Calveta Dining Services Essay

Calveta Dining Services, Inc.: Case Analysis Abstract Calveta Dining Services, Inc. was a $2 billion, privately held firm that managed food service operations for nearly 1,000 senior living facilities (SLFs) in the United States. It was built on Antonio Calveta’s passion for food and traditional family values. It made better food that was more nutritious for the residents of the SLFs whose current food budgets did not exceed. It also provided with not only higher-quality food but also more personalized service. Presently, Calveta Dining Services ran food services for 976 SLFs and employed 15,000 people. When Antonio retired from his 35 years of leadership, he named his eldest son, Frank, as the new CEO and was asked to double the company’s revenues within five years, of which 2 years have passed without any credible strategy adopted yet. He did not want to disturb the special company culture or risk their reputation for quality food services on the race to double the re venue. Now he finds it difficult to carry out his father’s directives. The humanistic and emphatically pro-employee company culture should not be disturbed while the growth strategy takes place. Currently, he is in a dilemma whether to expand beyond the SLF market and he is worried if he could continue to maintain the quality level, for which Calveta is renowned, in this process. Analysis In order to increase the revenue as promised to his father, Frank has to consider growth strategies for his organization. He has around three strategies in his mind and has to work on them to see which one brings the maximum benefit and fulfils his needs aptly. The strategies that he has in mind are either to continue in the existing situation itself or introduce it to the hospital segment. He also has thought of taking up Great Southwest Dining Service

Self Realization Through Education

Self-Realization through Education Over the past 32 years of my life, I have been both directly and indirectly impacted by numerous social institutions. Without question, education has been the most influential by creating a positive change in my life. There are many benefits to pursuing an education. First, embarking on a rewarding career path has its own rewards such as a generous salary and social prestige. In addition, an individual’s relationships within the institutions of family and marriage are also affected by the presence of an educated head of household.Lastly, the impact of a good education on mental well-being is tremendous since most people feel a sense of accomplishment after earning a college degree. Above all, I believe that education, as a social institution, has helped to shape my mental attitudes towards society as well as mold my sense of identity. Beforehand, I would like to define the term social institution followed by my own interpretation. According t o Merriam-Webster’s dictionary, an institution is defined as â€Å"a significant practice, relationship, or organization in a society or culture† (Institution, 2010).I feel that social institutions in particular are systems which  require society to form social groups; these social groups work towards  their collective goal of attaining desired statuses  and roles within said society. Simply put, a social institution is a system that can be used to attain certain social goals that are predefined by its respective social group, governed by a set of social norms. By adhering to social norms of academia, I have been able to earn an Associate’s degree which aided me in securing a new career.By depending on the institution of education, I have been able to meet one of my social goals and achieve Federal employment status. Social institutions are necessary components within our society in order to maintain and provide individual stability based on institutional dependence. Social institutions such as economy and education can directly correlate with one another. Common sense in today’s society tells us that the more educated a person is, the greater the likelihood that person will acquire high salaried employment.This so-called common sense also entails that a measure of normative isomorphism, or organizational standard, exists in the form of a college degree in order to establish a common â€Å"best practice† (Carter & Clegg, 2007, para 3). Individuals who do not possess the established minimum qualifications for employment are unlikely candidates due to an accepted social perception that said individuals lack the desired aptitude.In effect, being financially secure and having a  successful career that requires a college degree grants a sense of stability in the household. Family is considered to be another social institution and is affected by other social institutions, specifically economy and education. The involvement of the two latter social institutions has a great impact on the quality of life and stability of any given household. Herbert Spencer referred to institutions by using the analogy of society as if it were an â€Å"organism† (Henning, 2007, para 3).Basically, institutions are compared to the organs of the body since they too properly function only with effective interdependence. With respect to family, I believe that children are likely to grow up to become responsible members of society if they are raised in a household with educated parents. Seeking higher learning only strengthens the institution of family through both tangible and intangible benefits. Stability in the household, both emotional and financial, is directly affected by the level of education held by the working person.Indeed, family members traditionally benefit from the financial rewards which are bestowed upon the college-educated provider within the household. However, there are a multitude of intangible be nefits conferred upon graduation from a college or university. Social prestige, self-confidence, time management skills, and the ability to think critically are the most notable benefits. Abraham Maslow, a noted psychologist and theorist, developed a theory on human motivation that is widely known as a hierarchy of needs.After a person meets their esteem needs, he or she will seek to fulfill their potential through a process of self-actualization (Myers, 2010, pp 446-47, 564-65). Throughout this process, I feel that education is a key component towards self-actualization. In conclusion, by utilizing the institution of education, I am learning valuable life skills necessary to become a productive and successful member of society, as well as realize my true potential. References Carter, C. & Clegg, S. 2007). New institutional theory. The Blackwell Encyclopedia of Sociology. G. Ritzer (Ed. ). Retrieved from http://www. blackwellreference. com Henning, C. (2007). Institution. The Blackw ell Encyclopedia of Sociology. G. Ritzer (Ed. ). Retrieved from http://www. blackwellreference. com Institution. (2010). In Merriam-Webster Online Dictionary. Retrieved June 13, 2010 from http://www. merriam-webster. com/dictionary/institution Myers, D. G. (2010). Psychology (9th ed. ). New York, NY: Worth.

FLORIDA MEDICAID PROGRAM Essay Example | Topics and Well Written Essays - 500 words

FLORIDA MEDICAID PROGRAM - Essay Example However, they do not determine eligibility. There are many organizations like The Social Security Administration which determines eligibility for the disabled and The Florida Department of Children and Families (DCF) that determines eligibility for children, the elderly, families and people who need institutional care (Agency for Health Care Administration, 2009, p. 9). Because there are several agencies that are responsible for the eligibility requirements, it is difficult to state exactly all of the criteria. However, most of the agencies say that the criteria includes: Florida does many programs for children. One program is the S-CHIP program also referred to as Florida KidCare. According to the state mandates, states can have a program that includes a separate S-CHIP program, a Medicaid expansion program or a combination of both. Florida operates a combination program (National Academy for State Health Policy, n.d.). The program is provided for "targeted" low income children to provide healthcare. In Florida, families must meet the requirement of being 200% of the federal poverty level in order to get services. There are several benefits to having this program. The following services are covered: The goal of the S-CHIP program is to make sure that children who would otherwise not have health care will have it. Florida provides continuous eligibility for a full year and families are sent an application every 30 days; this makes sure that children are covered on a continuous basis and so they will note be dropped from the

