Education and School Uniform Essay Example for Free

Education and School Uniform EssayPupils all around the world have worn school same for many years. many an(prenominal) schools in Japan, France, USA and Israel, oblige pupils to come to school with a same. Wearing school uniform has advantages and disadvantages which I will present in my composition.On the unmatched hand, the school uniform is very Copernican. It is imporatant because it shows that a student belongs to a certain school. When a student wears a shirt with the schools symbol, everyone knows where the student studies, a thing which whitethorn help to create a feeling of belonging and school pride. Moreover, the school uniform saves money. Students some durations judge other students by their outward look.Therefore, many students clear much money on clothes in order to be more popular. When everyone wears the same uniform, the students dont need to spend much money to buy pricey brand names. In addition, school uniform saves time in the mornings because you d ont have to think much about what to wear. In addition, schools claim that school uniform is important for good education because pupils need to obey a certain dress code, a thing that helps the students be prepared for the army and any other framework.On the other hand, some pupils claim that wearing a school uniform hurts their individuality and self-expression. They claim it deprives them of the right to wear whatever they want. After all, they are mum children and at this age there should be more room for self expression. As far as saving money, some pupils claim that the school uniform doesnt save money because they need to buy additional clothes to what they already have. Therefore, they think it is not necessary and should be cancelled.To conclude, in the light of the above, school uniform has advantages and disadvantages. I strongly believe that the school uniform is necessary and has benefits. However, I think that each school should design its school uniform from time to time and let pupils and teachers decide on it.

Cover Letter Essay Example for Free

Cover Letter EssayHello BeaumontI am interested in the Hospitality,Please review the attached resume, which highlight skills and accomplishments that will enable me to contribute to your team. I have computer knowledge and years of customer service skills on with my ability to work within teams if needed for the job. I would appreciate the chance to show, apply, and learn more useful skills that will help me in pursuing my semipermanent career goals.I can be reached via email and or phone. Thank you for your time and consideration. I look forward to speaking with you about this employment opportunity.Sincerely,Your NameStreet AddressAddress 2City, ST hasten CodePhoneE-MailWebsiteDateRecipient NameTitleCompany NameStreet AddressAddress 2City, ST ZIP CodeDear Recipient NameName of Person Referring suggested that I contact you regarding the open job title position with Company Name. My educational background in field of study, along with my professional experience, makes me an exc ellent candidate for this position. As you will see from the enclosed resume, I have more than number years of experience in the field of area of professional expertise. My resume shows that I have been consistently rewarded for hard work with promotions and increased responsibilities. These rewards are a direct result of my expertise in area of professional expertise, my commitment to personal and professional excellence, and my excellent scripted and oral communication skills. If you have questions, or if you want to schedule an interview, please contact me at phone number. I look forward to meeting you to further establish employment opportunities with Company Name.Sincerely,Your NameEnclosure

Anxiolytic Properties of L- Theanine in Albino Rats

Anxiolytic Properties of L- Theanine in Albino RatsLakshmi Girija, Kiruthika, Arvind, Zaved Ahmed khanABSTRACTAnxiety is an unpleasant feeling of nervousness, uneasiness accompanied by sieve for anticipated events. Stressful conditions canister increase fretting many folds showing physically nonice sufficient symptoms and drastically affecting cognitive ability. Several minor tranquilizer drugs be in the market whose constant consumption may lead to problems in the long run. It is reported that L-Theanine, anamino acid running(a) that was discovered as a constituent ingreen tea, has minor tranquilliser abilities. As L-theanine is an analogue of glutamate and glutamine, it is absorbed in the small in proveine after oral digestion. It can cross theblood whizz barrier, and thereby directly register ph subdivisionacological effects. As it is open to cross thebloodbrain barrier, psychoactiveproperties are reported for theanine. Many studies have revealed ab break its potential ab ility to reduce mental and physical stress. It can give discontinue cognition and improve mood and cognitive performance. Diazepam is acommercially available benzodiazepine drug, used to treat a wide range of conditions, including care, panic attacks, insomnia, seizures etc. In this paper, the minor tranquilizer properties of L- theanine was studies in the albino rats taking diazepam as a positive drug for anxiety. Poly lactide nano particle encapsulate theanine was also tested to see if it could cross the blood brain barrier more rapidly to reduce anxiety. Theanine proved to be an efficient anxiolytic drug equivalent to diazepam as it improved the performances of anxiety bring on rats to match with that of the rats that were non anxious.KeywordsTheanine, anxiety, Diazepam,stress.IntroductionNowadays anxiety or stress have became one of the common important problem faced by the world today. owe to busy schedule and workloads people are not able to stay calm and so the demand for anti-anxiety drugs are gaining importance. Most commonly used drugs allow alprazolam, clonazepam, diazepam and oxazepam. But all these drugs are not safe in the long run and hence there is a need for a skilful alternative.L-theanine, an aminoacid analogue of proteogenicaminoacids, L- glutamate and L- glutamine has strand to have certain anti- stress effect properties. It was discovered as a constituent of green tea. Since it has multiple roles in the central and sovereign nervous system, it is receiving more attention. It was found that administration of L- theanine increases the alpha brain activity, depicting that L-theanine could render an alert and relaxed state 1,2.It was also found that stress can be reduced by inhibiting cortical neuron excitation 3.Stress can raise the blood pressure thereby activating the nervous system for producing large amounts of vasoconstricting hormones that result elevate blood pressure 4,5, L-theanine was able to reduce the blood pressure Vari ous studies in animals revealed that L-theanine had an effect on serotonin and dopamine concentrations in the brain, anxiolytic effect 6,7.Kimura (2007) reported that intake of L- theanine have reduced heart rate and salivary immunoglobulin production. In hypertensive rats L-theanine have found role in reducing blood pressure 8,9.. Hence, it can be hypothesized that L-theanine attenuates the stress responses in the autonomic nervous system induce by both physically and psychologically stressful tasks.Diazepam is one of the common benzodiazepine drug used for reducing anxiety. It reacts with the chemicals in the brain that causes anxiety. It also used for alcohol withdrawal symptoms. With other medications, diazepam is used to treat seizures. It helps to control symptoms of anxiety, so the people feel less agitated and less tense. It have sedative and an anticonvulsant properties. It can help seize to muscle spasm. Diazepam should be used for the shortest period of m possible as it will cause tolerance, dependence and also some cartridge holders withdrawal symptoms in some people.In this paper, the effect of theanine was tested in the albino mice taking diazepam as a positive drug for anxiety and then testing of theanine encapsulated with nanoparticle was through with(p) to check whether the drug crossed the blood brain barrier.MATERIALS AND METHODSAll animals used for this experiment were approved by the ethical committee for animals of VIT University.Animals subjects All rats used in the experiment were female albino Wistar from VIT animal house.The animals were in the age themeing of 6-8 months. The separated groups were kept in separate cages with 3 rats in apiece cage and were supply with food pellets and purified water from VIT animal house facility. All rats were healthy and free of any physical deformity or possible symptoms of any infection. The guess weight downs of the rats were 270 10 grams. classifying of the rats for the experimentThe rat s were divided into 5 groups with 3 rats per group for the experimental design. The details of the groups are as follows.Groups (Three rats/group)Induction of anxietyRestrain stress ideal was used to induce anxiety into rats. All rats except the negative control group were bring forth with anxiety continuously for 5 days. The rats were locked and immobilised in the restrain stress chamber inside a silent dark room for 1 h each day for 5 consecutive days to induce anxiety. No animals were injured or handled harshly in the process.Each group of rats were subjected to the process at the same metre each day and were then caged together in their respective group cages.Administration of drugThe drug was administered orally through eleven G syringe. Drug of 10 mg/ Kg of body weight was dissolved in 10 mL of distilled water and were fed orally to the rats.Tests performedOpen field of view test and marvellous addition internal ear test was performed for each rat in every group for 3 co nsecutive days and the performance readings were recorded for each rat and represented separately in the group performance table to be compared with other groups to determine the relative anxiety take aims of different groups in the experimental model.Open field testThe rats were introduced one at a time into the centre of the open field apparatus that consisted of 16 squares and a total accessible area of 1.6 sq m. The ambiance was maintained silent and was hygienic lit with lights for ensuring visibility. Each rat was allowed to exceed 10 mins inside the frame-up and the total number of square movements, fecal boli and rearings were recorded for the entire period of time fatigued inside the setup.Elevated positive(p) inner ear testThe rats were introduced one at a time into the centre of the elevated plus maze setup elevated to 50 cm above ground that had an open arm of length 60 cm and a closed arm of length 60 cm with the total accessible area of 2.4 sq m. The ambiance w as maintained silent and was well lit with lights for ensuring visibility. Each rat was allowed to spend 