other physical effects have been associated with more sexual activity, such as an improved sense of smell, healthier teeth, improved digestion, and that healthy-skin glow thats related to an increase in the release of DHEA by the body. Unsafe sex could tip the scale of benefits and risks in the opposite direction. Make sure you are familiar with safe sex practices. Relationship Benefits Having sex often can benefit you and your partner individually, but it can also help your relationship in a number of ways. Having regular sex in a monogamous relationship can increase your level of commitment and help you connect emotionally. Couples are more likely to stay together when they can express their love in this way, and the divorce rate is significantly higher for couples who dont. The relational benefits of sex are assisted by the chemicals our bodies make: The release of oxytocin, in addition to being calming, can contribute to bonding and greater emotional intimacy.?? Challenges We are wired from birth to crave the intimacy of sex, and lacking sex is one of the things that can lead people in a relationship to grow distant and, perhaps, look elsewhere. Its important to note, however, that an active sex life is sometimes difficult or impossible due to physical or psychological conditions. Couples can maintain a strong, healthy relationship despite this, and looking at non-sexual ways to improve intimacy is invaluable even for those who cant have sex on a regular basis. Working with a licensed couples therapist can help as well. Jumpstarting Your Sex Life The frequency of sex can, and often does, change over time, but that doesnt mean that its a progressive downhill slide. If youre wondering if sex can ever be as good as when you were first madly in love, the answer is yes. It can even be better when you add in what you didnt have before: a stable loving relationship thats grown mature and intimate. That said, it can take work. There are a number of ways to spice up your sex life, but looking at the non-sexual parts of your relationship is just as important. As many say, the biggest sex organ is between the ears. Increasing the frequency of sex without talking and connecting emotionally isnt likely to create lasting improvement. Stress management is also important. In her book, The Sex-Starved Marriage: Boosting Your Marriage Libido, a Couples Guide, therapist Michele Weiner-Davis  suggests taking a just do it approach: At first, many were understandably cautious about my Nike-style approach to their sex life; the Just Do It advice ran counter to everything they had believed about how sexual desire unfolds...I could often see the relief on peoples faces when they learned that their lack of out-of-the-blue sexual urges didnt necessarily signify a problem. It didnt mean there was something wrong with them or that something was missing from their marriages. It just meant that they experienced desire differently. If you always wait for your level of desire to match that of your partner, you may be waiting a long time. Getting in the Mood for Sex A Word From Verywell There are obviously many benefits to having sex more often (or a minimum of once a week) in a loving and supportive relationship. That said, all is not lost in your relationship if you are unable to have sex this frequently or at all. Your love can grow just as strong. If you are able to have sex but not enough, ask yourself why. Sometimes seeing a sex therapist may be the best way to work through any issues you are having. Keep in mind that it could make a difference not just for your relationship, but for your own physical and emotional health as well. The 6 Best Online Marriage Counseling Programs

Tour Operator Agency Database Essay - 634 Words

Tour Operator Agency Database Jeremy Clark Dr. Larisa Bulysheva CIS 515 – Strategic Plan For Database Systems August 14, 2013 Tour Operator Agency Database Week 6 Assignment 5 Mike Jennings Enhanced Database Management Strategy Proposal An efficient data structure design requires a thorough analysis of both the rules a business follows and the relational business objects that allow the production of output for the organization. An efficient model of data should as well require little maintenance and oversight if built properly. Designing a data model promoting data redundancy and normalization provides a design that requires minimal modification to handle. (Tupper 2011) For your†¦show more content†¦For the Tour table in Figure 5 the primary key that I chose I made composite to uniquely identify the attributes related to the purchase of a tour. The composite primary key CustomerID,EmployeeID,TourName,TourDate,TourSeason for the Tour table allows this table to almost act like an invoice for each tour sale. Figure 5 Tour Table 5. My tables were in 1NF and because I had no partial dependencies my tables were now in 2NF Proposed Naming Convention and Entity Attributes The table names â€Å"Employee†, â€Å"Customer†, â€Å"Tour†, and â€Å"TourCost† accurately define the data represented within each table. To better associate the data in the Tour with its operational purpose I will rename to TourInvoice. For this organization I’ve gone back and renamed several entities to better associate the entity to the table it belongs to. For example the FirstName attribute in the EMPLOYEE table was renamed to EMPFirstName to associate this first name attribute with the EMPLOYEE FirstName and not Customer First Name which was changed as well. See the captures below for entity and attribute names and their data types. Figure 6 Naming Convention for Employee and Customer Table Figure 7 Naming Convention for TourCost and TourInvoice Table Proposed Entity Relationship Model Figure 8 Many Customers complete one invoice (TourInvoice) at the sale of a tour. One TourInvoice is assigned a PricePerson contained within the TourCostShow MoreRelatedTour Operator Agency Database. Essay697 Words   |  3 PagesA multinational tour operator agency has gained new business growth in the North American market through the use of social media. Its operation has expanded by 50% within six months and the agency requires an enhanced data management strategy to sustain their business operations. Their existing data repository for its reservation processing system is limited in business intelligence and reporting functionalities. 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As a result, thanks

A Research Study On Nutrition And Treatment Of Blood Glucose

Today most people take for granted the amount of research, time, effort, and money that went into the development of medications or medical treatment. When someone reaches for the aspirin bottle to relieve a pounding headache or that lifesaving injection of insulin used daily to treat and manage levels of blood glucose are both the end results of long and costly research. Without research the awareness of vitamin deficiencies, treatments for cancer, organ transplantation, and vaccines for humans and animals would cease to exist. It all begins in the laboratory and the study of pathophysiology which looks at how living organism function and the effects certain disease. Basic research â€Å"bench studies† or preclinical research is performed†¦show more content†¦(Grady, 2008) For example, after a new drug or medical device has been proven safe and effective and is available to the general population, it still has to be monitored by the FDA for any possible unknown safety concerns, negative side effects, and/or potential unsafe drug interactions. In figure 1, the timeline only represents clinical trial research and development. In some cases basic research â€Å"bench† studies could take decades and may never even result in a clinical trial or ending up â€Å"beside†. Figure 1. Timeline of Clinical trail research and development. From Public Health News Ethical dilemmas can present themselves and consideration of ethical principles happen at every step of the way of the research process. For example, during the Ebola outbreak in 2014 there were several vaccines that were still in the experimental phase, meaning they had only been tested in laboratories on animals and still needed clinical researched involving human subjects. Researchers are under a great deal of pressure to find a cure or treatment and encounter ethical dilemmas. The need for a vaccine is urgent, however, rushing the experimental clinical phases could put people at greater risks and potential harm which violates the principle of beneficence to do â€Å"no harm†. The researchers had to decide which human subjects out of a large population infected with the virus would receive the experimental

