Urban economy Assignment Example | Topics and Well Written Essays - 250 words

Urban economy - Assignment Example The buildings are taller to make use of space and accommodate the main businesses that give the city its developmental characteristic. Gas price determines the construction rate of city structures, a high price less development and vice versa (Florida & Mellander, 2014). Rising incomes have a direct proportionality effect on cities because the development will be focused to assist the well-being of the income earners. Land prices take long because of the economic speculation that is linked to profitability of the land. Sprawl is considered a market where decision makers have direct impact to the spatial growth of the city. Consumer locational equilibrium is the ability for the consumer to embed owns preference over distance distribution cost when choosing to consume a product. Compensation differential is a state offered wage to offset the balance between a preferred and un-preferred job. Terminal cost is the cost incurred when disposing the asset (Florida & Mellander, 2014). Externality damage is unwanted cost to the least expected party. Scale economy is the advantages that in terms of cost cutting that establishment stand to gain due to magnitude of

Humanistic Theories of Organizations Essay Example for Free

Humanistic Theories of Organizations Essay The relationship between the â€Å"boss† and the employee is an important one indeed. It is a relationship that can make or brake an organization. While classical theorist such as Fredrick Taylor (Scientific Management Theory), Henri Fayol (Administrative Theory) and Max Weber (Theory of Bureaucracy) (Modaff, Butler, Dewine 2012 p26.) emphasized the literal structure of an organization; i.e. worker productivity, chain of command and preserving organizational authority, they were not too concerned with an organizations social structure. However, â€Å"Human Relations Theory† (Modaff, Butler, Dewine 2012 p43. ) builds more on an organizations social structure suggesting that an organization can benefit greatly from a positive social relationship between its supervisors and its employees. It is clear that there is a positive connection between â€Å"authentic leadership and employee voice behavior† (Hsin-Hua Hsiung 2012). Authentic Leadership, Employee Voice Behavior the Hawthorne Studies Hsin-Hua Hsiung (2012) quoting Walumbwa et al. 2008, p. 94 writes that â€Å"Authentic Leadership† refers to ‘‘a pattern of leader behavior that draws upon and promotes both positive psychological capacities and a positive ethical climate, to foster greater self-awareness, an internalized moral perspective, balanced processing of information, and relational transparency on the part of leaders working with followers, fostering positive self-development’’. In the referred to article Authentic Leadership and Employee Voice Behavior: A Multi-Level Psychological Process (Hsin-Hua Hsiung 2012) the author discusses an investigative study of the â€Å"psychological process of how authentic leadership affects employee voice†. He suggests that the â€Å"theoretical model† of the study proposes that positive mood of the employees and, what he terms, the â€Å"leader–member exchange† or LMX quality mediate the relationship between authentic leadership and voice behavior, while the procedural justice climate moderates the mediation effects of positive mood and LMX quality (Hsin-Hua Hsiung 2012). This study ultimately revealed â€Å"the cross-level effects of authentic leadership†, and provided practical suggestions to assist employees expressing themselves and their opinions in the organization (Hsin-Hua Hsiung 2012). Ironically, the Hawthorne Studies (Mayo, Roethlisberger Dickson 1939) in human relations had a similar conclusion. Among other implications these studies (Illumination, Relay Assembly Test Room, the Interviewing Program and Wiring Room Studies) collectively proposed that supervisors â€Å"pay attention to your workers to increase their satisfaction and productivityà ¢â‚¬  (Modaff, Butler, Dewine 2012 p). Conclusion, Strengths and Weaknesses In conclusion, the article in my opinion was a fair explanation of a study that concluded that there are positive implications for social interaction between supervisors and employees. The strength and weakness of the article is the authors supporting research material. While he quotes several researchers and documents to validate his findings and his theory is supported by what the author terms â€Å"multi-level data from 70 workgroups of a real estate agent company in Taiwan†, he failed to research or mention the Human Relation Theory or the Hawthorne Studies (Mayo, Roethlisberger Dickson 1939) which in my opinion would have further strengthened theory. References: Hsiung, H. H. (2012). Authentic leadership and employee voice behavior: A multi-level psychological process. . Journal of business ethics, 107 (3), 349-361. doi: 10.1007/s10551-011-1043-2 Modaff, D. P., Butler, J. A., Dewine, S. (2012). Organizational communication: foundations, challenges, and misunderstandings. (3rd ed.). Glenview Illinois: Pearson

Sterile versus non-sterile gloves