5 mins inside the setup and the total number of open arm entries, closed arm entries, total time washed-out in open arm and total time worn out(p) in closed arm were recorded for the entire period of time spent inside the setup.ResultsThe observations of the open field test and elevated plus maze test for all the groups of experimental rats are as follows.Group detailsOpen field testParameters tested in open field test wereNo. of squares crossedNo. of fecal boliNo. of rearings put over 1 to 5 show the raw data of observation for the 5 groups for the open field test.Table1 Group I observation for OFTTable 2 Group II observations for OFTTable 3 Group III observations for OFTTable 4 Group IV observations for OFTTable 5 Group V observations for OFTDetermining the level of anxietyNumber of squares crossedThe destine value of squares crossed by the rats in each group is depicted in fig 1.As pass judgment rats with no induced anxiety were able to show high movement by crossing a implicate of 62.4 squares in 10 mins and rats induced with anxiety only when not administered with any anxiolytic drug showed the least movement by crossing a mean of only 14.6 squares in 10 mins. The group administered with theanine as the anxiolytic drug out preformed as compared to the group administered with diazepam by crossing a mean of 48.4 squares in 10 mins showing reduced level of anxiety. The nano particle reflection does not show significant improvement in the performance as compared to theanine administered alone.Number of fecal boliFig 2. Shows the anxiety level of the different groups having fecal boli as the disceptation for measuring anxiety.Maximum number of fecal boli was detect in group II where the rats were induced with anxiety but was not administered with any drug. Non anxiety induced rats in group I had the least number of fecal boli recording of 2. Thean ine seems to be effective than diazepam in this test. Fecal boli is reduced by a mean of 0.11 as compared to the rats administered with diazepam. Nano formulation administered rats show increased fecal boli doings as compared to rats administered with diazepam or theanine.Number of rearings smashed number of rearing demeanor for the 5 groups are shown in fig 3.Group I rats that were expected to show the least number of rearings showed rearing behaviour more than the test groups. Group II rats showed the maximum mean number of rearings fo 32.2 in 10 mins in the open field setup. Theanine and nano particle formulation of theanine reduced the rearing behaviour as compared to diazepam proving their efficiency as anxiolytic drug. The effect of normal drug and nano particle formulation were almost equal and nano formulation seems to show no improvement in crossing the blood brain barriers.These results from open field test confirms that the restrain stress model is effective in inducing anxiety in rats and the test drug theanine performs better than diazepam that is now being commertially used to treat anxiety.Elevated plus maze testThe parameters tested in the elevated plus maze test wereNo. of entries to open armNo. of entries to closed armTime spent in open armTime spent in closed armTables 6- 10 show the raw data collected for each group of rats in the elevated plus maze test.Table 6 Group I observations for elevated plus maze testTable 7 Group II observations for elevated plus maze testTable 8 Group III observations for elevated plus maze testTable 9 Group IV observations for elevated plus maze testTable 10 Group V observations for elevated plus maze testNumber of open arm entriesMean number of open arm entries by the 5 groups of rats in elevated plus maze test are depicted in fig4.Group I rats with no induced anxiety showed the maximum mean open arm entries of 13.4 times in 5 mins. The least number of open arm entries were observed in group II rats that were induced with anxiety but not administered with any drug.Diazepam was more effective in reducing the anxiety as the mean open arm entry for rats administered with it was 11.5 as compared to only 9.1 and 9.0 for rats administered with theanine and nano formulation of theanine respectively.Number of closed arm entriesThe mean number of closed arm entries for the groups of rats are shown in fig 5.Number of closed arm entries were recorded maximum for group I rats without anxiety, these rats were very active in entering both the weapons system yet they spent most of the time in open arm chamber. Group II rats had least closed arm entries but they tend to spend more time without movement inside the closed arm showing high level of anxiety. Mean number of closed arm entries for the rats administered with diazepam was found to be 5.4 and the mean closed arm entries for rats administered with theanine and its nano formulation were found to be 6.1 and 3.4 respectively qualification the obs ervations inconclusive without its correlation with the time spent in the closed arm for each group.Total time spent in open armThe mean time spent in the open arm by each group of rats in the elevated plus maze setup is shown in fig 6.Rats belonging to group II that were induced with anxiety but were not administered with any drug spent the least time in open arm proving increased level of anxiety. Rats with induced anxiety and administered with diazepam, theanine or nano formulation of theanine spent mean time of 2.96, 2.7 and 2.93 mins in the open arm respectively. These are higher than 2.5 mins of time spent by group I rats that were not induced with anxiety. This proves that level of diazepam and theanine administered were able to reduce anxiety and also improve the performance of the test rats more than the control group in this test.Total time spent in closed armMean time spent by different groups of rats in the closed arm of elevated plus maze setup is given in fig7.Group II rats spent the mean maximum time of 3.76 mins in the closed arm showing maximum level of anxiety as they were not administered with any anxiolytic drug.Rats administered with diazepam spent the least time in the closed arm that was about a mean value of 2.03 mins. Theanine and nano particle formulation of theanine showed no variation with respect to this parameter as both the groups administered with either one of the drug spent an equal mean time of 2.3 mins in the closed chamber. These values are lower than the time spent by the non anxious rats in group I thus making it clear that the amount of diazepam and theanine used have not only been anxiolytic but also have improved performances of the rats in the test.Relative time spent in open armRelative time spent in open arm for each group of rats with respect to non anxious rats were reckon and depicted in fig 8.Time spent by the non anxious rats in group I was taken to be 100 % and the time spent by the other groups were plotted relative to the group I rats.Relative time spent by the group2 rats with anxiety and no administered drug was lowest as expected. Rats administered with diazepam, theanine or its nano formulation showed 18 %, 8% and 17% high relative time respectively as compared to the non anxious rats used as control, showing the potence of the drug against anxiety.Relative time spent in open armRelative time spent in closed arm for each group of rats with respect to non drug administered rats in group2 were calculated and depicted in fig 9.Time spent by the rats in group II that were induced with anxiety but not administered with any drug was taken to be 100% and the time spent by other groups were plotted relative to this.As expected all the other groups of rats showed lower relative time in the closed arm proving lower level of anxiety than the control group II. Rats administered with diazepam spent the least relativ

Procter Gambles Innovation And Information Technology Practices Marketing Essay

Procter Gambles intromission And Information Technology Practices Marketing EssayThe PESTEL analysis found forbidden that g overnment taxes/ corporate tax and global economic downturn become the issues of the PG changes its business to get together trade. And the SWOT analysis evaluate that PG have the strong m wholenesstary position and strong branding makes it success in this new grocerys trend. The efficiency and effective of furnish chain besides is the strong point for PG establishment.The report also evaluates and concludesthat would be an ideal to meet the challenge which presented by the market and could satisfy the consumer demand since it uses open conception- Connect and Develop program outsourcing the raw- materials and technologies and through skill of national and foreign competitors. But it also has the barriers on this program and learnedness.Since carriage out the Obamas foreign tax proposals, foreign rivals pay less in taxes in their domicil countries, foreign-based competitors would be able to reinvest much than, elaborate faster and sell their products at lower prices than U.S. companies and this affect PG. The tax changes put PG at a cost disadvantage, PG slay a 15% to 20% cost disadvantage comp atomic number 18d with different rivals. This will make PG unable to effectively compete against foreign corporations in the future (www.msnbc.msn.com).The heavily of IRS ( intimate receipts Service) fees is a burden of PG. This will reduce the profit of PG. For the face, PG valued artwork donated Cincinnati Art Museum in 2003 at $8.5 million but the IRS allowed PG subtract $6.4 million of the income taxes because the familiarity states that in the lawsuit that PG is uses third-party appraisers to value its donations, so the company not allow PG subtract the full amount of the donation. And, PG had paid more than $6 billion of national income taxes over the six historic period that were audited (www.usatoday.com).The national income and GDP growing will append buying power. It will course PG raised its consumers especially in evolution markets such as China and India. According to the report, GDP growing helps the Procter Gamble gain the premarket it was gained from 2.2 percent to $58.51 after it account results (www.reuters.com). Today, according to The New York Times (2009) reported that the sales from developing countries are doubling e really four socio-economic classs. The sales from developing markets represent 32 percent of P Gs $78 billion in annual revenue, up from 23 percent four years ago.Global economic downturn- merging marketsIn the worlds four most populous nations, three are state in emerging markets there are China, India and Indonesia. According to the Capital Groups estimation, it found that 70% of the worlds economic growth under the next 10 years will pretend towards from emerging market countries (Delfeld Carl T, 2009). Delfeld Carl T (2009) defines that Emerging markets now account for half of global economic growth, 33% of world GDP, and nearly 20% of world stock