The World is Flat †Thomas Friedman

1. Do you agree or disagree with Friedman’s assessment that the world is flat? Be sure to justify your answer I agree with Friedman that technology has made the world flat. But there is another point of view disagree with Friedman stating that there are still many people that do not have access to technology and for them the world is still round.2. What are the potential impacts of a flat world for a student performing a job search? In a flat world it is far more difficult to get a job because competition will be increasing at an incredible rate. There are currently 1 billion people online in 2006. It is anticipated that 4 billion people will be online by 2010. As the next 3 billion people come online in the next 4 years competition is going to dramatically increase. But the truth is that Students can now perform a global job search right from their apartment. A student in Chicago can accept a job in Tokyo and never leave the apartment, even when the job starts.3. What can stu dents do to prepare themselves for competing in a flat world? Businesses operate using technology and understanding how business and technology relate will help them achieve success. They can use it as advantage in their completion. And they will gain more skills and learn new ideas4. Identify a current flattener not mentioned on Friedman’s list Videophones and collaboration tools allowing people to meet face-to-face even when they are in different parts of the world Technologies such as Voice-over-IP that offer a cheap alternative to traditional long-distance carriers

Increasing the Age to 25 When Purchasing Alcohol

In today’s society, alcohol consumption has been taken on as a norm. It can be seen in every arena of life from been seen through the media or through our own personal eyes. When consumed in moderation, alcohol consumption can have some positive effects on individuals. One can get livelier, easier and relaxed. One can also talk more easily and feel less tired. According to some researchers, moderate alcohol use protects against cardiovascular diseases (Carlson, 2009). Socially, some people claim that it also has positive effects. It provides a lot of employment in the production, catering and retail of products and services in which alcohol plays a part. Also, people claim that alcoholic beverages help people socialize. However, if consumed when young, alcohol consumption can have a negative effect. Increasing the age limit on alcohol purchasing to 25 can decrease the consumption rate, misuse rate, and addiction rate among individuals. First, increasing the age limit on alcohol purchasing to 25 can decrease the overall consumption rate. By increasing the drinking age to 25, it can reduce consumption amongst young people because it will be harder to buy alcohol. According to U. S. Department of Health and Human Services for the Centers for Disease Control survey, approximately 52% of Americans over the age of 18 are regular drinkers (Sondik, 2010). The percentage of alcohol consumption can decrease with the increase of the age limit. Secondly, increasing the age limit on alcohol purchasing to 25 can decrease the overall misuse rate of alcohol among the younger crowd. By increasing the drinking age to 25, the group of impaired driver accidents and deaths may decrease. According to the U. S. Drunk Driving Car Accident Statistics, approximately 34% of individuals between the age of 21 and 24 did from vehicle accidents each year (NHTSA, 1997). The percentage of death from motor vehicle accidents and alcohol can decrease with the increase of the age limit. Thirdly, increasing the age limit on alcohol purchasing to 25 will decrease the percentage of individuals that become addicted to alcohol at a young age. The younger a person begins using alcohol, the greater the chance of developing alcohol dependence or abuse some time in their life. Of those who begin drinking at age-18, 16. 6% subsequently are classified with alcohol dependence and 7. 8% with alcohol abuse. If a person waits until age-25 before taking his or her first drink, these risks can decrease by over 60% (Grant, 1997). The percentage of individuals that become addicted to alcohol can decrease with the increase of the age limit. In conclusion, by increasing the age limit on alcohol purchasing to 25 can decrease the consumption rate, misuse rate, and addiction rate among individuals. The overall rates decreasing will benefit every individual in every age group. This can also allow individuals to experience the positive effects of alcohol consumption by being livelier, easier and more relaxed. Work Cited Carlson, Neil H. â€Å"Physiology of Behavior†. Allyn & Bacon, Incorporated: New York, New York. 1 Jan 2009. Grant, B. F. & Dawson, D. A. â€Å"Age of Onset of Alcohol Use and Its Association with DSM-IV Alcohol Abuse and Dependence: Results from the National Longitudinal Alcohol Epidemiologic Study,† Journal of Substance Abuse, 9:103-110, 1997. National Highway Transportation Safety Administration (NHTSA), â€Å"Traffic Safety Facts 1996: Alcohol,† 1997. http://www.nhtsa.gov/people/injury/alcohol/SocialNorms_Strategy/images/SocialNorms .pdf Sondik, Edward J. â€Å"Summary Health Statistics for U.S. Adults: National Health Interview Survey†. Series 10: Data From the National Health Interview Survey No. 249. August 2010. http://www.cdc.gov/nchs/data/series/sr_10/sr10_249.pdf

History of Dance Essay

INTRODUCTION: Once upon a time there was dance! In dance there are many forms. There is Ballet, Jazz, Tap, Hip hop, partner dancing, modern, and country and western. Dance originated many, many years ago. People used it to express emotions and stories. As time went on so did new dance techniques. Ballet came into the world around the 15th century Italian Renaissance and it slowly became the backbone for all dancing styles. As Albert Einstein said â€Å"dancers are the athletes of God. † SPEECH: Danced changed throughout the centuries *Centuries* As stated earlier the 15th century was the beginning of Ballet. During the time of both the 15th and 16th centuries ballet was only performed in royal courts where performers would get the audience to participate. Male dancers were the majority of dancers during this time period. To portray women in their performances they wore masks. In the 17th Century King Louis XIV (14th), who also was a dancer, performed in The Sun King ballet de la nuit. Louis XIV also founded Academie Royale de Musique (The Paris Opera. ) Ballet was becoming more theatrical during this time period, and female dancers were becoming the majority of performers. The ballet Les Indes Galantes (the gallant Indies) was the first ballet to feature women. During the 18th century the costumes were very extravagant. These costumes included masks, wigs, corsets, and hoop skirts. All were big and voluptuous. Two rivals, rebels, and amazing dancers at this time were Marie Camargo and Marie Salle. Marie Camargo started dancing in 1726. Because of Camargo’s gracefulness and quickness she ditched the traditional costume by shortening her skirt and wearing slippers to improve her techniques (leaps). Salle who started dancing in 1721, danced in a muslim costume (greek robe like), hair down, and unornamented to express that dance should be natural and expressed. Both dancers opened many new doors in the world of ballet. The 19th century was the time where ballerinas were the most popular performer in Europe. The Romantic Movement evolved during the 19th Century. Which was concerned with the supernatural world of spirits and magic and often portrayed women as passive and fragile. The use of pointe shoes were increased during this time period. Pointe shoes are satin shoes with wooden blocks in the toes to keep dancers on their toes all the time. Each pointe shoe is constructed to the dancer, no two pointe shoes are alike. As dance continued in the centuries it continued to change and flourish. The 20th century was the century where different styles and forms began to break away. Traditional ballet was still there but a more modernized version came into play. In order to move forward from this point you need an understanding of the types and styles there are in ballet *Types and Styles of Ballet*. There are two styles in ballet and they are story and plotless. Story Ballets, obviously, tell a story. Between the music and the dance a story is portrayed. Popular stories told were love stories. Another type of ballet is plotless. In a plotless ballet, no story is portrayed. Instead an image is created and aims to cause emotion. The three styles of ballet include classical, neo- classical, and contemporary. Classical reached its height in the 19th century, when you think of ballet this is the first thing people normally think about. Many graceful and and flowing movements are depicted in this style. Neo-Classical Ballet was introduced in the 20th century. Speed and energy in these dances were increased. In this style classical form was manipulated a lot and the rules for classical were broken. Contemporary Ballet was influenced by the movement of modern dance. Many new moves and techniques were established. Floor work and the turning in of the legs was a major change. There was a greater movement and body line in this style. With the changing of ballet through the centuries and the difference in types and styles, five positions and moves were always constant *ABC’s Of Ballet*. As a dancer, when I think of ballet I immediately think of the five positions. 1st, 2nd, 3rd, 4th, and 5th. I know, I know not hard to remember. These positions have been around since the start of ballet in the 15th century. This is the grammar of ballet and the classical building blocks. No matter what century, type, or style of ballet these positions are there. Ballet is a whole new world when you think about it. Theres so much information that many people do not know. There is information I don’t even know. Here are some random and fun facts I discovered. Mindless trivia or surprisingly interesting? *Mindless trivia or surprisingly interesting? * A professional male dancer lifts over 1 ? tons worth of ballerinas during performances Most ballerinas go through two to three pairs of pointe shoes a week Tutus cost up to $2,000 to make and take 60 to 90 hours of labor with 100 yards of ruffle First ballet dancers didn’t dance in tutus or satin shoes-more focused on footwork and positioning 3 hour performance is equivalent to 2 90 minute soccer games or running 18 miles (and they say dance isn’t a sport). Pointe shoes add a minimum of 7 inches to a dancer A Prima ballerina can complete 32 fouette turns while staying in the same place. After pointe shoe is HOT to the touch Those are only a pinch of information there is from the world a ballet. CONCLUSION: In conclusion ballet is definitely the backbone to dance. Without its evolution from the 15th Century Italian Renaissance dance would not be where it is now. When you think of ballet don’t think of it as a little thing, ballet is full of history, it even teaches you many things such as gracefulness, poise, stamina, discipline, and lots of technique. Dancers all around the world are connected to one thing and that is ballet. â€Å"I dance because there is no greater feeling in the world than moving to a piece of music and letting the rest of the world disappear† Unknown You lose yourself and find yourself THANK YOU.

Nutrition for a childs health and welfare Essay Example | Topics and Well Written Essays - 750 words

Nutrition for a childs health and welfare - Essay Example Proper dieting and good nutrition for the age group is ensured by food safety and sanitation, food storage, food preparation, proper food handling and presentation. Safe food for consumption is well accounted for in terms of its stipulated expiry dates when purchasing. In case of purchasing meat ensure that the meat is free from bad or strange oduor/smell this possess a high risk of food poisoning to an individual .Proper food preservation is key: any well maintained and food fit for human consumption, one should ascertain that food especially highly perishable is well preserved in a cool dry place. In addition meat should be separated from fruits and vegetables as this would lead to contamination. Secondly food storage is the delicate point that sees long lasting foods and perishables well-kept before consumption. Basic rules do indicate that perishable foods should be stored in a cool place and even refrigerated to prevent them from going stale. Selecting food products whose labeling clearly indicates the mode of refrigeration for example: keep refrigerated, should be in a refrigerator and cold to touch. Again food storage is backed up by the clean environment at all times. Proper food handling and sanitation is key to healthy food practices. Hygiene should begin from an individual handling the food to the place where the food is being prepared. In case of eggs make sure they are cooked fully i.e. the yolk as well as the whites are firm.

