The TED Assignment Research Paper Example | Topics and Well Written Essays - 1500 words

The TED Assignment - Research Paper Example In this essay I will discuss a few of the videos and how they believe one should lead their lives. The first video I saw was by Amy Purdy who lost her legs due to bacterial meningitis. At that time, she was devastated and wondered how she was going to fulfil her dream of traveling the world and of snowboarding. But then she realized that she had an option to take her life in the direction she wanted to take. So she accepted the fact that she doesn’t have real legs anymore and will have to bear with the artificial ones. She imagined herself to keep walking, helping people and snowboarding again. And this is the life she chose. She became creative about the artificial legs and customized them according to her needs. She failed, slipped, fell many times, but she would not let go of hope that easily. This was when she understood one of the most important life’s lessons: Obstacles do only two things to you-make you stop or force you to be creative. (Purdy, 2011) Her story tells you that one has two options when faced by a real tragedy: you can whine, be depressed, let go of hope and life or look right into the eyes of the world and follow your dreams irrespective of how many obstacles lay in front of you. These obstacles might stop you from doing something the way normally people do, but they also help you to imagine and discover new ways of following your dreams, living life to the fullest and being happy. Another speaker at Ted, Shawn Achor, a researcher and teacher of positive psychology talks about the formula of happiness. He argues that we always talk about what average people think, believe and do. We research on people and we generalize them as average people. He believes that â€Å"if we study what is merely average, we will remain average†. Furthermore he talks about the general perception of life and happiness. He argues that our happiness is mostly characterized by

Check List for Project Finance Essay Example for Free

Check List for Project Finance Essay 1. Brief description of every project sponsor: company history, establishment date, legal form, ownership, subsidiaries, core activities. Data on sponsor’s experience in the host country and in the project’s industry. Explanation of how the project relates to the sponsor’s strategic direction/goals. 2. Annual reports of the past three years for every project sponsor. Additional requirements in the case of project finance for activities in existing plants: detailed structured data for the past three years and budgets for the next five years on revenues (including a breakdown of export versus domestic foreign currency revenues if any, for countries with non-convertible currency; revenue mix by customer, country, and product) and expenses (in detail; in the case of non-convertible currencies, these need to be grouped separately). 3. Summary of the project concerned, including name, location, purpose, organisational form, ownership, equity, security structure, status of licenses/approvals, local partners, marketing and distribution, financing. 4. Brief characterisation of the role of the host country. For projects with currencies that are not completely freely convertible: description of the measures to avoid convertibility and transfer risk (including escrow accounts). 5. Schematic representation of the contract structure and the significant existing or intended contractual relationships and security. 6.List of references of the general contractor and/or most important suppliers as far as known; list of references of comparable projects to document the proven technological feasibility and the experience in the sector and host country. 7.Information on operator/management company: Company history, ownership, core activities, list of references, documentation of relevant experience in industry and host country. 8.Independent feasibility study reporting on the project’s economic and financial viability and political and environmental acceptability. Information on the level of expertise of the advisers/experts used in terms of subject area and geographic region, as it relates to the project (list of references). 9.The following information, if not already included in the feasibility study: a) Technical description, flow sheet, layout b) Detailed derivation of estimated operating costs (price and quantity details) c)Procurement situation for raw materials and supplies, including corresponding contract documents d) Description of the management, training of staff, staff costs and qualifications e) Environmental aspects, environmental impact assessment report, required environmental approvals and environmental measures, general description of location and emphasis on its specific relevant features, socio-economic and socio-cultural aspects. Also see our detailed requirements for the environmental review. f) Discussion of the amounts and appropriateness of the investment value and the risks regarding time and cost overruns. g) Timetable for construction and commissioning, milestones h) Market information on the project’s products/services, including the price and volume trends for the past 5 to 10 years; competitive situation, current and future supply and demand situation; forecast, identification and geographic location of main customers; marketing and logistics strategy; description of the planned marketing activities and off-take agreements (e.g. take-or-pay agreements) i) Detailed project costs, broken down by main categories of the key construction and commissioning cost items, interest over construction period, financing of working capital j) Projected procurement of funds, including source, amount, currency, time of input k) Cash flow projection over the repayment term of the requested export-credit-insured loan (including sensitivity analysis: a realistic base scenario, an optimistic and a pessimistic scenario), explanation of how any cash deficits will be covered l) Derivation and assumptions of the cash flow projection, including basis for sales quantity and prices, operating and administrative expenses, depreciation, amortization and impairment losses, taxes, inflation, exchange rate movements, export licenses, influence of local government.