market value.After global economic downturn, PG trend to focus its growth dodging on emerging markets, it has opening about 20 new manufacturing facilities outside its established markets (www.wikinvest.com). It makes PG raising its capita sales in India and China more than 1 billion residents each and added $40 billion a year in Mexico (social.forecastfocus.com). And Delfeld Carl T (2009) also defines that PG now gains 32% of total sales from these merging markets and this is doubling every four years.PG have a spectacular descale of operations and strong financial position in the domestic and foreign markets. PG serve 4 billion customers near the world and it has operations in over 80 countries (Procter Gamble, 2010). In the year 2008, PG was the 8th largest corporation in the world by market capitalisation and 14th largest US caller-out by profit. Now, it is sixth in Worlds Most Admi red Companies in year 2009 (Americas Most Admired Companies 2009). In the Fortune 500, the company was the 20th in annual ranking of Americas largest corporations in the year of 2009 (CNN Fortune ranking). This strength helps PG gain opportunities in merging markets with the successful result.PG brings many new triggers to the market around the world. This is one of the strengths that PG success its business in the world. PG products inception are very popular around the world, it gain a lot of awards, example, SymphonyIRI Group recognizes PG in its annual Pace behaveters list and with the Outstanding Achievement in Innovation award (Procter Gamble, 2010). According to Business week, it reported PG is ranked 12 among the Worlds Most Innovative Companies (Procter Gamble, 2010). This is the marketing strategic that PG employ to present around the world.PG provides well- known, indisputable brands touch the lives of consumers in over 180 countries allows PG to efficiently and eff ectively to serve more consumers at more price points and gain the switch off markets advantages, for example Tide is the clear leader in the U.S. laundry detergent market with approximately 38% value share. Ariel is the leading detergent in Western europium with about 16% value shares (2009 Annual Report).According to the IRI New Product Pacesetter Report, it ranks that PG products are the best-selling new products in the U.S. every year. Over the historical 14 years, PG has had 114 top 25 Pacesetters. In the last year alone, PG had five of the top 10 new product preparees in the U.S. and 10 of the top 25. (www.marketingweek.co.uk)Gillette acquisition, Ambi Pur acquisitionAfter Gillette acquisition, PG believe that will create a group with annual sales of GBP 32bn, pushing its rival Unilever turn into second position in the UK toiletries market (Business Services Industry 05, 2010 CBS Interactive Inc). The PGs Gilette brand drop off its market enters a new era in male personal care. That is a great opportunities to PG to expend it markets to male markets and gain more market share. There have many advantages to PG acquire Ambi Pur. Ambi Pur brand was rich history in innovation, if PG acquire with Ambi Pur success, it rout out eff millions of consumers which come from air care market. Beside that, Ambi Pur brings new technologies and high-performance products to PG current Air Care portfolio (Procter Gamble, 2010). This will increase the markets share of PG and brings PG go future.2. Innovation and IT means to PGInnovation and IT become most and most importance in markets to every company. According to the Bob McDonalds speech which presented at the Innovation Institutes of India Global Conference (2008, p.4), claim that the innovation means at PG is the conversion of a new idea into consumer delight and, ultimately, into revenues and profits. In PG, the innovation very roughly, they enter at every point of brands and innovate in every part of business . Its cover in terms of product or packaging innovation, and to innovate include design, media, communications, business models, cost structures and organizational structures (Bob McDonald, 2008). bluff Innovation has significantly increased PGs innovation speed. Bob McDonald define that open innovation not as a form of out-sourcing but, rather, as a carriage to in source the creativity of the world. Nowadays, over half of the ideas and technologies innovations that PG bring to market are come from foreign countries (CASE III-5 by DeHayes, 2009). For examples, PGs Swiffer brand works together with Unicharm, purple/Dirt Devil, and IDEO for the innovation of product, commercial and design. PGs Febreze partnerships with KJK, Givaudan, and GK Design for the package design, technology and perfume development. A Pringles potato chip is a successful example of the PGs open innovation effort (www.business-strategy-innovation.com). In this case, PG taking the innovation in, at the same tim e its also taking innovation out, for example PG licensing PGs food technologies and packaging capabilities to ConAgra Foods (www.pg.com), in come in to gain the licensing fee (CASE I-4 by Lyn Denend and Burgelman).Procter Gamble try to maintain its free-enterprise(a) advantages by focusing on product innovation, its always look for innovation ideas by its total portfolio of businesses and technologies. Its use its internal capability with an external network of innovation partners through Connect and Develop program. Theres a global network provide authorization innovation partners for PG with about researchers, scientists and entrepreneurs doing work in areas relevant to PG businesses (www.pg.com). Through its Connect + Develop initiative, PG bring in new product ideas from outside, allows others developers to obtain their concepts and designs into PGs product pipeline. For example, they helped PG launch Olay Regenerist Eye Derma-Pods, and become its top-selling skin-care ite m in the year 2008 (www.fastcompany.com, 2008). According to the wiki analysis, it found that PG will launch a flurry of new products globally, using innovation to move on sales in fiscal 2010 coming out of the global recession (www.wikinvest.com, 2010).Acquisition of domestic and foreign competitorsPG management had adopted other innovative play-to-win strategy by acquisition of domestic and foreign competitors. PG acquired other companies that helped in innovation its products, diversified its product line and increased its profits (knol.google.com knol.google.com). For example, the cases of Gillette acquisition, and Ambi Pur acquisition. After Gillette acquisition, PG gain the innovation in male personal care products, for example the Gillette Fusion ProGlide razors and ProSeries male skin care products, there are innovation products which combine Gillette technologies (Procter Gamble, 2010). After acquisition of Gillette, PG increase its position in faster growing, higher mar gin, and more asset efficient businesses. The PG gain 22 brands with sales of $1 billion or more and 14 brands with sales between $500 million or $1 billion (Rick Ciccone, 2006). Besides, Ambi Pur brings new technologies and high-performance products to PG current Air Care portfolio, (Procter Gamble, 2010). This will increase the product innovation, expands PGs market and gain more market share. (CASE II-17 by Burgelman and Meza).JIT inventory controlJust-in-Time inventory control, can save costs, save time, reduce waste and move products and armed services to customers on time. In this case, PG is using this method and partnership with Wal- Mart. Wal-Mart linked with PGs inventory management frame, provides information sharing and opened its consumer information to PG. After stock the sales data directly from the checkout of Wal- Mart, PG used JIT inventory control on time deliveries to Wal-Mart and deliver the stock to the computer memorys to meet the contracted customer servi ce level. The just-in-time process works well for Wal-Mart and helps PG reduce the waste and more efficiency PGs sales have increased significantly to Wal-Mart and directly to the consumer (Handfield and Nichols, 1999 Simchi-Levi, et al, 2000).TQM the processTotal flavour Management (TQM)s principle provides many guidelines for PG to support its management approaches. Each principle will create their procedure to help PG in continually improving with breeding, behave and education (hubpages.com). The Five components of PGs TQM programs that primary to the improvements are1) Plant and division waste assessments to track discharges by site and set goals for improvement2) Process assessments3) Lifecycle assessments4) Research on product impacts5) Benchmarking.For example, the case at the Lima Ohio facility had success reduced 77% of air, water, and solid energy over four years using the TQM method. The other success example that is paper plant in Mehoopany, PG has created an innovat ion reduced 75% of the solid waste going to the landfill (www.future500.org).3. The ways to improve and changeThe some(prenominal) ways that innovation and IT aspects of the organization/ fork up chain of PG might be improved there are hang on chain reinventions, eStore website, products innovation and logistics.3.1 Setting Up the Web StoreEarly in this year, PG ran e- transaction in USA, e Store provide a wide range of potential consumer to PG. EStore allow PG to monitoring device sales volume. World Wide Web allows PG to sell products directly to the consumer and it also allows PG get the consanguinitys with customer. PG can get the comment and suggestion or advices directly to the consumer and waste the action to change and improve faster. In addition, PG can overcome geographic barriers to reach a global markets and customer- base. In this case, PG can march on use e- commerce to expand its Web Store to another country, such as Western Europe, Asian countries, because on line shopping is not new news to the world, people can cause this marketing method.The PG also can set up its eStore in the lower cost places or overseas, for overseas PG can set up the web gunstock office at merging market such as India or Taiwan because, India is IT developed country can provide good IT with low prices. And in Taiwan, the online shopping market is mature and popular, there have a mature market to PG expands its market to South Asian and China. Beside that, consumer on the Internet do not care where are the web store built. If PG built in the low- cost places, it can gain more profit and reduce the cost. This method that have used by CASE II-4 by DeHayes (2009), they move their offices from high- cost New Jersey to lower- cost Indiana.Supply chain reinvention- supply networkIn the PGs existing supply chains, it was limit its ability to reduce material use in PGs packages. The existing supply chain in PG is Supplier manufacturer retailer consumers. After reinventi ng to the supply networks the PGs supply chain method will be change to Supplier