Ehrs in Health Care Free Essays

EHRs in Health Care x x x Abstract In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH) was passed into law mandating interoperable Electronic Health Record (EHR) adoption throughout the United States health care system for all providers who serve Medicare or Medicaid patients. The HITECH Act sets â€Å"meaningful use† requirements, goals, and objectives, and gives specific timelines for which to achieve them. As an incentive to expedite the process, the Centers for Medicare and Medicaid Services (CMS) has offered monetary rewards for those facilities and physicians who are taking steps to implement an EHR system by 2015. We will write a custom essay sample on Ehrs in Health Care or any similar topic only for you Order Now Beginning in 2015, CMS will penalize facilities and physicians who have not implemented an EHR system. One of the stipulations of receiving the incentive money is demonstrating â€Å"meaningful use†, or utilizing EHR technology in a meaningful way that improves patient care. Meaningful use has three stages, each focusing on different areas of patient care. There are several advantages and disadvantages of implementing an EHR system, but the benefits greatly outweigh the risks. The HITECH Act is one of the most important pieces of health care legislation to date and has been called the â€Å"foundation for health care reform† (Blavin Ormond, 2011). In 2004, the Bush administration introduced a plan to ensure that the medical profession completely converts to electronic health records (EHR). This plan was passed into law by the Obama administration in 2009 under the Health Information Technology for Economic and Clinical Health Act (HITECH), which is a provision of the American Recovery and Reinvestment Act (ARRA) (Kwami, n. d. ). This Act is essentially a $27 billion stimulus package meant to accelerate health care information technology in the United States. It allows the Centers for Medicare and Medicaid Services (CMS) to offer financial incentives (up to $44,000 from Medicare and $63,750 from Medicaid per physician or up to $2 million per hospital) for implementing an Electronic Health Record (EHR) system in their facility by 2015 (Murphy, 2012). Not only do they have to implement it, they must also meet the â€Å"meaningful use† requirements set forth by CMS for successful utilization of the EHR system. To receive the maximum incentive payment, physicians/facilities must begin participation by April 1, 2013. Starting in 2015, physicians and facilities who have not met those requirements will be penalized. What is Meaningful Use? Meaningful use is an umbrella term for the rules and regulations that hospitals and physicians must meet to qualify for the federal incentive funding under ARRA. There are three stages of meaningful use; each has different goals and objectives. For example, stage one focuses on data capture and sharing, and is grouped into five patient-driven areas related to patient health outcomes: 1. ) Improve quality, safety, and efficiency, 2. ) Engage patients and families, 3. ) Improve care coordination, 4. ) Improve public and population health, and 5. ) Ensure privacy and security for personal health information (â€Å"Meaningful Use 101,† n. d. ). Step two focuses on the advanced clinical processes involved in patient care and stage three will focus on improving actual patient outcomes. Requirements for meaningful use include the ability to e-prescribe, electronically exchange patient health information, and report on clinical data. The eventual goal is a national health information network. Facilities and physicians must achieve stage three of meaningful use by 2015. Traditionally, physicians have been reimbursed based on how many services they provide (fee for service). Meaningful use shifts this paradigm to a more patient centered process and concentrates on performance-based initiatives like pay for performance (P4P) reimbursement. CMS recently introduced three P4P programs mandated by ARRA designed to reward higher-performing hospitals and penalize poorer-performing hospitals through these reimbursement practices. Hospitals performing at or below the 50th percentile nationally on hospital quality and patient experience measures can expect to see a significant reduction in payment from CMS as early as 2012 (â€Å"Pay for Performance Payment,† n. d. ). The shift from volume-based to value-based reimbursement methodology puts more emphasis on patient care and achieving positive outcomes. Another part of meaningful use requires that EHRs are interoperable with other facilities and physicians even if they are not the within the same organization. This means that every organization’s EHR system must to be able to â€Å"talk† to other organizations’ systems. If a patient travels to another state or another country and needs to go to the doctor for any reason, the physician there will be able to bring up the patient’s EHR and treat them based on the up-to-date medical information contained in their EHR. This is especially important in emergency situations where the patient may not be in the position to supply needed information. Locally, interoperability is important because it helps physicians communicate with other facilities such as a referral. A patient’s family physician may refer them to a specialty doctor and with an EHR, both doctors can view and document findings in one record rather than having separate papers that need to be brought in by the patient and filed in their paper record. EHRs are also an asset within the same facility. When a patient gets a lab or x-rays done, the physician can immediately bring up the results rather than having to wait for the lab/x-ray technician to physically bring the results to them. Interoperability makes coordination of care easier and more efficient. Advantages of Implementing an EHR In addition to the benefits of interoperability, there are several other advantages of implementing an EHR. The main goal of an EHR is to improve the quality and safety of patient care. EHRs can help provide better health care by improving all aspects of patient care like safety, effectiveness, patient-centeredness, communication, education, timeliness, and efficiency (â€Å"What Are the Advantages,† n. . ). Having a single record that includes all of a patient’s health information and is up to date, complete, and accurate allow for better coordination of care, accessibility of information, convenience, simpler disease management, enhanced collaboration between providers by improved information sharing, a significant reduction in medical errors, up-to-date medication and allergy lists, and cost savings in the long run (â€Å"Benefits of EHRs,† n. d. ). EHRs al so reduce waste and liminate duplicate screenings and tests, as well as help physicians make better, more comprehensive clinical decisions by integrating patient information from multiple sources into one EHR (â€Å"What Are the Advantages,† n. d. ). Another advantage of having your health record in electronic format is increased security and privacy. With a paper record, anyone can pull it off the shelf and browse through it, but with an electronic record there are differing levels of authorization allowing only certain people access to your chart. Also, your chart cannot get â€Å"lost†. Instead of someone having to sign it out every time they need to use it and having to manually track it, an EHR allows multiple users to access it at different times, on different computers, and leaves an audit trail automatically. Disadvantages of Implementing an EHR There are also disadvantages of EHRs including overall cost, ongoing maintenance costs, changes in workflow, and temporary loss of productivity just to name a few (Menachemi ; Collum, 2011). One of the biggest concerns of implementing an EHR system is the initial cost. Acquiring and implementing an EHR system can be quite expensive depending on the size of the facility. The projected total cost for a medium sized inpatient facility with a seven year EHR installation is approximately $19 million. In the outpatient setting, cost is approximately $14,000 per physician in the initial year of implementation for a six-physician practice, and $19,000 per physician with three or fewer physicians (Menachemi ; Collum, 2011). Smaller practices may find it hard to cope with the added expense of an EHR system; the viability of those practices may suffer as a result. Another disadvantage of implementing an EHR system is the cost of transitioning from paper to electronic records. Additional staff will be required to scan in all of the paper documents into electronic format. This process can take months depending on how big the facility is so it could really have an impact on a facilities bottom line. There will also be a period of time where the staff is less productive than they would normally be as they learn how to use the electronic system. This period is called the â€Å"learning curve†. To help remedy this, temporary staff will need to be hired to fill in the gap and keep the workflow up to date which also has a significant financial effect on an organization. The maintenance of an EHR system can be costly and technology is not always reliable. Hardware must be replaced and software must be upgraded on a regular basis. In addition, providers must have ongoing training for staff as well as IT support available, such as a 24/7 help line. Also, as with all things electronic, there is always the possibility of the system going down. Hospitals and physicians must have a plan in place outlining what the proper procedure is for the â€Å"down time† until the system is up and running again. This generally means they will have to revert back to paper documentation while the system is down, so they also need to have a recovery plan in place detailing how they will go about getting the paper documentation from the â€Å"down time† transferred into the EHRs. Conclusion Although some might argue that an EHR system is too costly and too much work, it is a federal mandate that all physicians/facilities (who service Medicare or Medicaid patients) implement an EHR system. And while the transition from paper to electronic is a costly and tedious process, the benefits of an EHR are numerous and greatly outweigh the cost of implementation. As President Obama said, â€Å"You shouldn’t have to tell every new doctor you see about your medical history or what prescriptions you’re taking. You shouldn’t have to repeat costly tests. All that information should be stored securely in a private medical record so that your information can be tracked from one doctor to another — even if you change jobs, even if you move, even if you have to see a number of different specialists. That’s just common sense. † (Making the Switch: Replacing, 2010). References Benefits of EHRs. (n. d. ). Retrieved February 13, 2013, from http://www. healthit. gov/providers-professionals/improved-care-coordination Blavin, F. , ; Ormond, B. (2011, May). HITECH, meaningful use, and public health: Funding opportunities for state immunization registries [White paper]. Retrieved from http://www. medicaidhitechta. org/Portals/0/Users/011/11/11/ImmunRegWhitePaper. pdf Kwami, K. K. (n. d. ). The EMR federal requirements of physicians. Retrieved February 13, 2013, from http://www. how. com/list_6961848_emr-federal-requirements-physicians. html Making the switch: Replacing your EHR for more money and more control [White paper]. (2010, September). Retrieved from http://www. healthcareitnews. com/sites/default/files/ resource-media/pdf/making_the_switch_replacing_your_ehr. pdf Meaningful use 101. (n. d. ). Retrieved February 13, 2013, from http://www. medicity. com/meaningful-use- 101. html Menachemi, N. , ; Collum, T. H. (2011, May 11). Benefits and drawbacks of electronic health record systems. Retrieved from http://www. ncbi. nlm. nih. ov/pmc/articles/PMC3270933/ Murphy, K. (2012, May 9). American Recovery and Reinvestment Act (ARRA). Retrieved from http://ehrintelligence. com/glossary/american-recovery-and-reinvestment-act-arra/ Pay for performance payment systems that reward or penalize hospitals based on performance. (n. d. ). Retrieved February 13, 2013, from http://www. getwellnetwork. com/services/health-reform/pay-performance What are the advantages of electronic health records? (n. d. ). Retrieved February 13, 2013, from http://www. healthit. gov/providers-professionals/faqs/what-are-advantages-electronic-health-records How to cite Ehrs in Health Care, Essay examples