Risperidone for Methamphetamine Induced Psychotic Disorder

Risperidone for Methamphetamine Induced Psychotic Disorder On the efficacy of risperidone for the treatment of methamphetamine induced psychotic disorder, a dose ranging study Induced psychosis, diagnosis and treatment Worldwide growing methamphetamine abuse is one of the most serious health problems with several different consequences for victims, especially in developing countries. Chronic methamphetamine abuse is associated with several psychiatric problems in all countries which are faced to epidemic methamphetamine abuse. Methamphetamine induced psychosis (MIP) is a major medical challenge for clinical practitioner from both diagnostic and therapeutic viewpoints. Stimulant psychosis commonly occurs in people who abuse stimulants, but it also occurs in some patients taking therapeutic doses of stimulant drugs under medical supervision. The main characteristic of meth psychosis is the presence of prominent hallucinations and delusions. Other drugs, such as cocaine and marijuana, can trigger the onset of psychosis in someone who is already at increased risk because they have vulnerability. The current literature review attends to explain several aspects of MIP, including epidemiologically, clinically and investigators proposed pharmacologically treatment based on recently published data. Introduction Amphetamine and methamphetamine have the most substances for abuse among the synthetic psychostimulant across the world1. The overall the prevalence of methamphetamine users (excluding amphetamine users) ranges from 10.5 to 28.5 million people worldwide (0.2% to 0.6% of adults between 15 to 64 years old)2. Accompanied to amphetamine these synthetic psychostimulants are ranked as the 2nd abuser illicit drugs after cannabis as the 1st and before cocaine and opiates1. Many consequences follow methamphetamine abusers including medical, psychiatric, cognitive, legal and socioeconomic problems. It is unclear why methamphetamine abusers are more involved with legal consequences than all other illicit drug abusers3. It might be due to more psychotic symptoms induced by these psychostimulant drugs, or flaring of symptoms in a subtle or stable schizophrenia which could be exacerbated by methamphetamine4. It has been well known that such drugs are able to produce psychotic symptoms in persons with no history of previous psychiatric disorders.5,6 Epidemiology and clinical manifestations of MIP There are other substances able to produce psychosis including cocaine, cannabis, alcohol, hallucinogens, heroin and sedatives7.There will be a diagnostic challenge to meet a net diagnosis for drug-induced psychosis, if the clinical practitioner cannot establish the presence of psychotic symptoms before initiating drug abuse. In a survey, among 400 cases who admitted in different psychiatric emergency departments for their psychotic symptoms, 44% received a substance-induced psychosis diagnosis and 56% were diagnosed essential psychosis8. According to DSM-IV criteria, diagnosis of primary psychosis is usually after at least 4 weeks with persisting symptoms without heavy substance use. In addition to the previous history of substance abuse, other factors lead to drug-induced psychosis including parental substance abuse, dependency to drug (rather than occasional abuse) and visual hallucination. Lower positive and negative syndrome scale with th positive history of drug abuse put in fa vor of drug-induced psychosis, as well as more consciousness to psychotic symptoms and more tendency to suicidal thoughts are another feature of drug-induced psychosis. Generally, reported psychotic symptoms due to MethAmphetamine(MA) abuse, from USA, Japan, Taiwan, Australia and Iran are the same as each other including (as studied by Fasihpour et al) persecutory delusions (82%), auditory hallucination (70.3%), reference delusion (57.7%), visual hallucination (44.1%), grandiosity delusion (39.6%) and jealousy delusion (26.1%)9. Although certain risk factors could not be extracted among documented literature and many conducted studies by different authors in involved countries have been reported more common factors include: 1. Pyschosis induction is largely dose-dependent than duration-dependent5,10,11 2. Positive family history of psychotic symptoms especially in first degree relatives5. Interestingly protracted and more resistant psychosis was occurred in abuser persons, whose one of their first degree relatives has been involved by schizophrenia12.3. Presence of premorbidity in abuser subjects, such as schizoid/schizotypal personality traits, alcohol dependency, antisocial personality disorders and major depression, all can be psychosis induced by methamphetamine5. 4. History of sexual abuse experience, recent higher occasion of MethAmphetamine(MA) abuse plus another illicit substance13. 5. Childhood Attention Deficit Hyperactive Disorder (ADHD) may be associated frequently with psychosis reports14. 6. Hi gher serum level of methamphetamine and amphetamine are associated with more profound psychotic symptoms4. The route of consumption (oral, smoking, injection) was not a significant factor in Mc Keit et al study6. But according to Matsumoto et al. smoker abuser show more quickly acute psychotic symptoms than who use the injection, because smokers have poor control on MA consumption. In addition psychotic syndromes in injection abusers require more medical care to respond to treatment15. Other personal characteristics such as age at which abuse is started, education, IQ, and duration of methamphetamine use were not associated significantly with risk of psychosis developing among abusers8. Female preponderance for undergoing psychotic symptoms was established among participant persons in the study of Mahoney and his coleagues16. It is noticeable to mention that the results of studies on MIP characteristics are somewhat inconsistent because of different cultural population, different accuracy in methods of studies and so on. But they provide a general opinion for further investigations and more accurate and localized studies. Sign and symptoms of MIP Reported psychotic symptoms among several different studies performed in Japan17, Taiwan5, Australia6, Tailand18 and Iran9 all are unanimous in obtained results. The most common features include persecutory delusion and auditory hallucination followed by delusion of reference, visual hallucination and thought broadcasting. MIP is initiated with excitation and increased focusing or concentration states, following by prepsychotic states and delusions which may subsequently progress to overt psychosis with positive symptoms10. The onset of first psychotic episode from the first occasion of methamphetamine consumption ranges from 1.7 years in smoker abusers to 4.4 years in injectioners19 and or 5.2 years without considering route of abuse10. Individuals with intense eagerness20, injection of methamphetamine and methamphetamine abusers are at higher risk for experiencing more severe psychosis21. Although MIP usually have short courses duration but longer and persistent episodes of psychos is have been reported even after discontinuation of drug abuse and in abstinence period17. As protracted MIP frequently occurred in many studies, it remains unclear whether methamphetamine can produce a chronic psychotic disorder or methamphetamine has uncovered a psychotic disorder in a patient with psychotic background5. The risk factors for developing long lasting MIP include positive family history of first degree relative involved to schizophrenia, premorbidity with a personality disorder specially schizoid/schizotypal form, a former neurological disorder like ADHD, head injury and learning disability2. During the abstinent period, MIP