manufacturer consumers. The supply chain has shorter the journal and also giving many benefits. The supply network is more focus on external market and consumer, using supply chain will help PG in expand its market to merging markets. So using the supply networks, PG can more focus on the consumer- driven especially external consumer, it also help PG run its business more fast and flexible. The table 3.1 below has shown that the effective when PG after using the supply networks in PG (Rick Ciccone, 2006).FromToChainNetworkLong and slowFast and flexibleForecast-basedDemand-basedManufacturer-drivenConsumer-drivenInternal focusExternal focusDesigned from product forwardDesigned from shelf backCost-reductionValue and growth creationTable 3.1, source by Ciccone, R. (2006) AMR Supply Chain Conference, Reinventing the Supply Chain and Manufacturings RoleImprove product innovation- health medicines combine wi th Chinese herbal teaAccording to the research of University of Maryland medical exam Center (UMMC), (2009) reported that Recently, the World Health Organization estimated that 80% of people worldwide rely on herbal medicines for some part of their primary health care. In Germany, about 600 700 plant-based medicines are available and are prescribed by some 70% of German physicians. In the last 20 years in the United States, public dissatisfaction with the cost of prescription medications, combined with an interest in returning to natural or organic remedies, has led to an increase in herbal medicine use.Nowadays, Traditional Chinese Herbal Medicines (TCHMs) have been modified into solutions, soluble granules and tablets by extracting the plants natural ingredients. Due to the fact that TCHMs are natural and with very smaller side effects, its usage has been increasing significantly throughout the world. Research has shown that, similar medicinal plants are being used for the same purposes around the world (Chen, 2009). In this case, PG can change the health- care products ingredients to Traditional Chinese Herbal such as facial products, shampoo products. This is a good idea for the products innovation that can bring PG into another business level and markets.3.3 Partnership with foreign countries companyToday, the merging markets are developing so fast, many businesses tries to invest in this market to gain the competitive advantages. In order to survival in the market, PG can choose partnership entry mode to entry foreign countries to avoid dispersal system and high cost of inputs problems. This can help PG invest to overseas save more cost, share risk with others and easy to entry the market. Partnership Company will provide the supply chain information to PG, help PG run the business smoothly. For example, PG partnership with Darlie which is a toothpaste brand of the Taiwan of Hawley Hazel company. This product is very popular in Asian countries, incl uding Malaysia, Thailand, Singapore and the China (www.darlie.com). If PG partnership with this company, it will increase the market share significant. At the same time, PG also can gain the innovation and IT technology. But the Hawley Hazel company may less international business experience. This makes collaboration has a little difficult to manage because of their inexperience in the global business arena (CASE III-3, Christensen and Anthony).4. Overcome the barriersIt might be very difficult to overcome the barrier usherd above, unless the organization stamp down financial resources and human resources inBuilding global network in different languageAlthough the online marketing has createn PG a lot of advantages but the cost and logistics of delivering goods to consumers have been the biggest barriers to PG, this barrier is around this supply chain and cost-effective thing. The cost of logistics and packaging fees are costly, it will affect the profit of PG. Another problem i s the delivery problem some of the agrestic places there have no convenient transportation for transport. So PG have to create the solutions to reduce the cost of packaging fees and logistics fees.The language and cultural differences also are the barriers of supply network in PG. PG want to expand its business in the merging markets, its has to change the its website page language to multi- languages specially Chinese language because Chinese language popular in Asian including China, Singapore, Taiwan and Malaysia. Those are big developing markets to PG, PG have to improve this services in order to gain the competitive advantages (CASE III-8 by DeHayes, 2009)The program for building a global network of professionals requires a lot of time and resources. PG had taken many years to identify and build its network of technology entrepreneurs, suppliers and scientists (www.business-strategy-innovation.com). Another barrier in building global network that may face is online advertising . Using search engine advertising also is a costly media innovation, because the GoTo search engine charge for the list position. In order to solve these problems, there have two ways that let PG Web store may appear on search engine results, which are sponsored links and relevancy ranked listings (CASEII- 4 by DeHayes, 2009, p 329). Beside that, in order to unpack the barriers in Chinese markets, PG has to spend the money and human resources to create a Chinese language website or software (CASE III- 8 by DeHayes, 2009).Using 3PL to sequester logistics barriersFor the case which improve product innovation to low- income market, normally the facility such as transportation in low- income countries not that develop and convenient especially in the rural places. The problem of delivery to the rural places problem might be very difficult to overcome, besides the organization appropriate financial resources to solve the problems, the another way is using 3PL to remove the logistics ba rriers, because 3PL helps company to save costs, reduce waste, reduce financial risks.Relationships with Asian retailerIn Europe, PG partnerships with Wal- Mart retailer to serve the consumer necessarily and market. The PG also can use the same method to entry Asian market, it can relationship with Watson, Tesco, The Store, Guardian, Giant etc. Those are famous retailer in South Asian, partnership with them PG can gain more competitive advantages and market share. It also help PG invest to Asian easier. The Asian retailer can give the feedback from the Asian consumer comment and suggestion this will help PG to improve and bench mark with others company and continue improve itself, same with CASE III-3 by Christen and Anthony (2009) relationship with outside, take the knowledge from others.Stay focused on its customers need, Kanban continue improvement strategyIn order to overcome the barriers from competitor, PG should stay focused on its customers needs, continue improve in techno logies and also product, using the Kanban continue improvement strategy to maintain its business strategy and competitive advantages. At the same have to benchmark itself and competitor. Benchmarking helps PG opens organizations to new methods, gives ideas and tools to improve their effectiveness. PF can get more innovation from this management method, and this management has been used by many companies, such as Toyota, Nissan etc. inhabit the Open innovation activitiesInnovation is PG business strategy, it cannot survival without innovation, PG come out many ideas to remove the barrier. And the open innovation is the way that PG use to remove the pretermit of innovation period in its business and this activities run (CASE III-3 by Christensen and Anthony, 2009). The open innovation activities need a lot of money and human resources such as scientist, chemistry, engineering, materials science, biological sciences, designer to develop the technology or innovation products and also p ackaging design. To overcome the barrier indicated above, PG has appropriate financial resources in place and the appropriate human resources to operate the equipment. For example, the Summer Camp program, that is a way to search for the best or brightest innovation group (Procter and Gamble, 2010). Company has to appropriate financial resources to groom this program to keep the open innovation run. That is hard to find a talented and creative scientist, chemistry and engineering, and also costly to hire (CASE IV- 2 by Matthew C. Verlinden).Mass advertiseAccording to the research of University of Maryland Medical Center (2009) there are still some Europe countries which do not widely accept the usage of Chinese Herbs medicines, they classified the Chinese Herbs as drug that are not fully regulated. In order to overcome the problem, the company should book advertise Chinese Herbal products to the public, by introducing its health benefits and the little side effect it has on peopl e. To do that a company has to invest a large sum of money in promoting and advertising these products to gain consumers trust which then leads to an increase in its market share.Training systemHuman resource is one of the main resources that need most. Training system uses to provide company human resources such as expert skills and knowledge. PG training system provide a set of session to train all its leadership team and subject matter experts including cultural, language, and religious differences with the organization. People can use the knowledge which they learn in the training system to manage the implementation of innovation and change (www.business-strategy-innovation.com). In order to run this system successful, the financial resources have been providing by PG (CASE II- 1 by DeHayes, 2009).5. ConclusionsThe findings indicate that PG is now looking for more innovation and IT that can move the supply chain more efficient and effectiveness. Recently PG has used the outsourc ing method, there is open innovation and through the acquisitions other company to increase the innovation and IT. JIT and TQM to confirm the supply chain run smoothly, and meet the consumer demands on time. Open online web store helps PG expand its business without geography barriers, increase its market share. Change to supply network is to reinventing its Supply Chain and Manufacturings Role.However, there have a lot of barriers, such as lack of innovation problems, Websites language problems, logistics problem and the quality control barriers of the innovation and IT in the supply chain become the burden of PG to improve and reduce its benefit.In order to overcome the barriers, it can be concluded that the organization must appropriate financial resources and human resources in open innovation program, training system to overcome the lack of innovation barriers. Focus on merging market to gain the competitive advantages and overcome the competition barriers and using the 3PL to remove logistics barriers in low- income market.

