Nutritional assessment- a vital component The WritePass Journal

Nutritional assessment- a vital component Introduction Nutritional assessment- a vital component IntroductionCase scenarioNutritional assessmentMedical history collection approachesPhysical examinationBiochemical dataDiscussionConclusionReferenceRelated Introduction Malnutrition and undernourishment pose a major healthcare problem in the care of hospitalized patients in different care units in developed countries. There are numerous studies in health care literature reporting frequent malnutrition of patients in acute hospitals on admission and deterioration of nutritional status during hospitalization, particularly older people (Inge.K, 1999). Malnutrition can be defined in older people as faulty or inadequate nutritional status; undernourishment characterized by insufficient dietary intake, poor appetite, muscle wasting and weight loss (Carole S. Mackey, 2004). The cause of malnutrition is commonly contributed to medical, social and environmental as well as individual factors, such as poor appetite and disinterest in food, unpalatable or inadequate food, and lack of assistance with eating, poor skills in recognizing malnourished patients or those at risk of malnutrition and the low priority given to patients’ nutrition by doctors and nurses. Undetected and untreated, malnutrition is found to be detrimental to the quality of life and can lead to severe consequences such as prolonged hospital stays, high risk of infection, pressure ulcers, reduced wound healing, increased morbidity and mortality as well as increased costs for care, therefore, it is vital that hospital wards for older people have a nutritional care policy to prevent and/or treat malnutrition (Carole S. Mackey, 2004). Case scenario In 2010 August, Mr. Wong complained dizzy and fell in the morning and initially presented to orthopedic ward for collapse of L1 after fall. On admission, Mr. Wong’s ear temperature was 36.8, blood pressure was 100/ 50 mmHg, pulse was 75 /min, oxygen saturation was 93% on 2 L/min oxygen. During the acute state, he was developed hospital acquired pneumonia and put on Augmentin for one week course. In same year of November, Mr. Wong was transferred to rehabilitation ward for recovery and physiotherapy. Mr. Wong was retired. He has a 30-yr smoking history with one pack per day. He tries to quit smoking several times, but does not succeed. He lives in a 4-bedroom house with his wife and two sons and one daughter. He attended a Tai-Chi course with his wife in nearby park every day and had balanced diets prepared by Mrs. Wong. Mr. Wong had past history of Parkinson’s disease, hyperlipidaemia and gout followed up by Princess Margaret Hospital medical. On 2008 he had old lacunar infarct on computer tomography scan. In the rehabilitation ward, Mr. Wong had some exercise or limbs training with physiotherapists on the bed, as he could not have enough energy to stand up or walk with or without any support. Therefore, Mr. Wong always lied on the bed and then subsequently suffered from bed sore at his sacral. Firstly, he just suffered from stage one pressure sore, which was redness at the site without any discharge, and protected from duoderm. The health care workers provided daily normal saline dressing, frequent turning and pillows to relieve the pressure at the sacral. However, the pressure sore still became worse. At first, when the health care workers assessed Mr. Wong had high risk of worsening pressure sore; there are six risk factors including mobility, continence, nutritional, skin integrity, physical condition and medication common leading to developing pressure ulcers (Sharp CA, 2006). All possible preventions such as maintenance of well personal hygiene, frequent turning, and use of ripple bed had been provided. Also, wound nurse had assessed Mr. Wong’s situation and recommended the nurses for continuously providing dressing care and frequent skin observation. However, all recommendations and protections were given under strict supervision, but there is one criteria area missing in dealing pressure sore, this is nutrition. Poor nutritional status has been reported by several studies to be contributing factor to pressure ulcer development and malnutrition is positively correlated with pressure ulcer incidence and severity (Sharp. CA, 2006). Inadequate nutrition can increase the r isk of developing pressure ulcers and infection as well as impede the healing process of all wounds. Also, adequate dietary protein is absolutely essential for proper wound healing, and tissue levels of the amino acids may influence wound repair and immune function. As a result, a nutritional support should be given to patients with identified nutritional deficiency and any support be based on nutritional assessment using a recognized tool, general health status, patient preference or expert dietician (Ulrika Soderhamn, 2008). Moreover, nursing staff play an important role in the detection of the patient at risk and the implementation of sufficient preventive strategies. However, a comprehensive nutritional assessment is seldom performed on geriatric patients as routine and very few at-risk patients have a nutritional care plan. And some studies pointed that nurses in geriatric care feel they have a great responsibility for nutritional assessment and care but lack of sufficient knowledge for the tasks as well as of support from physicians (Ulrika Soderhamn, 2008). It is recommended that the health care workers should take the responsibility for informing, ordering, serving food and observing food intake and securing sufficient intake. These require the health care workers have sufficient knowledge and appropriate tools for screening and assessment of the older patients (Sharp. CA, 2006). Nutritional assessment A nutritional assessment is an in-depth evaluation of both objective and subjective data to define a person’s nutrition status. Specific data are obtained to create a metabolic and nutritional profile of the patient. The goals of the nutritional assessment are identification of patients who have, or at risk of developing malnutrition; to quantify a patient’s degree of malnutrition and to monitor the adequacy of nutrition therapy. It includes gathering information from the patient’s careful medical history, dietary history, a physical examination and laboratory tests (Weber, J, 2009). Medical history collection approaches Foremost in nutritional assessment is the patient interview for determining clinical history. Health care workers have recognized the way in which various diseases and conditions affect a person’s nutritional status. Attention should be focused on the disease state, duration of illness, intake of nutrients and presence of such gastrointestinal systems as nausea, vomiting and diarrhea. Also, the natural aging process can lead to increased nutritional problems among the elderly. Nearly 65% of elderly patients are calorie-protein undernourished or nutritional deficits developed while in the hospital (Vanderwee K, 2010). There some risks that are related with poor nutrition on the elderly such as normal aging changes in the senses of smell and taste, the effects of chronic diseases on food intake, psychological factors, social isolation, side effects from multiple medications or diminished function that subsequently limits their ability to shop or prepare meals. Choosing a dietary approach to nutritional status assessment The most valid or accurate dietary methods are prospective methods. These involve keeping records of foods consumed over the period of time of interest. This can be done by individuals themselves, or by health care workers observing them. Sometimes the foods are weighed before eating and then plate waste is weighed and subtracted. A similar method is to prepare two duplicate meals; one is consumed by the subject and the other is analyzed for nutrient content. Another method is the dietary record, in which the subject records estimated amounts of foods consumed. In any case, these methods are highly reactive because individuals may alter usual behavior to make their diet more socially desirable or to simplify the process of record keeping. Recall methods are the most widely used type of dietary data collection method. They are less reactive, but also less accurate than record methods. Twenty-four hour recalls, in which the previous days intake is queried in detail, for instance, foods , amounts, preparation techniques, condiments, are easiest for health care workers to complete (Sharp. CA, 2006). The