Cross cultural communication and internal communication improvement in Dissertation

Cross cultural communication and internal communication improvement in the oil and gas industry (ADNOC) - Dissertation Example This is because they could be having ethnic and cultural differences. There has been extensive discussion about the significance of poor internal communication together with cross – cultural communication towards the inability of companies to realize positive performance. The comprehension of cross – cultural and internal communication is crucial to the realization of organizational competitiveness. It has been observed that communication challenges within organizations have made it difficult to manage and screen threats the performance. As workplaces increasingly become global, there is the need to ensure effective cross – cultural communication as well as maintaining internal communication excellence. Companies must comprehend how to pass information to their workers and clients in order to meet the organizations goals and aspirations. The Oil and Gas Industry is one such global workplaces where there is the need to have excellent communication both internally and across other cultural groups. It is notable that the gas and oil company (ADNOC) is experiencing challenges in its internal and cross-cultural communication, which has affected performance in the exploration and production section of the corporation. In order to rectify this challenge, there is a need to commission research to help understand how internal and cross-cultural communication can be improved. ... The research methodology shall entail both quantitative and qualitative exploration strategies such as group observations, scheduling and conducting interviews, and carrying out surveys to complete data gathering. Literature Review Cross – cultural communication entails that which takes place between people who necessarily have differing cultural perspectives. These differences might include a range of issues from nationality, age difference, and gender difference among others in the same workplace (Guffey & Almonte, 2009). Cross-cultural communication  also connotes the capability to effectively form, foster, and develop relationships with people of a background different from one's own (Stringer & Cassidy, 2009). This is founded on the knowledge of several issues including values in other cultures, perceptions, behaviours, social class, decision making strategies, and a comprehension of how people belonging to a certain group convey message orally, non verbally, through do cumentation, and in diverse business and common contexts (Stringer & Cassidy, 2009).. Previously, authors and communication specialists have studied cross – cultural communication as well as internal communication under organizational contexts. The focus of such studies has been to attempt to develop a comprehension on how differences among people might affect the way they interact or fail to while with others (Stringer & Cassidy, 2009). The notion that some individuals in the course of their life adapt to one cultural orientation may present massive challenges whenever they meet people from other differing cultures. Furthermore, exposure to many other cultures has a direct influence on an individual's ability to interact with others and realize meaningful results (Guffey &

Cours Essay Example | Topics and Well Written Essays - 2750 words

Cours - Essay Example Reduced weight increases fuel consumption efficiency and reduces the amount of carbon compounds produced (Das 2001, 1). Reducing the weight of a vehicle by about 100kgs would lead to a reduction of about 0.3 to 0.4 liters of fuel per 100km (Yu & Dean 2006, 580). For example, the Ford Explorer model by Ford has a scratch resistance and corrosion proof cargo area made from integrated liners and side panels, reducing the vehicle’s weight by up to 20% compared to its conventional metal model. In addition, using composites makes it possible to reduce the number of parts required in fabrication of vehicles, compared to use of steel or aluminum (Calister 2007, 582). This leads to achievement of high volume composite concept in vehicle manufacturing, which leads to increased cost effectiveness. The use of natural based fibre has further improved fibre applications in the vehicle industry. Natural fibres are environmentally sustainable to use compared to metals. These fibres are proces sed from natural plants, making them biodegradable and environmentally friendly. Currently, natural fibres are mostly used in making of seat liners, equipment panels, carpets, among other applications in vehicles (Riaz 2012, 9). Natural fibres such as jute, sisal, hemp, and kenaf offer good acoustic properties to vehicles, high stability, less splintering in case of accidents, and reduced forging behavior compared to metals (Sanadi et al 1994, 469). Through the use of fibre reinforced composites, many parts of different shapes can be produced with much ease, and at high speed compared to use of metallic materials. The ability to configure and produce complex shapes inexpensively makes the use of polymers to considerably reduce the cost of a vehicle, making them more affordable to customers. Composites offer increased stiffness, toughness, and strength over structural metal alloys. These superior properties come along with vehicle

Soviet Union Invasion of Afghanistan Research Paper

Soviet Union Invasion of Afghanistan - Research Paper Example The paper describes also the aftermaths of the war. With the collaboration of America-Pakistan against the USSR, Afghanistan saw an emergence of ongoing guerrilla warfare. The United states, through Pakistan, funded the Afghan insurgents and Mujahideen, financing them with weapons as well as money. The Soviets suffered enormously through the hands of this mujhahideen. The soviets had to pay a huge price because of this ferocious resistance as it turned out to be disastrous in terms of military, financially as well as diplomatically. In 1988, the Geneva accords were signed and it included in it a time table which ensured a full Soviet withdrawal from Afghanistan in 1989. Estimates of the Afghan death vary from 1 million to around 2 million. 15000 soviet soldiers were also injured and killed in the war. Around 10 million Afghans fled to Pakistan as well as Iran. Another 2 million Afghan people were displaced within the country. The Aerial bombing by the soviets destroyed important stru ctures like irrigation canals which were extremely crucial to the agriculture in and arid climate. Most of the farmers who decided to stay in Afghanistan had their fields and irrigation systems bombed and live stocks destroyed. The Landmines alone killed 25000 Afghans during the war and another 10-15 million land mines have been left scattered throughout the country. Even today, Afghan people die or are critically injured as a result of these land mines. A year after the withdrawal of troops from Afghanistan, the USSR collapsed. Similarities between the USSR and US war in Afghanistan: Of course, there are many similarities between the Soviet strategies and policies of their Afghan war of 1979 and the American tactics in Afghanistan since 2001. In 1980s, the USSR was failing in Afghanistan even after a new leadership was emerging the capital of the Soviet Union. The new leadership started to make new strategic changes in order to rescue

Critical issue in globe health Assignment Example | Topics and Well Written Essays - 250 words - 1

Critical issue in globe health - Assignment Example Global health is a critically important issue, but many people are still unable to fully comprehend the ginormous nature of this problem. More people are killed every year in the African countries than can be killed by wars or natural disasters. Stupart (2012) validates this idea offered by Nye that not much reasonable or useful foreign aid has been seen over recent years which could be considered powerful enough to address either poverty or global health. Many campaigns are identified in Stupart’s video to explain their usefulness and how they cannot eliminate poverty in countries like Somalia and Ethiopia. Duflo (2010) also suggests the same idea as offered by Nye in her ted talk that there is not much change made by foreign aid which is why poverty is still a gigantic issue. This aid has not done much to fight poverty. This is due to such development efforts made which hurt more than heal. These are the kind of development efforts which are highlighted by Stupart (2012) in his

Women and Self-Esteem Essay Example | Topics and Well Written Essays - 250 words

Women and Self-Esteem - Essay Example Other researchers are in line with the current findings that the more affirmed women feel by their fathers, the greater their self-esteem. In addition, perceived affirmation by the father goes in hand with feeling less fearful of intimate relationships. The need to uphold the relationship between perceived fatherly affirmation and fear of intimacy as noted in the current study by partializing the effect of self-esteem on the variables is significant. Even though it contradicts Naus and Thesis, 1994 study on males, the finding is appropriate. In addition, feeling affirmed with one’s father and feeling comfortable with one’s sexuality cannot be separated. I will include the perception of father’s feeling towards and treatment of one’s mother as an exploratory variable. Such inclusion is significant as it showed a high correlation with some of the other variables in the studies. Especially, it correlated with the perceived fatherly affirmation and fear of intimacy and thus will culminate in women developing self-esteem during the counselling. Tanya S. Scheffler and Peter J. Naus, (1999). The Relationship Between Fatherly Affirmation And A Womans Self-Esteem, Fear Of Intimacy, Comfort With Womanhood And Comfort With Sexuality. University Of St. Jeromes College. Waterloo, Ontario. The Canadian Journal of Human Sexuality, Vol. 8(1). Spring, P.

Vogue female magazines Research Paper Example | Topics and Well Written Essays - 2000 words

Vogue female magazines - Research Paper Example The primary objective of this research is to take advantage of my background in public relations, organization communication, international marketing and advertising to pursue an in depth research in the customer loyalty aspect of the Chinese Edition of the popular Vogue Female Magazine. As we know that a magazine is a periodical publication containing articles, photographs, advertisements and other features that primarily relies on advertisement and sales to accrue revenues. Thus customer loyalty is an aspect of business that is of cardinal importance, so far as assessing and assuring the profitability in a publishing business is concerned.On the accomplishment of a Masters degree in International Management from Loughborough University, I realized that I am immensely interested in the marketing issues associated with customer loyalty and retention. So in this research I intend to combine the knowledge I gained while pursuing my Masters and Bachelor degree to conduct an in depth and thorough research on the customer loyalty and retention issues faced by the International Chinese Edition of the popular Vogue Magazine. All the relevant data will be collected through return mail (on paper or through website), questionnaires and sales figures, which will aid in the sorting out and study of issues associated with the customer loyalty aspect of the publication under consideration. If this research turns out to be successful, it will serve as a rich source of reference for many foreign publishing companies. that are interested in entering the Chinese speaking market so as to enhance their global market share. After all Chinese is the second most spoken language in the world and the Chinese magazine market has a vast potential and scope that can be exploited by the foreign magazine companies. I would specially like to mention that while pursuing my Bachelors degree I not only achieved a high score of 87 in the 'Research Methods' course, but also finished a dissertatio n that was published in the Shi Hsin University's Journal of Graphic Communication and Technology. The topic that I choose for this dissertation was 'A Study of International Chinese Edition of Vogue Female Magazines' Market Segmentation and Positioning'. I preferred to join the Manchester Business School because I am particularly interested in the practical aspects of the business theories and dogmas and the Manchester Business School is an institution that believes in transcending the barriers between theory and practice so as to arm it's students with the right knowledge that will go a long way in ensuring that they become the business elite of the future (Manchester Business School, 2008). Manchester Business School is an institution that is committed to research (Manchester Business School, 2008). I am confident that the topic selected by me fits well into the priorities of the Marketing and Research Centre and Marketing Research Cohort at the

Review of a Reading Essay Example | Topics and Well Written Essays - 1250 words

Review of a Reading - Essay Example For this reason, the author says that, the concept of designing strategy for a business organization must address the whole business organization. Consequently, the author says that, strategy in business must be formulated at three independent levels, i.e. corporate level, business level, and functional level. A critical analysis of this view by the author shows that the author’s conception of strategic management is right. This is because strategic management affects all facets of a business organization unlike other areas of business. The author of this reading defines strategic management as the process of creating interdependent activities that will enable an organization to compete successfully. The author goes on to say that, for most business organizations, creating the interdependent activities is the difficult part. An evaluation of this view shows that author’s views on this point are true. This is because harmonizing various portfolios of a business organization to operate with synergy is quite a challenging task; it normally requires skills in management and leadership to create such synergy in an organization with different portfolios. In the assigned reading, the author discusses in details the corporate Level Strategy and the scope of corporate level strategy. According to the author, corporate level strategy sets the overall direction for the whole Company. The author recognizes specific tasks and questions to that are unique to corporate level strategy. Expressed as questions, the author argues that the scope of corporate level strategy is: To explain further the actual meaning of corporate level of strategy, the author explains in details the meaning of each of the four questions; the author uses a concrete case of the Pepsi Company to demonstrate how the four questions of corporate level strategy are applied in actual situation. The author begins by explaining how the Coca-Cola Company has applied the