Effective Hand Washing Program Nursing Essay

Effective Hand Washing Program Nursing EssayAcute respiratory disease and in turn outinal tract transmittings ar the uncreated causes of morbidity and mortality among young children (Vivas et al., 2008). Annu solelyy, more(prenominal) than 3-5 million children aged less than 5 years pass away from diarrhoea and acute baseborner respiratory-tract contagious disease (WHO, 2005 cited in Luby et al., 2005). Moreover, WHO (2010) estimated that diarrhoea and respiratory infection argon responsible for 35% of child deaths. The huge majority of child mortality occurs among the world poorest populations in low and middle-income countries. Vivas et al. (2008) inform that 62% and 31% of all deaths in Africa and Southeast Asia, individually, be ca employ by morbific disease. In In dosia, the largest cause of infant mortality and children less than quint years mortality are diarrhoea and pneumonia (31.4 %, 23.8% and 25.2%, 15.5 %) (Ministry of Health of Republic of Indonesia, 2007). A ccording to the results of basic wellness enquiry (2007) by MoH of Indonesia, 26% cause of death in the countryside in the age group 5-14 years are diarrhoea and pneumonia. This indicates there essential be a comprehensive treatment for age groups that are penetrable to infectious diseases can be protected.Although e actuallyone is susceptible to the transmission of disease, but children as future generations are one group that is at biggest risk (Hezel, Bartlett, Hileman, Dillon, Cessna, 2000 cited in Vessey, Sherwood, Warner, Clark, 2007). Children who are at conditionhouse age are very vulnerable because infectious diseases most affect younger children (Vivas et al., 2008). At this age they will blend with the purlieu outside their home that does not allow parents to keep their attention. Behaviours of children such as do not want to lose time to play or whoremaster facilities are smelly and dirty increase the risk for infection. With their vulnerability, children will b e very easily affected by diseases cause by infection.A previous take apart by Luby et al. (2005) reported that infectious diseases are common among school-age children are diarrhoea, acute lower respiratory infection and impetigo. As a result of this disease children of school age are not able to follow the lessons in school payable to absences. Absenteeism is a chief problem among school-aged children, with approximately 75% of all school absences endorsed to illness. Illness-related absences take a leak been shown to escort to both negative cultivational and economic outcomes (Lau et al., 2010). Moreover, society-acquired infections are a major reason for absenteeism among elemental school students commendationed by Dyer, Shinder, Shinder, 2000 Hammond, Ali, Fendler, Dolan, Donovan, 2000 McGuckin, Ali, 2002 cited in Vessey et al., 2007). Absenteeism due to infectious diseases will usually increase during the winter (Adams, Hendershot, Marano, 1999 cited in Vessey et a l., 2007). Moreover, Afroza (2007) argued that rinse muckles with soap right to reduce the risk of diarrhoea, avian influenza, pneumonia and opposite(a) diseases. seat on the stages of development according to Erikson (1968), school-age children referred to as the apprenticeship of bouncing. This stage is the period of learning and mastering more basic acquirements models (Erikson, 1968) so it is earmark to introduce to them about how to cancel infectious diseases. Children are more interested to learning and are very possible to adopt wellnessy behaviours at a younger age. Due to school children is the symbolism of the unification of all components of the family and society (Yuhanna, 2010), they can also being agents of adjust by spreading what they have learned in school to their family and residential district members (Vivas et al., 2008). From the above description thusly hatful airstream program in school-age children are very precise and strategic. If open backw ash is taught from the inception then surely hand wash will become a habit until the end of their lives.Hand washing is very important technique was introduced to the school-age children. To get the go around health benefit out of it, it is very important to consider the proper ways of washing hands with soap and running water (if possible). Several previous studies conducted in Indonesia found that although most of the people know about the importance of washing hands with soap but very few people (5%) know how to do it properly (Afroza, 2007). Hand washing with soap has been ranked the most cost-effective intervention for control of disease in the worldwide (Judah et al., 2009). A bailiwick conducted by Lau et al. (2010) found that hand washing interventions have been significantly reduce illness-related absences in elementary school students and significantly reduce a subset of illness-related absences (i.e. gastrointestinal illnesses).Hand washing is very effective program s conducted in schools. As a community, the school consists of various elements in them such as teachers, parents, students and the community around the school. Certainly the role of the other party is very important and needed. Then to involve other parties such as teachers, parents, community or society, strategic activities that possible to be implemented are community empowerment and health onward motion (MoH of Indonesia, 2010). Furthermore, UNICEF (2006) stated that in order to create effective relationships need to do the communication and collaboration between schools, families and community. The connexion of positive attitudes toward hand washing and the programs authorization in imparting knowledge back uped to create a sustained social norm of hand washing among umpteen children in disparate locations (Rosen, Zucker, Brody, Engelhard, Manor, 2009).Furthermore, to discuss many more in detail, the phenomena above will be describe into several topics such as definition , summarise and analyze, critically analyze opinion, and synthesize of phenomena into thesis plan.DefinitionIn accordance with the phenomenon found in my interest area then the next explain about the appropriate definitions as followsHand washingHand washing is washing hands with plain or antimicrobial soap and water (WHO, 2009). Hand washing is cleaning the hands of any dirt, starting from fingertip to elbow and arm in a certain way as needed (Subroto, 1987 cited in Yuhanna, 2010). Another definition by Potter (2005 cited in Yuhanna, 2010) hand washing is the rub with soap in with the whole hand skin surface with a strong and compact which is then rinsed under running water. Related to the definition above, in my opinion the definition of hand washing is place of washing hands with soap by elementary school students in grade 1st 3rd .Elementary schoolAccording to Ministry of Education of Indonesia (2010) elementary school is a form of formal education unit conducting public educ ation on basic education. Primary education aims to build a foundation for the growth potential of learners to become a human beings being a healthy, independent, and confident. Public school or other equivalent form consisting above 6 (six) levels of classes, namely grade 1 (one), grade 2 (two), grade 3 (three), grade 4 (four), grade 5 (five), and grade 6 (six). As far as my knowledge, elementary school is operationally delineate as the place where students 1st 3rd grades doing hand washing activities.EffectiveAccording to businessdictionary.com effective is the degree to which objectives are achieved and the extent to which targeted problems are solved. Effectiveness is goaded without reference to cost and, whereas effectiveness means doing the right thing. Moreover in dictionaryreference.com effective is adequate to accomplish a purpose producing the intended or pass judgment result effective teaching methods. Based on the definition in front, for this phenomenon effective is how grade 1st 3rd elementary school students to wash hands in accordance with quality of hand washing.ProgramAccording to oxfortdictionary.com definition of program is a think series of future events or performances. The synonym of program is a set of related circulars or activities with a particular long-term aim. Moreover in Cambridge dictionaries online program defined as a plan of activities to be done or things to be achieved. Program is operationally defined as a series of hand-washing activities made by the community school for students grade 1st 3rd. add together and analyzeBased on previous studies obtained, further in this paper will describe summarise and analyze six components, namely definition, objective, conceptual framework, research send off, samples, main result and bound.ObjectiveThe purpose of this paper was to identify, describe, explain, or predict the solution to a situation or a phenomenon that occurs (Hamid, 2007). As the best of my literacy, all r esearch studies have clearly set goals. Based on 28 studies were found, the purpose of the studies can be divided into six categories. First, it aims to determine hand washing institutionalize behaviour (Quintero, Freeman, Neumark, 2009 Drankiewich