data reported are converted from foods to nutrients with the use of food composition tables. Because a single day is not representative of usual intake, multiple twenty-four hour recalls are frequently used. Besides, the twenty-four hour recall of food intake record are used, the health care workers should observe the patients’ food preference, history of eating pattern and eating ability such as mood changes or swallow problem that might affect their eating. Physical examination Evaluation of the patient’s overall appearance and thorough physical examination of the skin, eyes, mouth, hair, and nails provide a clue the presence of malnutrition. Weight is one of the most useful elements of the physical examination for the assessment of nutritional status (Inge.K, 1999). Body weight is expressed as a relative to established norms in the general population. For adults, body weight and height are used to evaluate overall nutritional status and to classify individuals as at healthy or non-healthy weights. The most recent classification is to use body mass index (BMI, in kg/㎠¡). BMI, regardless of age or population, is normal at 18.5-25.0 kg/㎠¡, overweight at 25.0 to 19.9 kg/㎠¡, and obese at over 30.0 kg/㎠¡. In general BMI greater than 30 is assumed to be due to excessive adiposity (World Heart Federation, 2005). Weight loss is often the first clue to an underlying cause of malnutrition. The loss of more than 10% of the patient’s usual weight necessitates a thorough nutritional assessment. Recent unintentional loss of 10% to 20% of the patient’s usual weight indicates moderate protein-calorie malnutrition, and loss of more than 20% indicates severe protein-calorie malnutrition (Ulrika Soderhamn, 2008). In addition to weight and height, anthropometric approaches are for most part relatively noninvasive methods that assess the size of body composition of an individual. Anthropometric measures, such as mid-arm muscle circumference and triceps skin-fold thickness, estimate fat and lean tissue mass respectively (Carole S. Mackey, 2004). Anthropometric measures of nutritional status can be compromised by other health conditions. For example, edema characteristic of some forms of malnutrition and other disease states can conceal wasting by increasing body weight. Anthropometric data are used in nutritional assessment to compare measured values with standardized controls and to compare serial measurements over time in the same patient. These are useful in identifying the most severely malnourished patients, especially those with fluid retention as a result of disease (Inge.K, 1999). Biochemical data Laboratory tests based on blood urine can be important indicators of nutritional status, but they are influenced by non-nutritional factors as well. Measurements of serum protein levels are used in conjunction with other assessment parameters to determine the patients’ overall nutritional status. Serum proteins used in nutritional assessment include albumin and transferrin and preablumin. Albumin is a complex, high-molecular-weight protein produced by the liver and decreased albumin levels have been shown to correlate with increased morbidity and mortality in hospitalized patients; therefore it is often used as a prognostic indicator. If the patient’s serum albumin concentration lower then 3.5g/dL and the total lymphocyte count lower than 1500 cells/mm3, it should be take more concern with them (Carole S. Mackey, 2004). Also lab results can be altered by medications, hydration status, and disease states or other metabolic processes, such as stress. As with the other are as of nutrition assessment, biochemical data need to be viewed as a part of the whole. Discussion Before utilization of the nutritional assessment, the health care workers might only concern how the pressure sore can be healed and provided further treatment or protection. The nutritional issue related to wound healing might be ignored. The health care workers should have knowledge and be conscious of nutritional issues and know the importance and relevance of these issues for the particular patient promoted the nutritional nursing assessment. Identifying, assessing and treating older patients’ nutritional problems is a challenge for all staff groups involved in the patients’ care, therefore, it need to collaboration between other caregivers and professionals and sufficient knowledge about nutrition among the staff groups (C. E. Weekes, 2009). For example, the nurse can organize one person into performing specific tasks like serving food to Mr. Wong to highlight his eating ability and facilitate the assessment process. There is also collaboration between the nurse an d physician, speech therapist or dietician who can help with the estimation of the nutritional requirements and get suggestions of food supplements. The first priority for the nurses is to let Mr. Wong know their nutritional needs and current problems, as he might think that he ate enough every day, but the situation perhaps was adverse. They should have an individual holistic patient view and discuss with Mr. Wong about his situation and then find out how and why the identified nutritional problem influenced the pressure sore. And the four assessment techniques in a nutritional assessment can perform at the same time. The health care workers always perform the twenty-four hours intake and output record with Mr. Wong for calculating the fluid balance and energy intake in the daily nursing routine. Also, it can be recognized Mr. Wong’s nutritional status from physical examination like Body mass index reading and mid-arm circumference to determine the specific needs and problems. And then collaboration with physicians to taking his blood for further laboratory assessment. The laboratory results like protein level and albumin level provide information for the nursing diagnosis. Using the clinical, biochemical and dietary data, influences on the nutritional status can be determined. A nutritional intervention which includes dietary guidance and exercise recommendations is then formulated and discussed with the individual. Further dialogues with and observations of Mr. Wong are used promoting for a continuous assessment process, because it can supply the nurse with information about the effects of the interventions and how the nutritional status of Mr. Wong changed, The nurse then feels a responsibility for him having a continuous and proper nutritional intake (C. E. Weekes e, 2009). If all the possible preventions and nutritional problem can be treated, the rate of getting infection should be minimized and the wound healing should be better. Conclusion Malnutrition becomes a considerable problem among hospitalized patients. The use of nutritional care practices and nutrition assessment of elderly patients is necessary and optimal in hospitals. Nutrition assessment involves a combination of examinations and patient history, and as such, no single laboratory test or finding should be used to indicate poor nutrition. An increased consciousness of the importance of nutritional care and assessment among health care professionals will contribute to further improvement of the quality of nutritional care. Reference Carole S. Mackey. (2004). Nutritional Assessment. Retrieved 19 February, 2011, from diet.com/store/facts/nutritional-assessment Ho. S Lee. S. ( 2011, March 18).   Slow food culture on stress-city menu. The Standard, p. A4 Inge.K, Simon. S Wood. J (1999). Nutritional care of the patient: nurses’ knowledge and attitudes in an acute care setting. Journal of clinical nursing, 8, 217-224 Sharp CA McLawa M.L (2006). Estimating the risk of pressure ulcer development: it is truly evidence based?. International Wound Journal, 3(4), 344-353 Ulrika Soderhamn. Olle Soerhamn. (2008). A successiveful way for performing nutritional nursing assessment in older patients. Journal of clinical nursing, 18, 431-439 Vanderwee K, Clayse E, Bocquaert I, Verhaeghe S, Lardennois M, Gobert M Defloor T. (2010). Malnutritiona and nutritional care practices in hospital wards for older people. Journal of advanced nursing, 67(4), 736-746 Weber, J. Kelley, J. H. (2009). Health assessment in nursing. Philadephia: Lippincott Williams Wilkins Weekes, C. E, Spiro, A, Baldwin, C, Whelan, K, Thomas, J. E, Parkin, D Emery, P. W. (2009). A review of the evidence for the impact of improving nutritional care on nutritional and clinical outcomes and cost. Journal of Human Nutrition and Dietetics, 22, 324-335 World Heart Federation (2005). Body Mass Index [Leaflet]. World Heart Day 2005 Leaflet