relapse might occur in a previously undergone short MIP, as well as any stressor like insomnia and severe alcohol intake.10,23,24 Methamphetamine and not stress induced MIP relapse occur with a likelihood of 60% to 80% in less than 1week to 1 month respectively, after re-exposure to MA8. A history of more than 2 years MA abuse makes the person susceptible for spontaneous relapse of psychosis without any methamphetamine reabusing for years.10 MIP Treatment pharmacological approaches Although no medical agent(s) are approved as therapeutic drug for MIP yet, due to a few numbers of pharmacological evaluations which have been proformed for finding a suitable choice in recent years. According to bio-molecular neurotransmitters influenced by MA, several pharmacologic agents are proposed for treating MA with clinical implications such as dependency and MIP. In this review a brief will run to introduce involved pharmacological groups separately. Dopaminergic agents Modafinil is a dopaminergic agonist approved essentially for sleep disorders such as narcolepsy, obstructive sleep apnoea/hypopnoea and idiopathic hypersomnia. Modafinil may increase efficacy of cognitive behavioral treatments and decrease craving in methamphetamine dependency25. It may have beneficial effect in schizophrenia and thereby in MIP.26,27 Bupropion, a re-uptake inhibitor of dopamine has demonstrated its effect as decreasing methamphetamine use specially in low to moderated dependency.28,29,30 Methylphenidate (Ritaline) and Dextroamphethamine (d-amphethamine) both increase releasing of dopamine in synaptic cleft and have high capacity to be abused. They show strong efficacy in studies to stop or reduce MA abuse in even deep dependency.31-34 Although the above quoted drugs have not revealed any direct effect for MIP, but it seems that appetite decreasing for MA use occur by these drugs, which can be indirectly effective for managing MIP as well. Aripiperazole, a dopamine D2-receptore partial agonist and a second generation antidepressant is proposed for MethAmphetamine(MA) dependency and MIP. In a study driven by Sulaiman et al. Aripiperazole was effective for diminishing the severity of psychosis resulted from methamphetamine, but it was failed to increase abstinence duration.35 In another study, Farnia et al. compared the efficacy of aripiperazole versus risperidone in MIP cases, in a double blind randomised control trial. After six weeks trial with aripiperazole 15mg/day or risperidone 4mg/day, they concluded that both drugs are able to significantly decrease the MIP severity, however rispridone causes showed more reduction on positive symptoms while aripiperazole was more effective on negative symptoms.36 The ability of antipsychotics like aripiperazole and haloperidol in suppressing the dopamine releasing in amygdala of animal experiments which caused marked reduction in behavioral sensitivity following MA exposure, may explain its benefits on MIP.37 In another animal model study, it was shown by Futamara et al. that aripiperazole can diminish behavioral sensitization through acting on 5-HT1A receptor.38 Risperidone is evaluated solely for its ability to prolong abstinent period in 4 weeks administration of 3.6mg/day in an open-label trying. Results demonstrate a decrease in meth consumption in abusers.39 Two separate case reports have considered the dramatic response of MIP to risperidone therapy.40,41 Despite safety applications of classic antipsychotics Hatzipetros et al. warned about an unknown toxic effect of conventional antipsychotics like administrating the haloperidol to GABAergic cells in subchronic treatment of MIP might lead to hyperkinetic movement disorder and convulsion42. Other antipsychotics like quetiapine and olanzepine were applied successfully for drug– induced psychosis.43,44 GABAergic agents Several different GABA agents like baclofen45,gabapantine45,46, vigabatrine47,48, topiramate49 and benzodiazepines were proposed for treatment of MA dependency and associated psychosis based on their effects on decreasing the dopamine transmission in mesolymbic system by which reinforcing effects of MA is reduced.50,51 But ,actually conducted trial studies are somewhat inconsistent to suggest a precise recommendation.49,52 Nevertheless Ito K et al. showed that clonazepam in animal model experiments did not obtain explicating of behavioral sensitization in rats which were under treatment with MA.53 Serotonergic agents No pharmacological trial studies lead to any clinical recommendation of serotonergic agents for MIP found in web published searching except for two animal experiments in which the role of serotonergic receptors are evaluated in locomotor activating and developing behavioral sensitization. Kaneko et al. studied the inhibitory effect of fluoxetine and paroxetin, 2 clinically available SSRI agents, on establishing and expression of MA induced behavioral sensitization and suggested a prophylactic role of SSRIs for preventing of psychotic states like hallucination and paranoid symptoms due to methamphetamine abuse.54 Ago et al. demonstrated the critical role of serotonine system in behavioral sensitization formation in mice by osemozotan a 5-HT1A-receptor agonist and ritanserin a 5-HT2-receptore antagonist and again suggested a capacity of serotonergic agents for treating methamphetamine psychosis.55 Opioid antagonist Naltrexone, a pure antagonist of morphine have showed successful outcomes in MA dependency management by decreasing craving, probably because of endogenous opioid system modulating role in reducing of reinforcing effects of metamphetamine.56-61 Behavioral sensitization produced by frequently exposure to methamphetamine is prevented by induction and expression of naltrexone in mice.62 But naltrexone plus N-acetylsysteine, an antioxidant, fail to demonstrate priority to placebo group for MA dependency treatment.63 Although no particular study with emphasis on the effects of naltrexone on MA-induced psychosis was found, it may be associated with precise changes in severity and prevalence of MIP because of its strong effects on abolishing dependency. Other unclassified treatment Minocycline, a second generation antibiotic was proposed for MIP treatment. In two separate case reports minocycline administration were associated with significant results in curing the psychotic symptoms of methamphetamine abuse probably due to its anti-inflammatory effects on micoglia.64,65 Electroconvulsive therapy (ECT) is mentioned for its high capacity to create a dramatic response in a MIP cases whose psychotic symptoms were resistant to conventional pharmacological antipsychotic therapy.66 Discussion Methamphetamine abuse is now going to become an epidemic problem in many countries. Chronic MA abuser underwent many medical psychiatric cognitive and legal consequences. One of the most important complications is the psychosis. Many studies were performed and a plenty of pharmacological drugs were proposed for managing of MA dependency, although none of them were approved yet, but only a few investigations tried to find drugs targeted on psychosis due to MA. These drugs as reviewed in this articles belongs to different biochemical neurotransmitters like dopaminergic antipsychotics, serotonergic agents and GABAergic drugs. All the studied drugs failed to obtain approval validity, although according to the results of conducted studies merely all of these agents could subside the MA associated psychosis. Recognizing neurotransmitter/receptor systems involved and influenced by MA in animal models and human experiments that can elevate knowledge about developing MA-induced psychiatric sy ndromes, especially psychosis, is the best way to overcome MIP pharmacologically and is recommended strongly for future studies.