Strengths And Weaknesses Of Diversification †MyAssignmenthelp.com

Question: Discuss about the Strengths And Weaknesses Of Diversification. Answer: Introduction Diversification is a strategy which is used for the purpose of expansion of business in the existing marketplace or in the other fields of market. Primary aim of implementation of this strategy is to enter into a new market with a new product or service or launching the existing product by adding unique and attractive features for the purpose of re-launching in the existing market. This strategy sometimes acts as the part of defensive and offensive set of strategies. It is one of growth strategies described under Ansoff Matrix model. The statement Diversification is a perfectly logical development, ensuring the rationale and efficient use of resources defines that diversification is implemented in the workplace with the objective of ensuring success and growth (Aspara, et. al., 2011). When a business enters into a new market, lot pf challenges and opportunities comes which needs to be faced in an effective manner so that desired goals could be acquired. For the same purpose, diversif ication strategy is implemented in the workplace. In this essay, several aspects of the diversification, its correlation with the other aspects of Ansoff Matrix framework will be covered. Along with this, strengths and weaknesses of diversification strategy will be covered. Further, tools which describe relation between external business environment and diversification will also be discussed. Concept of diversification and types of diversification Concept of Diversification Diversification is a risky section of Ansoff Matrix as business organizations does not have much experience in the new market, thus, the chances of products succession are very less. Ansoff Matrix has defined four growth strategies i.e. market penetration, product development, market development and diversification. As per Ansoff, diversification strategy is unique and distinct from other three growth strategies because the risk level is pretty high in diversification. The first three strategies are applied in the workplace with the help of existing technical, financial and merchandising resources which company already using for its existing product line. But in case of diversification, organization requires to adopt new set of strategies along with new technological and facilities. Acquisition of new skills and knowledge is also required in adaptation of diversification strategy with the objective of successful expansion of business in new markets with new products (Kumar, Gaur Pat tnaik, 2012). Before implementing diversification strategy in the workplace, organization is required to conduct market research and related strategies so that the target customers needs, market environment, competitors involved in the industry, strategies used by them, etc. elements needs to be considered. This helps the organization to introduce and promote new products in new marketplaces with the objective to gain success and growth. Product diversification is a concept under which new products and existing products are being manufactured and promoted in new marketing conditions so that business could be expanded. Various companies have also adopted the method of expansion of existing product line under which a new product is being launched related to the existing product (Villarreal, Cusimano Renner, 2015). For example, tooth paste manufacturing firm launches tooth brushes and tooth powers under the same brand name. Companies also use product extension and brand extension in order to uplift sale volumes and the number of customers with the objective of increase market share in the target or in new market (Whittington, 2014). Types of diversification In order to establish a sustainable competitive advantage in the target market along with implementing the differentiation strategy, it is required to make a clear understanding regarding differentiation strategy. The rationales on which differentiation strategy is implemented in the workplace are customer needs, quality of product and services and competitors. Product differentiation has various approaches and this is carried out at workplace with the core business objective of gaining competitive advantage through adding unique features in their existing products or by launching totally different product for making a separate image from its competitors. There are various means through which product differentiation could be carried out in a business such as product differentiation, image differences, service differentiation and many more (Martin, et. al., 2012). Through adaptation and implementation of differentiation strategy within workplace, organization could gain success and gr owth by using the existing brand value which will help them to successfully launch the product in the new market along with avoiding the direct confrontation with the competitors. Therefore, it could be said that differentiation is an effective strategy through which companies could earn sufficient amount of profits by utilising the available industrial resources (Zhou, 2011). Following are certain types of diversification: Horizontal Diversification: Approaching to the different target market through launching unique products and services which are unrelated with the existing product line of the organization is known as horizontal diversification (Park Jang, 2013). For instance, PepsiCo diversify its products through launching an energy drink. This type of diversification is also known as related diversification because companies diversify their offerings related to their existing product lines. Vertical Diversification: Under this type of diversification, company starts from the initial stage of its existing product line in order to make improvise existing products and services (Chioda, et. al., 2011). For example, a reconstruction company starts selling paints. Concentric Diversification: Available technologies and marketing system of an organization are fully utilised with the motive of enlarging the production portfolio (Liu, et. al., 2014). For instance, cosmetic products manufacturing company starts producing shampoo. Unrelated diversification: When a company diversify its offerings unrelated to its existing product lines is known as unrelated diversification. For example: Coca-Cola starts rendering consultancy services. For example: In last 80 years, Volvo Group which is a Swedish multinational company engaged in production of trucks, cars, buses, etc. Its technical team is constantly working on exploring security technologies for improving the credibility of their products in the international market. In this regard, three-point belt invention is their landmark invention. Company granted this invention free to all other companies of the same field which has now become a basic configuration for all automotive. Although, there is not much complications in this invention and it is too simple but it has saved many lives and it has also helped the Volvo to gain effective image in terms of safety technology in the global automotive market (Althoff, Segraves Johnson, 2014). Benefits and diversification Diversification generates various ways for an organization to grow, prosper and expand in the target market. With the help of diversification, organization could gain several financial advantages. For instance, when a company acquires another enterprise or comes into a joint venture with other business enterprise, it leads to increase in the revenues of the organization which also impacts organizational profitability (Kim Reinschmidt, 2014). For instance, before launching of a new drink in the target market, PepsiCo executes market research strategy with the objective of ascertaining the risk and opportunities factors. Successful implementation of diversification strategy will lead the organization to increase its market share in marketplace. Introduction of new and effective products and approaching to the appropriate group of customers is an essential aspect of diversification which helps organization to increase its customer base. For instance, if product launched by the company will meet customers requirements, chances for success increase while if the product fail to meet customers requirements, chances of success decreases for the organization as well as for the newly launched product. Diversification strategy increases growth opportunities for an organization because it helps the organization to enters into a new market with a new product without any experience. Risk factor plays crucial role in the success and growth of an organization. Diversification strategy leads to introduction of new product in the new market, thus, high level of risk is involved. With the help of diversification, it decreases the impact of risk over business because there is various range of product and if one of them will fail, it will not much affect enterprises performance (Vik McElwee, 2011). Dangers of Diversification In order to gain financial advantage, various companies enter into a joint venture or acquire other enterprises and miscalculate the profitability from that venture against the cost incurred to form that venture. For example, PepsiCo enters into a joint venture with a construction company but PepsiCo does not have sufficient information related to construction business, thus, it may originate negative outcomes. Increasing market share by introducing new products in new markets leads to increase in the competition level. For example, PepsiCo is planning to launch an energy bar chocolate with the view to diversify its product ranges to other fields. But due to aggressive competition in the chocolate industry and due to lack of experience of that particular field, desired goals and objectives may not acquire. On one side, diversification increase growth opportunities for an organization while on the other hand, it also generates various chances of failures due to non-acceptance of product by target customers, etc. (Wan, et. al., 2011). Critical comments on Whittingtons statement According to Vaara Whittington (2012), diversification is a perfectly logical development, ensuring rationale and efficient use of resources. This is true because every business enterprise needs to face decline stage