Sterile versus non-sterile gloves Sterile technique is generally used for laceration repair despite a lack of scientific evidence that this is necessary (Wilson, 2003). This study addresses whether there is a difference in the infection rate of lacerations randomised to receive repair using sterile versus nonsterile gloves. This will help to increase knowledge on the evidence of infection rates when nonsterile gloves are used. If it can be proven that the use of nonsterile gloves for laceration repair poses no risk, this could save time and have considerable financial savings. This may change clinical practise in the future. Research Question: Sterile versus non-sterile gloves: A safe alternative in the management of acute simple wounds in the pre-hospital environment? Sterile technique (including the use of sterile gloves) for acute simple wound or laceration management is traditional and the practise continues to be recommended (Wilson, 2003). However, there are few studies and little evidence to support this practise. Using clean nonsterile gloves rather than individually packaged sterile gloves for uncomplicated wound repair in the community may result in cost and time savings. Study objective: This proposal is for a prospective randomised controlled trial designed to determine whether there is a difference in the rate of infection, after suture repair of uncomplicated wounds and lacerations, using clean nonsterile gloves versus sterile gloves in a community setting. Justification: The research question separates this proposed study from in-hospital studies, and addresses the small data set available specific to community and pre-hospital environments (Perelman et al, 2004; Worral, 1987; Bodiwala George). Results will add to the body of evidence, broaden the knowledge base for the healthcare community and further the cause of science (Medical Research Council, 2010). This trial aims to provide quality data for publication, enabling informed re-use by others and thereby reducing the risk of data creation duplicity. Background: The Department of Health (DoH) (2005) paper Taking healthcare to the patient states that at least one million of the people taken to AE every year could be treated at the scene, in their homes or in the community. With the advent of the Emergency Care Practitioner (ECP) role, many simple wounds / lacerations are suitable for treatment and closure in the pre-hospital setting. During the year 2008 09, the National Health Service (NHS) reports that there were 663,475 Accident and Emergency attendances in England for lacerations, accounting for 8.5% of total attendances (NHS, 2010). Figures for the Ambulance service this trial will be run at show that over a six month period from April to September 2010, their ECPs attended 1555 calls for laceration / haemorrhage, 72.5% (n= 1127) of which were dealt with at the scene, negating a visit to an Accident and Emergency department. These wounds were cleansed, treated and closed where necessary using a variety of techniques from tissue adhesiv e to paper stitches or sutures. As sterile gloves are not available, the practitioner carrying out treatment of these wounds would have been using clean, non sterile gloves. This is in stark contrast to wound closure in the Accident and Emergency department where the use of sterile gloves is universal (NHS Clinical Knowledge Summaries, 2010). The question asked by this study is whether there is a difference in the rates of infection between wounds treated by practitioners wearing sterile versus non sterile gloves in the community. To answer this it is necessary to investigate what contributing factors to wound infection there are, how they are best managed and what, if any, difference gloves make to the control of infection. Pratt et al (2007) advise that best practice (in the absence of strong evidence) must be guided by expert opinion and national and international guidance; all of which should be integrated into local practice guidelines. In the case for use of sterile versus nonsterile gloves, there has been insufficient research to provide reliable evidence, therefore clinical tradition is followed and sterile gloves are the preferred choice. This dogmatic adherence to tradition is underlined by Flores (2008) who states Although ritualistic practice needs to be questioned, with the rising incidence of multi-resistant infections, it seems prudent to err on the side of caution when in doubt. Obviously then, it is important to remove the doubt by rigorous research into the area for concern, thereby adding quality data to the body of evidence and knowledge, and allowing this to steer best practise, however this is out of the scope of this study. Literature Review. A search of Cochrane Library gave 135 results, 1 of which directly answered the question (Perelman et al, 2004 see appendix one). A search of three other databases British Nursing Index (BNI), The U.S. National Library of Medicine premier life sciences database (PubMed) and Cumulative index to nursing and health literature Nursing allied health (CINAHL) revealed the same plus 2 others: Bodiwala George (1982) and Worral (1987) using the search term Infection OR Cross Infection OR Disease Transmission OR Infection Control AND Glove* OR Protective Device* OR Surgical Glove* OR Sterile Glove* OR Non Sterile Glove* AND Acute Traumatic Wound* OR Wound*.  LIMIT set to Human AND English. This shows there is little tangible research into the hypothesis suggested in this proposal. The prospective Randomized Control Trial (RCT) by Perelman et al (2004) in Canadian Emergency Departments compared sterile versus nonà ¢Ã¢â€š ¬Ã‚ sterile gloves (both latexà ¢Ã¢â€š ¬Ã‚ free) in sutured repair of lacerations. The study enrolled 816 patients (age à ¢Ã¢â‚¬ °Ã‚ ¥ 1) with blinding of patients and outcome assessors. Infection rates by 23 days were 4.3% in the nonà ¢Ã¢â€š ¬Ã‚ sterile group and 6% in the sterile group (no statistical difference), however credence was given to the possibility of skewing results due to the Hawthorne effect (Bowling, 2009) (As blinding the clinician in this type of study is impossible, it is possible that physicians using nonsterile gloves are simply more careful). This is the only RCT study of sterile versus nonsterile gloves. It is of high quality with a reasonable sample size, let down only by the non-standardised partially blind