Letter of Recommendation Sample Close Colleague

Letter of Recommendation Sample Close Colleague SAT / ACT Prep Online Guides and Tips You don't have to be somebody's boss to write her a recommendation letter. You might have a coworker ask you to write one when she applies for an internal promotion or a position outside the company. This sample letter's written by a colleague for someone applying to a leadership position at another company. As a coworker and friend to the candidate, the writer can speak both to her professional skills and to her personal interests. Read on to see how the writer supports his colleague's job application. Sample Recommendation Letter #7: Written by a Coworker Mr. Ernie SandersChief Marketing OfficerGlobex Tech55 Valley RoadPalo Alto, CA 95014 Dear Mr. Sanders, I’m very pleased to recommend Alice for the position of Editor-in-Chief with Globex Tech. As a fellow IT Content Editor at CloudArk, I’ve worked alongside Alice for the past five years. Not only has she been a key player on our team, but she’s also become a close personal friend. Alice’s skills and leadership qualities would make her an invaluable addition to your information technology content development team. While Alice has found success at CloudArk, helping increase our blog traffic from a few thousand to over one million monthly readers over her time here, she’s looking to maximize her skills as a leader within a larger company. Our small start-up doesn’t yet have the opportunities for leadership for which Alice is qualified. Alice is poised to step into a role of editorial management for a content program with the potential for global reach. Alice can plan, create, and market IT content and build a global presence for Globex Tech. She’s an excellent writer and editor with a facility for translating technical information into engaging content. She has used her knowledge of the tech world both to popularize CloudArk’s blog and to develop a platform for educational training, including IT-related certifications, workshops, and webinars. She has her finger on the pulse of technological trends and provides content that’s both useful and captivating to readers. Alice marries her writing skills with a working knowledge of digital and inbound marketing. She works across social media, email campaigns, and other public relations outreach to effect viral engagement. Her last three posts across our social media platforms generated an all time high of 20,000 shares and helped bring in many unique visitors. In a leading position with your company, Alice would use strategic tactics, like search engine optimization and social media metrics, to take your web presence to the next level. In addition to her professional qualifications, Alice has personal qualities that make her well-suited to leadership. She’s naturally fallen into the role of â€Å"point person† that many of us go to with questions. She’s not afraid to take risks and often suggests new directions to explore. Alice was instrumental in introducing our educational platform for training, for instance, a direction that has proven to be very fruitful. She’s committed to quality, growth, and progress, and she inspires her team members to strive for the same. In short, Alice is a person with vision. On a personal note, Alice has become a close friend over our years of working together at CloudArk. She organized several social events for the company, like bar meet-ups and 5k races, helping to facilitate team cohesion and allowing us to form a great friendship. In fact, we’re going trail running this Saturday. Alice’s fun and friendly personality are just icing on the cake of her many other qualifications. Alice has my highest recommendation for the position of Editor-in-Chief with Globex Tech. I’m excited to see the directions in which Globex Tech will grow under Alice’s leadership. Please feel free to contact me for any further information. Thanks very much for your time. Sincerely, Robert WordsworthIT Content EditorCloudArkrwordsworth@cloudark.com(866) 811-5546 Robert sounds confident that Alice has the editorial and social media skills to beEditor-in-Chief. Recommendation Letter #7: The Breakdown This recommendation letter sample is one written by a coworker for someone applying outside of the company. This coworker describes his personal friendship with the applicant while also pointing outthe applicant’s professional skillsand work performance. He starts with a statement of strong support, as well as an explanation of why Alice is looking to step into a leadership position at a larger company. Robert describes Alice’s past accomplishments and future potential. He shows how she contributed toCloudArk's growth, describing her skill in content creation and knowledge of technological trends. He also touches on her digital and content marketing abilities, both of which would be essential in her target job. In addition to discussing her experiences, Robert explains that Alice has the leadership capabilities and vision to move into an Editor-in-Chief position. He says she’s become the â€Å"point person† for her colleagues while also excelling at collaborative work. This former skill is further evidenced by virtue of the fact that the letter is written by a work colleague. As Alice’s friend, Robert’s also able to touch on some of her personal interests, providing an additional dimension to the letter. Overall, Robert states strong support for Alice’s application and gives examples as to why she’s ready to step into a position of editorial leadership. His letter presents Alice’s editorial and marketing qualifications and proves that she’s established positive relationships with her colleagues. Want to provide a strong recommendation for your employee, but don't have the time to craft the perfect letter? PrepScholar's new recommendation tool, SimpleRec, takes you from good intentions and a blank page to a fully written and formatted letter of recommendation in under 5 minutes. All you need to do is give us some simple pieces of information about your employee and your experience working with them, and we'll do the rest. Try out SimpleRec risk-free today: What's Next? Not everyone asks a coworker or manager to provide them with a letter of recommendation. People who are just out of college often ask a former professor. Check out this next recommendation letter sample to see how a professor supports a former student's job application! Are you looking for more rec letter samples? Refer to this complete reference letter guide to find more samples and learn more about the letter writing process.