once in a lifetime and in that period of time, organization may get success otherwise it will fail. Authors have described that Strategy-as-Practice plays crucial role in strategic management concept and it helps the organization to manage the activities in an effective manner. Strategy-as-Practice has two meanings: practice signals both an attempt to be close to the world of practitioners and other meaning is sociological theories of practice. Main aims of these studies are that the strategy processes are relies upon the organizational functions and on other functions that affect the performance of the strategies and their outcomes. SAP research has provided an alternative method to the organizations in relation with performing decision making process in an effective m anner. Strategy-as-Practice has common characteristics with the approaches of strategy process and the new micro-foundations approaches of strategy. The primary focus of SAP approach is to find out the most appropriate way so that distinct method could be originated with regards to strategic management. Apart from the utilisation of SAP approach to determine alternatives for decision making processes, it is also used in the research for analysis of social practices (Tixier, Bataill Jagla, 2010). In relation with diversification, it is required for an organization to perform market research activity in an appropriate manner so that the desired outcomes could be acquired. Diversification is being implemented within the workplace with the objective of expansion and for expanding business into new fields of market, it is required to adopt certain unique and advanced level strategies such as SAP approach. This approach has the capability to strengthen the process of making strategies and it is also essential in the procedure of executing all functions of the organization in an appropriate manner. As per my opinion, the statement given by Whittington (2012) is true because diversification is the only activity through which organization could expand its business in the domestic or in international marketplace. This is the strategy which promotes the organization to enter into a new industry with a new product and that too without any experience, talent or knowledge for that market. This strategy helps the organization to identify its capability as well as various challenges occur for an organization which could be moulded into opportunities using unique strategies of organization. If organization will not be able to make their separate image in the new marketplace then it could be observed that the chances for surviving in the dynamic business environment for a long run are quite less (Vaara Whittington,, 2012). Diversification is a strategy which is essential for the growth of an enterprise. It helps the organization to mitigate risks factors involved in the market as well as it also expand the network of the organization so that desired outcomes could be attained. Apart from this, the statements second part says that efficient and rationale utilisation of resources is necessary in order to implement diversification and related strategies effectively. Resource management is another crucial task for an organization which should be executed in an appropriate manner with the objective of attaining higher results with minimum wastage of resources (Calms Thoret, 2011). Resource management technique includes management of technical resources, production, man power, etc. All these resources should be combined together in such a way so that the task could be accomplished in the most appropriate manner. This will help the organization to gain its desired goals and objectives along with this, organization will be able to develop its separate image from competitors. Diversification is implemented with the purpose of expansion and this could be done in the existing product line or in the different product line. Thus, combination of resource management and diversification strategies should be executed in an appropriate manner so that organization will be able to create opportunities for itself for achieving desired outcomes. Under resource management technique, one of the crucial tasks is allocation of duties to the employees (Lamin, 2012). While allocating the tasks to the employees, it is required for the organization to ascertain its employees capabilit ies, skills and knowledge so that right task could be allocated to the right person. This is also known as the golden role for business enterprises in relation with gaining success and gaining competitive advantage in the marketplace. It has been observed that every product and service has a limited life and if an organization will focus over single product or service, then the life for that organization will be dependent upon that particular product only (Delcoure, 2010). But while setting up business, primary objective is to survive in the dynamic business environment for a long run and this is the reason organization focus over various products and services of the same product line as well as over different products and services from different fields. Diversification helps the organization to make its network broad and wide and while diversifying the business, organization should determine every aspect of the new filed so that the chances of failure could be mitigated. Apart from this, it has also been observed that the authors have said that the resources usage should be rationale as per their requirements (Belousova Dorfleitner, 2012). For instance, Disneyland has developed their position as performing company in terms of providing its customers qualitative entertainment services. Through this, organization has attained highest value visitor satisfaction and a huge number of tourists along with pleasure and happiness. In this manner, employees plays crucial role in attainment of desired goals and objectives of the organization. Conclusion From the aforesaid information, it can be concluded that strategic management plays crucial role in success and growth of an organization. In this essay, various aspects of strategic management and diversification have been discussed. Diversification helps the organization to gain its desired goals and objectives along with ascertaining the opportunities for acquiring success and growth related objectives. The fact cannot be denied that diversification consist of high risk factor but there are various benefits which could be attained through application of this strategy such as expansion, growth, etc. In this essay, strategy-as-practice approach has also been discussed which is essential in acquiring success and developing strategies for attaining competitive advantage and growth as per the managements expectations (Chambers Zdanowicz, 2014). References Althoff, D.M., Segraves, K.A. and Johnson, M.T., 2014. Testing for coevolutionary diversification: linking pattern with process.Trends in ecology evolution,29(2), pp.82-89. Aspara, J., Lamberg, J.A., Laukia, A. and Tikkanen, H., 2011. Strategic management of business model transformation: lessons from Nokia.Management Decision,49(4), pp.622-647. Belousova, J. and Dorfleitner, G., 2012. On the diversification benefits of commodities from the perspective of euro investors.Journal of Banking Finance,36(9), pp.2455-2472. Calms, C. and Thoret, R., 2011.The rise of shadow banking and the hidden benefits of diversification(No. UQO-DSA-wp042011). Dpartement des sciences administratives, UQO. Chambers, D.R. and Zdanowicz, J.S., 2014. The limitations of diversification return.Journal of Portfolio Management,40(4), p.65. Chioda, M., Peranzoni, E., Desantis, G., Papalini, F., Falisi, E., Samantha, S., Mandruzzato, S. and Bronte, V., 2011. Myeloid cell diversification and complexity: an old concept with new turns in oncology.Cancer and metastasis reviews,30(1), pp.27-43. Delcoure, N.N., 2010. Diversification benefits: correlation and return gaps.International Review of Applied Financial Issues and Economics,2(3), p.597. Kim, H.J. and Reinschmidt, K.F., 2010. Association of risk attitude with market diversification in the construction business.Journal of management in engineering,27(2), pp.66-74. Kumar, V., Gaur, A.S. and Pattnaik, C., 2012. Product diversification and international expansion of business groups.Management International Review,52(2), pp.175-192. Lamin, A., 2012. The business group as an information resource: An investigation of business group affiliation in the Indian software services industry.Academy of Management Journal, pp.amj-2011. Liu, Y.J., Xu, H., Kong, W.J., Shang, M., Dai, H.X. and Yu, J.Q., 2014. Overcoming the limitations of directed CH functionalizations of heterocycles.Nature,515(7527), p.389. Martin, A., Papa, R., Nadeau, N.J., Hill, R.I., Counterman, B.A., Halder, G., Jiggins, C.D., Kronforst, M.R., Long, A.D., McMillan, W.O. and Reed, R.D., 2012. Diversification of complex butterfly wing patterns by repeated regulatory evolution of a Wnt ligand.Proceedings of the National Academy of Sciences,109(31), pp.12632-12637. Park, K. and Jang, S.S., 2013. Effects of within-industry diversification and related diversification strategies on firm performance.International Journal of Hospitality Management,34, pp.51-60. Tixier, V., Bataill, L. and Jagla, K., 2010. Diversification of muscle types: recent insights from Drosophila.Experimental cell research,316(18), pp.3019-3027. Vaara, E. and Whittington, R., 2012. Strategy-as-practice: Taking social practices seriously.Academy of Management Annals,6(1), pp.285-336. Vik, J. and McElwee, G., 2011. Diversification and the entrepreneurial motivations of farmers in Norway.Journal of small business management,49(3), pp.390-410. Villarreal, J.C., Cusimano, N. and Renner, S.S., 2015. Biogeography and diversification rates in hornworts: The limitations of diversification modeling.Taxon,64(2), pp.229-238. Wan, W.P., Hoskisson, R.E., Short, J.C. and Yiu, D.W., 2011. Resource-based theory and corporate diversification: Accomplishments and opportunities.Journal of Management,37(5), pp.1335-1368. Whittington, R., 2014. Information systems strategy and strategy-as-practice: a joint agenda.The Journal of Strategic Information Systems,23(1), pp.87-91. Zhou, Y.M., 2011. Synergy, coordination costs, and diversification choices.Strategic Management Journal,32(6), pp.624-639.