Benefits of a Liberal Arts Degree Essay Example for Free

Benefits of a Liberal Arts Degree Essay The student who decides to pursue a liberal arts education in University often faces a discouraging reaction from family and friends. Everyone seems to know a B. A. in Philosophy who is flipping burgers at Wendy’s, or an M. A. in English who is clerking at Wal-Mart. Students who choose liberal arts hear the same remarks over and over: â€Å"What good is a degree in Medieval History, or Chinese literature, or Classics? Study something practical and get a real job! † In fact, however, no degree provides an automatic job ticket, since the market for employment is constantly in flux. The liberal arts offer education, not training, and thus prepare students for a wide range of possibilities in both work and life. By developing their minds through a liberal arts education, students benefit themselves, their eventual careers, and the culture at large . For anyone interested in personal and intellectual growth, the liberal arts offer immeasurable benefits. Studies in such fields as English and Philosophy introduce a student to the great writers and thinkers whose ideas have shaped our culture. By working through the dialogues of Plato, students see logic in action; by studying the plays of Shakespeare, the poetry of Wordsworth, or the novels of Dickens, they realize the power of language. Without knowledge of the great writers and thinkers of the past, people operate in a vacuum, unable to see beyond their immediate world. How can they gauge the validity of ideas if they know nothing except the present moment? In a media-driven culture of instant celebrity, students need to experience truths that have endured over hundreds and even thousands of years. These truths expand their thinking beyond their immediate limitations, and they discover new insights into their own minds. The benefits of a liberal arts education, however, go beyond personal growth into longer-term career skills. Every liberal arts course from Art History to Women’s Studies requires proficiency in reading and writing. Graduates with Arts degrees find their communication skills in demand by employers seeking people who can read, write, and speak well. As Francis Bacon observed nearly 400 years ago, â€Å"Reading maketh a full man; conference a ready man, and writing an exact man†(106). No courses develop these skills more fully than do those in the liberal arts. In addition, the liberal arts foster analytical thought: the ability to break an argument into its parts and assess its validity. Clear analysis is fundamental to the practical worlds of trade  and commerce. Finally, the liberal arts encourage originality, as students learn to think in creative ways. The student who gives an inventive presentation or develops a fresh perception will enhance the workplace with that creativity. It’s no surprise that law schools actively seek liberal arts graduates for its programs, or that jobs in the civil service, human resources, and upper management are typically staffed by people with Arts degrees. The only surprise is that anyone still scoffs at the notion that a general B. A. is a useful degree. As significant as its impact may be on personal and career growth, the real value of a liberal arts education is found in its benefits to the culture as a whole. The liberal arts retain and transmit the history of civilization itself. Without a commitment to preserving that history, our culture runs the risk of forgetting or distorting its past. Liberal arts students serve as guardians of intellectual thought for the next generation. Writers, journalists, film-makers, and politicians – the people shaping the thoughts and actions of the future – are drawn from the ranks of liberal arts majors. For example, the creator of the Harry Potter series, J. K. Rowling, has an undergraduate degree in Classics, and Liberal leader Michael Ignatieff earned degrees in History. Moreover, the liberal arts tend to be interdisciplinary in nature. Knowledge in one area illuminates another, so that instead of creating a society of narrow specialists, liberal arts studies actually encourage a culture of educated, open-minded people. Such individuals have both the capacity and the training to address practical problems in society. Leading reformers of the 20th century, including Nelson Mandela (â€Å"Nelson†) and Martin Luther King, Jr. (â€Å"Martin†), profited from their liberal arts studies. A degree in the liberal arts is not a dead-end route that culminates in a lifetime of serving fries or stocking shelves. Rather, it is a doorway that opens to paths heading in every direction. Students who expand their minds through liberal arts benefit themselves, their future career choices, and the wider culture.

The Importance Of Water Recycling Environmental Sciences Essay

The Importance Of Water Recycling Environmental Sciences Essay The aim is to review the importance of water recycling and the unending effects of hard water all round us. Objective is to achieve a clear understanding of the present and future benefits of water recycling and why it is still practised today. A number of up-to-date water recycling tehnologies are studied to an extent. The perpetual need for the various solutions in softening hard water is looked into retrospectively carefully highlighting typical problems likely to occur. Water is a common substance that is essential to all forms of life. A massive 75 percent of planet earth is covered in water and is mostly found in oceans and large water bodies. Of this total volume of water, 97 percent is saltwater and 3 percent is freshwater. 69 percent of this freshwater is glacial and 31 percent is groundwater. For billions of years, earth has been reusing water over and over again in a natural process called the hydrologic cycle (BENEFITS OF RECYCLING., 2010). This cycle is the path water takes as it circulates from the land to the sky and back again. 1.1 Water Recycling Water recycling is a natural process which relies on technology to speed up such projects. It is sometimes described as unplanned and planned (GREYWATER RECYCLING SYSTEMS., 2010). By unplanned, this means for example, when cities draw their water supplies from rivers that receive waste water upstream from these cities. Water from these rivers has been reused, treated and piped into the water supply a number of times before the last downstream use withdraws the water (GREYWATER RECYCLING SYSTEMS., 2010). However, that of planned water recycling projects is developed with the aim of reusing a recycled water supply. Recycled water is waste water that has been treated and processed for useful nonpotable purposes such as agricultural, landscape, public parks, and golf course irrigation (GREYWATER RECYCLING SYSTEMS., 2010). Other nonpotable applications include cooling water for power plants and oil refineries, industrial process water for facilities such as paper mills and carpet dyers, toilet flushing, dust control, construction activities, concrete mixing, and artificial lakes (GREYWATER RECYCLING SYSTEMS., 2010). In an industrial facility, water is recycled and reused onsite used in cooling processes for example (GREYWATER RECYCLING SYSTEMS., 2010). Although most water recycling projects have been developed to meet the demands of nonpotable water, a number of them use recycled water indirectly for potable purposes (GREYWATER RECYCLING SYSTEMS., 2010). These projects include recharging ground water aquifers and augmenting surface water reservoirs with recycled water (OASIS DESIGN., 2009). Recycled water can be spread or even injected into ground water aquifers to augment ground water supplies, and to prevent salt water intrusion in coastal areas. Environmentally, water recycling provides tremendous benefits. Water recycling can help us find ways to reduce the diversion of water from sensitive ecosystems by providing a supplementary source of water. The lack of sufficient water flow, as a result of diversion for agricultural, urban, and industrial purposes, can cause impairment of water quality and ecosystem health for plants, wildlife, and fish which depend on adequate water flow to their habitat for sustenance and reproduction ( OASIS DESIGN., 2009). For streams that have been dried from water diversion, recycled water may be used to build these habitats (GREYWATER RECYCLING SYSTEMS., 2010). Water flow can be augmented with recycled water to develop and sustain the aquatic and wildlife habitats (GREYWATER RECYCLING SYSTEMS., 2010). 1.2 GreyWater Greywater is water that has been used domestically (from baths, showers, clothes washers, and wash-hand basins) except for water from toilets (GREYWATER RECYCLING SYSTEMS., 2010). Greywater takes up 50 80% of household wastewater (OASIS DESIGN., 2009). Wastewater produced by toilets is called black water (OASIS DESIGN., 2009). However wastewater from kitchen sinks and dish-washers is also considered to be black water as well due to the presence of organic contents (OASIS DESIGN., 2009). The clearest purpose of recycling domestic grey water is that it replaces potable water use (OASIS DESIGN., 2009). 2 BUILD-UP OF TOXIC ORGANIC POLLUTANTS FROM RECYCLING In water treatment, a wide range of chemicals are added in excess due to poor operation or accidents (GRAY N. F., 2005). However, most of these chemicals are discharged with the finished water product due to the nature of the processes themselves. These include iron, aluminium, and organic compounds used as coagulates, such as polycrylamide (GRAY N. F., 2005). These chemicals result in odour and discolouration in the water as well as poor taste. Furthermore, the new Drinking Water Directive sets limit values for all these compounds. Chemicals such as chlorine and fluorine are added intentionally to protect the public from pathogens and teeth decay respectively (GRAY N. F., 2005). 3 THE NEGATIVE PUBLIC PERCEPTION OF DRINKING SEWAGE WATER The increasing concern of the public is reflected by a large rise in the sales of bottled water and home treatment systems (GRAY N.F., 2008). The view of reusing sewage water for the purpose of drinking water ignorantly puts people off now and again. However, the knowledge of water recycling plays a big role here so educating the consumer about water quality and the regulatory functions of water undertakers is mandatory (GRAY N.F., 2008). All water is reused and with the system of treatment in place, sewage water can be drinkable. The use of chlorine in water treatment is a major source of complaint with consumers (GRAY N.F., 2008). The prevailing reasons for boiling water, buying bottled water or the use of home treatment systems are over an improvement in taste and health concerns. There is a strong belief that bottled water is safer and purer to drink which unfortunately is not always true. The media also plays a role in the influence of attitudes towards water and the assessment risk (GRAY N.F., 2008). 4 REGULATIONS In protecting public health, conditions and regulations have been made to allow for the safe use of reclaimed water. Reclaimed water often provides a vital water supply and fertilizer source (METCALF EDDY., 2003). For most developing countries, the greatest concern with the use of wastewater for irrigation is that untreated or treated wastewater can possess quite a number of intestinal nematodes (e.g., Ascaris and Trichuris species and hookworms) and bacterial pathogens which are often difficult to control (METCALF EDDY., 2003). The health of the general public consuming farm produce that have been contaminated by the wastewater infected by these viral and bacterial agents can deteriorate over time. The world health organisation suggest that irrigation of farm produce prone to be eaten uncooked, sports fields, and public parks should be irrigated with wastewater dealt with stabilization ponds (METCALF EDDY., 2003). From country to country, regulations in reusing water and wastewat er vary. In England and Wales, Drinking Water Inspectorate control the standard of drinking water provided (GRAY N. F., 2005). However, the quality of the water is the privatised water companies responsibility (GRAY N. F., 2005).These responsibilities are regulated by the Office of Water Services and it also controls the price of water before hitting the market. The Environment Agency for England and Wales is responsible for controlling water pollution, regulating waste and manage integrated pollution control (IPC) licensing (GRAY N. F., 2005). It also has the duty to issue licenses for water control functions, promote the conservation and enhancements of freshwater to promote the recreational use of freshwater, to improve and develop fisheries and regulate them, to issue flood warnings and the provision of defences to reduce the risk of sea and river flooding, the issuing of land drainage consents and many other tasks (GRAY N. F., 2005). The Agency points out water protection zones , protects groundwater and sets the objectives for water quality (GRAY N. F., 2005). 