Upstreaming Essay Example | Topics and Well Written Essays - 500 words

Upstreaming - Essay Example Therefore, this paper will analyze the process Anne May undergoes after her son’s death and the significance of embracing life in a phenomenal swim of faith. The memories of her son made Anne May unable to get over his death. Her son had fallen out of the boat and drowned while they were fishing with his father. The images of his son drowning could not leave her mind, which resulted in nightmares almost every day until they became her companion. In her dreams, she could see â€Å"her son drowning in the water, his skinny arms flailing the waves, his mouth opening to scream, but no sound coming forth† (Brant 50). This dreams kept the memories of her son alive; thus, she welcomed them. However, Anne May enters another process where she blames herself for her son’s death. Although she had not been there when the accident occurred, Anne May felt that it was her duty to protect her son. â€Å"It is my fault, she said out loud. She thought of all the things she should have done to prevent Simon’s leaving. She should have placated Tony, she should have lived alone, she should have pretended to be straight, and she should have never been an alcoholic, she should have never loved, she should have never been born (Brant 53). This hurt her and made it difficult for her to forgiven herself, as well as her ex-husband, Tony who desperately begged for forgiveness. The joy of her son’s birth made Anne May stop drinking. Her desire to have a drink ended when she saw Simon. However, his death made her thirst for the drink and hated attending meetings. â€Å"She wanted to drink and drink and drink until it was all over† (Brant 52). She finally buys a bottle of wine at a liquor store and decides to travel as she thinks about her past life, about her alcoholic father and how he made her mother live a miserable life. While standing on a rock at Sauble Falls, she watched the fish as

The Unexamined Life Is Not Worth Living Essay Example | Topics and Well Written Essays - 1500 words

The Unexamined Life Is Not Worth Living - Essay Example For a philosopher, every life form should have a way of life suitable for it, that is, the life that is in harmony with its nature. But according to human nature, ‘the good’ involves living that kind of life subject to the truly critical use of reason, namely to live such a life implying anything less that it is quite unworthy of such person’s nature. Indeed he stands to find it intolerable and further, that way of life is quite unworthy of such person’s nature, and he/she should not endure the unexamined life, which is in Kant’s words ‘an eternal childhood’ which in essence is a condition of lack of freedom. This paper discuses Socrates’ words "The unexamined life is not worth living". This would help ascertain if such words are any meaningful in human life. "The unexamined life is not worth living." Certainly those are Socrates’ words while at his trial for heresy. Socrates was on trial and said those words intentionally to encourage his students to always think for themselves and challenge the accepted belief of the time. He was condemned to death, although he had the choice of suggesting an alternative punishment. Rationally, it was expected that Socrates could have opted for exile or life in prison, which would have helped him avoid death. But according to Socrates, these promising alternatives would instead rob him of that only thing that would make him useful in examining the beautiful world around him and discussing how well to make it a better place to live. Without his examined life Socrates believed then that there was no point in living. He, therefore, suggested that the Jury should consider rewarding him for his service to the society. This implied that the Athens had no other alternative but be forced to vote for his death punishment. Socrates believed that the purpose of human life would always be personal and spiritual growth. People are not able to grow towards their greater understan ding of their true nature unless they spend some time reflecting and examining their lives (Palmer 34). Just like philosopher, Santayana, observed, â€Å"He who fails to remember the past is condemned to repeat it.† (Karl 11). Lucky enough, people do not have to make a choice between death and examined life. The saddest thing is that most people always avoid living an examined life not because they do not have the time, but because they actively like to avoid examining their own life. Socrates’ words are significantly relevant in every bit of human life, and I unreservedly agree to them. It implies that a person who is not open for questioning by others concerning his action and thoughts certainly lives in denial of such motivations prompting his actions and thoughts. It follows that such an individual wastes his or her life. That kind of life is but a superficial act that reveals nothing new and nothing unique and such a life is not "real" Socrates’ careful cho ice of words provides much color to his quote. The word ‘examined’ might be interpreted to mean to analyze, study, to check condition or health of someone or something, or to inquire. One would imagine that Socrates insists that asking other persons what his quote implies defiles the precise nature. It is, therefore, best for one to have his or her meaning from it. Socrates suggests that ‘unexamined life’ refers to that life whose purpose has at no time been questioned; a

Cremation Essay Example | Topics and Well Written Essays - 2250 words

Cremation - Essay Example However the remains are not ashes in the literal sense but they are dried bone segments. Cremation leaves the bones in fine sand like texture. These bone segments left are cremation are called as cremated bones. (1986) A place where modern day cremation occurs is called as crematorium (Cambridge , 2009). Crematorium usually consists of furnaces called as cremators and other facilities for handling of ashes. Cremation usually takes places in crematorium at very high temperatures of up to 870-980 C with special modifications to ensure the efficient disintegration of the corpse (L, 2005) . Europe which had earlier practised cremation of bodies abandoned the rite with the advent of Christianity which forbade cremation of bodies. The custom of earth burial came into vogue. It symbolised the burial of Jesus Christ and the day of Resurrection. (Kohmescher, 1999) However modern day Christianity permits cremation without violating its basic Christian norms and there has been a steady rise in this funerary practice form the mid 1960's especially in England , France , Italy and Switzerland. Skin and Hair are the first parts of the body which burn when a body is put to fire. During this phase 60-70% of the total body weight which is water vaporises due to intense heat. The loss of water causes muscles and tendons of the body to shrink. (L, 2005) When body burns further, the skeleton gets exposed when the soft underlying tissue disintegrates due to heat. Brain and ligament tissues are the last to be destroyed due to heat. Bones are however not destroyed at this heat, their composition and structure changes as there water content and collagen is destroyed and only mineral component is left behind. Bone crystal constantly increase in when heated up to 525 degree Celsius, and between the temperatures of 525 degree to 645 degree Celsius there is a sudden shift to a greater crystalline structure with a greater increase in the individual size of a single crystal. Above 645 degree Celsius there is no further change. After the cremation is over what remains behind are these dried out bone fragments that are altered in size and shape, both. Besides minerals these dried bone fragments also contain calcium phosphates. These cremated bone fragments are ash grey in colour and form about 2.5% (in children) to 3.5% (in adults) of the total body mass of the body. (Mays, 198) Information available