Is the Media in the UK Sexist and Racist Essay Example | Topics and Well Written Essays - 2000 words

Is the Media in the UK Sexist and Racist - Essay Example The X rating imposed by the BBFC was as a result of explicit sexual and violent content, according to Stuart McDougal (2003: 3) in his book, Stanley Kubrick’s A Clockwork Orange. Today, the censorship that resulted in an X rating for A Clockwork Orange, and prevented the film from being made available to the British public country-wide, is noticeably absent in the British media; as is the moral judgment and assertion of political interest that once prevailed in the UK’s media. The discernable sexism and racism that once defined the UK’s media were by design, according to David Buckingham, in a journal article published in the Journal of Communication (1998: 33). In his journal essay, Buckingham describes, â€Å". . . the history of media education in the UK, tracing its evolution Leavisite (Leavis and Twerepson 1933) origins, through the advent of cultural studies to the more explicitly political approaches developed in the 1970s. These approaches reflect a gradual democratization of the curriculum, as well as a form of cultural or political protectionism (1998: 33).† There has been, writes Buckingham, a noticeable and discernable move away from the aforementioned protectionism, resulting in a more open, less sexist, less racially discriminatory British media (1998: 33). The teaching of media in the UK, utilizing the Leavis and Thompson (1933) methods, was, according to Buckingham, focused on â€Å". . . salvation of the (British) culture – preserving the literary heritage, language, values, and health of the nation it was seen to embody and represent (1998: 34).† In their book, British Cultural Identities, authors Peter Childs and Mike Storry write, â€Å"The British are famed for both their prurience and their sexual reserve, a stereotype which, though exploited with many British cultural forms (Merchant/Ivory â€Å"heritage† cinema, for example), probably derives less from contemporary cultural attitudes than from England’s former role in the global imposition of repressive middle-class norms and values (2002: 128)†.

Managing Change in Healthcare Essay Example | Topics and Well Written Essays - 2750 words

Managing Change in Healthcare - Essay Example Some of the most favored approaches that have been preferred are cycle-time reduction, process engineering, and total quality management (TQM), with which companies have tried to flatten the organizational structure [3]. However, structural change programs on its own are likely to fail as they do not account for the human element, which actually forms the structure. Change management must work towards removing fear, cynicism, and defensiveness from the minds of the people. In the healthcare sector of US, the practice of midwifery was almost eliminated by concerted effort of university educated physicians [11]. The changes in perceptions about the profession of midwifery and its reinstatement into the healthcare industry, started in 1939, with the Frontier Nursing Service and has since then passed through various changes and reconstruction [11]. To enhance the performance of an organization it is important to improve the performance of the individuals and groups that comprise that organization. When organizations set new goals, they must also take care to see that the employees are made aware of these new goals well in advance or better still the company can set the new goals after consulting the employees. The employees must be backed by timely and adequate infrastructure to attain the goals; proper feedbacks and timely interventions must be integrated into the system. The Midwives Alliance of North America (MANA) was formed in 1982 and the struggle and persistent effort of the initial women of the midwifery profession has enabled it to get a legitimate status in 33 states of the country [11]. Managing Change - The Impact of Relevant Theory on the Change Process Aims Technological development has ushered in changes across organizations and our personal world. In the midst of these changes to better and sophisticated machines, it is important to remember that people form the basis of organizations. Technology makes structured and repetitive work easy while people use their intelligence to think, create, and solve. The major change today is the transformation of the work force from an information worker to an information user or what can be better described as a knowledge worker. Peter Drucker in his 'The New Society of Organization' has said, that the world economy is transforming to a knowledge society, where knowledge is the primary resource for the economy and for the individuals. In such an economy, according to Drucker, the competitive advantage comes not from the research and development of technology but from the skill and expertise of the knowledge workers, who form the organization [2]. The legitimacy of midwifery as a practice was established by the vision and persistence of the traditional midwifery experts, who encouraged self regulation in the next generation. Their efforts paid off and by the 1980's the standards of practice and certification began to be established in one state after another. The Midwives Alliance of North America (MANA) was formed in 1982, to help the movement gain support and legitimacy [11]. Issues Affecting Change and Personal Behavior Healthcare organizations are different from other organizations, as they involve something beyond business. According to