5 PRECAUTIONS Dont store grey water Grey water should be used within 24 hours before the build up of bacteria develops. After this period, it is on its way to becoming septic, that is, black water (LETS GO GREEN., 2009). Avoid contamination and contact Identify grey water plumbing by labelling it. The use of gloves is vital when in contact with grey water filters or anything that has come in contact with it (LETS GO GREEN., 2009). Use only grey water that is fairly clean to start with. If otherwise, it should be diverted to a sewer or septic system (LETS GO GREEN., 2009). Microorganisms on consumable goods Untreated grey water possesses some microorganisms which affect lawns, or fruits and vegetables that are eaten raw (e.g., strawberries, lettuce, carrots) to an extent (LETS GO GREEN., 2009). Contamination of surface water Grey water should be disposed of properly either underground or in a mulch (a mulch is a covering made up of rotten vegetable matter which prevents evaporation and soil erosion). The addition of grey water to an already soaked soil should be avoided (LETS GO GREEN., 2009). 6 DESALINATION Desalination involves removing dissolved minerals from aquatic bodies to create drinking water (CITY OF RYDE, 2009). 15-50% of water is recovered with the other portion being brine (CITY OF RYDE, 2009). A few technologies have been produced for the execution of this process, including the best known and common membrane process is the reverse osmosis (CITY OF RYDE, 2009). http://www.esru.strath.ac.uk/EandE/Web_sites/98-9/offshore/ro.gif Figure 2: Diagram showing osmotic and reverse osmotic flow (Source: Courtesy of FWPBDP., 2010) Countries which do not have the advantage of continual fresh water supplies, competition for fresh water continually soars (TENE A. 2010). Israel is regarded pioneer in the area of desalination (TENE A. 2010). Following the water crisis in Israel, the state of water economy improved to an extent that even during harsh drought years, the water economy will continue to flourish since the water in the sea would not be running out anytime soon (TENE A. 2010). This sea water is pumped to as much volume is required and the final desalinated water is supplied as necessary. Another type of separation technique is the evaporation process (PEREIRA H.C. 1973). Developing economies such as California have warm climates of high evaporation rates (PEREIRA H.C. 1973). Its primary water resource is the sea where the evaporation process is practised. It is an effective alternative to water recycling in water poor regions (PEREIRA H.C. 1973). 7 FUTURE OF WATER RECYCLING Recycling is generally vital to our planets future. The rate at which the earths highly valued resources are been consumed is taking a rapid turn and many of these resources are not renewable (U.S. EPA., 2009). Recycling as a process takes considerably less energy to reuse an existing product than to source and make one from scratch (U.S. EPA., 2009). Water recycling has certainly established beyond doubt to be effective and resourceful in developing a new and reliable water supply. Nonpotable reuse is a widely accepted practise that will continue to expand (YOSHIKAWA N., 2006). Advances in wastewater treatment technology and health studies of indirect potable reuse will become common soon (YOSHIKAWA N., 2006). As water and environmental needs becomes urgent, water recycling would play a greater role in our long-term water supply (U.S. EPA., 2009). 8 WATER RECYCLING TECHNOLOGY The type of wastewater is essential for determining the kind of treatment plant and technologies to employ. Wastewater primarily arises from water usage by residential, commercial and industrial institutions including groundwater, surface water and storm water as shown in Figure 3. Figure 3: Sources of Wastewater (Source: Courtesy of ESCWA., 2003). Typical examples of water recycling systems in the domestic or industrial field are flotation and sedimentation, of which both are relevant to the chemical industry. 8.1 Flotation Flotation is a unit process used to remove solid or liquid from any form of liquid by releasing fine gas, usually air bubbles into it (ESCWA., 2003). The gas bubbles would stick to the liquid or would get trapped in the particle structure of the suspended solids, raising the floaty force of the particle and gas bubbles put together (ESCWA., 2003). Particles having a higher density than the liquid would be able rise. Flotation is used to remove suspended matter and to concentrate biological sludge in wastewater treatment (ESCWA., 2003). Flotation has an advantage over the sedimentation process in that; very minute and light particles are easily removed in a quicker time frame (ESCWA., 2003). Table 1: Data of Flotation Methods Process Brief Descriptions Dissolved Air Flotation Wastewater is subjected to the pressure of several atmospheres while air is introduced into it. The pressure then returns to atmospheric level, allowing the air to be released as small bubbles after a short time. These bubbles which stick to the suspended matter where it is removed by a skimming device. Air Flotation By the application of a revolving impellers or through diffusers, gas is passed into the liquid directly at atmospheric pressure Vacuum Flotation Wastewater is saturated with air. With the application of a partial vacuum, the dissolved air results in escaping as minute bubbles where they form a scam blanket. This blanket is removed by a skimming device. Source: Courtesy of ESCWA., 2003. Figure 4: A typical Flotation unit (ESCWA., 2003). 8.2 Sedimentation Sedimentation is a widely used unit operation in water and wastewater treatment (ESCWA., 2003). It involves the gravitational settling of suspended solids in a mixture usually water (ESCWA., 2003). These suspended solids are removed from suspensions by allowing it gravitate to the floor of a tank to form a sludge under near still conditions (ESCWA., 2003). This tank is referred to as a clarifier (ESCWA., 2003). It comprises of three main designs. They are; Horizontal flow clarifiers They can either be rectangular, square or circular in shape. The flow in rectangular clarifiers is rectilinear and parallel to the long axis of the basin. Furthermore, the water flows radially from the centre towards the outer edges in circular clarifiers. The clarifiers are usually made up of steel or reinforced concrete (ESCWA., 2003). Solid contact clarifiers They get solids into contact with a suspended layer of sludge near the bottom that acts as a blanket. The solids put in cumulate and remain trapped within the sludge blanket. As the solids remain below, the liquid is able to rise upwards (ESCWA., 2003). Inclined surface basins The flow here is laminar and there is little or no wind effect. Inclined trays are used to divide the depth into shallower sections, reducing the settling times in the process (ESCWA., 2003). Figure 5: Parts of a circular clarifier (Source: Courtesy of ESCWA., 2003). 9 HARD WATER Hard water is simply referred to as water that contains more minerals than ordinary water (FREE DRINKING WATER., 2009). Water that is said to be hard possesses minerals made up of calcium and magnesium compounds (FREE DRINKING WATER., 2009). This water usually comes from aquifers and other underground sources that collect dissolved minerals from rocks (FREE DRINKING WATER., 2009). Minerals of these sought reduces the ability of soap to lather and the ease of rinsing anything being washed made difficult. On the other hand, soft water is treated water that contains only sodium ion (FREE DRINKING WATER., 2009). Figure 6: Diagram showing hard and soft water processes (Source: Courtesy of LENNTECH., 2009). 9.1 PROBLEMS WITH HARD WATER Every cleaning task from laundering and dish washing to bathing and personal care is made unreasonably difficult taking up time and energy. The quantity of hardness minerals in water would determine the soap and detergent level required for cleaning. Additional detergent would have to be added to achieve the desired goal. Dishes and glasses washed using hard water may not be totally clean possessing certain spots when dry. The same goes with clothes which may feel harsh and scratchy when worn. Furthermore, skin was led with hard water may leave the skin feeling itchy and dry certainly not a remedy for skins with conditions such as eczema (HEIDEKAMP A. J., 2005). A number of detergents have ingredients that would mix with hard water minerals leaving a white deposit on clothing, making it look faded and worn out. Heated hard water affects water-using appliances (HEIDEKAMP A. J., 2005). It forms a scale of calcium and magnesium minerals which contributes to the inefficient and costly of these appliances (HEIDEKAMP A. J., 2005). Pipes become clogged with scale that impedes water flow and would in no time require pipe replacement. When hard water is heated, calcium ions react with bicarbonate ions to form an insoluble compound called calcium carbonate which is responsible for the scaling in pipes (HEIDEKAMP A. J., 2005). This is depicted in the equation below; 9.2 SOFTEN WATER TECHNIQUES 9.2.1 Lime-Soda Ash Technique It is the most common water softening method which involves the addition of slaked lime to hard water in water plants (FREE DRINKING WATER., 2009). Lime and soda ash are used because they are readily accessible and cost effective for softening water (FREE DRINKING WATER., 2009). Non-carbonate hardness is in turn reduced by the addition of soda ash to form insoluble precipitate which is also removed by filtration. Slaked lime is used to remove calcium bicarbonate from water (FREE DRINKING WATER., 2009). In this method, the slaked lime ions react with the calcium bicarbonate to form a slightly soluble calcium carbonate. This precipitate is usually removed by allowing it settle and then filtering (FREE DRINKING WATER., 2009). Additional lime is used in removing magnesium (FREE DRINKING WATER., 2009). This treatment becomes more costly as the hardness level has to be reduced to less than 5 grains. The use of the lime-soda ash treatment in homes was farfetched because of the equipment siz e and high cost involved in running one and even owning one (FREE DRINKING WATER., 2009). 9.2.2 Ion Exchange Columns Technique Ions could either be positively or negatively charged. A positive charge ion is called a cation while a negatively charged ion is an anion. The minerals, calcium and magnesium, that result in hardness are positively charged cations (NORDEN R. L., 2010). An ion exchange water softener has three main parts; A resin tank containing small beads of synthetic resin, A brine tank, The control valve (NORDEN R. L., 2010). When using ion exchange equipment, calcium and magnesium are exchanged for sodium from the brine tank (NORDEN R. L., 2010). As water passes through the resin tank, the sodium ions are exchanged with calcium and magnesium ions (NORDEN R. L., 2010). This is because the calcium and magnesium ions have a higher positive charge than the sodium ions. As the calcium and magnesium attach themselves to the resin beads is released simultaneously into the water. After the sodium in the resin, medium is exhausted, the medium can be regenerated by the sodium from the brine tank (NORDEN R. L., 2010). People with health problems such as heart or circulation problems, or are on low sodium diets may need to avoid using the ion exchange because of the high sodium content (NORDEN R. L., 2010). It is not even recommended for watering lawns or plants due to the sodium content present. However, potassium can be used in replacing sodium but it costs more. It is highly recommended that only hot water in a h ome be softened because the hot water line and heater benefits and the rate of soap consumptions are reduced (NORDEN R. L., 2010). Another importance in using the ion exchange equipment is that, it removes traces of iron as well to an extent because it is a positively charged ion (NORDEN R. L., 2010). 9.2.3 Chemical Conditioners/Suppressants Technique Chemical conditioning involves the addition of polyphosphates (SOUTHERN WATER., 2005). This reduces the availability of calcium in the formation of deposits. This would result in the water behaving as though softening although this would be false regarding the removal of calcium. A measure of this supposed softening is that such water would need less soap or detergent to lather. The polyphosphates can easily be set up by installing a relatively cheap dispenser in the pipework that could easily treat all the water going into the property (SOUTHERN WATER., 2005). When exhausted in the dispenser, the polyphosphates usually in solid glass-like balls are added at any appropriate time frame (SOUTHERN WATER., 2005). Alternatively, using polyphosphates helps to reduce traces of lead from any lead pipework but this should not be a guaranteed reason for using this technique (SOUTHERN WATER., 2005). HARD WATER CONTAINING CALCIUM AND MAGNESIUM ENTERING SOFTNER SOFTEN WATER CONTAINING SODIUM CONCLUSION Water is reusable. A high percentage of our water is recycled and the same water has been around for a long time. In this effect, water technologies have been cleverly developed in keeping this natural tradition alive. Hard water is water that contains calcium and magnesium ions, and can be reversed by softening it thereby leaving it usable in homes and industries. It has a costly effect on most equipment in our homes and a health risk in humans. In softening hard water, the rate at which all these negative effects take its course would be minimised.