Name Micah Delo Essays - Harry Houdini, Spiritualism, Escapologists

Name: Micah Delo Title of Book: The Great Houdini; Magician Extraordinary Author: Beryl Williams and Samuel Epstein Publisher: Julian Messner Where Published: New York When Published: 1966 Number of pages: 178 1. Who is the subject of the book? The subject of my book is Ehrich Weiss, also known as the ?Great Houdini?. 2. What aspects of the book made it enjoyable? Well I really liked some of his tricks and famous escapes. I also liked the way he and his wife never quit trying to find a circus or act to play at. They never got down on themselves for not getting an act to play at. 3. State the subject's most outstanding personality trait. Cite evidence from the book to support your statement. Houdini's most outstanding personality trait was his perseverence. Once, when Ehrich was desperately trying to promote the act he called The Houdini Brothers, which was most unsuccessful. His failures were particularly discouraging with the death of his father, shortly after the new career was launched. He was left with increased sense of responsibility for his family and especially for his mother. He refused to give up. Another time he got an act at Tony Pastor's show. Just about the best show around. He performed better than he ever had. When he asked Mr. Pastor for an endorsement the man pulled out a sheet of paper and wrote, ?Satisfactory and interesting?. He took Mr. Pastor's statement to a dozen agents, but the agents just nodded and handed it back. He didn't give up, and several weeks later he got an invitation to perform with Welsh Brothers' Circus. Finally, he di dn't even get down on himself for having to run errands at a supermarket for most of his early life to get money to eat and pay the rent. 4. Give frank criticism of the story including reasons for your statements. In some parts of the book the sentences ran on forever. When I reached the end of them, I found them to be pointless. 5. Write a summary of the book. Highlight the person's successes and failures. Ehrich Weiss was born on April 6, 1874. Just a few months before the Weiss family had moved to the United States from Hungary. They settled in Appleton, Wisconsin. In Hungary his father was a highly respected teacher; but here in Appleton it was different. Here he was a stranger and ignorant of many things they themselves took for granted. Ehrich took his professional surname from that of the French magician Jean Eugene Robert- Houdin. Houdini began his career in 1882 as a trapeze performer. Later he became famous for his performances of feats of magic. He showed great ability in extricating himself from handcuffs, ropes, locked trucks, and bonds of any sort. At one time he had himself tied and them locked in a packing case, which was bound with steel tape and dropped into the harbor off the Battery in New York City. Houdini appeared on the surface of the water in 59 seconds. Houdini attributed all his feats of magic to natural, physical effects. He also explained how many of his tricks were performed. He exposed the tricks of fraudulent spiritualistic mediums, often producing ?spiritualistic? phenomena himself that he explained in nonmystical, physical terms. Before he died, Houdini arranged a definitive test of spiritualism. He devised a ten-word code that he would communicate to his wife, if possible, within ten years after his death. After he died, various mediums maintained that they were able to establish contact with him, but none was able to transmit to his wife the prearranged code. He left his library of magic, one of the most valuable in the world, to the Library of Congress. Among his writings are The Unmasking of Robert- Houdin, Miracle Mongers and their Methods, and A Magician Among the Spirits. A selection of his writings, Houdini on Magic, appeared posthumously in 1954. He performed until his death in 1926.

Ryan Buckley Essays - Neuroscience, Sleep, Biology, Insomnia

Ryan Buckley Essays - Neuroscience, Sleep, Biology, Insomnia Ryan Buckley Eng. 105 9:40-11:10 11/28/17 Sleep Deprivation of the 21 st Century In a rapidly evolving American society, people are sleeping less and less. Yet, due in part to the economic strength of the pharmaceutical industry, they are often not receiving proper treatment. And the larger cultural forces at work, crucial for understanding 21st century sleep, are rarely considered to be a causal factor. Sleep is very complex. In fact, scientist do not even understand why our bodies really need sleep. What is known is that there are many different individual and social factors that are related to the amount people sleep, including age, homeostatic traits, anxiety and depression, medical conditions, alcohol and drugs, and . While sleep deprivation and insomnia are both related to insufficient sleep, they are two qu ite different things. Increased sleep deprivation, or sleep deficit, has sometimes been described as a symptom of the recent decrease in leisure time in American society. Working hours have increased during the second-half of the 20th century, along with sharp growth in American productivity and growth. A doubling of productivity could have translated into both higher incomes and decreased working hours, yet today employees rarely have a choice between getting paid in time or money. Instead, Americans, rel ative to the past, work more, earn more, and spend more. This focus on work and consumption over leisure time has brought an increased "time squeeze." While this is especially true for the average American woman, the time squeeze cuts across gender , social class, and marital status. Moreover, the recent growth of digital media and smartphones has dramatically raised productivity expectations and blurred the line between work and personal lif e. This decrease in free time and increased pace of life and stress has brought with it reduced sleep, with real consequences for physical and mental health, performance at work, and quality of life. For example, in the 1960s, the average amount of time A mericans spent sleeping was between 7 and 8.5 hours a night, while today 50% of the population averages under 7 hours, and, according to a 2008 survey, 1 out of 3 Americans say they get a good night's sleep only a few nights a month or less. Research sho ws that negative consequences of sleep deprivation include increased risk of physical problems such as diabetes, infection, and cardiovascular disease; excessive daytime sleepiness; microsleep episodes during waking hours; lapses in concentration, attentio n, memory, and judgment; reduced creativity and mental flexibility; increased irritability; and decreased motivation, interest, and initiative. Additionally, automobile driving skills suffer and several major accidents have been linked to sleep deprivation , underlining the seriousness of the issue as a public safety hazard. Insomnia, as opposed to sleep deprivation, is defined by the World Health Organization as a problem in falling and/or maintaining sleep. Severity is usually determined by the amount of time it takes to fall asleep and the duration of awakenings, as well as frequency and duration of sleep difficulties. Most people, at some point or another, experience acute insomnia in life; this is normal and must be distinguished from persistent insomn ia that lasts more than a month. Hyperarousal and hypervigilance around sleep are key factors in persistent insomnia. Several psychological and quality of life symptoms appear to be caused by insomnia. These include daytime fatigue and emotional dis turbances such as irritability, anxiety, depressed mood, and helplessness. Longitudinal studies suggest that persistent insomnia may be a risk factor for developing clinical depression. Somatic complaints such as gastrointestinal and respiratory problems, headaches, and non-specific aches and pains are also linked with insomnia. Interestingly, cognitive impairments resulting from insomnia, such as those in attention, concentration, and memory, appear to be more limited than those resulting from sleep depri vation.

Analyzing Primary Sources Essay Example | Topics and Well Written Essays - 1000 words

Analyzing Primary Sources - Essay Example Second, primary sources are biased by the personal views of the narrator and may lack objectivity and neutrality. This is unavoidable, not because people have bad intentions but because humans are subjective. Our personal views and observations can be influenced by our ethical and moral standards and intentions, which can and do change the way we recount events. Third, primary sources vary in quality, so not all have equal credibility. Some people are more observant and notice details others do not, while others notice more details than are objectively evident and necessary. Examples are the "Georgia" article writer's obvious stand against slavery shown in the harsh comments against the slave buyers and Sadie's more credible cheery disposition in "Shorrow". Lastly, primary sources vary in degrees of reliability. Narrations close to the date and place of the events would be more reliable because personal experience shows that human memory fades over time. Primary sources need to be checked against other sources on the same event to establish truthfulness and credibility. Offhand, none of the documents is completely unbelievable because each one is based on firsthand accounts. ... Knowing all these, historians should practice critical analysis when studying primary sources. Was any document completely believable, or completely unbelievable Offhand, none of the documents is completely unbelievable because each one is based on firsthand accounts. Unless we can prove the person identified never existed, or the event recounted never took place (e.g., the sale of slaves in Savannah on March 2-3, 1859 as in "Georgia"), these primary sources should be given the benefit of the doubt. However, we can also state that none of the documents is completely believable for similar reasons until we can establish the actual existence of characters (of Mrs. Hawkes who wrote "Shorrow", the Holt family in Walton County who owned the slaves, etc.), of minor details (was there a Senator John Hill from Madison, Georgia who served two terms on the Whig ticket as in "Evans"), and of events (Mrs. Brice closing her school in June 1861 in "Freedmen"). All facts need cross-checking to definitely establish each document's credibility. Some sources seemed less believable, notably "Freedmen" because of its pompous and exaggerated tone, and "Georgia" because the author sounded like someone vehemently against slavery, giving these articles their biased tone. The others were more believable because they sounded like a recording, the characters in "Bowers", "Shorrow", and "Evans" speaking in a way that is verified by my personal experience. The documents provided a wide range of information about slavery in the U.S., from the harsh and cruel to the gentle and kind. While some slaves really suffered at the hands of their masters ("Freedmen" and "Georgia"), others enjoyed working and were treated well ("Shorrow", "Bowers", and "Evans"). The slaves' ambitions