follow up. There are two older studies with significant limitations (comparing no gloves to sterile gloves) and questionable randomisation. Bodiwala George (1982) showed through their study of 408 patients that the difference in infection rates between gloved and ungloved suturing was not statistically significant. Worral (1987) found that infection rates were higher in the sterile gloved group, although the study group was small (n=50). Both these studies lend support to the idea that sterile gloves offer little in the way of reducing infection rates in the repair of simple lacerations, however suturing without any gloves is inappropriate and unsafe for practitioner and patient. Allan (2009) supports the findings of these earlier studies and concludes that present evidence indicates simple lacerations can be repaired with clean nonsterile gloves without an increased risk of infection. Acute traumatic wounds, in comparison to surgical incisions, are by their very nature already exposed to infective agents and the time delay between injury and treatment is longer (Forsch, 2008). Meticulous cleansing and where necessary, debridement is essential in reducing infection rates (Durham Hines, 2001). Moscati et al (1998) found that irrigation of acute traumatic wounds to remove grit, foreign bodies, dressing residue, excess exudates and other potential contaminants to be vitally important in preventing later complications of infection and tattooing. Generally it is agreed that wound cleansing by irrigation is preferable to swabbing or wiping (Dealey, 2005). Trott (2005) supports the old maxim The solution to pollution is dilution, stating that the most effective method for reducing bacterial load on wound surfaces and for removing debris and contaminants from within a laceration is through irrigation. This begs the question: if in the acute traumatic laceration a high bac terial load is already present, of what benefit are sterile gloves in their treatment and closure? Theoretical framework: This is a positivist paradigm (Parahoo, 2006), collecting scientific quantitative data. The research question is based on the empirical data from previous similar trials. It is acknowledged that empirical data is vulnerable to interpretation (Rubin Rubin, 2005) and this trial seeks to limit this by means of closed questions in the data gathering tool. The proposed study hypothesises that the use of clean nonsterile gloves when suturing acute simple lacerations in a community setting has little or no effect on post procedure wound infections. To refine the research question, guidance was taken from Lewith Little (2009) to ensure it is focused, is feasible and explicit. It is also a Statement of expectation relative to the variables investigated (Polit Beck, 2004). Research Methodology: This research will be a randomised controlled trial (RCT). This is chosen as there is a direct comparison between two variables; an RCT providing robust data. The RCT is the most appropriate method of study design, especially in the setting of wound repair, as suggestibility and patient expectations are potentially significant sources of bias (Jadad Cepeda, 2000). Although double blinding is impossible in this trial, the assessing clinician (data gatherer) will be blinded as to what gloves were used. However a weakness is acknowledged in that the patient may inform the assessing clinician and by so doing inject a risk of bias. To reduce the effect of other variables, ECP practise and equipment is standardised (Health Professions Council, 2010). All wound closure by the ECPs will comply with the most recent evidence based practise (NHS Clinical Knowledge Summaries, 2010). All cleaning materials, local anaesthetics and equipment are identical county wide, ensuring equality. Only mono-filament suture material will be used (no silks). Acknowledgement is given to the following variables over which this trial has no control: Individual client hygiene, poor compliance with wound care advice, further trauma to wound site post repair. The trial will be run over a six month period and utilise cluster randomisation by geographical area. For three months, sterile gloves will be used by ECPs in the west of the county whilst the east ECPs will use clean nonsterile gloves. At the three month point this will be reversed with west ECPs using clean nonsterile gloves and east ECPs using sterile gloves. Data will be collected by RW at the end of each week. Sampling: Randomised from the population area (east / west). Randomisation is automatic due to the nature of calls; assistance only being sought when needed by the public, therefore the study has no control over and cannot affect bias of patient, place, time etc. Only those calls attended by ECPs and deemed suitable for suture closure will be included. Limits: Inclusion: Patients over 18 years of age, who have sustained an acute, simple traumatic laceration which is less than six hours old requiring primary closure with simple, interrupted sutures. Exclusion: Patients with the following Very dirty / Tetanus prone wounds, immunocompromised, immunosuppressed, concomitant antibiotic use, deep wounds requiring layered suturing to eliminate dead space, puncture wounds, bite wounds (animal or human), any wound where there is suspicion of retained foreign body or damage to underlying structures, diabetes, wounds over 6 hours old. Data Collection: Data will be collected via post in the form of two clinician completed multi choice questionnaires at 3 days and at removal of sutures (ROS). The first interval gives a reasonable healing time for wound review and early identification of infection if present (patient safety). The second time interval was chosen as patients will need to re-present for this procedure and it gives