The African American Struggle From Slavery

The African American Struggle From Slavery A long and favored mantra of the African American community has been that which doesnt destroy you tends only to makes you stronger. Using these as bywords, the struggle to survive and prosper in the United States has not always been an easy road traveled by African Americans . From surviving the Middle Passage, to the auction blocks, to life on the plantations, to the Emancipation Proclamation and on to the Great Migration of blacks from the south to northern cities, life has always been one of definite hardships. Religion, faith in a loving and forgiving God and a belief that there had to be a better way helped the African American ever forward moving and strong. Although the concept of slavery was not new to Africans, there were a number of differences in the enslavement in ones own country and the enslavement in one so foreign. In Africa, for example, slaves became adopted members of the kinship group that enslaved them. Often, they married into a lineage, even into high ranks of society. Slaves could also move up in society and out of the slave role. Also, the children of slaves were not presumed to be born into slavery. The beginning of slave trade began as early as the 1500s and was a profitable business to both sides , African and European. As time wore on, Europeans needed more and more slaves. The African tribesmen who had once been in favor of such trade, no longer wished to continue. Thus began the capturing of the needed slaves. Those Africans who resisted dealing in human cargo themselves became the victims of bloody slave trade. (Cayton, 2003) As it was for all slaves, the Middle Passage was a long, arduous nightmare. The slaves were branded with hot irons and restrained with shackles. Their living quarters was often a deck within the ship that had less than five feet of headroom and throughout a large portion of the deck, sleeping shelves cut this limited amount of headroom in half. Lack of standing headroom was the least of the slaves problems, though. With 300 to 400 people packed in a tiny area an area with little ventilation and, in some cases, not even enough space to place buckets for human waste disease was prevalent(Africans in America/Part 1/The Middle Passage). Faced with the nightmarish conditions of the voyage and the unknown future that lay beyond, many Africans preferred to die. But even the choice of suicide was taken away from these persons. A slave who tried to starve him or herself was tortured. If torture didnt work, the slave was force fed (Cayton, 2003). Despite the captains desire to keep as many slaves as possible alive, Middle Passage mortality rates were high. Although its difficult to determine how many Africans died en route to the new world, it is now believed that between ten and twenty percent of those transported lost their lives. (www.essortment.com) Most contemporary historians estimate that between 9.4 and 12 million Africans arrived in the New World. Disease and starvation due to the length of the passage were the main contributors to the death toll with amoebic dysentery and scurvy causing the majority of deaths. Additionally, outbreaks of smallpox, syphilis, malaria, measles, and other diseases spread rapidly in the close-quarter compartments. The number of dead increased with the length of voyage, since the incidence of dysentery and of scurvy increased with longer stints at sea as the quality and amount of food and water diminished with every passing day. In addition to physical sickness, many slaves became too depressed to eat or function efficiently because of the loss of freedom, family, security, and their own humanity.(Library think quest) Still, the majority of the captives survived and were soon headed for the auction blocks in America. Once in the Americas, slaves were sold, by auction, to the person that bid the most money for them. It was here that family members would find themselves split up, as a bidder may not want to buy the whole family, only the strongest, healthiest member. When the slave ship docked, the slaves would be taken off the ship and placed in a pen like this one. There they would be washed and their skin covered with grease, or sometimes tar, to make them look more healthy. This was done so that they would fetch as much money as possible. They would also be branded with a hot iron to identify them as slaves. The slaves would be brought from the pen, in turn, to stand on a raised platform so that they could be seen by the buyers. Before the bidding began, those that wished to, could come up onto the platform to inspect the slaves closely. The slaves had to endure being poked, prodded and forced to open their mouths for the buyers. The auctioneer would decide a price to start the bidding. This would be higher for fit, young slaves and lower for older, very young or sickly slaves (Davidson, 2008). Potential buyers would then bid against each other. The person who bid the most would then own that slave. The picture below shows a slave being aucti oned to the highest bidder. The slave auction was a terrible ordeal for the slaves, they did not understand the language and had no idea what was happening   (historyonthenet.com). Most owners saw slaves as property that performed labor for their businesses. As the demand for slaves rose, so did their value. After the importation of slaves ended, owners began buying additional slaves from owners in the upper South (Cayton, et al, p288). This development started the breakup of many slave families. The slaves unable to live and work under such harsh and dehumanized conditions, started to steal away, and rebel. The institution of slavery had such a stronghold on the economy of America that it would prevail for a number of years. The most important thing to be said about slavery from the perspective of the enslaved is that millions of African Americans endured slavery by making a world for themselves in the midst of their bondage. At the foundation of this enslaved culture stood the black family. Slaveholders did this for simple economic reasons and to make it easier to control the slaves. Whatever the reasons, slaves took advantage of the opportunity to use the family environment as a refuge and as a source of cultural endurance. Enslaved children learned family history from their parents by the stories told to them while they worked along side their mothers in the fields or at night in the slave cabins. Among the survival skills taught them were proper work habits, respect for elders, reverence for a spiritual world, and how to deal with whites by putting on the Massa. In this way, black parents showed their children how to cope with slavery by fooling the master without losing ones self respect (www.slaver yinamerica.org.). In addition to relying on the strength of family networks, the enslaved turned to religion as a means of coping with slavery. During the colonial era, most enslaved Africans retained as best they could their indigenous African religions or Islam in the cases of those who had come from Muslim countries. It was not until the mid-eighteenth century that large numbers of Africans began converting to Christianity during the religious revival movement that swept over the English colonies. During this Great Awakening, English Methodists and Baptists (later) preached an evangelical style of Christianity that appealed to the emotions and offered salvation to all who embraced Christ regardless of ones class or race. This new emotional religion blended nicely with African spiritual beliefs and religious practices. Its emphasis on singing, emotional fervor, spiritual rebirth, and total body immersion in water during baptism was especially attractive to enslaved blacks (http://www.slaveryinameric a.org/history/hs_es_overview). But, the country was not at rest. Religious reforms, the anti-slavery movement and the civil war were all in progress at this time. Although very few chose not understand why the slaves wanted their freedom, several citizens did not understand the separation of the institution based on religion and religious reform(Cayton et al.) Starting in 1861, states of the North clashed with states of the South in a brutal conflict that Americans called the Civil War. The causes of the Civil War were many and complex. Many white Northerners believed that slavery violated the basic principles of both the United States and the Christian religion, and believed that slavery was an evil that could not be tolerated. The first shots fired in 1861 signaled the start of the nations Civil War and lasted for four years. Slaves were used involuntarily for labor by the Confederates. Freed African Americans were employed to build forts, drive wagons and perform noncombat jobs. Black volunteers were not allowed to join the Union army, however in 1862 Congress authorized Lincoln to accept African Americans into the military. Several months later, Lincoln made the announcement in the Emancipation Proclamation. Given this encouragement, nearly 185,000 African Americans had enlisted in the Union Army. For these soldiers, fighting to help f ree others who were still enslaved had special meaning(Cayton, p.397). From 1861 to 1865 an estimated 620,000 soldiers were killed, of which more than 38,000 were African American. The wounds of war, both physically and psychologically were not easily healed, and carried on into the twentieth century(Goldfarb, S). Nearly 240 years were to have passed before the Thirteenth Amendment to the U. S. Constitution officially ended slavery in 1865. This means that 12 generations of blacks survived and lived in America as enslaved people-direct descendants of the nearly 500,000 enslaved Africans imported into North America by European traders. Some of the 180,000 African Americans who fought for their freedom as Union soldiers in the American Civil War could trace their families to the time of the Pilgrims. Still this was not enough to be treated as citizen of the United States, or as a human being in general. Discrimination, education, voting rights and civil rights were to be the next items sought in the struggle to survive and prosper. The war for the African American waged on.   For many African Americans the surge of joy at gaining freedom quickly faded as they realized how many obstacles stood between them and true equality. Defeat in war had not changed the fact that white people still dominated southern society, and the white leaders of those governments quickly passed laws to restrict African Americans new found freedoms. These laws were known as black codes. These laws established again a virtual slavery. Curfews, vagrancy laws, labor contracts and land restrictions all but placed African Americans back into slavery. The ratification of the Fourteenth Amendment did little to help. The Fifteenth Amendment insured no person may be denied the right to vote and for the first time in history, African Americans had political power in 1870. More than 600 African Americans were elected to state legislatures. While this was all well and good, it did little for the little man not in government. The demand for a fair chance in the race of life was echoed by freed men across the South. This fair chance meant land. Give us our own land and we can take care of ourselves, but without land, our old masters can hire us or starve us as they please(Cayton, 2003). Planters had land, but no labor. Freedmen had labor, but no land. Out of these needs came sharecropping, tenant farming, and another way of being entrapped. However, a stronger people prevailed. African Americans have to this point survived the Middle Passage, life on the plantation, civil war, the black codes, sharecropping and tenant farming. They have survived beatings, burnings and even the Ku Klux Klan and World War I only to still be treated as a second class citizen. Down trodden, but not dead, African American moves on. Ever faithful, ever strong, ever seeking a better way or better day, to the land of milk and honey they go. Its migrating time-The Great Migration. After the war immigration from Europe virtually stopped, and the armed forces had taken many young men out of the labor pool. Businesses suddenly needed workers. Factory owners who had previously discriminated against African Americans now actively recruited them. The African American who had left the South to look for work in northern factories added to the steady stream of migrants had turned into a flood. Some 500,000 African Americans joined what came to be called the Great Migration(Davidson, et al, 2008). The dramatic exodus of African Americans from countryside to city and from South to North during World War I and the decade that followed changed forever black Americas economic, political, social, and cultural lives. The Great Migration was, up to that point, the largest voluntary internal movement of black people ever seen. There were several factors that drew African Americans out of the South and into cities throughout the nation. Poverty, the lack of educational facilities for the children, rigid segregation and discrimination, and limited opportunities were all among the reasons that led some to look North. Besides a dire economic situation, Southerners, as they had done during the Great Migration, were also fleeing Jim Crow. With little hope of redress in the justice system, African Americans were at the mercy of abusive employers, landlords, and almost anyone bent on depriving them of their rights. Notwithstanding the Fifteenth Amendment (1870), which guaranteed them the right to vote, the vast majority were effectively disenfranchised by restrictive rules that applied only to them. Rigid segregation in public spaces signaled by the constant presence of Whites Only and Colored signs on water fountains, restroom doors, hospital wards, transportation, and housing was a constant humiliation and a reminder that blacks were second-class citizens. Compared to the South, the North, although segregated in practice if not by law, appeared appealing (www.inmotionaame.org). The journey for equality for the African American citizen in the United States continue, great strides have been made. African Americans are once again in the political arena. We are entitled to fair and equal housing , education and employment. We now have an African American president. The struggle has been long, arduous, and steeped with many hills to climb. In keeping to the mantra by which many African Americans live it has been proven that which does not destroy us tends to make us stronger prevails.

Torchwood, Egoism, and Utilitarianism Essays -- Literary Analysis

Torchwood’s third season â€Å"Children of Earth,† contains many momentous events which question human rationality, having good sagacity, judgment, and equanimity. Throughout these events two ethical philosophies unravel. The first philosophy, egoism, actions with solely one’s interests in mind, plays a major role in the season. Ethical egoists believe that one should look out for no one else but themselves, and a theory of psychological egoism states that whatever the reasoning is behind an action, the action is always an individual’s self-interest. The inconceivable enthralling events in the season are due to the 456’s yearning for ten percent of the children population. However, their request is not based upon a life-supporting necessity, but merely an egotistical longing for a pleasurable â€Å"high† the children supply them with. The second philosophy, utilitarianism, is based on Jeremy Bentham’s principle of utility, actions whi ch amplify happiness and diminish pain for the majority of people, play an essential role. To restrain the heinous act from occurring, Jack sacrifices his own grandson, Steven, to spare the lives of the other children on Earth. The 456 are at fault for the outlandish children-related incidences around the world. The children stop in mid-action and recite exact words at the same time for five consecutive days. These events are linked to a previous abduction by the 456 in 1965. The only two people conscious of the previous abduction are immortal Captain Jack, who was there during the abduction, and the Home Office Permanent Secretary John Frobisher. For most of the first episodes, Torchwood members, Jack, Ianto, and Gwen, know nothing of the situation, but are able to communicate with an insider, Lois Habiba, ... ...uction to Ethics, 6th Edition. McGraw-Hill Higher Education/CourseSmart, 2008. 170. Online book. Rosenstand, Nina. The Moral of the Story: An Introduction to Ethics, 6th Edition. McGraw-Hill Higher Education/CourseSmart, 2008. 165. Online book. Rosenstand, Nina. â€Å"Individual Ethical Egoism.† The Moral of the Story: An Introduction to Ethics, 6th Edition. McGraw-Hill Higher Education/CourseSmart, 2008. 183. Web source. Rosenstand, Nina. The Moral of the Story: An Introduction to Ethics, 6th Edition. McGraw-Hil Higher Education/CourseSmart, 2008. 225. Online book. Rosenstand, Nina. The Moral of the Story: An Introduction to Ethics, 6th Edition. McGraw-Hill Higher Education/CourseSmart, 2008. 229. Web source. Rosenstand, Nina. The Moral of the Story: An Introduction to Ethics, 6th Edition. McGraw-Hill Higher Education/CourseSmart, 2008. 241. Online book.