College Tuition Essay Example for Free

College Tuition Essay In todays society, the idea of a college education has become less of an option and more of a necessary requirement and is commonly considered the only way to acquire a successful career and life. There are many careers, in which a college education is not technically necessary, that can often be just as or even more successful. With the cost of college tuition increasing with every passing year, the controversy of whether college is really worth the cost and burden is growing too. If our society wants to continue displaying a college education as somewhat of a necessity for success, I believe the cost of it should shift to being a more realistic price, suitable for the majority of students striving to go to college. Most high school students feel pressure by not only the family, but also peers and teaching faculty to go to college because it’s â€Å"the smart thing to do†, but some may be hesitant to choose the college route because they believe their experiences will be different and the benefits of getting the job and making all their money back wont apply to them. Economic research concludes that more students would gain from college rather than opting out from it, and choosing a different route. Yes, there are many careers that require little or no further education after high school that may be considered successful jobs, such as construction and more hands on jobs, but it is averaged that over a lifetime those who attend college make about $500,000 more than those who do not. â€Å"Seven out of ten college seniors (71%) who graduated last year had student loan debt, with an average of $29,400 per borrower. From 2008 to 2012 debt at graduation †¦ increased an average rate of six percent each year. † (The Project of Student Debt). With all of the debts, not covered by either scholarships or financial aid, accumulated over the course of an individual’s schooling, the amount of additional money made becomes less substantial; if the tuition and fees were to decrease, the additional money made would not be as affected. The costs to attend two of the leading universities in Oregon, University of Oregon and Oregon State, for four years averages at about $88,000, and that doesn’t even include everyday personal expenses. For non-residents that price is more than doubled that of a resident student. â€Å"In 1980, it cost an  average of about $56,000 (adjusting for inflation) to attend a university for four years. This figure includes tuition, fees, and the â€Å"opportunity cost,† or income one foregoes to attend school instead of holding a job. (This figure excludes room and board: one must eat and sleep whether she is in college or not. ) In 2010, four years of college cost more than $82,000, a nearly 50 percent increase over that 30-year period. †(Brookings Institute). Sure there are many scholarships and financial aid a student is able to apply for, but with so many students applying for such scholarships, you’re chances of receiving them become slimmer. A lot of scholarships also do not benefit students as a whole and either target minorities, athletes, or financial aid students. Community college is also a viable option for many, but is often looked down upon. You don’t often hear a high school student say â€Å"I want to go to a community college† or â€Å"I can’t wait to go to a community college† with loads of enthusiasm. Not only do students and their families look down upon going to a community college, but teachers as well think lesser of community colleges and often express their opinions out loud. This makes students look at community colleges as less of a viable option and more of a last option. When applying for jobs, it also looks a lot more prestigious when it is shown that one attended a university rather than a community college. Although most colleges may not consider ways to lower the costs of college, there are many ways in which a lower tuition and overall price is possible. One direct contribution to the costs of schooling is the professor’s salary. Many college educators do not actually deserve the amount of money they make. Teachers should receive a salary that accurately reflects how affective the professor is at teaching. College fees also include unnecessary additions that are not required and could easily be taken off, such as gym memberships, recreation center memberships, and other additional bonuses that are not essential. Also, although I’m a student-athlete as well, the amount of money given away in scholarships just to play sports at that school has become a bit ridiculous. If the amount of money for scholarships went back into the school directly, the cost of tuition would decrease, and the need for those said scholarships would decrease as well. It is apparent that student athletes are held to a higher regard than other students. Often, you see students that are all-state athletes that get decent grades receive more money and â€Å"special treatment† in comparison to a student that does not do related extra-curricular activities, yet gets exceedingly high grades. This is not fair in any way; the elimination or decrease of athletic scholarships given out would eliminate the inequality commonly displayed throughout colleges. College tuition is at an outrageous high right now and is not showing many signs of decreasing. The costs of college and sending a student off to college have become much of a burden for many families across America. With how necessary getting a college education is considered, the cost of it all should shift to a more suitable price. The shift would be very difficult to achieve, and would be a very long process, but I do believe it is possible, not only for my generation, but the next several generations of students on the path to attend college. Work Cited Page: Greenstone, Michael, and Adam Looney. Regardless of the Cost, College Still Matters. The Brookings Institution. The Hamilton Project, 05 Oct. 2012. Web. 31 Oct. 2014. . Student Financial Aid and Scholarships. Cost of Attendance. University of Oregon, n. d. Web. 31 Oct. 2014. . Financial Aid and Scholarships. Cost of Attendance. Oregon State University, n. d. Web. 31 Oct. 2014. . State by State Data. Project on Student Debt:. The Project on Student Debt, 2013. Web. 31 Oct. 2014. .