reasonable opportunity for infection, dehiscence or other problems if present, to be apparent and acted upon as necessary. RW will be the dedicated researcher for collection of questionnaires, data analysis and telephone follow-up, (thus reducing response loss and attrition of data) at no cost to the trial. Patients will be supplied with 2 copies of the questionnaire as part of their discharge advice pack to facilitate continuity should they re-present at an earlier time for any reason, or at another facility. If the forms are not returned, telephone follow up will be done. As the patient should attend for wound review regardless of this research, completion of the questionnaire will cause minimal impact on clinician time, with little interference to departmental workloads. Questionnaires are designed to be simple and rapid to complete. All questionnaires will be supplied with a self-adhesive stamped self addressed envelope for ease of return. It is recognised that a limitation of this study is non return of questionnaires for whatever reason; this will be factored into the final statistical analysis. As it is impossible to blind the clinician as to whether the gloves are sterile or nonsterile in this trial, their input into it will be limited to indicating on the ECP form (See appendix 2) which group the patient fits into; A for sterile glove use, B for clean nonsterile. Randomisation and selection bias through allocation is avoided by the unpredictable nature of the emergency and unplanned workload covered by the clinicians (ECPs). This should help increase validity of findings (Bowling, 2009). As the division of the Ambulance service utilised for this trial is already divided into east and west areas, this will be used to control the intervention by allocation of sterile or nonsterile gloves. Initially, the west ECPs will use only sterile gloves for suturing wounds, with the east ECPs using clean nonsterile gloves. At the half way point in the trial, the researcher will reverse this. This allocation of gloves gives a reasonable control group from both sides of the county and acknowledges differences in individual ECP procedure, geography, demographics etc. Ethics: The four point biomedical ethics framework suggested by Beauchamp Childress (2001) has been considered in the design of this trial. This trial recognises autonomy for both patient and practitioner by seeking informed consent from participants. It promotes beneficence through its attempt to treat patients expeditiously, to high standards, without prejudice; and non-maleficence by reassuring participants that their data with be kept confidential. Justice is assured by equality of treatment for each participant. Ethical approval for the research will need to be sought from both the Ambulance service Clinical Review Group and University Ethics Committees prior to starting the research process. The researcher will be responsible for ensuring that the participants welfare is maintained. Consent will be sought by the attending ECP. Kimmel (2007) acknowledges that participants should come to no harm psychologically, physically or socially. By strict adherence to wound care guidelines (cleansing, dressing etc) in the acute assessment and treatment phase, and due regard for the patient during follow-up, this should be addressed. Consent: Prior to the study, education of ECPs through a micro-teach session (a 5 minute presentation) and poster campaign for those who cannot attend will be carried out. The ECPs will be asked if they will partake in the trial; there will be no expectation on them to do so and their inclusion will be purely voluntary. Informed consent will be sought from all patients although acknowledgement is given to the fact that the patient will be presenting in a post injury phase; they may be distressed, in pain and anxious. All patients participating in the trial will have a clear explanation given to them prior to discharge to ensure they fully understand their role and right to leave the trial at any point. Confidentiality: All data for publication, dissemination or public review will be purely statistical and numerical, having no personal details of the participants; there will be no breach of confidentiality. Participant safety: All prior research has concluded that there is statistically no difference in rate of infection when comparing glove use, adding support to the argument that there is little risk to the patient (Bodiwala, Worral, and Perelman). All gloves used will be latex free, reducing any risks of latex allergy / sensitivity to patient and clinician alike. All participants will have the opportunity to withdraw at any phase of the trial. Data Analysis and discussion: Data will be presented in a 22 contingency table (See appendix 4). As the research question is looking for a possible relationship between two variables, a bivariate statistical analysis will be used (See appendix 4). Specialist advice will be sought for the analysis of the statistical data. It is hoped that response rates will be very high as the respondent will be a medical professional (not the patient), the questionnaire is very short and straightforward, and is supplied with a self adhesive, stamped self addressed envelope. This scenario is similar to Perelamans experiment which achieved a 98% response. The patient, by the very nature of their injury, will need to attend for follow up / ROS. Calnan et al (2005) suggest a response rate of approximately 56% when reliant on the patient. Timeline: Year 2011 Initiate experiment 1st April Data collection Continuous and ongoing (RW) Complete fieldwork by 1st September Complete analysis by 1st October Give presentation on 8th October Complete final report by 1st November Conclusion: Sterile technique is generally