Buddong System Case Study Example | Topics and Well Written Essays - 1000 words

Buddong System - Case Study Example Though the company headquartered in New South Wales, it became able to present its products in varied parts of the world in a very efficient way. It is mainly due to high-level of dedicated and committed employees, who always try to fulfil the requirements of the customers and leads to the betterment of the organization. Due to which, its range of profit margin and ROI tends to increase day by day to a significant extent as compared to others. Along with this, the level of reputation of the organization also enhances to a considerable extent as compared to others (Rosengren, 2000). However, due to certain communication and ethical issues and problems, Buddong system failed to maintain its sustainability, due to which its competitiveness also reduced considerably. Side by side, due to lack of proper communication among the members of the organization, the morale and dedication of the employees are declining day by day resulting in downfall of the entire organization in long run. Criti cal Analysis Ethical and Communication Issues Ethics is also described as the moral philosophy that helps an individual to perform the accurate things in accurate time. It also involves defending and recommendation accurate facts and opinions to the peers and other members of the organization so as to achieve the goals and objectives of the organization.... deas that help an organization or its members to improve its portfolio or profit margin along with the level of dedication and commitment to perform the work. Not only this, corporate ethics that helps to increase the strengths of the organization thereby reducing, its weaknesses in this competitive market among other rivals. Apart from this, appropriate ethical conducts also need to be followed within the organization within its entire hierarchical process so as to enhance the productivity of the organization in the market among other rivals. Only then, the level of sustainability of the organization (Buddong System) might get enhanced in the future run. However, after reading the case study, it may be analyzed that proper corporate ethics is not followed within the entire organizational hierarchy. The CEO of the Buddong System, Mr Ken Young advised his financial officer, Simon Cheng to present $ A 200,000 as a bribe to the officials of Absurdastan so as to extend its mode of operat ions. Along with this, it also helps in increasing its market position and brand image of the Buddong Systems in the market among other competitors. But, Simon Cheng was not at all happy with the decision of Ken Young as he always desired to follow ethical paths in each and every sort of situations. So that, he might remain ethical at the time of tough situation, that is extremely essential on the part of an officer or manager of an organization. This is because the officer or CEO of the organization is just as the driver or controller of an engine, who drives the car or organization in accurate way (Warren & Fassett, 2010). But if, he or she follows the wrong path then the entire organization might move in wrong way resulting in is downfall among all other organizations. So, it is

UK Medical Law Essay Example | Topics and Well Written Essays - 1250 words

UK Medical Law - Essay Example Terminally ill patients are also adaptable to a high level of disability as they value what little quality of life they have left. The legal position in respect of selective non-treatment was addressed by the House of Lords in Airedale NHS Trust v Bland1, wherein the applicant, a health authority sought an order to discontinue life-sustaining treatment and that the only medical treatment to be furnished should be for the purpose of enabling a peaceful and dignified death with the minimum of pain. The family of the patient supported this application. The respondent, 21-year-old Anthony Bland, had been in a persistently vegetative state for 3 years and though not brain dead, he had no cognitive function. The unanimous opinion of all the doctors who examined him was that there was no hope of recovery or improvement. Under these circumstances, it was considered appropriate to cease further treatment. The judge granted the order as requested and this was confirmed by both the Court of Appeals and the House of Lords. The House of Lords held that a doctor, who has to care for a patient who is incapable of consenting t o treatment, is under no obligation to prolong the patient's life regardless of the quality thereof. The court referred to ... sts of the patient, the court used the test laid down in Bolam v Friern Hospital Management Committee3, namely whether the proposed conduct would be in accordance with the opinion of a large informed and responsible group of medical practitioners. As the cessation of life-supporting treatment in this case was in accordance with the criteria set out in a discussion paper by the British Medical Association4, the court found that there had been compliance with the Bolam requirement. In this case Lord Mustill pointed to the need for legislation relating to euthanasia stating that, "The whole matter cries out for exploration in depth by Parliament and then for the establishment by legislation not only of a new set of ethically and intellectually consistent rules, distinct from the general criminal law, but also of a sound procedural framework within which the rules can be applied to individual cases." In R (Pretty) v. Director of Public Prosecutions5, Lord Steyn reiterated that reform of the law on assisted suicide should be undertaken by the legislature rather than by judges. Case law demonstrates the paradox that results from the current law. As Dame Butler-Sloss P. emphasised in B v An NHS Hospital Trust6, a competent patient may refuse any form of medical treatment, even life-prolonging medical treatment, for whatever reason. B was able to insist that the ventilator, which kept her alive, was to be disconnected.Diane Pretty was also able to make a competent and autonomous choice about the timing and manner of her death, but was unable to implement this decision due to a prohibition of assisted suicide and thus died in exactly the way she had tried to avoid. Bland, who could not make such a choice, was deemed to have an existence whose futility justified the