Harry Potter and the Order of the Phoenix :: essays research papers

  Ã‚  Ã‚  Ã‚  Ã‚  Harry Potter and the Order of the Phoenix is a book about a boy named Harry Potter who is a wizard. Its setting is in London, which is where Harry lives. The time element is supposed to be present day, but it is a fiction book.   Ã‚  Ã‚  Ã‚  Ã‚  Harry has spent all summer waiting to hear news about Lord Voldemort, a evil wizard that Harry saw return the year before, but nobody believes him. One evening after listening to news ,he decides to go for a walk. He then sees his cousin, who he lives with and hates. They then get in a fight and Harry pulls out his wand and at that exact moment two dementors attack them. Dudley thinks Harry is attacking him so he punches Harry. Harry then heroically saves them both by producing a patronus and driving away the dementors.   Ã‚  Ã‚  Ã‚  Ã‚  They get back home and Harry gets a letter from the Ministry of Magic that says because he used magic he is expelled (Harry is underage and underage wizards aren't supposed to use magic). He is horrified. He can't believe he was expelled. Hogwarts was the only good thing in his life. He then gets another letter that says he isn't expelled but that he has to go to a hearing.   Ã‚  Ã‚  Ã‚  Ã‚  When Harry's friends here about him being expelled they are speechless. Hermoine just can't understand why he might be expelled when he saved Dudley. She is aghast. Ron is stupefied.   Ã‚  Ã‚  Ã‚  Ã‚  Harry goes to the hearing and is cleared, but there is a new teacher at Hogwarts that makes Harry's life miserable. Her name is Professor Umbridge. She was one of the people at Harry's hearing that said he was guilty. She is really rude to Harry. She gives him detention and makes him write lines with a quill that scratches whatever you write into your hand and uses your blood as ink. She also takes away Harry's privilege of playing Quidditch ever again. Somehow Harry gets through it all.   Ã‚  Ã‚  Ã‚  Ã‚  The climax is when Harry goes to the Ministry of Magic to rescue his godfather, Sirius, but Sirius isn't there. There are some people there though. They are the Deatheaters, Lord Voldemort's loyal servants. There is then a big fight where the Deatheaters try to steal a prophecy from Harry. Then Lord Voldemort himself arrives after the prophecy was smashed. Harry Potter and the Order of the Phoenix :: essays research papers   Ã‚  Ã‚  Ã‚  Ã‚  Harry Potter and the Order of the Phoenix is a book about a boy named Harry Potter who is a wizard. Its setting is in London, which is where Harry lives. The time element is supposed to be present day, but it is a fiction book.   Ã‚  Ã‚  Ã‚  Ã‚  Harry has spent all summer waiting to hear news about Lord Voldemort, a evil wizard that Harry saw return the year before, but nobody believes him. One evening after listening to news ,he decides to go for a walk. He then sees his cousin, who he lives with and hates. They then get in a fight and Harry pulls out his wand and at that exact moment two dementors attack them. Dudley thinks Harry is attacking him so he punches Harry. Harry then heroically saves them both by producing a patronus and driving away the dementors.   Ã‚  Ã‚  Ã‚  Ã‚  They get back home and Harry gets a letter from the Ministry of Magic that says because he used magic he is expelled (Harry is underage and underage wizards aren't supposed to use magic). He is horrified. He can't believe he was expelled. Hogwarts was the only good thing in his life. He then gets another letter that says he isn't expelled but that he has to go to a hearing.   Ã‚  Ã‚  Ã‚  Ã‚  When Harry's friends here about him being expelled they are speechless. Hermoine just can't understand why he might be expelled when he saved Dudley. She is aghast. Ron is stupefied.   Ã‚  Ã‚  Ã‚  Ã‚  Harry goes to the hearing and is cleared, but there is a new teacher at Hogwarts that makes Harry's life miserable. Her name is Professor Umbridge. She was one of the people at Harry's hearing that said he was guilty. She is really rude to Harry. She gives him detention and makes him write lines with a quill that scratches whatever you write into your hand and uses your blood as ink. She also takes away Harry's privilege of playing Quidditch ever again. Somehow Harry gets through it all.   Ã‚  Ã‚  Ã‚  Ã‚  The climax is when Harry goes to the Ministry of Magic to rescue his godfather, Sirius, but Sirius isn't there. There are some people there though. They are the Deatheaters, Lord Voldemort's loyal servants. There is then a big fight where the Deatheaters try to steal a prophecy from Harry. Then Lord Voldemort himself arrives after the prophecy was smashed.