used for laceration repair despite a lack of scientific evidence that this is necessary (Wilson, 2003). This study addresses whether there is a difference in the infection rate of lacerations randomised to receive repair using sterile versus nonsterile gloves. This will help to increase knowledge on the evidence of infection rates when nonsterile gloves are used. It is apparent that could it be proven that there is little evidence to support the continued use of sterile gloves; this could reflect a significant cost saving for the NHS (see appendix 5). This may change clinical practise in the future. References / Bibliography: Allan, M.G. (2009) Lacerations: Sterile Gloves Water? Tools for Practice. June 1, 2009. Beauchamp, T.L. Childress, J.F. ( 2001) Principles of Biomedical Ethics. New York: Oxford University Press. Bodiwala, G.G., George, T.K. (1982) Surgical Gloves During Wound Repair In The Accident And Emergency Department. The Lancet: July 10, 1982. pp 91-92. Bowling, A. (2009) Research Methods in Health (3rd ed), Maidenhead: Open University Press. Calnan, M., Wainwright, D., ONeill, C., Winterbottom, A. Watkins, A. (2005) Lay evaluation of health care: the case of upper limb pain. Health Expectations. 8(2):149-160. Dealey, C. (2005) The Care of Wounds (3rd ed). Oxford: Blackwell. Department of Health (2005) Taking Healthcare to the Patient: Transforming NHS Ambulance Services [online] Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4114269 Accessed 24/10/10. Durham C. Hines, S.E. (2001) Laceration assessment and management. Patient Care for the Nurse Practitioner. Jun; 4 (6): 17-20, 23. Flores, A. (2008) Sterile versus non-sterile glove use and aseptic technique. Nursing Standard. 23 (6) 35-39. Forsch,  R..  (2008). Essentials of Skin Laceration Repair.  American Family Physician.  78(8),  945-51.   Grava-Gubins, I., Scott, S. (2008) Effects of various methodologic strategies: survey response rates among Canadian physicians and physicians-in-training. Canadian Family Physician. Oct;54(10):1424-30. Hampton, S. (2003) Nurses inappropriate use of gloves in caring for patients. British Journal of Nursing 12(17):1024-7. Health Professions Council (2010) Standards of Proficiency. [Online] Available at http://www.hpc-uk.org/assets/documents/1000051CStandards_of_Proficiency_Paramedics.pdf Accessed 13/11/10 Jadad, A.R., Cepeda, M. (2000) Ten challenges at the intersection of clinical research, evidence-based medicine and pain relief. Annals of Emergency Medicine 2000;36:247-52. Kimmel A.J. (2007) Ethical Issues in Behavioural Research: Basic and applied Perspectives (2nd ed). Oxford: Blackwell. Lewith, G. Little, P. (2009) Randomised Controlled Trials in Saks, M. Allsop, J. (2009) Researching Health: Qualitative, Quanatitative and Mixed Methods. London: Sage. p 225. Medical Research Council (2010) Data Sharing Initiative: Aims. [Online] Available at www.mrc.ac.uk Accessed 09/11/10. Moscati, R.M., Reardon, R.F., Lerner, E.B., Mayrose, J. (1998) Wound irrigation with tap water. American Academy of Emergency Medicine. 1998; 5(11): 1076-80. National Health Service: Accident and Emergency Attendances in England (Experimental Statistics) 2008-09. Hospital Episode Statistics [online] Available at http://www.ic.nhs.uk/webfiles/publications/AandE/AandE0809/AE_Attendances_in_England%20_experimental_statistics_%202008_09_v2.pdf Accessed 24/10/10. National Health Service (2010) Clinical Knowledge Summaries: Lacerations Management. [Online] Available at http://www.cks.nhs.uk/lacerations/management Accessed 11/11/10. Parahoo, K. (2006) Nursing Research: Principles, Process and Issues. (2nd ed.) London: Palgrave-Macmillan. Perelman, V., Francis, G.J., Rutledge, T., Foote, J., Martino, F., Dranitsaris, G. (2004) Sterile versus Nonsterile Gloves for Repair of Uncomplicated Lacerations on the Emergency Department: A Randomized Controlled Trial. Annals of Emergency Medicine. 2004; 43(3): 362-370. Polit, D.F. Beck, C.T. (2004) Nursing research: Principles and methods. (7th ed.). Philadelphia: Lippincott, Williams Wilkins. Pratt, R.J., Pellowe, C.M., Wilson, J.A., Loveday, H.P., Harper, P.J., Jones, S.R.L.J., McDougall, C., Wilcox, M.H. (2007) epic2: National evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England. Journal of Hospital Infections 65(Supplement): S1S64. Royal Mail [Online] available at http://www.royalmail.com Accessed 11/11/10. Rubin, H. Rubin, I. (2005) Qualitative Interviewing: The Art of Hearing Data (2nd ed.) London: Sage. Trott, A.T.(2005) Wounds and Lacerations: Emergency Care and Closure (3rd ed.) USA: Mosby. Wilson, J. (2003) Infection Control in Clinical Practice. (2nd edn.) London: Balliere-Tindall. Worral, G.J. (1987) Repairing Skin Lacerations: Does Sterile Technique Matter? Canadian Family Physician 1987; 33:1185-1187. Appendix 1 Relevant Paper Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses Perelman et al 2004 Canada 816 patients over the age of 1yr old with simple lacerations prospective randomised controlled trial Infection post repair Infection rate for sterile vs non-sterile gloves was 6.1% and 4.4% respectively with no significant statistical difference partially blind follow up looking for signs of infection was not standardised Appendix 2 ECP information form Questionnaire 1 ECP No: Group A / B Incident No. Name: Age M / F Contact Tel. No: Site of laceration: Number and size of sutures: Appendix 3 Follow up Questionnaire Name: Age M / F Contact Tel. No: Is there any erythema extending à ¢Ã¢â‚¬ °Ã‚ ¥ 1cm from the wound? Y / N Is the wound hot to touch? Y / N Is the wound inflamed or swollen? Y / N Is there any purulent discharge? Y / N Does the patient report any increase in pain? Y / N If yes to any/all of above, is the patient systemically well? If no, refer immediately.