Cats Rule :: essays research papers

"A dog is a man's best friend." That common saying may contain some truth, but dogs are not the only animal friend whose companionship people enjoy. For many people, a cat is their best friend. Despite what dog lovers may believe, cats make excellent housepets. In the first place, people enjoy the companionship of cats. Many cats are affectionate. They will snuggel up and ask to be petted, or scrached under the chin. Who can resist a purring cat? If they're not feeling affectionate, cats are generally quite playfull. They love to chase balls and feathers, or just about anything dangling from a string. They especially enjoy playing when their owners are participating in the game. Contrary to popular opinion, cats can be trained. Using rewards and punishments, just like with a dog, a cat can be trained to avoid unwanted behaviour or preform tricks. Cats will even fetch! In the second place, cats are civilized members of the household. Unlike dogs, cats do not bark or make loud noises. Most cats dont even meow very often. They are generally content to lead a quiet existence. Cats also don't often have "accidents." Mother cats train their kittens to use the litter box, and most cats will use it without fail from that time on. Even stray cats generally understand the concept when shown the box and will use it regularly. Cats do have claws, and owners must make provisions for this. A tall scratching post in a favorite cat area of the house will usually keep the cat content to leave the furniture alone. As a last resort, of course, cats can be declawed. Lastly, one of the most attractive features of cats as housepets is their ease of care. Cats do not have to be walked. they get plenty of exercise in the house as they play, and they do their buisness in the litter box. Cleaning a litter box is a quick, painless procedure. Cats also take care of their own grooming. Bathing a cat is almost never necessary because under ordinary circumstances cats clean themselves. Cats are more particular about personal cleanliness than people are. In addition, cats can be left home alone for a few hours without fear.

Islamic Influences in the Philippines

Barter trade, equivalent exchange, and financial agreement, these words fall to the similar idea of agreeing to a set amount of items to exchange between two or more parties. A very underrated type of business, but very effective in the world of today. People see the world of business as a meaner to earn and make the most out of exchanges in order to buy more and more things for themselves, rather than the idea of getting the most out of a certain item purchased or traded.Barter in the Philippines had first been recognized in the lower regions such as Gambling, Zebu and Taw-Taw. The Filipinos there would encounter numerous people from around the world but most commonly would be the Chinese and the Muslims. The Muslims would often be known to be trading spices and silk to the Filipinos for fruits and rice, which became a very common trade throughout time. With this more and more Muslims even styled and taught many Filipinos the concepts Enid Trade and Commence between countries and cu ltures.Barter trade was an Islamic influence towards the Filipinos as it was a very common practice within the Middle East. Spices, Silk, Fruits, and Cattle were commonly traded among travelers in order to refill their stocks or to try new items. More so, Barter was a way of life in the early civilizations due to the fact that it allowed surplus foods and items to be traded for more useful items. In modern day Taw-taw, Gambling and Zebu, barter trade practices can still be en throughout the shores and towns along the coasts.Many countries such as the neighboring Malaysia have found these cities to be a well loved tender to all their needs for trading. Studies show how even families have relatives from both the Philippines and Malaysia due to the trade industry between relationships of the trading parties. The naturalistic relationship of the neighboring countries has brought many influences into the Philippines. Barter trade being one of the many, such as theIslamic religion, the sp ices in meals and the use of silk in clothing to name a few, have been significant markers to the development of the Filipino Culture. Even as the Philippines has been colonized multiple times by Spain, Japan and the United States, it still is a known fact that the Islamic culture has made quite an indention on the culture that is of the Filipino. Reference: http://pH. News. Yahoo. Com/Islamic-culture-barter-bind-Filipinos- Malaysian-134516022. HTML