Analysis of India and Stagflation Literature review

Analysis of India and Stagflation - Literature review Example It is caused by cost-push inflation according to new Keynesian economic models. Such inflation occurs when certain factors increase the cost of production. These include government policies, e.g., fiscal ones, or the paucity of resources. Radhika Rao, a Singapore-based economist with DBS Bank, opines that â€Å"The economy might be trapped in a stagflationary-type environment, as growth is at the cusp of moving another leg lower while inflation bottoms out† (qt. in Kala). There is less local and foreign demand for Indian industrial goods. Even the borrowing costs have gone up. The automobile industry which drives manufacturing growth has forecast that auto sales will fall for the second continuous year. However, as Kala notes, exports grew on stronger global demand as the weak rupee makes Indian exports more competitive; and consequently, the imports into India become costlier, thus bringing down the deficit. Globalization is greatly responsible for stagflation, with the effec ts felt in most other countries. The question that Shrivastava asks is whether the Indian economy should have been opened up in a more selective manner. The global financial markets are volatile, which affects the Sensex, for instance. Moreover, the demand for Indian goods and services has reduced due to the recession in the US. Inflation has been growing due to a rise in commodity prices and a steady rise in the price of oil. Because the Indian economy is dependent on those of the US and other rich countries, a home market for products is no longer a prerogative of the government. The US recession has led to fall in exports, whereas the rise of the rupee against the dollar (till recently) cost many job losses. Indian companies are finding it difficult to raise capital abroad due to the decisions taken by the Federal Reserve, the central bank of the USA. The rise in prices of steel, cement, and oil has increased the costs in all industries. Due to the hike in interest rates to keep inflation under check, the cost of interest has also gone up. Uncertainties at the global level have slowed down the growth of industrial investment. Oil prices have increased due to futures trading in oil because of excess liquidity in the hands of big speculators. Another reason for this was the low value of the dollar (before the Indian rupee went into a free fall). Food prices have increased for various reasons. The demand for food has changed greatly. Since industrial agriculture is based on the use of fossil fuels, price hikes in oil directly affect food prices too. Climate change is another reason for raised food prices. With the increase in globalization, there is constant pressure on India to globalize the food sector and to bring the prices in line with those abroad. The US decision to push biofuels has led to a rise in food prices. The US government started giving subsidies to farms for growing corn to make ethanol for use in cars.  Ã‚  

Micro Short Answer Personal Statement Example | Topics and Well Written Essays - 750 words

Micro Short Answer - Personal Statement Example This in itself cannot determine the power of choice. Other factors are critical when making any economic decision. These include opportunity costs, credit market, prices and desires. The fulfillment of the fundamental needs depends on the desire with the market prices playing a critical role. The purchase behavior depends on opportunity costs or tradeoffs. The credit market determines the ability to borrow and purchase items. For instance, people contract their spending whenever the high borrowing cost raises the consumption prices (Jiang 407). 2.0. Four resource categories A resource category refers to the source that provides benefits to people. A resource category can be in the form of money, staff, service or asset. The four primary categories of resources include government, education, health and family, and business. i. Education acts as an investment in an economy. An informed economy highly depends on skilled, knowledgeable and educated workforce. Goods education is an indica tion of increased economic performance. ii. Government is critical in creating jobs within the private sector and plays a significant role in finding projects. Whenever a particular government level funds a project, other levels of the government may be prompted to fund the same projects through private foundations and private capital funding. Government plays a significant role in fiscal stimulus package, monetary policy action, and other government interventions. iii. The family acts as a source of resource like labor, production and decision making. The population growth is a critical concept of economics as it determines demand and supply. On the other hand, health determines productivity of the population/family. iv. Business provides services to people. These include supply of goods and services, harnessing of resource and other capital, provision of employment and preserves the natural resources among others (Jiang 410). 3.0. Scarce factors of production The major factors of production are land, labor and capital. Limited factors of production imply shortage of such resources. This indicates insufficiency of productive resources in an economy towards the fulfillment of human needs and attainment of goals. Scarcity and its notion in economics. Scarcity refers to seemingly having unlimited wants in an environment of limited resources. In economics, scarcity indicates a fundamental economic problem where the productive resources are insufficient in an economy. Economics relates to purposeful human action, and without scarcity, economics cannot suffice. Scarcity creates the need for people to consume. Abundance never creates the need for people to make tradeoffs. Scarcity enhances rationing and encourages competitive behavior where people compete for the scarce goods (Jiang 412). 4.0. Production possibilities curve and relationship to the law of increasing costs Production possibility curve refers to the graph showing the combination of various amounts of c ommodities producible using fixed amount of each factor of production. This graphically bounds production set for a group of fixed input quantities. The curve indicates the maximum possible production level that defines the production efficiency. The increase in production of one good requires one to sacrifice a greater amount of another good. This is because of inequality in efficiency of resources. For instance, opportunity cost for producing j in terms of k

Huffman Trucking Essay Example for Free

Huffman Trucking Essay Huffman Trucking is a large organization that provides transportation of goods and services to its customers. In order to better serve these customers and to compete and stay at a high level above other suppliers, Huffman Trucking management enlisted the assistance of Team B to upgrade their companies systems to be able to create, maintain, and report on a database, which tracks the servicing of Huffman Trucking vehicles. Huffman Trucking has a number of business needs that should be met. The system should not require more than a few days of supervision to learn. It should be usable on modestly priced computer systems. Most of all, it should be simple and convenient for the users. The current system is not meeting business objectives because they are not able to tracks the servicing of the vehicles at Huffman Trucking. Huffman employees usually scan alphabeticly for vehicles . This is a fairly simple procedure if the exact name of the vechilce is available. However, many new employes may only know the few words of the vechile type. A tracked vehicle could possibly be misfiled, which requires a full stock review to find it. With the new shipment of vechicles need maintanes every month, it is close to impossible for a counter employee memorize Project Requirements There are two different types of requirements for this project. One is the technical requirements of the chosen database system and another is the business requirements of the Huffman Trucking. The business requirements  define the boundaries. Starting college can be like entering an entirely new world. You have more freedom than youve ever had before and you are in total control over your own life. This increased responsibility however can make you susceptible to some serous pitfalls. Read the following article to learn what habits to avoid in order to have a successful college career. Business Accounting Project Overview Huffman Trucking is a large organization that provides transportation of goods and services to its customers. In order to better serve these customers and to compete and stay at a high level above other suppliers, Huffman Trucking management enlisted the assistance of Team B to upgrade their companies systems to be able to create, maintain, and report on a database, which tracks the servicing of Huffman Trucking vehicles. Huffman Trucking has a number of business needs that should be met. The system should not require more than a few days of supervision to learn. It should be usable on modestly priced computer systems. Most of all, it should be simple and convenient for the users. The current system is not meeting business objectives because they are not able to tracks the servicing of the vehicles at Huffman Trucking. Huffman employees usually scan alphabeticly for vehicles . This is a fairly simple procedure if the exact name of the vechilce is available. However, many new employes may only know the few words of the vechile type. A tracked vehicle could possibly be misfiled, which requires a full stock review to find it. With the new shipment of vechicles need maintanes every month, it is close to impossible for a counter employee memorize Project Requirements There are two different types of requirements for this project. One is the technical requirements of the chosen database system and another is the  business requirements of the Huffman Trucking. The business requirements define the boundaries in which the project team has room to operate in. Huffman requires that the new system be relatively inexpensive with little ongoing maintenance required. The new system should not require many hours of training in order to use. The new system should also be usable  gout of the box. h Given these business requirements.