Negative Effects of High Fructose Corn Syrup on the Human Body Essay

The Negative Effects of High Fructose Corn Syrup on the Human Body Excluding Obesity, Diabetes and Kidney Failure Abstract: This research paper investigates the effects of high fructose corn syrup on the body without discussing obesity and diabetes. While obesity and diabetes are two major consequences of an unhealthy consumption of high fructose corn syrup, they tell only a fraction of the story. Many of the lesser-known effects of high fructose corn syrup are the result of a trickle down effect. When high fructose corn syrup changes the balance of nutrients, it also can lead problems with vitamin and mineral deficiency. The most noticeable effects of high fructose corn syrup include problems with the liver disease, heart failure, minerals, osteoporosis, micronutrients, accelerated aging, and copper deficiency. One of the organs that is most affected by high fructose corn syrup is the liver. High fructose corn syrup is composed of 55 percent fructose and 45 percent glucose. This differs from table sugar which is 50 percent fructose and 50 percent glucose. Researchers have found that high fructose has the same effect on the liver as non-alcoholic fatty liver disease. As fructose is absorbed by the second part of the small intestine, the jejunum, the liver has the task of converting the fructose to triglycerides which is easier than converting glucose into triglycerides. Elevated levels of triglycerides lead to an increased risk of heart disease. A study conducted by the University of Minnesota published by the American Journal of Clinical Nutrition in 2000 concluded that "men, but not in women, fructose â€Å"yielded significantly higher blood levels" than did glucose. The researchers found that "diets high in added fructose may b... ...06, from Osteoporosis: A debilitating disease that can be prevented and treated. Web site: http://www.nof.org/osteoporosis/index.htm (2006, July 30). American Heart Association. Retrieved July 30, 2006, from Understanding Heart Failure Web site: http://www.americanheart.org/presenter.jhtml?identifier=1593 Beyer , PL, Caviar, EM, & McCallum, RW Fructose intake at current levels in the United States may cause gastrointestinal distress in normal adults. PubMed, Retrieved July 23, Retrieve&dopt=AbstractPlus&list_uids=16183355&query_hl=2&itool=pubmed_docsum. Sanda, Bill (2004, February 19). The Double Danger of High fructose Corn Syrup. Retrieved July 24, 2006, from The Double Danger of High Fructose Corn Syrup Web site: http://www.westonaprice.org/modernfood/highfructose.html Squires, Sally Sweet but Not So Innocent. (2003, March 11). The Washington Post, p. HE01.

Helping Children with Learning Disabilities Essay

Children with learning disabilities are smart or smarter than their peers, but may have difficulty with things like reading, writing, reasoning, and organizing information by themselves. A learning disability is a lifelong issue that cannot be cured or fixed with a snap of the fingers. Children who have the right support and intervention can succeed in school. Then later they will be able to go and be successful later in life. Children with learning disabilities need the support of parents, school and their community to be successful. Parents need to be able to encourage children with their strengths, know what their weaknesses are, and be able to understand the educational system to be able to work with professionals. Learning Disabilities cannot be categorized into one diagnosis. Learning disabilities are caused by biological factors that are caused by differences in the structure and functioning of the nervous system. Many people, both in the local and professional community, use the terms handicap and disability interchangeably, but they are not. A learning disability means that preschoolers are unable to complete tasks in a certain way. Children with learning disabilities have a hard time functioning in areas such as sensory, physical, cognitive, and other areas. Handicap means that preschoolers are unable to function and cope in their environment. These children have impairments such as cerebral palsy or down syndrome. In 1991, the federal government amended the disabilities label to â€Å"Individuals with Disabilities Act† (PL 102-119). This act allowed states to be able to not identify with one of the thirteen federal disability labels, but to classify preschoolers with special needs. (Kilgo, pg 27) With the new changes professionals were able to use new terms like developmentally delayed and at risk when identifying children. Developmentally delayed is determined on the basis of various developmental assessments and/or an informed clinical opinion. Children starting at the age of three years old can now be identified for services. Delays can be expressed in a difference between a child’s chronological age and his/her performance levels. Delays occur when a child does not reach his/her developmental milestones at the expected age level or time. If a child is slightly behind it is not considered a delay until he/she are lagging in two or more areas of motor, language, social or thinking skills. Developmental delays are usually diagnosed by a doctor or medical professional based on strict guidelines and take more than one visit to diagnose. Parents or childcare providers are usually the first to notice children not progressing at the same rate as other children. Testing will help to gauge a child’s developmental level. At risk describes children with exposure to certain adverse conditions and circumstances known to have a high probability of resulting in learning and development difficulties? (Kilgo, pg 28) These children have not been identified as having a disability, but as children who may be developing conditions that will limit their success in school or lead to disabilities. There are three factors that can result in a child’s environment. The first is established risk/genetic. This could be where a child is born with cerebral palsy, Down syndrome, or spinal bifida. Biological risk means that a child has a history of pre- or post- natal conditions that heighten the chance of development. These could be conditions such as premature births, infants with low birth weights, maternal diabetes, and bacterial infections like meningitis or HIV. Environmental risks are considered biologically typical, meaning they are environmental conditions that are limiting or threating to the child’s development. All three at risk factors can result in cognitive, social, affective, and physical problems. (Kim, pg. 4) Some signs of learning disabilities in young children are: †¢ A toddler may reach developmental milestones quite slowly. †¢ The child may have trouble understanding the concept of time. Is the child confused by the use of words like â€Å"tomorrow†, â€Å"today†, and â€Å"yesterday†? †¢ Young children have a lot of energy, but some have an excessive amount of kinetic energy, known as