Free Essays on Moods And Communication

What are Emotions? Velma Walker and Lynn Brokaw, authors of Becoming Aware, define emotions as, â€Å"feelings that are experienced.† Feelings are opinions â€Å"based on emotions rather than reason,† according to Dictionary.com. A person is always experiencing some emotion at any time since when the present emotion fades away, another emotion will take its place and be felt by him/her. No single emotional response can remain permanent. When any emotion, such as anger, is experienced the person can stay angry only for some time, eventually the anger will fade away and a fresh emotion will arise. In many instances, we do not feel one single emotion but many different one mingled together. What are the characteristics of emotions? Emotions are your body’s adaptive response. They focus your attention and prepare you for action. When our emotions are aroused, there are changes in our body that we do not have control over. Some of these changes are easily noticed- quickened heart rate, rapid breathing- but your body also gets ready for action in less noticeable ways- as if being wounded and your body will clot blood faster. All of these are called physiological changes, meaning they are internal. These changes contribute to how you will feel about what has happened to cause the arousal (i.e. fear, grief, or happiness). Although emotions are felt internally, they do lead to detectable behavior, or how we react to what we are feeling. We reveal our emotions not only in our bodily responses, but also in our expressive behavior. It may take the form of a smile, laugh, crying or cursing. This may be nonverbally as well as verbally. Most of us are good at reading nonverbal cues to decipher emotions, and some are more sensitive than others at doing so. Emotions themselves also act as motivation for other things. They can push us to do something good or pull us away from something bad. Types of emotions. There are four types of emotions... Free Essays on Moods And Communication Free Essays on Moods And Communication What are Emotions? Velma Walker and Lynn Brokaw, authors of Becoming Aware, define emotions as, â€Å"feelings that are experienced.† Feelings are opinions â€Å"based on emotions rather than reason,† according to Dictionary.com. A person is always experiencing some emotion at any time since when the present emotion fades away, another emotion will take its place and be felt by him/her. No single emotional response can remain permanent. When any emotion, such as anger, is experienced the person can stay angry only for some time, eventually the anger will fade away and a fresh emotion will arise. In many instances, we do not feel one single emotion but many different one mingled together. What are the characteristics of emotions? Emotions are your body’s adaptive response. They focus your attention and prepare you for action. When our emotions are aroused, there are changes in our body that we do not have control over. Some of these changes are easily noticed- quickened heart rate, rapid breathing- but your body also gets ready for action in less noticeable ways- as if being wounded and your body will clot blood faster. All of these are called physiological changes, meaning they are internal. These changes contribute to how you will feel about what has happened to cause the arousal (i.e. fear, grief, or happiness). Although emotions are felt internally, they do lead to detectable behavior, or how we react to what we are feeling. We reveal our emotions not only in our bodily responses, but also in our expressive behavior. It may take the form of a smile, laugh, crying or cursing. This may be nonverbally as well as verbally. Most of us are good at reading nonverbal cues to decipher emotions, and some are more sensitive than others at doing so. Emotions themselves also act as motivation for other things. They can push us to do something good or pull us away from something bad. Types of emotions. There are four types of emotions...

nazi movement essays

nazi movement essays There is no single answer as to why the Nazis were able to gain so much support during the 1920's; there are several, and people still argue about them. Some people - especially during the Second World War - suggested that the Nazi movement grew out of something basically wrong in the German character. However, modern historians recognise that a combination of factors such as Hitler's personality and mesmerising oratory skills, the problems with the Weimar Republic, the Nazi's effective use of propaganda, Hitler's exploitation of the Dolchstoss myth and the German people's fear of communism and the Great Depression all aided the National Socialist Workers' Party (NSDAP, or Nazi Party) in attracting growing support throughout the 1920's. According to Robert Gibson and Jon Nichol in their book Germany, the reasons for Hitler's success were: 1. The Nazi Party was well organised; 4. Few people like the governments of the Weimar Republic; 6. There was an agricultural depression; 8. The Communists thought that the Social Democrats were a greater danger than the Nazis; 9. Industrialists supported Hitler. These and other factors all contributed to the increasing support of the Nazi Party in the 1920's. Hitler, the leader of the NSDAP, was suave, charismatic and always impressive. He would always arrive at functions and meetings in a Mercedes and had extensive visits to the most exclusive hotels in Germany. Hitler had a very memorable personality, and it has been stated that "There is no question that it was the personality of Hitler that held the NSDAP together ... and was the party's main weapon." Hitler was above all of this a passionate and emotive speaker who, some would argue, captured his audiences' attention with greater ease than any other figure in history. "He shone in print and positively dazzled on the lecture platform." Even an American journalist realised Hitler's ability to grasp people's attention wit...