Literary Criticism Quotes and Explanation Essay Example for Free

Literary Criticism Quotes and Explanation Essay â€Å"Writing is easy. All you do is stare at a blank sheet of paper until drops of blood form on your forehead. † -Gene Fowler Fowler conveys that writing is a difficult, exacting task. The purpose of writing is to put our thoughts into words, and to make our words move our readers. Many writers are frustrated by their inability to put their thoughts onto paper. I have always had a difficult time writing. I find that I have good ideas, but that putting my thoughts into words is challenging. I find this problem in all kinds of writing, even projects I enjoyed like a short story we wrote in the 7th grade. I enjoy reading science fiction; it is the most interesting to me. I have always had a hard time picturing what I am reading in my head, but science fiction is easier to visualize. I dislike non-fiction the most because I find it uninteresting. â€Å"Human speech is like a cracked kettle on which we tap crude rhythms for bears to dance to, while we long to make music that will melt the stars. † -G. Flaubert Flaubert’s message is that human speech is imperfect and inelegant. Many people strive to speak fluently but aspects of their speech like word choice and grammar are imprecise. One way to express yourself when words do not work is body language. For example, if somebody doesn’t understand that you are trying to be sarcastic you can use body language to convey your message. You can also express yourself through art, like paintings or music. Some people also try to express themselves through the way that they dress. One advantage to using these methods is that you do not have to say anything but people can simply interpret your message. This can also act as a disadvantage because they might interpret it the wrong way.