hyperactivity. †¢ A child that has difficulty distinguishing right from left may have difficulty identifying words. †¢ A child with a learning disability often masters several areas, while failing in two or more areas. A child that is perceived as disobedient may actually have difficulty understanding and following instructions. Once a child has been identified as having a possible learning disability, assessments need to be completed. An assessment is the process of gathering information for the purpose of making a decision about children with known or suspected disabilities in the area of screening, diagnosis, eligibility, program planning, and/or process monitoring and evaluation. (Kilo, pg. 90) During the assessment, evaluations should be accomplished with the e goal of identifying developmentally ppropriate goals, identifying unique styles and strengths, looking at parent goals and outcomes for their children, reinforcing family’s competence and worth, and creating a sense of shared commitment between families, schools, and professionals. Families possess a wealth of information and should play a very active role in the decision making, planning, and evaluations of their children. Schools are required to foster a child’s education, offering and supporting the needs of each child through a series of individualized instructions and interventions. School districts must provide documentation stating that the student has received the required instruction by qualified personnel. These interventions help teachers and staff to educate and foster the needs of children with learning disabilities. Assessments are an ongoing process. The initial assessment should be used to screen, diagnose, and check for eligibility for services. Ongoing assessments are to focus on a child’s skill level, needs, background, experiences, and interests, as well as the family’s preferences and priorities. Over the years practice has shown that there is a link between assessments and curriculum to provide for the needs of the child. It is important to keep records of a child’s progress. A very useful way is through portfolio assessments. These portfolios can be considered a looking glass into a child’s growth. Portfolios also help teachers and team members to keep observations and comments about a child’s activities and behaviors. The information collected can help meet many of the required criteria for planning and monitoring. An important responsibility of an educator is to have an environment that will both nurture and foster learning. When designing an environment childcare providers should use best practice guidelines from places like National Association of Education of Young Child (NAEYC) and National Association of Family Childcare (NAFCC). Environments should look at available space, age of children, visual appeal, safety and health, and organization. (Perri Klass, pg. 46) Always remember that environments exert powerful influences on children and help to play a vital role in children’s lives. Activity areas should include gross- motor, quiet/calm, discover, dramatic, therapeutic, and arts and crafts areas. Rooms should not have furniture that is used to separate centers or activities but should use things like lower lightening, parachutes hanging from the ceiling and area rugs to help children understand the use of different centers. The main goal of childcare providers and educators is to provide the best possible services for children with learning disabilities by providing services â€Å"as early and comprehensively as possible in the least restrictive setting†. Services and interventions should be supported in the most natural environments that will include the child’s primary care giver. Individual Education Plans (IEP) plays a large role in the education process of children with learning disabilities. These IEP’s require professionals, parents, and caregivers to work together as a team. They hold teams to accountability standards for the care of children with disabilities. A child’s IEP helps to furnish an instructional direction, sort of like a blueprint of care, to measure the effectiveness and progress of children. If an IEP is carefully written and appropriate goals are set, it will provide special education services to a child that will be reflected throughout his/her life. In the field of early childhood education, the definition of special needs has drastically changed for children with learning disabilities over the years. We live in a very diverse society of languages, foods, music, values and religious beliefs that brings us the strengths of our nation. Every day the makeup of our society changes and so does the needs of our children, especially those of children with learning disabilities. Our community is seeing a growing need for services for children with learning disabilities. Young children with learning disabilities need to receive services at the earliest age possible. Parents need to remember that learning disabilities do not go away overnight and for some children it takes years of recognizing, expressing, thinking, and problem solving to succeed at being the young adult that they are meant to be.

Finance- understanding cost, revenue and profit for a business Essay Example

Finance Finance- understanding cost, revenue and profit for a business Essay Finance- understanding cost, revenue and profit for a business Essay In accounting, costs are the monetary value of expenditures for supplies, services, labour, products, equipment and other items purchased for use by a business or other accounting entity. Here are some of the costs a business needs to know: * Fixed * Start-up cost : * Variable * Total * Marginal * Semi-fixed costs * Direct costs * Indirect costs * Average * Operating costs Fixed costs These costs do not change however many units of a product are made. Factory rent, insurance premiums and administration salaries stay the same, whether the factory is working at full capacity or producing nothing. The owner of the business may have taken out a loan to buy equipment or refurbish a building. The loan will have to be repaid whether or not the business has customers. Variable costs Variable costs change as output changes. For example, the amount of raw materials needed varies as the levels of output go up or down. Piece-work wages also fluctuate, depending on the employees efficiency and the demand for the companys products. Start- up costs These are incurred before a business begins to operate, such as the purchase of land, building and equipments. Total costs The fixed costs and the variable costs are added together to establish the total costs. The fixed costs remain constant, but the variable costs increase in direct proportion with output. Marginal costs Using marginal cost is a way of measuring how much more it will cost a company to make one more individual item. Semi-fixed costs Semi-fixed costs are costs which only change when there is a large change in output. For example, costs