President Jimmy Carters Record on Civil Rights and Race Relations

President Jimmy Carters Record on Civil Rights and Race Relations When Georgian Jimmy Carter won the 1976 presidential race, no politician from the Deep South had been elected since 1844. Despite Carter’s Dixie roots, the incoming president boasted a large black fan base, having supported African-American causes as a lawmaker in his home state. Four out of every five black voters reportedly backed Carter, and decades later, when the country welcomed its first black president, Carter continued to speak out about race relations in America. His record on civil rights before and after entering the White House reveal why Carter long garnered support from communities of color. A Voting Rights Supporter During his tenure as a Georgia state senator from 1963 to 1967, Carter worked to overturn laws that made it challenging for blacks to vote, according to the University of Virginia’s Miller Center. His pro-integration stance did not prevent him from serving two terms as state senator, but his views may have hurt his gubernatorial bid. When he ran for governor in 1966, an outpouring of segregationists turned out to the polls to elect Jim Crow supporter Lester Maddox. When Carter ran for governor four years later, he â€Å"minimized appearances before African American groups, and even sought the endorsements of avowed segregationists, a move that some critics call deeply hypocritical.† But Carter, it turned out, was simply being a politician. When he became governor the following year, he announced that the time had come to end segregation. Clearly, he’d never supported Jim Crow but catered to segregationists just to win their votes. Appointments of Blacks in Key Positions As Georgia governor, Carter didn’t just verbally oppose segregation but also worked to create more diversity in state politics. He reportedly raised the number of Georgia blacks on state boards and agencies from just three to a staggering 53. Under his leadership, almost half, 40 percent, of public servants in influential positions were African American. Social Justice Platform Impresses Time, Rolling Stone Gov. Carter’s views on civil rights so markedly differed from other Southern lawmakers, such as notorious Alabama Gov. George Wallace, that in 1971 he made the cover of Time magazine, which dubbed the Georgian the face of the â€Å"New South.† Just three years later, legendary Rolling Stone journalist, Hunter S. Thompson, became a fan of Carter after hearing the lawmaker discuss how politics can be used to effect social change. A Racial Gaffe or More Duplicity? Carter sparked controversy on April 3, 1976, while discussing public housing. The then-presidential candidate said that he thought community members should be able to preserve the â€Å"ethnic purity† of their neighborhoods, a statement that sounded like the tacit support of segregated housing. Five days later, Carter apologized for the comment. Had the pro-integrationist really meant to express support of Jim Crow housing, or was the statement just another ploy to get the segregationist vote? Black College Initiative As president, Carter launched the Black College Initiative to give historically black colleges and universities more support from the federal government. â€Å"Other administration education initiatives covered in the collection include science apprenticeships for minority students, technical assistance to black colleges, and minority fellowships in graduate management education,† according to the â€Å"Civil Rights During the Carter Administration† report. Business Opportunities for Blacks Carter also tried to close the wealth gap between whites and people of color. He developed initiatives to give minority-owned businesses a boost. â€Å"These programs focused primarily on increasing the government’s procurement of goods and services from minority business, as well as through requirements for procurement by federal contractors from minority firms,† the CRDTCA report states. â€Å"The aided industries ranged from construction to manufacturing to advertising, banking, and insurance. The government also maintained a program to help minority-owned exporters gain footholds in foreign markets.† Affirmative Action Supporter Affirmative action became a heavily debated topic when the U.S. Supreme Court heard the case of Allan Bakke, a white man denied admission to the medical school at the University of California, Davis. Bakke sued after UC Davis rejected him while admitting less qualified black students, he argued. The case marked the first time affirmative action had been challenged so vigorously. Yet, Carter continued to support affirmative action, which endeared him to blacks. Prominent Blacks in the Carter Administration When Carter became president, more than 4,300 blacks held elected office in the U.S. African Americans also served in the Carter cabinet. â€Å"Wade H. Mc-Cree served as solicitor general, Clifford L. Alexander was the first black secretary of the army, Mary Berry was the top official in Washington on educational matters prior to the establishment of the Department of Education, Eleanor Holmes Norton chaired the Equal Employment Opportunity Commission, and Franklin Delano Raines served on the White House staff,† according to the Spartacus-Educational website. Andrew Young, a Martin Luther King protà ©gà © and the first African American elected as a Georgia congressman since Reconstruction, served as U.S. ambassador to the United Nations. But Young’s outspoken views on race caused controversy for Carter and Young resigned under pressure. The president replaced with him another black man, Donald F. McHenry. Expansion from Civil Rights to Human Rights When Carter lost his bid for re-election, he opened the Carter Center in Georgia in 1981. The institution promotes human rights across the world and has overseen elections in a number of countries and curbed human rights violations in places such as Ethiopia, Panama, and Haiti. The center has also focused on domestic issues, such as in October 1991, when it launched the Atlanta Project initiative to address urban social problems. In October 2002, President Carter won the Nobel Peace Prize for â€Å"his decades of untiring efforts to find peaceful solutions to international conflict.† The Civil Rights Summit Jimmy Carter was the first president to speak at the Lyndon B. Johnson Presidential Library Civil Rights Summit in April 2014. The summit commemorated the 50th anniversary of the groundbreaking Civil Rights Act of 1964. During the event, the former president  urged the nation to do more civil rights work. â€Å"There’s still a gross disparity between black and white people on education and employment,† he said. â€Å"A good amount of schools in the South are still segregated.† Given these factors, the civil rights movement isn’t just history, Carter explained but remains a pressing issue in the 21st century.