Benefits of Different Oxygen Levels Administered in ICU

Benefits of Different Oxygen Levels Administered in ICU ABSTRACT: There have been numerous studies conducted to identify the benefits of different oxygen levels administered in ICU (Intensive Care Unit) patients. However, the studies do not reveal a definitive conclusion. The proposed systematic review plans to identify if either conventional or conservative oxygen therapy methods is more constructive in critically ill adult patients who are admitted in ICU. BACKGROUND Oxygen therapy is a treatment that provides oxygen gas to aid breathing when it is difficult to respire and became a common form of treatment by 1917. (Macintosh et.al 1999). It is expended for both acute and chronic cases and can be implemented according to the needs of the patient either in hospital, pre-hospital or entirely out of hospital based on their medical professionals opinions. It was established as the most efficient and safest medicines required by the health system by World Health Organisation (WHO). PaO2 has become the guideline test for finding out the oxygen levels in blood. And by the 1980s, pulse oximetry method which measures arterial oxygen saturation was also progressively used alongside PaO2 (David 2013). The chief benefits of oxygen therapy comprise slowing the progression of hypoxic pulmonary hypertension, emotional status, cognitive function and improvements in sleep (Zielinski 1998). In UK, according to the national audit data about 34% of ambulance journey s involve oxygen use at some point while 18% of hospital inpatients will be treated with oxygen at any time (Lo EH 2003). In spite of the benefits of this treatment, there have been instances where oxygen therapy can negatively impact a patients condition. The most commonly recommended amount of saturation for oxygen intake is about 94-98%, and saturation levels of about of 88-92% are preferred for those at risk of carbon dioxide retention (BMA 2015). According to standard ICU practice, the conservative method denotes that patients receive oxygen therapy to maintain PaO2 between 70 and 100 mm Hg or arterial haemoglobin saturation between 94-98% while conventional method allow PaO2 values to rise up to 150 mm Hg or SpO2 values between 97% and 100% (Massimo et al. 2016).There are also low flow systems where the delivered oxygen is at 100% and has flow rates lower than the patients inspiratory flowrate ( i.e., the delivered oxygen is diluted with room air) and, hence the Fraction of Inspired Oxygen(FIO2) may be low or high. However, this depends on the particular device and the patients inspiratory flowrate. AIM To investigate and conclude whether the use of a strict protocol for conservative oxygen supplementation would help to improve outcomes, while maintaining PaO2 within physiologic limits among critically ill patients. RESEARCH QUESTION A well- defined, structured and exclusive research question will lead as a guide in making meticulous decisions about study design and population and consequently what data can be collected and used for analysis.(Brian, 2006) The early process of research for finding the research questions is a challenging task as the scope of the problem is bound to be broad. Significant time and care is needed to polish, extract and compare the information required from the vast sea of information (Considine 2015) .If a proper and specific research question is not formed, the whole process will be useless (Fineout-Overholt 2005). The fundamental success of any research project is attributed in establishing a clear and answerable research project that is updated with a complete and systematic review of the literature, as outlined in this paper. A PICO framework is a universally used framework used to develop a robust and answerable research question which is also a useful framework for assuring the quality or for evaluating projects. PICO stands for Problem / Population, Intervention, Comparison, and Outcome. The research question presented in this paper is to identify whether conventional or conservative oxygen therapy methods is more beneficial among critically ill adult patients admitted in Intensive Care Unit. LITERATURE REVIEW The literature has focused on the effect of conservative and conventional oxygen therapy methods on mortality among patients in an Intensive Care Unit. Although there have been several studies to analyse which of the two methods is more beneficial to critically ill patients, a definitive study which determines the mortality rate among the different categories needs to be analysed and investigated for its benefit. Different devices used to administer Oxygen: Nasal cannula provides about 24-40% oxygen and flow rates up to 6L/min in adults (Fulmer JD 1984). A basic oxygen mask delivers about 35-50% FIO2 and can have flow rates from 5-10L/min depending on the fit and requirement of flow rate. The other respiratory aiding device is a partial rebreathing mask which has an additional reservoir bag with it which is also classified as a low flow system with flow rate of 6-10L/min and delivers about 40-60% oxygen. The non-breathing system is similar to the partial rebreathing mask, where it has an additional series of one way valves and it delivers about 60-80% FIO2 with a flow rate 10L/min. Review and findings of different oxygen therapy studies: A systematic review of two different published Journals indicated that the usage of additional oxygen when managing acute myocardial infarction arrived at the same result: that there is no significant benefit when oxygen therapy is administered while being assessed with air breathing (Cabello 2010) and it may in fact be damaging which results in greater infarct size and higher mortality rate (Wijesinghe 2009). Although a number of smaller studies could clarify the reviews, none of the original studies could reach a statistically substantial result ( Atar 2010); this stresses the need to provide data that validates the requirement for further analysis. Studies to support this have already been started, where The AVOID (Air Versus Oxygen In Myocardial Infarction) study is presently hiring patients to resolve this critical medical question (Stub 2012).Actual clinical trial data suggesting the effects of varied inspired oxygen levels are even more inadequate in acute ischemic stroke. It is proposed that oxygen therapy may be beneficial if administered within the first few hours of commencement, however it has also been observed that with continued administration, it may induce harmful results (higher 1-yr mortality) (Ronning 1999). In a survey of group study where more than 6,000 patients were case studied following resuscitation from cardiac arrest , hyperoxemia ( defined as a PaO2 > 300 mm Hg (40 kPa),the results obtained were considerably worse than both normoxemia (60-300 mm Hg (8to 40kPa) and hypoxemia (PaO2 There is also no robust proof for the postulation that an increased PaO2 is interrelated with improved long-term survival in critically ill patients( Young JD2000).A reflective study where more than 36,000 patients were considered and arterial oxygenation was administered while being mechanically ventilated, signs of a biphasic relationship was observed within a span of 24 hours between PaO2 and in-hospital mortality(De 2008).The average PaO2 level found was 99mm Hg, yet the foundation for unadjusted hospital mortality was just below 150mm Hg. A very similar study of more number of patients was conducted in Australia and New Zealand and this resulted in a report recording a mean PaO2 of 152.5mm Hg, indicating supraphysiological levels of oxygenation, with 49.8%of the 152,680 group was categorised as hyperoxemic PaO2>120mmHg(Eastwood , 2012). In contrast to the Dutch study, even though hypoxemia was associated with elevated mortality, after an adjustment of disease severity, a progres sive association between progressive hyperoxemia and in-hospital mortality could not be linked together effectively. (Martin 2013). The assumption that patients with hypoxemia secondary to ARDS (acute respiratory distress syndrome) respond positively to elevated arterial oxygenation reinforces many studies done in this field (McIntyre 2000). Nevertheless, data from clinical trials in patients with ARDS seem to disregard this assumption as frequent oxygenation and long-term outcome have a disconnection (Suchyta 1992). And the studies that report a correlation arterial oxygenation and mortality, a systemic review of 101 clinical studies in ARDS patients came to the conclusion that P/F ratio was not such a reliable predictor (Krafft 1996). Thus a more intense study was conducted to compare the supplementary oxygen therapy with no oxygen therapy in normoxic patients with ST Segment elevation myocardial infarction (STEMI). Oxygen therapy has been known to be only universally used for the initial treatment of patients with STEMI which is based on the belief that the additional oxygen may increase oxygen delivery to isc hemic myocardium and hence reduce myocardial injury and is supported by laboratory studies done by Atar in 2010. The adverse effects of supplementary oxygen therapy were noted from a meta-analysis of 3 small, randomized trials as done by Cabello in the same year. More recently, another analysis was done by comparing high concentration oxygen with titrated oxygen in patients with suspected acute myocardial infarction which found no difference in myocardial infarct size on cardiac magnetic resonance imaging (Ranchord 2012). Hence, there are no studies that assess the effects of supplemental oxygen therapy in the setting of contemporary therapy for STEMI, specifically acute coronary intervention. With these reports and analysis put together, we can safely deduct that there remains a substantial amount of uncertainty over the usage of routine supplemental oxygen in uncomplicated Acute Myocardial Infarction, with absolutely no clear indication or recommendation for the level of oxygen th erapy in normoxic patients in the STEMI guidelines. More recently, another analysis was done by comparing high concentration oxygen with titrated oxygen in patients with suspected acute myocardial infarction which found no difference in myocardial infarct size on cardiac magnetic resonance imaging (Ranchord 2012). The annual congress of European Society of ICU (2016) states that patients dying in the ICU was lowered by 9% while using conservative oxygen strategy as compared with the conventional one(JAMA 2016). METHODOLOGY Firstly the terms method and methodology needs to be differentiated. Method is a process used to collect and examine the data whereas methodology includes a philosophical inquiry of the research design as stated by Wainworth (1997). It is vital that the suitable methodology needs to be analysed in carrying out the research question and in assembling the data (Matthews 2010). Research Methodology is a way to find out the result of a given problem on a specific matter or problem that is also referred as research problem (Jennifer 2011). In Methodology, researcher uses different criteria for solving the given research problem and always tries to search the given question systematically in their own way to find out all the answers till conclusion. If the research does not work systematically on the problem, there would be less possibility to find out the final result. For finding or exploring research questions, a researcher faces lot of problems that can be effectively resolved while us ing a correct research methodology (Industrial Research Institute, 2010). This research proposal was done under the systematic review method because it provides a very comprehensive and clear way of assessing the evidence (Chalmers 2001). Also it lowers error and bias and establishes a high standard of accuracy (Jadad, 1998). Healthcare providers, researchers, consumers and policy makers are overwhelmed with the data, evidence and information available from healthcare research. It is unlikely that the all this information is digested and used for future decisions. Hence a systematic review of such research will help to identify, assess and synthesize the information based on evidence needed to make those critical decisions. (Mulrow 1994). There are a number of factors for choosing systematic review for this study. A systematic review is generally done to resolve mismatched evidence, to verify the accuracy of current practice, to answer clinically unanswered questions, to find changes in practice or to focus for