APA Forms and Format Essay Example | Topics and Well Written Essays - 500 words

APA Forms and Format - Essay Example It is also apparent that many families cannot afford health care and proper housing, thus leading to many unresolved cases of health and illnesses in many communities. Obesity is a critical health and therapeutic problem in both the developing and developed countries. It has significantly increased during the last two decades (El-Helaly, Kamel, Abd-Elaziz, Elwan & Nabih, 2009; Alsayed, Gad & Azab, 2007). According to Alsayed et al. (2007), obesity subjects individuals to metabolic and endocrine disorders. Such complications can pose significant risks to children’s health and general life performance. Additionally, it can lead to an increase in many complications and illnesses which further results in obstruction of a country’s economic progress and the development of an entire health care system (Parikh, Edelman, Uwaifo, Freedman, Semega-Janneh, Reynolds, & Yanovski, 2004; Wang & Dietz, 2002; Afridi, Khattak, Safdar & Khan, 2003). In conclusion, overweight children are at risk of vitamin D deficiency and secondary hyperthyroidism. It is clear that BMI may be a significant risk factor for vitamin D deficiency obese and non-obese children and adolescents. Considering the above cases, it is recommended that obese children, especially those with high body mass index, take routinely vitamin D supplementary treatment. Additionally, they should go for routine screening with regard to vitamin D

Communication for Health Promotion

Communication for Health Promotion The purpose of this assignment is to strongly critique an interaction between a health professional and a service user in a video clip titled â€Å"Sexual Health Advice Role-play† (Nice (National Institute for Health and Care Excellence) Media, 2012). In the video clip, an adolescent male is seen using the C card scheme to obtain free condom from a pharmacy. The health professional in the pharmacy takes this as an opportunity to offer the adolescent service user a free chlamydia test. The type of health promotion and communication seen in the video clip will be discussed including the health promotion models observed in the clip and the strategies that could have been used to enhance the opportunity will be highlighted. In order to promote health, heath professionals must understand the definition of health. Health is commonly defined by two definitions; one of which is a negative definition and the other positive. The negative definition of health defines health as the absence of disease or illness (Naidoo and Wills, 2009), whereas the positive definition looks at holistic health and defines health as not just the absence of disease and infirmity but as a state of complete physical mental and social well-being (World Health Organisation (WHO), 1946). Health is holistic and consists of different dimensions which all need to be considered (Naidoo and Wills, 2009). Health promotion is a practice of empowering people to improve control over their health, and to also better it. It encourages people to improve their mental, physical and social well-being and to do so individuals and groups should have the knowledge of interventions that are in place in order to help people satisfy their needs, and change or cope with the environment (WHO), 1986). Nutbeam (1998) suggested that a comprehensive social and political process is represented by Health Promotion. It does not just look at strategies used to strengthen people’s skills and capabilities but it also looks at the strategies used to change social, environmental and economic conditions in order to improve their impact on individuals and public health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions (WHO) 1986). There is a variety of health promotion approaches which all have different objectives. These approaches are medical, behaviour change, educational, empowerment and social change (Naidoo and Wills 2009). The medical approach concentrates on strategies used to decrease morbidity and premature mortality. The approach is also concerned with disease prevention among high-risk groups. This approach is usually linked with the three levels of health promotion, which are primary, secondary and tertiary (Leddy, 2006). Primary health promotion consists of strategies that prevent ill health before it occurs. Strategies may include immunisation or encouraging people to live healthier lifestyles (Hubley et al, 2013). The C card is a form of Primary health promotion because it aims to help young people protect themselves from sexually transmitted diseases by issuing free condoms.[g1] Condoms are an effective way of preventing sexually transmitted diseases (National Health Service (NHS) choices, 201 3) therefore the C Card scheme is a good example of primary health promotion because it prevents disease before it occurs. Secondary health promotion consists of actions taken to identify and prevent the progression of disease at an early stage (Scriven,2005). Secondary health promotion strategies may include health screening programmes. Secondary health promotion is seen in the video clip when the health professional encourages the service user to get screened for chlamydia. Every young person under the age of 25 is entitled to a free and confidential chlamydia test through the National Chlamydia Screening Programme (NCSP). The NCSP is an NHS sexual health programme which was put into place by the Department of Health (DOH) in 2003 (NCSP 2003). In 2012 206,912 people in England tested positive for chlamydia and 64% of these were under 25 (NHS Choice, 2013). The NCSP targets young people under 25 because they are a high risk group where chlamydia is concerned. The programme’s aims are to make sure that young people under the age of 25 who are sexually active are aware of the effects of chlamydia and have access to free and confidential chlamydia screening (NCSP, 2013). According to Public Health England (PHE) (2013), since the NCSP was introduced there has been a 40% increase of chlamydia diagnoses in young people. This shows that more young people are being tested and getting treatment for chlamydia. The last level of health promotion is tertiary health promotion which looks at improving the health of individuals who are already affected by a disease. It consists of actions to avoid deterioration and aims to reduce complications (Fertman and Allensworth, 2010). An example of tertiary health promotion is when an HIV infected person takes antiretroviral drugs to help slow down the spread of virus in the body (NHS choice, 2012). The educational approach aims to enable individuals to make informed choices about their health behaviours by educating and assi sting them in developing skills (Trapani 2007). The educational approach is applied in the interaction when the health professional firstly provides the service user with information about chlamydia before performing the chlamydia test. The behaviour change approach aims to change individual’s unhealthy behaviours, by encouraging them to adopt healthy behaviours (Dixey, 2013). An element of the behaviour change approach is seen in the video clip; by providing free condoms to young people, the C card scheme is trying to change their behaviours by encouraging them to stop engaging in unprotected sex. The C-Card