Healthcare-associated infections (HAIs) Essay

BACKGROUND Healthcare-associated infections (HAIs) are bacterial infections acquired during a patient’s stay in a healthcare institution.   It imposes a huge burden on healthcare institutions, costing billions of dollars for additional care costs as well as a significant fraction of lost lives (Houghton, 2006).   Current estimates depict that approximately 2 million patients acquire healthcare-associated infections (HAIs) or nosocomial infections each year, of which 90,000 to 100,000 patients die (Houghton, 2006), making HAIs not only a national health problem, but a global threat as well.   Common HAIs include hematological, surgical site, dermatological, respiratory, urinary and gastrointestinal systems.   In order to control the increase in number of healthcare-associated infections, it is fundamental to identify key factors that make healthcare institutions susceptible to such outbreaks.   There is a need to evaluate the sensitivity and efficiency of healthcare institutions to healthcare-associated infections in order to prevent future outbreaks. PROBLEM STATEMENT   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This study will investigate the sensitivity of detection and efficiency of reporting healthcare-associated infections to the hospital administration, in the context of providing measures in improving the current surveillance program in the country.   The guidelines to identification of a healthcare associated infection will be evaluated through personal interactions with healthcare workers using questionnaires which will be designed using a multiple choice approach. CONCEPTUAL/THEORETICAL FRAMEWORK   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This study is based on the need to address the current epidemic of healthcare-associated infection that is emerging around the world.   Before an effective solution to the problem is designed, it is essential that shortcomings in the standard procedures of healthcare institutions be identified.   This may be done by determining the level of sensitivity of healthcare personnel to symptoms of healthcare-associated infections, as well as knowing what are the first set of actions to be done once an infection is confirmed within a healthcare institution.   This study may serve as the first measurement tool that addresses these aspects of the global epidemic.    RESEARCH QUESTION/HYPOTHESIS   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This investigation aims to address the question of whether the current hospital administration is sensitive enough to detect and substantially efficient to report to healthcare institutions any incidents of healthcare-associated infections.   This will be directly evaluated using survey data collections from retrospective cases of particular health institutions as related to dates of hospital admission, confirmation of infection and treatment time.    SIGNIFICANCE OF THE STUDY   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There is a need for an effective surveillance and control program for healthcare-associated infections that are based on current settings in a healthcare institution.   Through surveys that inquire on common practices and responses of healthcare workers, any shortcomings or avoidable gaps in the hospital system may be reformed, which in turn will alleviate the spread of infection in the healthcare institutions.   Review of medical records and interviews with attending healthcare personnel will be performed in order to determine whether there are certain discrepancies and gaps in the healthcare protocol that facilitate contamination and further spreading of infectious microbials around the healthcare institution.   This study may facilitate the identification of key factors that influence the increase in frequency of nosocomial infections in hospitals.   The results of this investigation may positively serve as a tool to healthcare workers such as nurses and laboratory technicians. STATEMENT OF THE PURPOSE (OBJECTIVES)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This research will determine the sensitivity and response rate of healthcare workers to healthcare-associated infections.   This proposal aims to develop a measurement tool that will determine the sensitivity for identification, efficiency of reporting and the response rate to a healthcare-association infection, with the aim of designing a cost-effective and quick way of controlling and ultimately eradicating the healthcare-related problem.       LITERATURE REVIEW   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The prevention and control of HAIs requires a comprehensive approach that addresses as many pathogens as possible (Wiseman, 2006). Urinary tract infections (UTI) associated with catheter use are the most common HAIs, with hospital-acquired pneumonia having the highest mortality rate (Houghton, 2006).   These infections are frequently problematic to treat due to the fact that the microorganisms involved have become resistant to antibiotics (Broadhead, Parra and Skelton, 2001). Recent media coverage of meticillin-resistant Staphylococcus aureus (MRSA) has increased the awareness of healthcare professionals to the threat of this particular microbe.   S. aureus infections can result in cellulitis, osteomyelitis, septic arthritis and pneumonia, and some of the systemic diseases such as food poisoning, scalded skin syndrome and toxic shock syndrome (Zaoutis, Dawid and Kim, 2002).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   MRSA and vancomycin-resistant Enterococcus (VRE) are the primary causes of nosocomial infections and are significant factors in increased morbidity and mortality rates. These microbes are currently endemic in many healthcare institutions, particularly problematic in intensive care units (ICUs) (Furuno, et al. 2005).   VRE Infections have become prevalent in U.S. hospitals over the last decade, increasing in incidence 25-fold (Ridwan et al., 2002).   Vancomycin is the antibiotic frequently used to treat infections caused by MRSA, but recent years have seen the emergence of Staphylococcus aureus infections that have high-resistance to vancomycin, which makes the future effectiveness of this drug questionable (Furuno et al., 2005). All known variants of the vancomycin-resistant Staphylococcus aureus (VRSA) isolates have possessed the vanA gene, which carries with it resistance to vancomycin.   This development is believed to have been acquired â€Å"when the MRSA isolate conjugated with a co-colonizing VRE isolate† (Furuno et al., 2005, p. 1539). This means that patients who suffer co-colonization from MRSA and VRE have an increased risk for colonization and infection by VRSA (Furuno et al., 2005). Furthermore, Zirakzadeh and Patel (2006) stated that VRE has become a major concern due, in part, to its ability to transfer vancomycin resistance to other bacteria, which includes MRSA.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Infection of susceptible patients typically occurs in environments that have a high rate of patient colonization with VRE, such as ICUs and oncology units (Zirakzadeh and Patel, 2006).   In these healthcare settings, VRE has been known to survive for extensive periods and research has also observed that VRE has the ability to contaminate virtually every surface (Zirakzadeh and Patel, 2006). Efforts to control HAIs, such as VRE, have focused on prevention, such as through hand hygiene, as the first line of defense.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Hand hygiene has been improved by using â€Å"user-friendly, alcohol-based hand cleansers, but there still remains the goal of achieving consistently high levels of compliance with their use† (Carling et al., 2005, p. 1).   Screening-based isolation practices have likewise improved transmission rates of MRSA and VRE; however, logistic issues and the cost-effectiveness of these practices are still being analyzed (Carling et al., 2005). Additionally, despite isolation practices, outbreaks and instances of environmental contamination have been documented in regards to MRSA, VRE and Clostridium difficile, which cannot be screened with any practicality (Carling et al., 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The numerous obstacles that exist in regards to effective screening practices suggest that a focus on improving existing cleaning/disinfecting practices may prove to be more effective in halting the spread of HAIs (Carling et al., 2005). Studies over the last several decades have shown that there is often contamination of surfaces in and around the patient, as pathogens associated with the hospital environment have been known to survive on surfaces for weeks or even months (Carling et al., 2005). Significant rates of contamination with Clostridium difficile have been connected with symptomatic and asymptomatic patients (Carling et al., 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In 2002, the CDC issued guidelines that called for hospitals to â€Å"thoroughly clean and disinfect environmental medical equipment† surfaces on a regular basis (Carling et al., 2005, p. 2). Other organizations have followed suit and stressed repeatedly the need for healthcare provides to focus on environmental cleaning and disinfecting activities, yet these guidelines have not provided directives that address precisely how healthcare providers can either evaluate   their ability to comply with professional guidelines on this topic or ensure that their procedures are effective (Carling et al., 2005).   Nevertheless, literature on the subject does offer some guidance.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Surveillance, evidence-based infection control practices and the responsible use of antibiotics have been determined to be crucial to controlling HAIs (Wiseman, 2006).   The establishment of comprehensive surveillance programs has facilitated the creation of national databases the compile cases of infection which may be useful to researchers investigating progression rates and causal factors.   Evidence-based control practices may be implemented by distributing guidelines for aseptic hospital protocols, hospital hygiene, personal protective equipment and disposal of biohazardous sharps.   A review of commonly used antibiotics in terms of proper dosage and length of treatment based on clinical evidence and best practice guidance should also be performed.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Curry and Cole (2001) reported that the medical and surgical ICUs in large inner-city teaching hospitals developed an elevated patient VRE colonization rate. A multi-faceted approach was instituted to correct this problem, which involved changing behavior by â€Å"shifting norms at multiple levels through the ICU community† (Curry and Cole, 2001, p. 13). This intervention consisted of five levels of behavioral change. These encompassed: â€Å"1. intrapersonal and individual factors; 2. interpersonal factors; 3. institutional factors; 4. community factors and 5. public factors† (Curry and Cole, 2001, p. 13).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Educational interventions were developed that addressed each level of influence and behavioral change was predicated on â€Å"modeling, observational learning and vicarious reinforcement† (Curry and Cole, 2001, p. 13). These procedures resulted in a marked decrease of â€Å"VRE surveillance cultures and positive clinical isolates† within six months and this decrease has been consistent over the next two years (Curry and Cole, 2001, p. 13).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Research has shown that the nutritional status of preoperative and perioperative patients can influence their risk for acquiring a HAI (Martindale and Cresci, 2005). This is particularly true for patients who are undergoing surgery for neoplastic disease as this can commonly result in immunosuppression (Martindale and Cresci, 2005). Inadequate nutrition, â€Å"surgical insult, anesthesia, blood transfusions, adjuvant chemotherapy/radiation/ and other metabolic changes† have been identified as contributing to suppression of the immune system (Martindale and Cresci, 2005). Furthermore, studies have also associated infection risk with glycemic control Maintaining blood glucose levels between 80 and 110 mg/dL vs. 180 and 200 mg/dL has been shown to result in fewer instances of â€Å"acute renal failure, fewer transfusions, less polyneuroopathy and decreased ICU length of stay† (Martindale and Cresci, 2005, p. S53).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Citing Ulrich and Zimring, Rollins (2004) states that getting rid of double-occupancy rooms and providing all patients with single rooms that can be adjusted to meet their specific medical needs can improve patient safety by reducing patient transfers and cutting the risk of nosocomial infections. While these researchers admit that the up-front cost of private rooms is significant, this will be offset by the savings accrued through lowers rates of infection and readmission, as well as shorter hospital stays (Rollins, 2004).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A recent study conducted by researchers at Chicago’s Rush University Medical Center found that enforcing environmental cleaning standards on a routine basis resulted in less surface contamination with VRE, â€Å"cleaner healthcare worker hands, and a significant reduction in VRE cross-transmission in an ICU† (Cleaning campaign, 2006, p. 30). These improvement in VRE contamination continued to be experienced even when VRE-colonized patients were continually admitted and healthcare workers compliance with hand hygiene procedures were only moderate (Cleaning campaign, 2006). The strategies that the researchers implemented included that they: held in-services for housekeepers about why cleaning is important–emphasizing thorough cleaning of surfaces likely to be touched by patients or workers. increased monitoring of housekeeper performance. recruited respiratory therapists to clean ventilator control panels daily. educated nurses and other ICU staff on VRE and how they could assist housekeepers by clearing surfaces that need cleaning. conducted a hand hygiene campaign, including: mounting alcohol gel dispensers in common areas, patient rooms and every room entrance (Cleaning campaign, 2006, p. 30).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   CDC guidelines indicate that if hands are not visibly soiled, using an alcohol-based hand rub should become habitual between patient contacts. When hands are visibly soiled, use of an anti-microbial soap and water is required. If contact with C difficile or Bacillus anthracis is possible, it is recommended that the healthcare provider wash with anti-microbial soap and water, as other antiseptic agents have poor efficacy against spore-forming bacteria and the physical friction of using soap and water at least decreases the level of contamination (Houghton, 2006). Page (2005) indicates that the CDC has joined with the US Department of Health and Human Services, the National Institutes of Health (NIH and the Food and Drug Administration (FDA) to lead a task force of 10 agencies and departments, which have developed a blueprint outlining federal actions to combat this problem. This template emphasizes the efficacy of hand washing, among other points (Page, 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In 2002, the CDC issued updated hand hygiene guidelines, which address new development and research on this topic, such as â€Å"alcohol-based hand rubs and alternatives to antibacterial soaps and water† (Houghton, 2006, p. 2). However, while the efficacy of hand hygiene is well accepted, it is also well known that healthcare workers â€Å"of all disciplines† frequently fail to abide by adequate hand hygiene practices (Houghton, 2006, p. 2). In fact, research has shown that adherence rates to hand hygiene guidelines are lowest in ICUs, where to the frequency of patient care contact, multiple opportunities for hand hygiene exist on a hourly basis (Houghton, 2006). According to Houghton (2006), any direct patient-care contact, which includes contact with gloves and/or contact with objects in the immediate patient vicinity, constitutes an â€Å"opportunity† for appropriate hand hygiene.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This suggests that the proposed intervention should also include asking healthcare employees at the site of the intervention to participate in a survey that examines, first of all, how closely hand hygiene protocols are followed and, if they are not followed, why not. It may be that the activity level of ICUs is so great that the practitioners feel that they cannot take sufficient time to do adequate hand hygiene. If this is the case, alternative methods of hand hygiene to that institution’s traditional policy may need to be investigated.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Just as this study revealed factors that can be associated with non-compliance, a similar investigative effort may be called for to determine reasons why compliance may not be satisfactory for cleaning/disinfecting environmental surfaces. Again, it may be that non-compliance hinges on factors of time.   It may be, therefore, expeditious for hospitals and other healthcare organizations to look into hiring additional personnel to aid with cleaning/disinfecting tasks. It may also prove necessary, to cope with factors of time and efficiency, to train cleaning personnel to take a systematic approach to patient room cleaning that includes all â€Å"high touch† areas. As noted previously, researchers at Chicago’s Rush University Medical Center found that holding in-service training for housekeepers was an effective component of their overall strategy in lowering VRE related infections (Cleaning campaign, 2006). This process could be facilitated by a checklist approach or by periodically reevaluating rooms according to the Carling et al. (2005) methodology.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Given these detailed accounts of healthcare-associated infections in hospitals, it is of significant importance that the sensitivity and response rate of health personnel be identified in order to know if there are any discrepancies and gaps in the standard hospital protocols that foster the expansion of microbials in hospitals.   This study aims to determine the level of sensitivity and response rate of healthcare institutions to the growing epidemic of healthcare-associated infections.    SUMMARY   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   HAIs are an unnecessary tragedy, increasing morbidity and mortality figures and adding to healthcare costs. While there are ways to treat all the various HAIs, the clearest remedy for this insidious drain on healthcare resources and personnel is prevention, which begins with the simplest of acts–washing one’s hands–but also extends to considering all hospital surfaces as having the potential to harbor pathogens. This means rethinking some healthcare institutional procedures. It means habitually and routinely cleaning all surfaces, as well as everywhere and anything that is routinely touched, whether by a bare or gloved hand.