Dundes, 2003 Larson, Aiello, Cimiotti, 2004 Aslan et al., 2006 Larson Lusk, 2006 Yuhanna, 2010 Arfianti, 2010). In general the researchers would like to know about the implementation of hand washing compliance in various settings such as health premeditation setting and in education setting. A study conducted by Quintero et al. (2009) further explains that by knowing about the hand washing behaviour will be able to identify bottlenecks in the implementation of proper hand washing arranges. Meanwhile, Yuhanna (2010) connects the hand washing behaviour with parenting parents.Second, it aims to assess affect of hand washing (Luby et al., 2005 Nandrup-Bus, 2011 Thumma, Aiello, Foxman, 2009). Study conducted byLuby et al. (2005) dan Th umma et al. (2009) associate hand washing with incidence of acute respiratory infection, impetigo and diarrhoea. enchantment, Nandrup-Bus (2011) study associate hand washing with actual absenteeism because of infectious illness.Third, the objective is to determine hand washing barriers (Ramos, Schrader, Trujillo, Blea, Greenberg, 2010). To the best of my knowledge, there are three major barriers in hand washing practice such as facilities, supplies and supports. Specifically, Ramos et al. (2010) conduct studies about supplies barrier such as soap and paper towel/hand dryer.Fourth, to get an idea of application of various handwashing product ( brimming et al., 2011 Morton Schultz, 2004). Fuller et al. (2011) and Morton Schultz (2004) each using a technique gloving and washing hand by alcohol gel. Based on guidelines on hand hygiene in health care by WHO (2009) to determine an effective hand washing products for hand hygiene should be carried out laboratory tests. Meanwhile, the t wo studies above are not in actual laboratory tests. Fuller et al. (2011) only to take care whether hand hygiene compliance differed when gloves were worn and Morton Schultz (2004) linking the use of alcohol gel with reduction absenteeism inessential to infectious illness.Fifth, to evaluate knowledge, attitudes and behaviour of hand washing in community through the provision of education and progress (Vivas et al., 2008 Lau et al., 2010 Sjoberg Eriksson, 2010 Rosen et al., 2009 Nandrup-Bus, 2010, Tousman et al., 2007 Zain, 2010). According to WHO (2009) area of education and publicity is very appropriate to be applied in both developed and developing countries. Especially in the developing countries, conduct cost-benefit, cost utility and cost-effectiveness very useful for improving hand hygiene. In line with Curtis et al. (2001) education or promotion program can multifariousness behavior and to be effective if create on local research, use locally appropriate channels of c ommunication repeatedly and for an extended time. This is consistent with studies conducted by Lau et al. (2010) and Tousman et al. (2007), each of which carry education and promotion by given repetitive instruction and quadruple week learner centered.Finally, it aims to evaluate effectiveness of hand washing (Curtis et al., 2001 Judah et al., 2009 Park, Cheong, Son, Ha, 2010 Asiedu, Van-Ess, Papoe, Asiedu, Anderson, 2011 Dunn, Palombo, Salamone, 2002 Vessey et al., 2007 Guinan, McGuckin, Ali, 2002 bamboozle, White, Kim, 2008). Based on the best of my literacy, effectiveness of hand washing related to quality of hand washing. Larson Lusk (1985) stated that quality of hand washing consist of five versatiles such as appropriateness, frequency, agent use, continuation and technique. This statement are consistent with previous studies that conducted by Curtis et al., 2001 Judah et al., 2009 Park et al., 2010 Asiedu et al., 2011 Snow et al.,2008. On the other hand, reported that hand washing effective if able to reducing and subsequent absenteeism and no difference between different hand washing facilities (free wash hand basins and manual romance operated basins) in reducing microbial phytology of hands (Dunn et al., 2002 Vessey et al., 2007 Guinan et al., 2002).Conceptual frameworkFrom 28 research articles, several theoretical frameworks have been used, explicitly or implicitly, by the reviewed studies as the basis of intervention design and implementation. Although most articles failed to give a clear description of the theoretical framework behind the intervention design, based on the description of program procedure, I have identified the use of the following theoretical approaches health belief model (Park et al., 2010 Morton Schultz, 2004), behavioural change theory (Tousman et al., 2007) and Precede hold back model (Zain, 2010 Yuhanna, 2010).The Health intuitive feeling Model (HBM) is a psychological models that effort to explain and predict health behaviors focusing on the attitudes and beliefs of individuals (University of Twente, n.d.). Otherwise, Remocker Shea (2011) highlighted that HBM attempts to explain the thought process behind individuals decisions related to health behaviour change and maintenance. This model suggests that individuals determine the feasibility, benefits and costs related to an intervention or behaviour change based on the following constructs perceive susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. Park et al. (2010) used HBM to examine the perception, motivating factors, and behaviour related with the use of hand washing to prevent H1N1 influenza transmission. On the other hand, Morton Schultz (2004) used HBM to understand hand washing knowledge and behaviours in the school setting and how the children practice this behaviour both inside and outside the school environment. In these previous studies the use of HBM is appropria te because useful in understanding that perceived susceptibility to illness due to improper hand washing behaviours is necessary before commitment to changing or adopting the hand washing behaviour can occur.Tousman et al. (2007) used a model of health behavior change developed by Tousman Zeitz (2003). According to this model, behavior change is a function of factors related to the participants involved in the intervention, the structure of the intervention, and the techniques used in the intervention (Tousman et al., 2007). The participants factor refers to characteristics of the individual attempting to change behavior represented by 2nd grade students because they have a semantic knowledge base that allow them to accurately understand simple infectious disease principles. The structure of the intervention used four week 30 minute sessions. In this study, four typesetters cases of learner-centered teaching techniques were used those are learner-centered interactive words, skill training, students perform activities and self monitoring homework assignment.The Precede-Proceed model describes factors influencing health outcomes and provides a comprehensive structure for health needs assessment, program design, implementation, and evaluation of health promotion programs (Hu, Wallace, Tesh, 2010). This model posits that predisposing, reinforcing, and enabling factors have an effect on behaviour and the environment (Huang Goran, 2003). The Precede-Proceed model consist of two phases, firstly is Precede phase and secondly Proceed phase. The Precede phase include social, epidemiological, behavioural and environmental, education, ecological, administrative and policy assessment (Hu et al., 2010), continuing by Proceed phase to the implementation and evaluation of the intervention (Huang Goran, 2003). Yuhanna (2010) find patterns of parenting as a reinforcing factors influencing hand washing behaviour in school-age children. Whereas, Zain (2010) identified predi sposing factors which is education related to hand washing behaviour in school-age children. Zain (2010) stated that health education with lecture method, demonstrations and leaflets can affect hand washing behavior in school-age children. Both studies by Yuhanna (2010) and Zain (2010) only implement Precede phase, this may set up the question whether they can be specified using Precede Proceed model or not.A theoretical framework is essential at the beginning of a study to underpin research question and select variables as the end of a study to interpret the outcome (Kitrungrote Cohen, 2006). Furthermore, Bordage (2009) stated that conceptual frameworks help to understand problems or phenomenas that happen. Different conceptual frameworks emphasise different aspects of the problem or elements of the solution (Bordage, 2009). Thus, it can be concluded that the conceptual framework is essential. Researchers must determine the conceptual framework that will be use as a basis for re search to be conducted.Research designAccording to fire Grove (1993) cited in Hamid (2007) quantitative research is used to describe variables, examine the relationship between variables, and determine cause and effect interactions between variables. Each type of study design has advantages and disadvantages. Sastroasmoro Ismael (2008) states that the best design is to answer the research question accurately, effectively and efficiently. From 28 research studies, 25 studies used a quantitative study design and 3 used a mixed quantitative-qualitative design (Asiedu et al., 2011 Vessey et al., 2007 Tousman et al., 2007). None of the studies used a purely qualitative design. Among of studies that used quantitative study design, 2 studies used descriptive approach (Larson Lusk, 2006 Thumma et al., 2009), 13 studies used experimental approach (Luby et al., 2005 Dunn et al., 2002 Lau et al., 2010 Guinan et al., 2002 Sjoberg Eriksson, 2010 Nandrup-Bus, 2011 Rosen et al., 2009 Nandrup- Bus, 2010 Aslan et al., 2006 Ramos et al., 2010 Snow et al., 2008 Morton Schultz, 2004 Zain, 2010) and 10 studies used reflectional approach (Curtis et al., 2001 Fuller et al., 2011 Judah et al., 2009 Drankiewich Dundes, 2003 Larson et al., 2004 Vivas et al., 2008 Park et al., 2010 Quintero et al., 2009 Yuhanna, 2010 Arfianti, 2010). Among of 10 studies that used observational approach divided into 5 studies by cross sectional and 5 studies by longitudinal time dimension.Thirteen studies (46%) of the 28 studies used experimental design and 10 studies (36%) used observational design. This can be explained that in order to find the strongest causal relationship is to use an experimental study. While observational studies have the capacity of a causal relationship is weaker, but more widely used because it is relatively inexpensive and simple (Sastroasmoro Ismael, 2008).SampleTo the best of my knowledge, sample related to subject, sample size, places of setting, and instrumental r oles that used to collect selective information. According to 28 studies reported that there are three categories of subject such as community, students in several setting and health care providers. Most of the subject in previous studies are students (Vivas et al., 2008 Asiedu et al., 2011 Vessey et al., 2007 Quintero et al., 2009 Lau et al., 2010 Guinan et al., 2002 Morton Schultz, 2004 Nandrup-Bus, 2011 Nandrup-Bus, 2010 Tousman et al., 2007 Snow et al., 2008 Ramos et al., 2010 Yuhanna, 2010 Zain, 2010 Park et al., 2010 Drankiewich Dundes, 2003 Thumma et al., 2009 Aslan et al., 2006 Rosen et al., 2009) followed by health care providers (Fuller et al, 2011 Sjoberg Eriksson, 2010 Larson Lusk, 2006 Arfianti, 2010 Larson et al., 2004) and community (Curtis et al., 2001 Judah et al., 2009 Luby et al., 2005 Dunn et al., 2002). The selection of the student as a subject most closely related to two things the school age group is susceptible to diseases caused by infection (Hezel et al ., 2000 cited in Vessey et al., 2007 Vivas et al., 2008) and characteristics of development phase of school age (Yuhanna, 2010). School-age children is the great imitator, they would learn to behave as the behavior of those around them. So that when children are taught from childhood to live clean and healthy behaviors, such as washing hands before and after feeding, they will be familiar and accept become habits (Yuhanna, 2010). School children are the symbolism of the union of all components of the family and community. So in this case school-age children can serve as agents of change for healthy behavior (Yuhanna, 2010).The sample sizes of students range from 57 (Zain, 2010) to 2042 (Quintero et al., 2009). The sample sizes of health care providers range from 54 (Sjoberg Ericksson, 2010) to 131 (Larson Lusk, 2006). The sample sizes of community range from 32 (Dunn et al., 2002) to 198,000 (Judah et al., 2009). Dunn et al. (2002) used 32 premises become samples divided into 13 p remises with manual hand basins and 19 premises with hand free basins to investigate the effectiveness of hands free wash hand basins and manual tap operated basins in reducing microbial flora on food handlers hands.Related to the place of setting, school is the current setting that reported used followed by practise setting and community setting. At school setting consist of several specific setting. First in preschool (Rosen et al., 2009), second in elementary school (Vivas et al., 2008 Asiedu et al., 2011 Vessey et al., 2007 Quintero et al., 2009 Lau et al., 2010 Guinan et al., 2002 Morton Schultz, 2004 Nandrup-Bus, 2011 Nandrup-Bus, 2010 Tousman et al., 2007 Snow et al., 2008 Ramos et al., 2010 Yuhanna, 2010 Zain, 2010), third in secondary school (Aslan et al., 2006) and fourth in college (Park et al., 2010 Drankiewich Dundes, 2003 Thumma et al., 2009). At practice setting used wards in the hospital both inpatient and outpatient care unit (Fuller et al, 2011 Sjoberg Eriksson, 2010 Larson Lusk, 2006 Arfianti, 2010 Larson et al., 2004). At community setting used household, premises and natural setting (Curtis et al., 2001 Judah et al., 2009 Luby et al., 2005 Dunn et al., 2002).From 28 research articles, several instruments have been used, explicitly or implicitly, virtuoso or combination used such as structure observation check list, questionnaire, wireless devices, several hand washing promotion, reviewing document, self report and corporate trust of two or three instruments. Structure observation check list is the most widely used instrument (Curtis et al., 2001 Fuller et al., 2011 Dunn et al., 2002 Drankiewich Dundes, 2003 Aslan et al., 2006 Ramos et al., 2010 Snow et al., 2008). Followed by questionnaire instrument that used within 6 studies (Vivas et al., 2008 Park et al., 2010 Quintero et al., 2009 Sjoberg Eriksson, 2010 Larson Lusk, 2006 Yuhanna, 2010). Four studies from Lau et al. (2010) Guinan et al. (2002) Nandrup-Bus. (2010) Morton Schult z (2004) used reviewing document as instrument. Otherwise, several hand washing promotion instrument used by Luby et al. (2005) Rosen et al. (2009) Zain (2010). Furthermore, studies from Judah et al. (2009) Thumma et al. (2009) respectively, used wireless devices and self report as the instrument. Another four studies used more than one instruments. Asiedu et al. (2011) used combination between questionnaire and structure observation check list, Vessey et al. (2007) mixed between several hand washing promotion and reviewing document, Larson et al. (2004) combined between structure observation check list and self reported diary, Nandrup-Bus (2011) used questionnaire and reviewing document and Tousman et al. (2007) mixed multiple instruments such as training devices, handout, reviewing document and structure observation check list. As opposite, studies conducted by Arfianti (2010) did not mention what type of instrument used.As additional, all studies have explained about the ethical consideration. It is very important because the main objective of the ethics of research is to provide optimum protection to the subject of research (Sastroasmoro Ismael, 2008).Main resultWith regard to documenting outcome measure, in all 28 studies reported several outcomes measure, respectively, hand washing compliance, absenteeism rate, hand washing frequency, illness symptom, soap usage, glove usage, number of colonies, heading of hand washing supplies, hand washing disinfectant consumption and some of the studies used more than one type of outcome measure. Not only outcome measure, but also variables identified from all 28 studies.Eight studies used hand washing compliance for outcome measure (Vivas et al., 2008 Quintero et al., 2009 Drankiewich Dundee, 2003 Larson et al., 2004 Larson Lusk, 2006 Yuhanna, 2010 Arfianti, 2010 Zain, 2010). Seven studies used absenteeism rate as outcome measure (Vessey et al., 2007 Lau et al., 2010 Guinan et al., 2002 Nandrup-Bus, 2011 Nandrup- Bus, 2010 Tousman et al., 2007 Morton Schultz, 2004). Each of these two studies used soap usage (Curtis et al., 2001 Judah et al., 2009), hand washing frequency (Park et al., 2010 Snow et al., 2008), and illness symptom (Luby et al., 2005 Thumma et al., 2009). Each one a study that used glove usage (Fuller et al., 2011), number of colony (Dunn et al., 2002), presence of hand washing supplies (Ramos et al., 2010) and hand disinfectant consumption (Sjoberg Eriksson, 2010). Some of the studies used more than one type of outcome measure. Asiedu et al. (2011) mixed hand washing practice and presence of hand washing facilities and supplies become outcome measure. In other hand, Rosen et al. (2009) combined belief, attitude, knowledge and self efficacy of preschool educator as outcome measure and Aslan et al. (2006) used level of knowledge and hand washing practice become outcome measure.According to 28 studies reported several variables that influenced hand washing treatment, respective ly demography variable included age, education level, social norms and social status, quality of hand washing variable, impact of improper hand washing, insufficient of hand washing facilities or inadequate hand washing supplies, social support or social relationship and hand washing barriers.In eight intervention studies (Luby et al., 2005 Vessey et al., 2007 Lau et al., 2010 Guinan et al., 2002 Nandrup-Bus, 2011 Nandrup-Bus, 2010 Ramos et al., 2010 Morton Schultz, 2004), the study group was divided into one experimental and one control group. Rosen et al., (2009) and Aslan et al., (2006) have a one group experimental. Two studies (Sjoberg Eriksson, 2010 Zain, 2010) used pre test and post test questionnaires, whereas Snow et al., (2008) used one control group, two intervention group and post intervention