scheme is a service for young people which provides free condoms, advice and information. [g2]The service is free and confidential. The aims of the scheme are to help young people have more access to condoms, support them, educate them on sexual heath and how to correctly use condoms (Burtney, 2008). The initial reason why the service user went to the pharmacy was to obtain free condoms but the health professional takes this as an opportunity to promote health. The promotion of health and wellbeing is a fundamental part of being a health professional (Scriven, 2005). All health care professionals are encouraged to make every contact count. They are encouraged to use every interaction with an individual as an opportunity to promote health, whatever their profession or the reason of the interaction (Department of Health, 2012). Good communication skills are essential when health professional are attempting to promote good sexual health to young people. Effective communication enables health professionals to maximise the success of the interaction and this enhances the associated health promotion throughout the consultation (Barnes, 2009). The communication process begins at point of greeting and introduction (French, 2006). Williams and Davies (2005) suggest that communication with adolescents should begin with the development of trust. They further on elaborate that rapport with the adolescent should be built by health professionals and they are also are advised to be non judgemental and straight forward. Throughout the interaction, the health professional did not introduce herself to the service user. The health professional could have presented the idea of a chlamydia screening more effectively by firstly introducing herself. According to NICE (2012) health and social care professionals must always make it a priority to introduce themselves to service users and clearly explain their role and responsibilities. If the health professional had introduced herself to the service user, the service user would have felt more comfortable and would have had more trust in the health professional. Introducing herself could have helped her build rapport between herself and the service user. Establishing rapport and building a relationship between a service user and health professional are considered as foundations to good communication (Mitchell and Welling, 1998). Building a relationship is fundamental when working with young people because if a young person does not trust you, they may not disclose personal information (Royal College of Nursing (RCN), 2013). Throughout the consultation the health professional maintained excellent professionalism. The language used by the health professional was that of a professional manor and not over technical. The service user used clinical language that could be understood by the service user, she did not speak in way that could have been patronising to the service user. When interacting with adolescents, some health professionals resort to using patronising language because they believe an adolescent would not be capable of understanding professional language (Berry, 2006) The health professional maintained good eye contact throughout the interaction. When interacting with a service user, health professionals are advised to maintain eye contact if it is culturally acceptable for the service user because it shows honest, confidence and helps build a more therapeutic relationship (Eisenberge, 2012). According to Bateman (2000), a health professional’s advice may not be absorbed if there is a la ck of eye contact. Appropriate body language was used by the health professional throughout the interaction. The body language used by the service user was also that of a professional manor. Allen (2013) suggests that body language can be used as a foundation of building rapport between service user and health professional. She also goes on to say that trust can be established through mirroring and matching the body movements of a person. The health professional is seen mirroring the service user’s body movement throughout the interaction. Maintained good communication skill, eye contact, body language Good environment no noise, privacy, no interruptions When service user asked if it could be transmitted through kissing professional asked as if she didn’t know. No information. Did not ask for consent She did not give him a chance to ask questions Gave information before test References Burtney, E (2008) Guidelines for Setting Up a C-Card Condom Distribution Scheme For Young People. Available at: http://www.phru.net/shin/Condom%20Distribution%20Review/Brook%20guidelines%20FINAL%2029%20Oct.doc (Accessed: 23 April 2014) Department of Health (2012) The NHSs role in the publics health: a report from the NHS Future Forum. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/216423/dh_132114.pdf (Accessed: 23 April 2014) Public Health England (2013) Chlamydia screening intervention proves infectious in general practice. Available at: https://www.gov.uk/government/news/chlamydia-screening-intervention-proves-infectious-in-general-practice (Accessed: 24 April 2014) Fertman, C. and Allensworth, D. (ed.) (2010) Health Promotion Programs: From Theory to Practice. London: Jossey-Bass Hubley, H., Copeman, J. and Woodall, J. (2013) Practical Health Promotion. 2nd edn. Cambridge: Polity Press Leddy, S. (2006) Integrative Health Promotion: Conceptual Bases for Nursing Practice. 2nd edn. London: Jones and Bartlett Naidoo, J. and Wills, J. (2009) Foundations For Health Promotion. 3rd edn. London: Elsevier NCSP (2013) What is the NCSP?. Available at: http://www.chlamydiascreening.nhs.uk/ys/about.html (Accessed: 23 April 2014) NHS Choices (2012) HIV and AIDS – Treatment. Available at: http://www.nhs.uk/Conditions/HIV/Pages/Treatmentpg.aspx (Accessed: 23 April 2014) NHS Choices (2013) Chlamydia. Available at: ttp://www.nhs.uk/Conditions/Chlamydia/Pages/Introduction.aspx (Accessed: 24 April 2014) http://www.nice.org.uk/guidance/qualitystandards/patientexperience/PatientAwarenessOfHealthcareProfessionals.jsp Nutbeam, D. (1998) ‘Evaluating Health Promotion – progress, problems and solutions’, Health Promotion international ; 13, pp. 27-44 Scriven, A. (2005) Health Promoting Practice: The contribution of nurses and allied health professional. 1st edn. Hampshire: Palgrave Macmillan World Health organisation (1986) The Ottawa Charter for Health Promotion. Available at: http://www.who.int/healthpromotion/Milestones_Health_Promotion_05022010.pdf?ua=1 (Accessed: 23 April 2014) World Health Organisation (1946) Constitution. World Health Organisation, Geneva http://books.google.co.uk/books?id=TjI1QMi3cnoCdq=medical+approach+in+health+promotionsource=gbs_navlinks_s http://books.google.co.uk/books?id=xwOd0PcEdtoCsource=gbs_navlinks_s http://www.nursingtimes.net/nursing-practice/clinical-zones/sexual-health/health-promotion-in-sexual-health-2-nurses-role-in-engaging-with-clients/5001424.article http://books.google.co.uk/books?id=yUTP2ioasf8Csource=gbs_navlinks_s http://books.google.co.uk/books?id=bkDjTmriEiYCdq=why+is+eye+contact+important+in+health+and+social+caresource=gbs_navlinks_s http://books.google.co.uk/books?id=AK_Mg2J5EhUCdq=language+used+by+health+professionalssource=gbs_navlinks_s http://www.naturalhealthcourses.com/Reading_Room/Body_Language.htm [g1]Reference [g2]Reference