the need for any future research. Systematic reviews[AD1] are increasingly being used as a preferred research method for the education of post graduate nursing students (Bettany- Saltikuv, 2012). One of the best resources available on the conduct of systematic reviews of interventions is the Cochrane Collaboration (Tonya 2012). As defined by the Cochrane Collaboration (Higgins Green, 2011[AD2], Pg 6); A systematic review attempts to collate all empirical evidence that fits pre-specified eligibility criteria in order to answer a specific research question. It uses explicit, systematic methods that are selected with a view to minimizing bias, thus providing more reliable findings from which conclusions can be drawn and decisions made. The aim of a systematic review is to incorporate the existing knowledge into a particular subject or regarding a scientific question (British Journal of Nutrition (2012). According to Gough et al (2012) a systematic review is a research method that is undertaken to review several relevant research literatures. Systematic reviews can be considered as the gold standard for reviewing the extensive literature on a specific topic as it synthesises the findings of previous research investigating the same or similar questions (Boland et al 2008). Using systematic and rigorous methods systematic reviews are often referred to as original empirical research because they review primary data, which can be either qualitative or quantitative (Aveyard Sharp 2011). Over the past years, various standards have been evolved for portraying systematic reviews, staring from an early statement called the QUOROM guidelines to an updated widely accepted statement called the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) (Moher et al, 2009). While there are many differences in how each author approach a systematic review and there is no universal approach on one methodology for conducting review. However there are a set of fundamental set regarding the report of systematic reviews that authors are recommended to follow (Tonya 2012). METHODS SEARCH STRATEGIES: The selection of relevant study is based on two concepts: sensitivity and specificity (Wilma 2016).The purpose of the literature search is to identify existing published research in the particular area of interest to assist the researcher to clarify and specify the research question, and to identify whether the research question has been answered. The search of the literature must be strategic and systematic, and informed by a documented strategy. Search strategies have two major considerations: search terms, and databases. Some of the most common and beneficial search strategies used in systematic reviews are using the database of Cochrane Central Register of Controlled Trials (CENTRAL), hand searching, Grey literature which contains unpublished studies, clinical trials and ongoing research on the trials. Contacting an expert and extracting information is another useful method. The internet provides access to a huge selection of published and unpublished database. Studies can also b e found by referring the reference lists of the available published data. The database that have been referenced in this paper have been searched, collected and for extraction from the vast base of Northumbria [AD3]University accessible Journals. Journals from Medline, Ovid, ELSEVIER, PubMED and Cochrane Central Register of Controlled Trials, Journal of the American Medical Association( JAMA), newspaper articles from CHEST, Intensive Care Medicine ,CLOSE and ANZICS Clinical trial group, Resuscitation, Critical care journal, (all of the selected journals from the databases was validated as peer reviewed journals) were reviewed for this paper. INCLUSION AND EXCLUSION CRITERIA The inclusion of unpublished and grey literature is essential for minimizing the potential effect of publication bias (Cochrane Corner 2007). If systematic reviews are limited to published studies, they risk excluding vital evidence and yielding inaccurate results, which are likely to be biased as always positive results (Alderan 2002). The inclusion criteria should consider gender, age of participants, year(s) of publication and study type. For this review purpose, as conventional and conservative oxygen therapy studies are the primary research questions, patients aged 18 years or older and admitted to the Intensive Care Unit (ICU) with an expected length of stay of 72 hours or longer were considered for inclusion. Exclusion criteria also need to be justified and detailed and papers may be excluded according to paper type (such as discussion papers or opinion pieces), language, participant characteristics, or year(s) of publication. For the exclusion criteria, patients under 18 years, pregnant patients, and those who were readmitted in ICU, patients with DNACPR (do not actively resuscitate) and neutropenia or immunosuppression and the patients on who more than one arterial blood gas analysis was performed in 24 hours. STUDY SELECTION For the purpose of this research proposal the literature selected are based on Randomized Clinical Trials of conservative oxygen therapy methods and conventional (traditional) [AD4]oxygen therapy methods used in ICU and some systematic reviews of effective oxygen therapy in ICU, if they met the inclusion criteria. The controlled clinical trials provide the most appropriate method of testing effectiveness of treatments (Barton 2000). Observational studies on effect of hyperopia on post cardiac arrest are also reviewed. These studies can help to determine whether conservative oxygen therapy can help increase mortality among critically ill patients. PREPARATION FOR DATA EXTRACTION Data will be[AD5]extracted from the studies and grouped according to outcome measure. The data extraction tools should be used to ensure relevant datas is collected, minimise the risk of transcription errors, allow accuracy of data to be checked and serve as a record of the data collected. The data collected for extraction should be validated against evidence. It is necessary to extract the necessary studies and data that will help in resolving the research question which involves analysing different studies and a preferred way of methodology that reduces errors and bias. QUALITY ASSESSMENT Cochrane risk of bias tool (Higgins2011) will be[AD6]used for the assessment of risk of bias in estimating the study outcome. For the better outcome of this review involved few randomized clinical trials, some observational studies and pilot RCT studies for comparison among various methods. Quality assessment is given special importance because of the inclusion of RCT and non-RCT methodology (Eggers et al 2001). And only quality studies that satisfies the inclusion, exclusion and data requirements, validity and no bias and studies that are needed to answer the research question are carefully selected. SYNTHESIS STUDIES Synthesis helps to summarize and connect different sources to review the literature on a specific topic, give suggestions, and link the practice to the research (Cosette 2000). It is done by gathering and comparing evidence from a variety of sources when there is conflicting evidence or limited number of patients or large amounts of unclassified data. Systematic reviews of RCTs(Randomized control Trial) encompass the most strong form of clinical evidence (Sheik 2002) and occupies the highest layer in the hierarchy of evidence-based research, at the same time qualitative case studies and expert opinions occupy the lowest layer (Evans 2003 and Frymark et al 2009). RCT helps to understand the differences data among various studies (For Example, the studies considered here, conventional versus Conservative Oxygen therapy methods). RCT is the most applicable study used in assessing the results of an intervention, because it limits the effects of bias when performed correctly. (CRDs Guide 2009). It also easier to understand and any observed effect is easily contained to the treatments being compared. (Stuart 2000). The favourable results of an RCT lies with the methodology domain followed in the trial and it reviews its practicality which helps healthcare professionals, clinicians, researchers, policymakers and guideline developers to apply and review the effectiveness of the trials and tests. For example, if a study overestimates the effects of an intervention, it concludes wrongfully that the intervention works; similarly if the study is underestimating the effects, it wrongfully reflects that there is no effect to that study. This is where RCTs stands out, where minimum bias and evidence is the basis of such a study (According to Cochrane reviews). Hence this is why RCTs form the gold standard of comparison studies while questioning effectiveness of different interventions while limiting bias. As an example, groups that are randomly assigned are different from groups that follow criteria in the sense that the investigator may not be aware of certain attributes that they might have missed. It will also be likely that the two groups will be the similar on significant characteristics using chance. It is possible to control the factors that are known but randomisation helps to control the factors that are not known, which drastically reduces bias. Therefore assigning participants in other study designs may not be as fair and each participant may vary in characteristics on main standards. (Cochrane Handbook for Systematic Reviews of Interventions 2017) The observational studies or non-randomised studies can be argumentative as the choice of treatment for each person and the observed results may cause differences among patients being given the different types of treatments. (Stuart 2000). ETHICAL CONSIDERATION A systematic review is the scientific way of classifying the overabundant amount of information existing in research by systematically reviewing and accurately examining the studies concerning a particular topic. But in doing so, topic of ethics is hardly questioned. This will have some major downsides as some systematic reviews may have studies with ethical deficiencies, which in turn lead to the publication of an unethical research and such research is susceptible to bias. Systematic review does not automatically give the updated approval for an original study. Hence systematic reviews that are methodically and ethically assessed will have better ethical and methodological studies overall (Jean et al 2010). If an original study does not mention the ethical issues, it does not automatically mean that the studies in original papers avoided those ethical concerns and may indicate a lower risk (Tuech 2005).A primary rule for publishing articles is that redundant and overlapping data sh ould be avoided or needs to be cross-referenced while making the purpose clear to the readers in an unavoidable case. (Elizabeth et al 2011). Plagiarism is clearly unacceptable and care should be taken care to not replicate other peoples research work and the original words and data needs to be acknowledged as a citation or quote. A responsible publisher should follow the COPE (Committee on Publication Ethics) flowchart that explains suspected plagiarism (Liz 2008). It is also important to give information on funding and competing interests. The Cochrane Collaboration (2011) has very strict rules about funding and it is important to give reasons why the author may or may not be neutral or impartial on the review prepared and it relates to financial support, while competing interests can be personal, academic or political (WAME Editorial Policy and Publication Ethics Committees 2009). REFLECTION The objective of systematic reviews is to translate the results to clinically useful and applicable information while meeting the highest methodological standards. They offer a very useful summary of the present scientific evidence on a particular domain which can be developed into guidelines on the basis of such evidence. However, it is imperative that practitioners understand the reviews and the quality of the methodology and evidence used (Franco 2012). This study proposes to find the systematic review approach of conservative and conventional oxygen therapy methods used among critically ill adult patients in ICU. Incidentally, a RCT study by Susan (2016) found that the strategy of conservatively controlling oxygen delivery to patients in ICU results in lower mortality than the conventional and more liberal approach whereby patients are often kept in a hyperoxemic state.