questionnaires.As the best of my literacy, there are both concord finding and unlikeness finding highlight among 28 studies. According to variable demography, namely gender rep orted consistent that female were more likely to practice more frequent hand washing (Park et al., 2010 Thumma et al., 2009). Otherwise, Lau et al. (2010) Guinan et al. (2002) Nandrup-Bus, (2011) Nandrup-Bus, (2010) Tousman et al. (2007) Morton Schultz, (2004) explained that intervention group has fewer episodes of sickness absence and fewer sickness day than control group. Its become inconsistency finding because as opposite Vessey et al. (2007) state that no significant differences were noted between the groups, indicating that the number of student absence was not appreciably affected by the hand cleansing technique used. Based on the important inconsistency finding of this study suggesting implication for further studies in order that focus on absenteeism rate affect by hand washing action.LimitationFrom 28 research articles, several limitations have been founded, explicitly or implicitly, single or multiple limitations. Several single limitations have to consider when interpre ting the studies. First, limitation in approach system used (Curtis et al., 2001 Judah et al., 2009 Park et al., 2010 Vessey et al., 2007 Drankiewich Dundes, 2003 Larson et al., 2004). Curtis et al. (2001) stated that structured observation has limitation as a method of collecting data about human behaviour. Second, sample size and homogenous sample (Dunn et al., 2002 Sjoberg Eriksson, 2010 Yuhanna, 2010 Zain, 2010). Dunn et al. (2002) informed that small number of manual wash hand basins available for the project become limitation of the study. Third, Quintero et al. (2009) explained that instrument, namely questionnaire has any bias toward over reporting of proper behaviors. Fourth, out come variable from the studies (Larson Lusk, 2006 Morton Schultz, 2004). Morton Schultz (2004) stated that the outcome variable, absenteeism related to infectious illness could be perceived as bias in measurement because the school nurse served as data collector for the study. Fifth, 8 researc hers were not clearly describe limitation in their studies (Luby et al., 2005 Asiedu et al., 2011 Nandrup-Bus, 2011 Rosen et al., 2009 Nandrup-Bus, 2010 Aslan et al., 2006 Snow et al., 2008 Thumma et al., 2009).In other hand, 7 researchers stated that in their studies have more than one limitation (Vivas et al., 2008 Fuller et al., 2011 Lau et al., 2010 Guinan et al., 2002 Tousman et al., 2007 Ramos et al., 2010 Arfianti, 2010). Vivas et al. (2008) stated that in their study there are several limitations toward to approach system, sample, and study design. Whereas, Arfianti (2010) explained that there are two limitations, namely sample and instrument in her study.Only five studies that explain the conceptual framework used (Park et al., 2010 Morton Schultz, 2004 Tousman et al, 2007 Yuhanna, 2010 Zain, 2010), whereas 23 researchers did not explain the conceptual framework that used as the basis on their studies.Critically analyzeBased on the summary above, it will further be explain ed more specifically that jailbreaks are found. The discussion will be divided into three sections gap in knowledge and gap in conceptual framework.Gap in knowledgeTo the best of my knowledge, gap in knowledge found among others in objective and outcome variable. On the objective, all interventions have been prepared previously by the researchers. In this case, participants implement something planned by the researchers. Similarly, when the studies conducted in community setting (Curtis et al., 2001 Judah et al., 2009 Luby et al., 2005 Dunn et al., 2002). Curtis et al. (2001) evaluated whether the governments program of effective to behaviour change. Otherwise, Judah et al. (2009) determine effectiveness at increasing hand washing with soap in a natural setting. Moreover, Luby et al. (2005) assess the effect of hand washing promotion with soap on the incidence of acute respiratory infection, impetigo, and diarrhoea. Thus, all done by researchers have developed previously without th e involvement of community to decide for themselves what they need. Fallen Dwi (2010) expressed how important and strategic working together with the community

Ventricular Assist Devices :: Heart Transplants Health Technology Essays

Ventricular take c be Devices The Jarvik 2000 is a vast improvement in artificial flavors since its predecessor the Jarvik-7. The Jarvik 2000 is a ventricular advocate device. Ventricular Assist Devices (VAD) are a less invasive alternative to an artificial heart transplant. They are intended to assist the heart in pumping melodic line, not to replace the heart. These devices are implanted into the body and pump blood through the aorta thus, relieving the weakened ventricle of its normal workload. It works as a rotary pump so that blood is constantly flowing and therefore there is no longer a pulse. This device is not completely self-contained a battery block and the outside components must be worn around the waist. This allows the patient unrestricted movement and not be immobilized as was the case for the original artificial heart. The battery pack transmits energy up to a component around the skull, the power is then conducted through wires that pass inte rnally down the neck. Unlike Jarvik-7, which was to serve as a temporary artificial heart until a donor was found and a transplant could be performed, the Jarvik-2000 is being developed as a permanent assist device.5Peter Houghton Mr. Peter Houghton is the first patient who was fitted with the ventricular assist device. He was 61 years old during the clipping of the operation, which took place in June of 2000. Mr. Houghton, who was suffering from heart failure, was only expected to live a couple of weeks longer without a heart transplant or artificial help. He underwent the procedure that took 14 hours in order prolong his life. He showed significant progress six weeks after his surgery with his heart and liver functions improving greatly. Mr. Houghton is capable of exercise due to the force to manually control the blood flow rate of the device throughout his body. Recently on August 16, 2004 Mr. Houghton set the world record for longest time as a patient living with a cardiac assist device, at that day he had lived with the device for 1518 days. His condition has improved so a great deal that he can live with the device turned off for short periods of time.

Social Class in Charles Dickens Great Expectations Essay -- Great Exp

Social Class in Charles Dickens Great ExpectationsDuring the 19th century, Britain was first appearance a new era. The reign ofQueen Victoria had brought about many exciting propositions, withindustry leading the way at the forefront. Due to the industrial variation and the fact that Britain was being ruled by a woman, theaction of Great Expectations was occurring against the backdrop ofmajor social and cultural changes. Although Britain, as a whole, wasbecoming exceedingly richer, the Industrial Revolution that was takingplace also spawned great poverty. The working conditions in thefactories were deplorable. Child labour was prevalent and the slums oflarge cities, such as London, bred transgression, crime and disease. further men of property had the right to vote, so the proletariats wereexcluded from the political system, impeding the aristocrats to takeany action on the matters of lower classed citizens. Women had fewrights and little choice notwithstanding to marry and upon do ing so e actuallythingthey owned, inherited and earned automatically belonged to theirhusband. It was in this underside of society and the injustices oflife in Victorian Britain that Charles Dickens found the material forhis novels. These injustices are scarce what link Mrs. Joe Gargery, adowntrodden and poor blacksmiths wife, to Miss Havisham, animmensely rich and grim lady who lived in a large and dismal house.Mrs. Joe Gargery and Miss Havisham may be of alone divergentclasses, but they both suffer the detriments of life in VictorianBritain. Although Mrs. Joe Gargery and Miss Havisham are quiteidiosyncratic and eccentric characters, they are both examples of veryinexorable and domineering women.The eccentricitie... ...dumbfounded and destroyed,beyond the point of repair, and her quirky and peculiar idiosyncrasiesfade away.Dickens chose two very different female characters, which both helpedand hindered Pips journey to becoming a gentlemen. In my opinion, Ithink Dickens created these characters to show that in both ends ofthe social spectrum, there are still people who are not happy.Dickens intended inwardness about women that he tried to portray in thisbook is mixed. In Mrs Joe Gargery, he shows strength and dominanceover men, where as in Miss Havisham, he shows total dependence on men,and we see her world fall to pieces without one. I think he decided touse such extreme characters to help readers visualise and realisethat not all women are the same. They can vary from being confidentand domineering, to being dependant on others and very impressionable.