Job Sharing Essay Example | Topics and Well Written Essays - 2500 words

Job Sharing - Essay Example In this cutthroat competition, job sharing is playing an important role in almost all sorts of businesses. In job sharing, each partner receives the full time benefits. In contrary, there are people who say that job sharing reduces the efficiency of the company as well of its employees. In this paper, we will examine why job sharing is good and what type of benefits the employees can get from it Job sharing permits business to recruit skilled, experienced workers who may not be available for or eager to do full-time work. Job sharing is a good field for both males and females but more precisely for women having kids. They can work as well as look for their family. Job sharing tolerates one position to be filled by two people different but harmonizing knowledge. Without the knowledge it is not possible to go further with the work. There should be the knowledge of related work and the company's objectives. Where job sharers have administrative responsibilities staff may find it demanding or confusing to work for two people. There is a problem that the manager can experience is that there are two people to look for. In addition, some job sharers may feel that they are attaining proportional more than a full-time employee and that they are being insufficiently paid. TheDefinition "Deal in which the responsibilities and hours of one job position are accepted out by two people." The deal contains the agreement about working with the other employee and sharing the benefits and pays. The company must organize workshops in order to provide total knowledge about the job for both the sharers and must provide the total tools required to cover the job. If one of employee wants to leave the job the company must look for another person to follow the job with the one who is working. The work should be done on time with effectiveness and efficiency by both the workers and must take company's objectives as their own. The women can get more benefits in job sharing and can get the required benefits. Even males can get good results with job sharing they can work at two places at a time for better allowance. There must be better allowance for the workers and they should be given more benefits like transport facilities, hospital facilities etc. Chapter No. 2 - Literature Review Introduction Job Sharing is an adaptable work arrangement in which two employees share the responsibility and benefits of one permanent position with another employee. Some employees work few hours in

Measurement of human processes (Project Management) Assignment

Measurement of human processes (Project Management) - Assignment Example Therefore, the development of a good visual system is of tremendous benefit to the project manager. A paper system in binders is a poor way of keeping people informed. This drags the organization behind in progress tracking and reporting (Kerzer, 74). Poor scheduling or resource management (mismanagement) by the project manager often leads increasing your chances of project failure. This is because managing any project is managing a schedule, but a schedule is typically a collection of resources that are being managed on a schedule. There is poor scheduling on elicitation techniques, use cases, user screen design specifications, reports, business rules, functional, and the non-functional requirements (76). Weak requirements definitions which lead to planning inadequacy, this is brought about by the project manager failing to identify his or her target. One way of identifying project requirements is by describing how the end results look like in measurable terms. Requiring of a soft w are that is easy to use is an objective measure of our testing. Poor requirements lead to poor development and design. A software program ends up doing the wrong things for the users resulting in massive re-tests and rework. According to Kerzer (78) he asserts that inadequate planning, risks, resources, and assumptions by the project manager often leads to a failed project. ... This may be attributed to the fact that you may not be trained in the utilization of that software or technology. Ineffective quality controls which make you to deliver what the client does not want. The poor balances and check systems results in these ineffective quality controls. In addition, most of the projects have a system of correcting problems but do not have a system of corrective action Managing multiple projects at the same time or multi-tasking resources goes against, less is more, and focus is power. Multitasking introduces schedule risk and complexity which impacts negatively on all projects involved. Supply chain failures which emanates from contracted work. Managing of contractors is an inherent risk because they may not be having the level of skills required for the job. Contractors also have that tendency to multitask so as to stay busy thus introducing complexity and schedule risk. Scope creep or poor analysis of impacts has an effect on the schedule, budget, and r esources. It means there is an increase in the on what is delivered without a corresponding increase in resources to the project timeline. This can actually be alleviated by performing good impact analysis and clarification of real requirements. Another failure of project is attributed to lack of qualified resources and personnel. This makes you to question your resources thus giving the wrong task to the wrong person (Anderson, 1). Discussion 2 I have the following characteristics; visionary, decisive, a good motivator, technically competent, and support team members. Those that I need to work on are being a good motivator, encouraging new ideas, and standing up to top management when necessary.

Write a research paper discussing the affects of the Voting Term

Write a research discussing the affects of the Voting demographic on politics in the United States - Term Paper Example Because of these changes in the country’s demographics, democrats enjoyed a greater share of the country’s votes. According to the results of various studies, democrats will enjoy a favorable vote in the years to come, especially because of the increased rates of immigration into the country. Some of the leading populations in terms of immigration into the country are of Hispanic and Latino origin. The role of these populations has been widely felt especially in the 3 most recent elections. Democrats are therefore best advised to retain a hold on these populations. Al Gore scooped 66% of the votes from this population. This was especially notable in swing states examples being New Mexico. Cubans are not so keen on the democrats, a fact that resulted in Al Gore losing in states like Florida. This was one of causes of Gore’s loss to George Bush. The margin between the two candidates was quite slim but played a role in his loss. This effect was also noticeable in the 2004 election where George Bush was able to garner 44% of the Hispanic/Latino votes. This was a new achievement for the republicans. It was instrumental in his victory in that election. However, the republicans could not hold on to their Latino votes during the 2008 election when Barrack Obama of the Democrats won over 67% of their votes. The influence of the Latino/Hispanic vote was felt across several states in which republican’s George Bush won in the previous election in 2004. Florida was one of the most influential states during that election and Obama managed to clinch 57% of the votes cast by the Latino/Hispanic population. This win helped to raise Democrats’ confidence that had been lost due to Gore’s losses (Goldberg 17). The Latino/Hispanic population makes up 16% of the 312 million US citizens. The majority (64%) are whites while blacks make up 13% of the population. Asians make up 4% of the population while the rest 3% is made of less dominant races. The