Biomes of the World Essay -- The Worlds Biomes

A biome, also known as life zones, consists of all plants, animals, and other organisms, as well the physical environment in a particular area. A biome is characterized by its’ plant life, climate, and location. The climate and physical features determine the boundaries of a biome. A biome is made up of many different ecosystems. The ecosystems tend to have the same pants and animals as neighboring biomes around the boundaries. The major biomes are the tundra, taiga, tropical rain forest, temperate forests, desert, grassland, savanna, chaparral, and marine. Each biome has it’s own characteristics such as the tundra. The tundra is a biome that is located in the Northern Hemisphere of the world. It circles the North Pole and reaches down to the taiga. The tundra has a very cold and harsh climate, especially in the winters. The average winter temperatures is about -30Â °F and average summer temperatures is roughly 37-54Â °F. The yearly amount of precipitation, which includes melting snow, averages to about 6 to 10 inches. With these conditions it makes for a short growing season of about 50-60 days. In some parts it can be up to 180 days. This is only found in the more southern part of the tundra. Another aspect of the tundra includes the vegetation that is found there and the adaptations that have been made. The tundra is known for its’ cold temperatures, but also its’ limited plant species. The growth of the vegetation is primarily low to the ground and the biomass of plants is concentrated in the roots. Here the plants reproduce more likely by division and building than by flower pollination. Some of that growthforms that you will find in the tundra include tussock, mats or cushion plants, rosettes, and dwarf shru... ...enthic, coral reef, and estuaries. Some freshwater habitats include marches, lakes, rivers, ponds, wetlands, and bogs. All the biomes of the world have climates, plants, and animals all their own. Traveling through each zone you can pick out the similar adaptations of each plant and animal. Biomes are unique to their location, each one of great importance to the world. Bibliography 1. Biomes, http://ths.sps.lane.edu/biomes 2. Aquatic Biomes, http://redbaron.bishops.ntc.nf.ca/wells/biomes/html/aquatic.htm 3. Biomes, SLW, October 1996, http://runet.edu/~swoodwar/CLASSES/GEOG235/biomes 4. Chaparral, http://www.csun.edu/csc24235/hairach.html 5. Northern Coniferous Forest, http://www.uwsp.edu/acaddept/geog/faculty/ritter/geog101/biomes_northern_forest.html 6. The World of Biology, 4th ed., Davis, Solomon, Berg; Saunders College Publishing, Ó1994.

Eymp 4 1.1

1. 1: Health and Safety Factors. Factors; Within early years settings, there are various factors to consider for both indoor and outdoor activities. Things that need to be considered with indoor activities are; Safety: Safety gates are needed within any setting with children to keep them safe and secure. The safety gates are used prevent children causing any harm to themselves. Also, safety equipment is needed such as safety scissors to prevent the children randomly cutting themselves. High tables and chairs cannot be used within any setting where there are children.Low tables are needed as it prevents children running into them and causing themselves harm and prevents them giving themselves concussion. Low chairs are used because they can’t cause any harm to the child whereas if they were high chairs, the children could reach for something and fall off the chair. High door handles are very often used early years settings as it prevents the children from attempting to open the door and often there are two handles, a low and a high one so even if the children opened the low door handle, they’d need the high one open to be able to leave.Risk assessments are also needed for anyone Security: Early years settings can have a mass amount of security such as buzzers and identity cards. Buzzers are used so only the staff members can leave and enter the setting at any time they can and need to. This also prevents strangers wandering into the setting. Staff members should also have ID cards, CRB checks all that they are fully qualified to work within that setting.Also, if any other person is to collect a child from the nursery, the parents would need to ring up in advance to alert the staff otherwise if the carer comes into the setting to collect a child, the receptionist would need to ring the parents first to see if it was okay for that person to collect the child, otherwise the parent would normally have to collect that child. Health: Within the early yea rs setting, the children’s health is a big thing. To keep them healthy, they’d need to maintain a balanced diet and have regular exercise.For the child to keep regular exercise, the setting usually has both indoor and outdoor play areas that help to stimulate the children’s learning environment. An outdoor activity gives the child the freedom they need and also gives them more room to move around. The children tend to exercise without acknowledging it. Various activities such as bikes and running around generally helps keep them in a healthy form and active. The cafeteria provides a balanced diet so the child can get all the nutrients they need.

Armani Markting Plan Essay

Product:The original Armani Couture product line is the most well respected, developed and successful. Over the next three years this line should release all ties to the other products and become a stand alone business to differentiate itself and reestablish itself as the face of Giorgio Armani retaining its exclusivity and Brand distinction. This is the signature line or Armani and should remain under his management and direction. The other products Emporio, Collezioni, Armani Jean, A/X, Armani Jr. hould all be franchised to retain the Brand image yet capitalize on explosive growth potential. †¢ Promothion:ARMANI:Since  the  brand  was  founded  . almost  all  of  the  actress  have  had  close  contact  with  it  in  some  Large  awards  banquet,  Ã‚  ,such  as  in  the  Academy  Awards,  Cannes  Film  Festival,  you  can  see  the  well-designed  Armani  suit  dress. In  2005,  the  brand’s   new  Privecollection  suit  series,  priced  from  200,000  to  700,000  Yuan. Its  flagship  brand  Qiaozhi  Ou  Ã¢â‚¬ ¢Ã‚  Armani  has  been  widely  praised  by  the  successful  people. †¢ Place:The private holdings of Giorgio Armani span over 35 countries. They include 16 Armani casa home furnishing stores. 13 Armani Junior stores offering clothing for early to late teens and the twenty something crowd. 11 Collezioni, 120 Emporio, 94 A/X Retail outlets and 60 Giorgio Armani Boutiques for Couture offerings †¢ Price:Positioning in high-grade, aim at wealthy . Armani as high-end luxury brands, the main target consumption group is the high-income class, successful man, a famous film star, senior white-collar workers, etc. ), the main products are men’s clothing brand.