Overpopulation :: essays research papers

Overpopulation The twentieth century has drawn to a close and humanity faces the problem of being able to support its population without inducing catastrophic and irreversible destruction on Earth’s life-support systems. Throughout time, humankind has been living as though there are no consequences to its actions. But now, as people of the future, we see what is happening to the world that we live in. Despite all we know, these easily seen problems are still being ignored. Our actions in the past determine the present, and our actions now determine the future. In other words, we caused the overpopulation problems we are facing today, so we must also be the ones to solve them. Every day we share the Earth with 250,000 more people than the day before according to Zero Population Growth, a national non-profit organization working to slow population growth and achieve a sustainable balance of people, resources, and the environment. ZPG is the reason I have become an advocate and t hey have supplied most of my statistical information. Today’s children are likely to see a tripling of the global population within their lifetimes. These children our are next generation of parents, voters, consumers, and leaders. The choices they make are critical to stabilizing the population and protecting the environment. Educating the youth of the future will help them to understand the problems the earth faces and how they can help by influencing and being the political leaders who can adopt responsible population policies. One problem the earth and its inhabitants face today is our lack of resources due to of the increasing number of people. Tropical forests cover only 7 percent of the earth’s surface, but it holds over half of all plant and animal species in the world. The rate of destruction of these resources is now so far in excess of their renewable rates that they have effectively been turned into useless land. Although 3/4 of the earth is covered by wate r, less than one percent is readily available for human use. As the world population increases, this incredibly small amount of water will be the only supply for all humans, plants, and other animals on earth. Once this percent of water lessens even more, the agriculture will suffer, and people will have less food and so on. This cycle will continue until we consume all our natural resources. Humanity today is on a collision course due to our value system.

Acid Rain and Its Effects on the Biosphere :: Geology

Acid Rain and Its Effects on the Biosphere Introduction: Acid Rain: whenever I conjure up images of acid rain I always allude to huge, boiling-red raindrops falling from mean purple clouds on a path destined for destruction. I can see them spiraling down uncontrollably in fireballs of rage to the earth; it becomes very apparent. Perhaps my imagination has gotten the better of me here, but acid rain is definitely no sweetheart. Actually, acid rain looks like any other rain. Believe it or not, it does not have flaming tales on the end of it, but it can produce some serious risks to the world as we know it. These are pH testers. Formed high in the clouds where sulfur dioxide and nitrogen oxides combine with oxygen and water, acid rain has a devastating ability to kill off aquatic systems, vegetation, animals, etc. The definition of acid rain is the deposition of acidic components in rain, fog, snow, and sleet. Regular rain has a pH that is slightly acidic at 5.6, but what makes one worry are the places like Washington, D.C., which possesses rain readings of 4.2 to 4.4 on the pH scale. Acid rain is mainly composed of Sulfuric Oxide (SO2) and Nitrous Oxide, which are common air pollutants from big industries, 70% of which are electric utility plants. If one views the amount pH levels of various areas around the nation it is easy to see that there is a problem, especially when a 4.0 pH level can drive many fish to die. Certainly acid rain has a great deal of negative effects on the geosphere, atmosphere, and hydrosphere. But maybe the most important system for us to observe as scientist is the biosphere. The biosphere with out a doubt is the most visible of the systems on our planet. The reason it is so easy to monitor is because it is all around us. We see trees and their growth, animals running around, and fields of grass with cows grazing. We are the biosphere and therefore we can and will see the changes. If there is something wrong and we don’t have a pH scale to measure, we will sense it through the living environment around us. Trees and Vegetation: One of the most serious effects of acid rain can be traced to trees and the soil they grow from.