associated with buying a new machine to cope with increased production. Also telephones and electricity for instance have a fixed and variable element: a standard line rental and then a charge for each call/unit of electricity after that. Direct costs Direct costs are costs which can be identified directly with the production of a good or service; e.g. raw materials. Indirect costs Indirect costs are costs which cannot be matched against each product because they need to be paid whether or not the production of good or services takes place; e.g. rent on the premises. Classification of costs help allocate costs to right parts of the profit and loss account and also helps analysis of the break even point of the business. Average costs The example of the CD shows the benefits of economies of scale, where mass production results in a lower unit cost. The reason is that the fixed costs do not change and are spread across a greater level of output. Finding out the average cost of production helps a firm to monitor its progress, and makes it easier to set prices. It is calculated by dividing total cost by total output. Using the example of the compact disc firm above: Total costs / Total output = Average cost of production à ¯Ã‚ ¿Ã‚ ½1,000 / 100 CDs = à ¯Ã‚ ¿Ã‚ ½10 per CD This might seem expensive, but if the firm produces another hundred units at a marginal cost of à ¯Ã‚ ¿Ã‚ ½1.00 per CD, its average cost will fall radically: Total costs / Total output = Average cost of production à ¯Ã‚ ¿Ã‚ ½1,100 / 200 CDs = à ¯Ã‚ ¿Ã‚ ½5.50 per CD The firm can use this information to decide whether it is worth accepting a new order for goods. Operating costs Variables costs and fixed costs added together are known as operating or running costs since they are both incurred when a business is running. Revenue In business, revenue or revenues is income that a company receives from its normal business activities, usually from the sale of goods and services to customers. Sales these are the main source of revenue for most organisations because customers pay for the goods or services they buy. Leasing a part of a building to another business can also provide a source of income. Some businesses specialise in leasing cars or equipment to other organisations. Interest this earned when a business has no money in an interest bearing accounts at the bank. Calculating total revenue To do this we need two items of information: * The selling price * The number sold We then need use the following formula: Profit Profit generally is the making of gain in business activity for the benefit of the owners of the business. Profit is the difference between the income of the business and all its costs/expenses. It is normally measured over a period of time. Profit is important in three ways: 1. It rewards the business people who have taken risks to run it 2. It provides the funds to develop the business further 3. It is a source of cash, which allows the business to meet its debts Gross profit This is the difference between sales income and the direct costs of making those products. Gross profit is used as a performance indicator to help the business make decisions over its pricing policies and use of materials. In the example, the business had sales of à ¯Ã‚ ¿Ã‚ ½18,000 over the year. Its cost of sales was à ¯Ã‚ ¿Ã‚ ½4,850 and its gross profit, therefore, was à ¯Ã‚ ¿Ã‚ ½13,150. Trading Account for Filling Snacks for year ended 31 December, 2000 à ¯Ã‚ ¿Ã‚ ½ à ¯Ã‚ ¿Ã‚ ½ Sales 18,000 less Cost of Sales Opening Stock 750 Purchases 5000 Closing Stock (900) (4,850) Gross Profit 13,150 Net profit Net profit represents gross profit less all expenses associated with the normal running of the business. Net profit shows how well the business performs under its normal trading circumstances. It is used to calculate the primary efficiency ratio. Net profit is the final profit of the business. It is the amount of profit made by the owners of the business at the end of the period. In this Example when we take expenses into account, we can see that what was a gross profit of à ¯Ã‚ ¿Ã‚ ½13,150 is now a net loss of à ¯Ã‚ ¿Ã‚ ½1,650. Trading and Profit Loss Account for Filling Snacks for year ended 31 December, 2000 à ¯Ã‚ ¿Ã‚ ½ à ¯Ã‚ ¿Ã‚ ½ Sales 18,000 less Cost of Sales Opening Stock 750 Purchases 5,000 Closing Stock (900) (4,850) Gross Profit 13,150 less Expenses Rent 10,000 Interest Payments 1,800 Light Heat 1,500 Advertising 500 Other 1,000 (14,800) Net Profit (1,650) Retained profit Retained profit is the profit left over after the shareholders have been paid their dividends. Retained profit is normally reinvested in the business. Profit is important to a business because it is a reward to the owners of the business. They have taken risks with their money and time. If there was no profit, then there would be little point in starting up or putting more money into the business, they might as well put the money into a bank or building society Profit maximization Profit maximization is the process by which a firm determines the price and output level that returns the greatest profit. There are several approaches to this problem. The total revenue total cost method relies on the fact that profit equals revenue minus cost. There are two basic ways of improving profits: * Increasing sales income * Reducing running costs Increasing sales income There are different ways of trying to achieve this. They all have risks as shown in the charts. Methods Risks Increase prise Sales could fail Reduce prices to increase sales Not enough extra sales would be made to compensate Reducing operating costs We already know that cost fall in to two variables and fixed. Many business have operating cost like bills, labours, raw materials etc. An example of reducing operating profit is given below, a valeting business have a list which begins: Staff wages à ¯Ã‚ ¿Ã‚ ½200,000 Property rental à ¯Ã‚ ¿Ã‚ ½50,000 And end with Ball pens à ¯Ã‚ ¿Ã‚ ½20.00 Paper clips à ¯Ã‚ ¿Ã‚ ½4.50 Method of reducing costs falls into main categories: * Minimising usage * Finding the best purchase deal Item Use less Reduce purchase price Labour Reduce staff levels by increasing number of automated or computerised operations Increase productivity sub-contract work to cheapest bidder Raw materials Use fewer materials in product Look for a cheaper supplier Gas, water and electricity Replace older item with efficient ones, e.g. Energy- saving bulbs, light which turn off automatically. Switch utility company if this would reduced costs Consumable items, e.g. stationary Send documents by e-mail rather than by post. Shop around for cheaper suppliers and investigate online source The importance of profit After tax is paid the business can spend the remaining money in several ways. If the business is a limited company with shareholders, some of the profits will be paid as dividends. These are the rewards paid to shareholders for investing their money- similar to the interest you if you save money in the bank.