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Stopping the spread of HAIs includes multiple factors, such as restrained and appropriate use of antibiotics. However, the first line of defense is cleaning/disinfecting procedures. This constitutes the â€Å"ground zero† foundational line for battling HAIs and this means that all healthcare practitioners should keep the goal of reducing the spread of HAIs foremost in their minds while going about their daily routines, washing hands between each patient contact and paying attention to other sepsis concerns. In other words, the first step in stopping HAIs is simply to keep them in the forefront of practitioner consciousness. References Broadhead, J. M., Parra, D. S., & Skelton, P. A. (2001). Emerging multiresistant organisms in the ICU: Epidemiology, risk factors, surveillance, and prevention. Critical Care Nursing Quarterly, 24(2), 20. Carling, P. C., Briggs, J., Hylander, D., & Perkins, J. (2006). An evaluation of patient area cleaning in 3 hospitals using a novel targeting methodology. American Journal of Infection Control, 34(8), 513-519. Centers for Disease Control and Prevention. (2006). Healthcare-Associated Infections (HAIs).  Ã‚   Retrieved March 17, 2007, from http://www.cdc.gov/ncidod/dhqp/healthDis.html Cleaning campaign targets VRE transmission. (2006). OR Manager, 22(7), 30. Curry, V. J., & Cole, M. (2001). Applying social and behavioral theory as a template in containing and confining VRE. Critical Care Nursing Quarterly, 24(2), 13. Furuno, J. P., Perencevich, E. N., Johnson, J. A., Wright, M.-O., McGregor, J. C., Morris Jr, J. G., et al. (2005). Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococci co-colonization. Emerging Infectious Diseases, 11(10), 1539-1544. Harrison, S., & Lipley, N. (2006). Wipe It Out infection control initiative extended. Nursing Management – UK, 12(10), 4-4. Houghton, D. (2006). HAI prevention: The power is in your hands. Nursing Management, 37(5), 1-8. Johnson, A.P. Pearson, A. and Duckworth, G.   (2005):   Surveillance and epidemiology of MRSA bacteraemia in the UK.   J. Antimicrob. Chemo.   56:455–462. Lopman, B.A., Reacher, M.H., Vipond, I/.B., Hill, D., Perry, C., Halladay, T., Brown, D.W., John Edmunds, W. and Sarangi, J.   (2004):   Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003.   Emerg. Infect. Dis.   10(10):1827-1834. Martindale, R. G., & Cresci, G. (2005). Preventing Infectious Complications With Nutrition Intervention. JPEN, Journal of Parenteral and Enteral Nutrition, 29(1), S53. Page, S. (2005). MRSA, VRE and CDC’s plan to combat antimicrobial resistance. Vermont Nurse Connection, 8(3), 6-7. Parienti, J. J. M. D. D. T. M., Thibon, P. M. D., Heller, R. P. P., Le Roux, Y. M. D. D., von Theobald, P. M. D. D., Bensadoun, H. M. D. D., et al. (2002). Hand-rubbing with an aqueous alcoholic aolution vs traditional surgical hand-scrubbing and 30-day surgical site infection Rates. JAMA, 288(6), 722-727. Ridwan, B., Mascini, E., Reijden, N. v. d., Verhoef, J., & Bonten, M. (2002). What action should be taken to prevent spread of vancomycin resistant enterococci in European hospitals? British Medical Journal, 324(7338), 666. Rollins, J. A. (2004). Evidence-Based Hospital Design Improves Health Care Outcomes for Patients, Families, and Staff. Pediatric Nursing, 30(4), 338. Sheff, B. (2001). Taking aim at antibiotic-resistant bacteria. Nursing, 31(11), 62. STATA 8.0. College Station (TX): STATA Corporation; 2002. Stevenson, K.B., Searle, K., Stoddard, G.J. and Samore, M.H. (2005):   Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci in rural communities, Western United States.   Emerg. Infect. Dis.   11(6):895-903. Tacconelli, E. Venkataraman, L., De Girolami, P.C. and D’Agata, E.M.C.   (2004):   Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains.   J. Antimicrob. Chemother. 53:474-479. Wiseman, S. (2006). Prevention and control of healthcare associated infection. Nursing Standard, 20(38), 41-45. Zaoutis, T., Dawid, S., & Kim, J. O. (2002). Multidrug-resistan organisms in general pediatrics. Pediatric Annals, 31(5), 313. Zirakzadeh, A., & Patel, R. (2006). Vancomycin-resistant enterococci: Colonization, infection, detection and treatment. Mayo Clinical Proceedings, 81(4), 529-536. METHODOLOGY   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A retrospective non-probability cluster surveillance study will be performed on hospital records of two health institutions, Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006.   Such coverage will represent a larger population of similar environmental and socioeconomic settings, which may also influence the frequency of healthcare-associated infections in the area.   This type of non-probability cluster sampling will be used because it will benefit the split-level definition that will be followed, distinguishing normal hospital cases and healthcare-associated infections or outbreaks, based on the CDC’s guidelines for healthcare-associated infections.   Ethical approval from the respective ethics review committee of each hospital will be obtained before the study will be conducted. Study population.   ThÐ µ study population will includÐ µ 5,000 patiÐ µnts that have been admitted at the Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006.   These hospitals were chosen in order to primarily focus on collection of reliable, high-quality data based of systematic sampling.   The hospital’s administrative database will serve as the main source of information for this study.   For purposes of anonymity, patient’s names will be kept confidential and will be replaced with a case number instead.   A retrospective non-probability sampling using patiÐ µnt cases will be classified according to gender, age, diagnosis upon admission, length of stay and treatment received. The treatment category of the patients will be further characterized as surgical, respiratory, urinary, urological, obstÐ µtrical, intensive care, cardiac or trauma.   Any co-morbidities will be taken note of in every patient included in the study.   Patient records will also be reviewed to determine whether and when a healthcare-associated infection was observed after admission to the hospital or during the patient’s stay in the hospital and will be identified as the time-at-risk, or the time when the infection has been ascertained and may most probably be contagious to the patient’s immediate environment.   Among the inclusion subjects are healthcare workers such as nurses, laboratory technicians and other hospital staff members will be included in the study as population at risk.   Exclusion subjects are those patients that were not admitted into the hospital because their stay in the hospital was not recommended during their healthcare.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The database of the infection control team of each of the two hospitals will be reviewed to gather information on the study population in the hospitals.   Infection control nurses are responsible for monitoring any outbreaks in each hospital during hospital ward rounds, or are identified as the point-of-contact personnel that is alerted as soon as an HAI incident is suspected to occur in the specific ward of the hospital.   Cluster sampling will be performed when an infection does happen that fits the clinical definition of an HAI, the healthcare institution is required to report this incident to the area’s or county’s health protection agency.   The area or county health protection agency is in charge of ensuring the comprehensiveness of incident reports, monitoring data entry and conducting analyses.   The health protection agency also collects reports during months that no infections were reported to verify that no inf ections occurred at that time. Tools to be employed.   To determine whether a case patient has contracted a healthcare-associated infection, the system definitions established by the Center for Disease Control and Prevention’s National Nosocomial Infection Surveillance (NNIS) will be followed, with slight modification for usÐ µ in a rÐ µtrospÐ µctivÐ µ study.   ThÐ µ NNIS dÐ µfinitions were dÐ µvÐ µlopÐ µd according to a prospÐ µctivÐ µ approach to hospital survÐ µillancÐ µ and arÐ µ dÐ µsignÐ µd to bÐ µ quitÐ µ spÐ µcific.   BÐ µcausÐ µ clinical dÐ µcisions arÐ µ oftÐ µn not madÐ µ on thÐ µ basis of survÐ µillancÐ µ dÐ µfinitions, wÐ µ bÐ µliÐ µvÐ µ that somÐ µ casÐ µs of clinically suspÐ µctÐ µd infÐ µction would mÐ µÃ µt most but not all of thÐ µ NNIS critÐ µria and thus bÐ µ classifiÐ µd as non-HAI, Ð µspÐ µcially on a rÐ µtrospÐ µctivÐ µ chart rÐ µviÐ µw. WÐ µ designed a retrospective-based data classification scheme that follows the following criteria: patiÐ µnts who were not infÐ µctÐ µd, thosÐ µ with suspÐ µctÐ µd HAI, and thosÐ µ with confirmÐ µd HAI.   In gÐ µnÐ µral, patiÐ µnts with suspÐ µctÐ µd HAI will includÐ µ thosÐ µ who have received antimicrobial thÐ µrapy for a condition that appÐ µarÐ µd 148 h aftÐ µr hospital admission and who will mÐ µÃ µt all but onÐ µ clinical critÐ µria for a confirmed infÐ µction.   DÐ µfinitions for a confirmed HAI will bÐ µ the samÐ µ as thosÐ µ usÐ µd by thÐ µ NNIS, Ð µxcÐ µpt that rÐ µcÐ µipt of appropriatÐ µ antimicrobial thÐ µrapy will bÐ µ Ð µxcludÐ µd as a critÐ µrion for a confirmÐ µd infÐ µction. ThÐ µsÐ µ critÐ µria will bÐ µ finalizÐ µd bÐ µforÐ µ chart data abstraction bÐ µgins.   ThÐ µ Ð µconomic pÐ µrspÐ µctivÐ µ will bÐ µ usÐ µd for mÐ µasuring costs incurred by thÐ µ hospital, bÐ µcausÐ µ thÐ µ hospital administ ration will bÐ µ thÐ µ dÐ µcision makÐ µr for instituting and financing infÐ µction control programs. Data collÐ µction.   Clinical cases of healthcare-associated infection identified by the clinical laboratories of the two participating hospitals will be compiled.   Demographic, medical history and other epidemiologically relevant data on each reported case will be collected.   The microbiology laboratory of the hospital may also contribute information to the data collection.   The patient’s medical record will serve as the primary source of information for this study.   The data collected will be recorded in a standardized data collection form.   In addition, outbreak or infection summary forms that were previously completed by infection control nurses and reported to health protection agencies as a healthcare-associated infection will be collected and integrated into the study database. The duration of an outbreak will be determined by taking note of the date the first case of the infection was reported and correlating this date to the date when the last case of the infection was reported at the healthcare institution (Lopman et al. 2004).   All data will abstracted from patiÐ µnt mÐ µdical rÐ µcords of the healthcare facility.   IntÐ µrratÐ µr rÐ µliability will not bÐ µ mÐ µasurÐ µd, bÐ µcausÐ µ Ð µach abstractor will bÐ µ focusÐ µd on rÐ µcording a singlÐ µ Ð µlÐ µmÐ µnt of data for Ð µach patiÐ µnt, similar to an assÐ µmbly linÐ µ.   All data gathering will bÐ µ dirÐ µctly supÐ µrvisÐ µd by a member of the research program.   PatiÐ µnts with suspÐ µctÐ µd or confirmÐ µd HAI will bÐ µ idÐ µntifiÐ µd on thÐ µ basis of thÐ µir vital signs, laboratory and microbiology data, and clinical findings documÐ µntÐ µd in the respective physician’s progrÐ µss and consultation notÐ µs. To improve the validity of the collected data, the following approaches (Stevenson et al. 2005) will be employed:   1) a data dictionary and operations manual will be created with explicit instructions for completion of the data collection forms; 2) the data collection protocol will be discussed during conference calls along with frequent one-on-one communication; and 3) anomalous data in the data reports will be routinely searched for and corrected.   The definitions employed in this study will concentrate on the location of the patient at the time of microbiological testing for infection diagnosis, and the presence or of exposure to the healthcare environment.   The study will emphasize the time of response of any member of the healthcare institution to the definitive diagnosis of the healthcare-associated infection (Johnson et al. 2005).   Each identified HAI case will be further analyzed for its causative agent, such as MRSA or VRE.   All included in this study were HAI cases with any prior history of hospitalization, out-patient surgery, residence or care in a home/health agency with documented healthcare-associated infections in the last 6 months.   Examples would include former out-patient cases with post-operative infections.   Other coexisting factors that may be associated with healthcare-associated infections such as diabetes mellitus, immunosuppression, renal failure and other antimicrobial drug treatments, will also be included in the data collection form. The incidence rates of each type of healthcare-associated infection will be calculated for each hospital from January 2002 to December 2006.   Any patient cases that could not be ascertained to be completely reported in the medical records will not be included in the analysis.   The incidence rates will be expressed as the number of healthcare-associated infections per 10,000 patient-days or number of community cases per 10,000-person-years, based on county population (Taconelli et al. 2004). Instruments including reliability and validity.   A data collection form will be designed for use in this investigation.   Essential entry data will include case number (patient name is kept confidential), hospital name, date of admission, diagnosis upon admission, treatment regime, date of detection of healthcare-associated infection, treatment of healthcare-associated infection, date of admission of treatment of healthcare-associated infection, identification of HAI etiologic agent, resistance of HAI etiologic agent and date of patient discharge.   The healthcare institution personnel that have attended to the patient will also be noted, such as attending physician, consults, nurses, technicians and technologists.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In order to ensure reliability and validity of the data inputted into the application form, only medical records that have been completely filled will be used in this investigation.   In addition, there will be questions in the application form that will determine whether the patient has undergone any previous exposure to any hospital for outpatient or inpatient hospital or nursing facility in the last 6 months.   This is done to make sure that the source of the HAI is determined, whether it is coming from within the hospital or from another healthcare institution. Data Analysis.   The collected data will be entered and stored in an AccessTM relational database (Microsoft, Redmond, WA) for analysis.   AccessTM is a database management system that is very useful for handling and manipulation of data that are designed in the query format.   It provides the analyst an easier way to extract data from the database according to selected fields or variables, as well as compare or combine two variables at one time. Data analyses will be performed using Microsoft ExcelTM and Stata 8.0 (2002).   Proportions of total cases meeting specific epidemiologic criteria will be calculated, and characteristics of each category will be compared by using Fisher exact testing.   To compare means, the t-test will be employed, and to compare proportions, the χ2 test will be used.   All continuous data will be analyzed using linear regression.   To assess linear correlations between two variables, the Spearman rank test will be used.   Census data and ages of patients in each category will be compared using the Kruskal-Wallis equality of populations rank test.   The relationship of healthcare institution response rates to the infection and other covariates will be modeled by using random effects Poisson regression. Each hospital will be taken into account as a unit and treated as a random effect.   During thÐ µ initial phasÐ µ of data collection, dÐ µscriptivÐ µ statistics will be used to dÐ µscribÐ µ and summarizÐ µ thÐ µ data obtained in thÐ µ study.   ThÐ µ sÐ µcond phasÐ µ of analysis will focus on thÐ µ usÐ µ of multivariatÐ µ analysis to dÐ µtÐ µrminÐ µ thÐ µ rÐ µlationship bÐ µtwÐ µÃ µn variables such as length of stay and the severity of infection.   This will bÐ µ conductÐ µd through thÐ µ usÐ µ of cross tabulation of nominal data bÐ µtwÐ µÃ µn sÐ µlÐ µctÐ µd variablÐ µs in thÐ µ study.   Statistical significancÐ µ is to bÐ µ sÐ µt at an alpha lÐ µvÐ µl of 0.05; ANOVA will bÐ µ usÐ µd to Ð µxaminÐ µ thÐ µ variation among thÐ µ data. Along with it, ordinary lÐ µast-squarÐ µs (OLS) rÐ µgrÐ µssion will bÐ µ usÐ µd to tÐ µst for linÐ µar rÐ µlationships bÐ µtwÐ µÃ µn variables tested.   SuspÐ µctÐ µd HAI, confirmÐ µd HA I, and admission to ICU will bÐ µ codÐ µd as dummy variablÐ µs, with thÐ µ valuÐ µs of 1 that will bÐ µ assignÐ µd for patiÐ µnts with thÐ µ attributÐ µ and 0 for thosÐ µ without it. WhÐ µn prÐ µsÐ µnt, thÐ µsÐ µ dichotomous variablÐ µs act as intÐ µrcÐ µpt shiftÐ µrs but do not changÐ µ thÐ µ slopÐ µ of thÐ µ Ð µstimatÐ µd rÐ µgrÐ µssion linÐ µ. Limitations of the study.   Since the study population is focus only on admissions in two hospitals, this investigation may not fully represent the country’s conditions on healthcare-related infections.   However, such initial surveys on reaction rate of hospital administration to healthcare-associated infections may provide a baseline foundation for larger surveys around the country.       Ethical considerations.   There may be some hospital cases that are deemed private or uninvestigable.   These will not be included in the investigation.   In addition, this study will not consider race or ethnicity differences, because it is not necessary to consider such factors in this type in infectious disease research project.    Feasibility of the scope of this study.   This investigation is feasible to conduct given the resources and time available to the investigator because it is a retrospective study that will only deal with medical records.   Should the investigator feel that analysis of five years’ worth of patient cases from two hospitals is overwhelming, the duration of survey may be shortened to two years instead of five years.   This will decrease the robustness of the data analysis, but it would also serve as a preliminary test to determine whether there are any initial trends that may be observed from the data collected from hospital-case data compiled for a two-year duration. Summary assessment.   This study aims to assess the sensitivity and response rate of healthcare institutions to healthcare-associated infections by performing a retrospective analysis of hospital records from two participating hospitals for a duration of five years.   Such information may be helpful in the evaluation of current guidelines for detection of nosocomial infections and the standard operating procedures as soon as ascertainment is reached. Recommendation.   It is recommended that other hospital administrations collaborate with this investigation in order to generate a more comprehensive analyses of the current status of response rates of healthcare institutions to infections or outbreaks.   Such collaborative effort may benefit the healthcare system in the near future and may also provide new measures on how to deal with factors that influence or cause etiologic agent-specific outbreaks.