Should I Take the SAT Essay How to Decide

Should I Take the SAT Essay How to Decide SAT / ACT Prep Online Guides and Tips The SAT underwent some major revisions in 2016, and one of the biggest changes is that its previously required essay is now optional.This can be confusing for some students and parents. Should you take the essay? Will colleges require the essay or not? Will taking the essay make your application stronger? Read on for answers to all these questions.This guide will explain what the SAT essay is, what the pros and cons of taking it are, and how you can make the best choicefor you. What Is the SAT Essay? The SAT essay is one of the sectionsof the SAT. After being required since its inception, the College Board has now decided to make the essay optional. This is similar to the ACT, whose essay has always been optional. During this section, students will be given 50 minutes to write an essay.The essay for the new SAT is very different than it was for the previous version of the SAT. You can read all about the changes to the SAT here, but, as a brief overview, the essay will give you a passage by an author who is taking a stance on an issue. Your job will be to analyze how the author built that argument. If you choose to take the essay, it will be its own section of the SAT, and the score you get on the essay will be separate from your score on the rest of the exam. Your main SAT score will be out of 1600 while your essay will be graded across three different categories: Reading, Analysis, and Writing. For each area, your essay will be given a score from 2-8. Below isa sample prompt from one of the official practice tests released by the College Board. Here youcan read the entire prompt, including the passages you would need to analyze. Do Colleges Require the SAT Essay Now That It's Optional? So, the College Board has now made the essay an optional part of the SAT, but does that change how colleges view the essay (or if they even view it at all)?Kind of. Some schools that used the essays before no longer require them now that both the ACT and SAT have made the essays optional, but other schools continue to require the SAT essay. Each school makes this decision individually, so there are no patterns to follow to try and guess who will require the essay and who won’t. Even top schools like the Ivy League are divided on whether to require the essay or not. This can make things confusing if you’re applying to college soon and don’t know if you should take the SAT essay or not.The following sections of this guide will explain the benefits and drawbacks of taking the essay and walk you through different scenarios so you can make an informed decision. The #1 Consideration: Do Any of the Schools You're Interested in Require the Essay? The absolute most important factor, the factor that matters more than anything else in the rest of this guide, is if any of the schools you’re applying to or thinking of applying to require the SAT essay. The best way to get this information is to Googleâ€Å"[school name] SAT essay requirement,† look directly on each school’s admission webpage, orcheck out our list of the schools that require the SAT essay. Find this information for every school you plan on applying to, even schools you’re not sure you want toapply to, but are considering.If even one school you’re interested in requires the SAT essay, then you should take it, regardless of any other factors.There is no way to take just the SAT essay by itself, so if you take the SAT without the essay and then, later on, realize you need anessay score for a school you’re applying to, you will have to retake the entire test. So, if a school you’re interested in requires the SAT essay, your choice is clear: take the essay when you take the SAT. However, what if the schools you’re interested in don’t require the essay? If that’s the case, you have some other factors to consider. Read on! Benefits of Taking the SAT Essay If none of the schools you’re thinking of applying to require the SAT essay, why would you want to take it? The two main reasons are explained below. #1: You're Covered for All Schools Taking the SAT essay means that, no matter which schools you end up applying to, you will absolutely have all their SAT requirements met. If you decide to apply to a new school that requires the SAT essay, that won’t be a problem because you’ll already have taken it. If you already are absolutely certain about which schools you’re applying to and none of them require the essay, then this may not be a big deal to you. However, if you have a tentative list of schools, and you’ve been adding a school or removing a school from that list occasionally, you may want to be better safe than sorry and take the SAT essay, just in case. Taking the SAT essay means you have all your bases covered, no matter which schools you end up applying to. #2: A Good Score May Boost Your Application Slightly While it’s highly unlikely that your SAT essay will be the deciding factor of your college application, there are some cases where it can give you a small leg up on the competition. This is the case if a school recommends, but doesn’t require the essay, and that school is particularly competitive. Having a strong SAT essay score to submit may strengthen your application a bit, especially if you are trying to show strong English/writing skills. Want to learn more about the SAT but tired of reading blog articles? Then you'll love our free, SAT prep livestreams. Designed and led by PrepScholar SAT experts, these live video events are a great resource for students and parents looking to learn more about the SAT and SAT prep. Click on the button below to register for one of our livestreams today! Drawbacks to Taking the SAT Essay There are also costs to taking the SAT essay;here are three of the most common: #1: It's Another Section to Study For If you choose to take the essay, that means you have an entire extra SAT section to study and prepare for. If you already feel like you have a ton of SAT prep to do or have doubts about staying motivated, adding on more work can make you feel stressed and end up hurting your scores in the other SAT sections. #2: It Makes the Exam Longer Taking the essay will, obviously, increase the total time you spend taking the SAT. You’re given 50 minutes to write the essay, and, including time needed for students not taking the essay to leave and things to get settled, that will add about an hour to thetest, increasing your total SAT test time from about three hours to four hours. If you struggle with keeping focused or staying on your A game during long exams (and, let’s be honest, it’s not hard to lose concentration after several hours of answering SAT questions), adding an additional hour of test time can reduce your test-taking enduranceand make you feel tired and distracted during the essay, likely making it hard for you to get your best score. #3: The Essay Costs Extra Taking theSAT with the essay will also cost you a bit more money. Taking the SAT without the essay costs $46, but if you choose to take the essay, it costs $14 extra, raising the total cost of the SAT to $60. However, if you're eligible for an SAT fee waiver, the waiver also applies to this section of the exam, so you still won't have to pay anything if you choose to take the essay. Taking the essay likely means the cost of taking the SAT will be slightly higher for you. Should You Take the SAT Essay? Five Scenarios to Help You Decide Now you know what the SAT essay is and the pros and cons of taking it. So, what should you decide? Five scenarios are listed below; find the one that applies to your situation and follow the advice in order to make the best decision for you. Scenario 1: You're planning on applying to at least one school that requires the essay As mentioned above, if even one school you’re thinking about applying to requires the SAT essay, you should take it in order to avoid retaking the entire SAT again at a later date because you need an essay score. Scenario 2: None of the schools you're applying to look at essay scores If none of the schools you’re thinking about applying to even look at SAT essay scores, then you shouldn’t take it. Even if you get a perfect score, if the schools don’t consider essay scores, then taking it will have no benefits for you. Scenario 3: The schools you're applying to don't require the SAT essay and aren't highly competitive In this case, you don’t need to take the SAT essay, unless you’re trying to make up for weak writing skills in other parts of your application. Scenario 4: The schools you're applying to recommend the SAT essay and are more competitive For this scenario, you should take the SAT essay in order to give your application an extra boost, unless you really think you’d perform poorly or preparing for and taking the essay would cause your scores in other sections to decline. Scenario 5: You aren't sure where you're going to apply yet If you’re not sure which schools you want to apply to, then you should take the SAT essay, just to be safe. This way you’re covered no matter where you end up applying to college. If the thought of figuring out which colleges to apply to has you as confused as this blue panda, your safest option is to take the SAT essay. Conclusion Because of the College Board’s recent decision to make the SAT essay optional, students are now faced with the decision of whether they should take it or not.The best way to decide is to learn the essay policy for each of the collegesyou're interested in applying to.Some schools will still require the essay, some won’t even look at an applicant’s essay scores, and other schools don’t require the essay but will look at your score if you do take it. Use these school policies to help decide whether you should take the essay.Remember, if you end up needing to submit an essay score, you will have to retake the entire SAT, so make sure you have accurate and up-to-date information for each school you are thinking of applying to. What's Next? Have you decided to take the essay and want to know how to start studying? We have a step-by-step guide that explains how to write a great SAT essay. Want more examples of sample prompts? Here are all of thereal SAT essay prompts that have been released by the College Board. Are you aiming fora perfect SAT essay score?Check out our guide on how to get a perfect 8/8/8 on the SAT essay. Want to improve your SAT score by 160 points?We've written a guide about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now:

Patricia Vickers-Rich - A Profile of the Famous Paleontologist

Patricia Vickers-Rich - A Profile of the Famous Paleontologist Name: Patricia Vickers-Rich Born: 1944 Nationality: Australian; born in the United States Dinosaurs Named: Leaellynasaura, Qantassaurus, Timimus About Patricia Vickers-Rich Sometimes, even globe-trotting paleontologists become associated with the specific geographical areas in which they made their most famous fossil discoveries. Such is the case with Patricia Vickers-Rich, who along with her husband, fellow paleontologist Tom Rich, has become virtually synonymous with Dinosaur Cove. In 1980, the couple explored the remains of  this ancient river channel, studded with bones, on the southern coast of Australiaand soon they began a careful series of excavations, which involved the strategic use of dynamite and sledgehammers. (Vickers-Rich is not a native-born Australian; she was actually born in the United States, and emigrated Down Under in 1976.) Over the next 20 years, Vickers-Rich and her husband made a series of important discoveries, including the small, big-eyed theropod Leaellynasaura (which they named after their daughter) and the mysterious ornithomimid, or bird-mimic dinosaur, Timimus (which they named after their son). When they ran out of children after which to name their fossils, they turned to the corporate institutions of Australia: Qantassaurus was named after Qantas, the Australian national airline, and Atlascopcosaurus after a prominent manufacturer of mining equipment. What makes these finds especially important is that, during the later Mesozoic Era, Australia was located much farther south than it is today and it was therefore much colderso Vickers-Richs dinosaurs are among the few known to have lived in near-Antarctic conditions.

Duchennes Muscular Dystrophy Essay Example | Topics and Well Written Essays - 1250 words

Duchennes Muscular Dystrophy - Essay Example Duchenne muscular dystrophy or Pseudohypertrophic muscular dystrophy or Muscular dystrophy- Duchenne type is an X-linked neuromuscular disorder of muscle caused by an absence of the protein dystrophin. DMD was named in recognition of Dr. G. Duchenne de Boulogne from France around 150 years ago. He was the first person to attribute the signs and symptoms to a distinct familial disease entity. The gene responsible for it is DMD gene which is known to be the largest gene encoding the muscle protein, dystrophin the discovery of this gene was made around 20 years ago. Dystrophin provides structural stability to the dystroglycan complex (DGC) present on the cell membrane as it attaches with the inner surface of the muscle fiber membrane. A mutation in the DMD gene residing in Xp21 region of the X-chromosome, hampers the production of dystrophin protein causing progressive loss of muscle function and weakness (Partridge, 2007). It starts with the lower limbs and gradually covers the entire musculature. DMD is rapidly progressing form of muscular dystrophy affecting male with a frequency of 1 in 3500 infants (Chamberlain, 2006). It is observed that the affected boys start manifesting symptoms of disease early in life usually before 5 years of age. They become powerless and are unable to walk and are restricted to wheel chair during their late childhood or early teen years. Patients usually develop various complications related with respiratory insufficiency and/ or cardiomyopathy as the disease progresses. Death occurs at by late teen age or in the early twenties (Chamberlin, 2006). It is essential to provide appropriate treatment to overcome the basic genetic defect, either through medical, surgical, and rehabilitative approaches to make the patient comfortable (Sussman, 2002). Symptoms Before the age of 6 years symptoms start becoming obvious, although they are visible in early infancy. There are three clinical stages: an ambulatory stage, an early nonambulatory stage, and a late nonambulatory stage. Ambulatory Stage- This is between two and four years of age, at this stage, symptoms start appearing. Symptoms show weakness of forward head flexion and a inadequate capability to sit up persist beyond infancy leading to poor motor development, deficient memory skills and they gradually reduce their ability to cope with their peers both physically and mentally. Heel cord and elbow flexion contractures are also apparent. In rare cases, obstructive sleep apnea also develops along with facial soiling. The ECG readings show- Q waves leads in the lateral precordial while tall R and deep S waves leads in early precordial (Chamberlain, 2006). If glucocorticoids are not given then by the age of nine years, the child starts lacking ability to rise from supine to standing position and to climb stairs or arise from a chair and are able to ambulate with braces. Early Nonambulatory Stage- This stage is between 10 and 12 years, the patient becomes dependent on wheel chair and flexion contractures at the ankle and elbow becomes more obvious. In this stage aquatic therapy may slow the progression. The dependency on wheel chair develops scoliosis and the patient needs orthopedic consultation along with radiological evaluation. The average strength of the patient starts declining at the age of 9 years. Late Nonambulatory Sta