Part Two Chapter IV

IV Samantha's dinner invitation to Kay had been motivated by a mixture of vengefulness and boredom. She saw it as retaliation against Miles, who was always busy with schemes in which he gave her no say but with which he expected her to co-operate; she wanted to see how he liked it when she arranged things without consulting him. Then she would be stealing a march on Maureen and Shirley, those nosy old crones, who were so fascinated by Gavin's private affairs but knew next to nothing about the relationship between him and his London girlfriend. Finally, it would afford her another opportunity to sharpen her claws on Gavin for being pusillanimous and indecisive about his love life: she might talk about weddings in front of Kay or say how nice it was to see Gavin making a commitment at last. However, her plans for the discomfiture of others gave Samantha less pleasure than she had hoped. When on Saturday morning she told Miles what she had done, he reacted with suspicious enthusiasm. ‘Great, yeah, we haven't had Gavin round for ages. And nice for you to get to know Kay.' ‘Why?' ‘Well, you always got on with Lisa, didn't you?' ‘Miles, I hated Lisa.' ‘Well, OK †¦ maybe you'll like Kay better!' She glared at him, wondering where all this good humour was coming from. Lexie and Libby, home for the weekend and cooped up in the house because of the rain, were watching a music DVD in the sitting room; a guitar-laden ballad blared through to the kitchen where their parents stood talking. ‘Listen,' said Miles, brandishing his mobile, ‘Aubrey wants to have a talk with me about the council. I've just called Dad, and the Fawleys have invited us all to dinner tonight at Sweetlove – ‘ ‘No thanks,' said Samantha, cutting him off. She was suddenly full of a fury she could barely explain, even to herself. She walked out of the room. They argued in low voices all over the house through the day, trying not to spoil their daughters' weekend. Samantha refused to change her mind or to discuss her reasons. Miles, afraid of getting angry at her, was alternately conciliatory and cold. ‘How do you think it's going to look if you don't come?' he said at ten to eight that evening, standing in the doorway of the sitting room, ready to leave, wearing a suit and tie. ‘It's nothing to do with me, Miles,' Samantha said. ‘You're the one running for office.' She liked watching him dither. She knew that he was terrified of being late, yet wondering whether he could still persuade her to go with him. ‘You know they'll be expecting both of us.' ‘Really? Nobody sent me an invitation.' ‘Oh, come off it, Sam, you know they meant – they took it for granted – ‘ ‘More fool them, then. I've told you, I don't fancy it. You'd better hurry. You don't want to keep Mummy and Daddy waiting.' He left. She listened to the car reversing out of the drive, then went into the kitchen, opened a bottle of wine and brought it back into the sitting room with a glass. She kept picturing Howard, Shirley and Miles all having dinner together at Sweetlove House. It would surely be the first orgasm Shirley had had in years. Her thoughts swerved irresistibly to what her accountant had said to her during the week. Profits were way down, whatever she had pretended to Howard. The accountant had actually suggested closing the shop and concentrating on the online side of the business. This would be an admission of failure that Samantha was not prepared to make. For one thing, Shirley would love it if the shop closed; she had been a bitch about it from the start. I'm sorry, Sam, it's not really my taste †¦ just a teeny bit over the top †¦ But Samantha loved her little red and black shop in Yarvil; loved getting away from Pagford every day, chatting to customers, gossiping with Carly, her assistant. Her world would be tiny without the shop she had nurtured for fourteen years; it would contract, in short, to Pagford. (Pagford, bloody Pagford. Samantha had never meant to live here. She and Miles had planned a year out before starting work, a round-the-world trip. They had their itinerary mapped out, their visas ready. Samantha had dreamed about walking barefoot and hand in hand on long white Australian beaches. And then she had found out that she was pregnant. She had come down to visit him at ‘Ambleside', a day after she had taken the pregnancy test, one week after their graduation. They were supposed to be leaving for Singapore in eight days' time. Samantha had not wanted to tell Miles in his parents' house; she was afraid that they would overhear. Shirley seemed to be behind every door Samantha opened in the bungalow. So she waited until they were sitting at a dark corner table in the Black Canon. She remembered the rigid line of Miles' jaw when she told him; he seemed, in some indefinable way, to become older as the news hit him. He did not speak for several petrified seconds. Then he said, ‘Right. We'll get married.' He told her that he had already bought her a ring, that he had been planning to propose somewhere good, somewhere like the top of Ayers Rock. Sure enough, when they got back to the bungalow, he unearthed the little box from where he had already hidden it in his rucksack. It was a small solitaire diamond from a jeweller's in Yarvil; he had bought it with some of the money his grandmother had left him. Samantha had sat on the edge of Miles' bed and cried and cried. They had married three months later.) Alone with her bottle of wine, Samantha turned on the television. It brought up the DVD Lexie and Libby had been watching: a frozen image of four young men singing to her in tight T-shirts; they looked barely out of their teens. She pressed play. After the boys finished their song, the DVD cut to an interview. Samantha slugged back her wine, watching the band joking with each other, then becoming earnest as they discussed how much they loved their fans. She thought that she would have known them as Americans even if the sound had been off. Their teeth were perfect. It grew late; she paused the DVD, went upstairs and told the girls to leave the PlayStation and go to bed; then she returned to the sitting room, where she was three-quarters of the way down the bottle of wine. She had not turned on the lamps. She pressed play and kept drinking. When the DVD finished, she put it back to the beginning and watched the bit she had missed. One of the boys appeared significantly more mature than the other three. He was broader across the shoulders; biceps bulged beneath the short sleeves of his T-shirt; he had a thick strong neck and a square jaw. Samantha watched him undulating, staring into the camera with a detached serious expression on his handsome face, which was all planes and angles and winged black eyebrows. She thought of sex with Miles. It had last happened three weeks previously. His performance was as predictable as a Masonic handshake. One of his favourite sayings was ‘if it's not broke, don't fix it'. Samantha emptied the last of the bottle into her glass and imagined making love to the boy on the screen. Her breasts looked better in a bra these days; they spilled everywhere when she lay down; it made her feel flabby and awful. She pictured herself, forced back against a wall, one leg propped up, a dress pushed up to her waist and that strong dark boy with his jeans round his knees, thrusting in and out of her †¦ With a lurch in the pit of her stomach that was almost like happiness, she heard the car turning back into the drive and the beams of the headlights swung around the dark sitting room. She fumbled with the controls to turn over to the news, which took her much longer than it ought to have done; she shoved the empty wine bottle under the sofa and clutched her almost empty glass as a prop. The front door opened and closed. Miles entered the room behind her. ‘Why are you sitting here in the dark?' He turned on a lamp and she glanced up at him. He was as well groomed as he had been when he left, except for the raindrops on the shoulders of his jacket. ‘How was dinner?' ‘Fine,' he said. ‘You were missed. Aubrey and Julia were sorry you couldn't make it.' ‘Oh, I'm sure. And I'll bet your mother cried with disappointment.' He sat down in an armchair at right angles to her, staring at her. She pushed her hair out of her eyes. ‘What's this all about, Sam?' ‘If you don't know, Miles – ‘ But she was not sure herself; or at least, she did not know how to condense this sprawling sense of ill-usage into a coherent accusation. ‘I can't see how me standing for the Parish Council – ‘ ‘Oh, for God's sake, Miles!' she shouted, and was then slightly taken aback by how loud her voice was. ‘Explain to me, please,' he said, ‘what possible difference it can make to you?' She glared at him, struggling to articulate it for his pedantic legal mind, which was like a fiddling pair of tweezers in the way that it seized on poor choices of word, yet so often failed to grasp the bigger picture. What could she say that he would understand? That she found Howard and Shirley's endless talk about the council boring as hell? That he was quite tedious enough already, with his endlessly retold anecdotes about the good old days back at the rugby club and his self-congratulatory stories about work, without adding pontifications about the Fields? ‘Well, I was under the impression,' said Samantha, in their dimly lit sitting room, ‘that we had other plans.' ‘Like what?' said Miles. ‘What are you talking about?' ‘We said,' Samantha articulated carefully over the rim of her trembling glass, ‘that once the girls were out of school, we'd go travelling. We promised each other that, remember?' The formless rage and misery that had consumed her since Miles announced his intention to stand for the council had not once led her to mourn the year's travelling she had missed, but at this moment it seemed to her that that was the real problem; or at least, that it came closest to expressing both the antagonism and the yearning inside her. Miles seemed completely bewildered. ‘What are you talking about?' ‘When I got pregnant with Lexie,' Samantha said loudly, ‘and we couldn't go travelling, and your bloody mother made us get married in double-quick time, and your father got you a job with Edward Collins, you said, we agreed, that we'd do it when the girls were grown up; we said we'd go away and do all the things we missed out on.' He shook his head slowly. ‘This is news to me,' he said. ‘Where the hell has this come from?' ‘Miles, we were in the Black Canon. I told you I was pregnant, and you said – for Christ's sake, Miles – I told you I was pregnant, and you promised me, you promised – ‘ ‘You want a holiday?' said Miles. ‘Is that it? You want a holiday?' ‘No, Miles, I don't want a bloody holiday, I want – don't you remember? We said we'd take a year out and do it later, when the kids were grown up!' ‘Fine, then.' He seemed unnerved, determined to brush her aside. ‘Fine. When Libby's eighteen; in four years' time, we'll talk about it again. I don't see how me becoming a councillor affects any of this.' ‘Well, apart from the bloody boredom of listening to you and your parents whining about the Fields for the rest of our natural lives – ‘ ‘Our natural lives?' he smirked. ‘As opposed to – ?' ‘Piss off,' she spat. ‘Don't be such a bloody smartarse, Miles, it might impress your mother – ‘ ‘Well, frankly, I still don't see what the problem – ‘ ‘The problem,' she shouted, ‘is that this is about our future, Miles. Our future. And I don't want to bloody talk about it in four years' time, I want to talk about it now!' ‘I think you'd better eat something,' said Miles. He got to his feet. ‘You've had enough to drink.' ‘Screw you, Miles!' ‘Sorry, if you're going to be abusive †¦' He turned and walked out of the room. She barely stopped herself throwing her wine glass after him. The council: if he got on it, he would never get off; he would never renounce his seat, the chance to be a proper Pagford big shot, like Howard. He was committing himself anew to Pagford, retaking his vows to the town of his birth, to a future quite different from the one he had promised his distraught new fiancee as she sat sobbing on his bed. When had they last talked about travelling the world? She was not sure. Years and years ago, perhaps, but tonight Samantha decided that she, at least, had never changed her mind. Yes, she had always expected that some day they would pack up and leave, in search of heat and freedom, half the globe away from Pagford, Shirley, Mollison and Lowe, the rain, the pettiness and the sameness. Perhaps she had not thought of the white sands of Australia and Singapore with longing for many years, but she would rather be there, even with her heavy thighs and her stretch marks, than here, trapped in Pagford, forced to watch as Miles turned slowly into Howard. She slumped back down on the sofa, groped for the controls, and switched back to Libby's DVD. The band, now in black and white, was walking slowly along a long empty beach, singing. The broad-shouldered boy's shirt was flapping open in the breeze. A fine trail of hair led from his navel down into his jeans.