Business law Essay Example | Topics and Well Written Essays - 2750 words - 4

Business law - Essay Example Despite the fact that most of these laws are poorly implemented and enforced, those concerned with international business cooperation and trade are relatively clear and well applied. There is also evidence showing that after the 2003 leadership succession in china, from the third generation to the fourth generation, there was a launch of a new wave of economic legislation to advance the economic reform as well as reforming and building up the legal reforms in the country. The key driving factor to the new economic laws in china is attributed to the requirements of the world trade organization (WTO). Being part of the membership of the WTO, China has an obligation to meet the rules and regulations as stipulated under the penal code of the WTO (ECOVIS 2014). The most pressing rules and regulations that each member of the WTO is obliged to implement are concerned with the governance of trade as well as those related with other economic activities. As a result, its entry into the WTO, Ch ina has since strived to implement its business law to conform to the agreement with the WTO to meet its international obligations. This essay will attempt to critically discuss how China’s accession to the WTO in 2001 has reshaped its legal environment on the business regulation. In preparing to join the WTO, china initiated the overall process of reviewing its existing laws and regulations. Slightly either before the year 2000 ended, most of the administrative measures and the state council or ministries annulled regulations. Right from the time China became the member of the WTO, it has hastened its activities of revising its current laws and regulations. according to available literature reviews, china had by the year 2002 revised 37 administrative regulations and 14 laws, annulled a total of 12 administrative regulations, changed about 1,000 departmental rules and measures, and suspended a total of 34 relevant documents. At the time being, china had to timely adopt

Healthcare finance Essay Example | Topics and Well Written Essays - 250 words

Healthcare finance - Essay Example Once this is understood, the organization can accurately assess the profitability of each sector, clinical management, service lines or provider relationships in order to ensure growth in revenues and scalability (Glaser & Sett). Performance of each subsector can then be analyzed hence given room for improvement. To lower costs and enhance efficiency, there is need to revise networks in order to enhance coordination across health care services delivery. Accessibility of health care records to a greater amount of staff, physicians and clinicians is vital to ensure the speed of delivery and determine the individual cost of services offered. All these can be achieved through technology. Over the past, Electronic health records, revenue cycle management and costing systems have been operating individually, hence the high cost of delivering health care services. Since relevant technology started creeping in, from the integration of data storage facilities with the internet, the flow of information has been quick and accessible at numerous places at a one moment (Glaser & Sett). When health care data is recorded and coupled with time stamps, cost can be recorded instantly and bills can be calculated faster. This data is then recorded and will be accessible anytime for

Interim Assessment Report Research Proposal Example | Topics and Well Written Essays - 1500 words

Interim Assessment Report - Research Proposal Example Research objective Research objectives are the most important elements of a study. It is often regarded as the foundation of a research work (Babbie, 2012; Kumar, 2005). Moreover, the scope of the research is also established on the basis of the objectives of the study. This study principally aims to examine the impact of mobile search &social media on brand awareness, marketing and liberalization in Saudi Arabia. However, the study also has other objectives as well. The different objectives are presented below: - To identify the influence of mobile search & social media on brand awareness, marketing and liberalization in Saudi Arabia. To recognize how social media can drive customers towards a business and how it can help companies to embrace loyal customers. To identify the best or the most popular social media in Saudi Arabia. To explore how the indentified social media is helpful for the common people and business houses of Saudi Arabia. To identify how mobile search & social med ia can be used by business houses to investigate the business environment and simultaneously bring innovation to the business. To create an independent model to survey the business environment by employing mobile search & social media. ... In the similar context, O'Leary (2004) put emphasis on the fact that what used to be defined with ease 30-40 years back has now become exceedingly complex in the recent times. One of the obvious reasons is the rapidly changing business scenario and arrival of different type of research methods. Thus, which used to hold true 30-40 years back, not hold fully acceptable or not at all acceptable in the present days. In general, there are two broad research paradigms namely positivism and interpretivism. Positivism is often referred to as a scientific method of doing a research. A researcher believing in this philosophy considers realism as true and can be expressed from the viewpoint of an objective (Tobin &Joseph, 2006). Another significant differentiating factor between the two philosophies is that positivists considers quantitative analysis as the more reasonable and helps to draw a logical solution of the subject of concern. Researches believing in this philosophy often consider ques tionnaire survey, online polls, surveys as the best way of collecting data (Blaxter, Hughes & Tight, 2006; Scharff, 2002). The interpretivism philosophy on the other hand believes in anti-positivism concept. They do not consider reality to be stable or reality is articulated from the objective viewpoint. On the contrary, they regard reality is not stable and is constantly changing (Creswell, 2003). Furthermore, they also believe that the behavior of human being is constantly changing as the surrounding in which they exist, strongly impacts them. The researchers belonging to this category also tries to unearth the perception of people about the circumstances in which they exists (Mukherji & Albon, 2009). The differentiating

Business law Essay Example | Topics and Well Written Essays - 2750 words - 4

Business law - Essay Example Despite the fact that most of these laws are poorly implemented and enforced, those concerned with international business cooperation and trade are relatively clear and well applied. There is also evidence showing that after the 2003 leadership succession in china, from the third generation to the fourth generation, there was a launch of a new wave of economic legislation to advance the economic reform as well as reforming and building up the legal reforms in the country. The key driving factor to the new economic laws in china is attributed to the requirements of the world trade organization (WTO). Being part of the membership of the WTO, China has an obligation to meet the rules and regulations as stipulated under the penal code of the WTO (ECOVIS 2014). The most pressing rules and regulations that each member of the WTO is obliged to implement are concerned with the governance of trade as well as those related with other economic activities. As a result, its entry into the WTO, Ch ina has since strived to implement its business law to conform to the agreement with the WTO to meet its international obligations. This essay will attempt to critically discuss how China’s accession to the WTO in 2001 has reshaped its legal environment on the business regulation. In preparing to join the WTO, china initiated the overall process of reviewing its existing laws and regulations. Slightly either before the year 2000 ended, most of the administrative measures and the state council or ministries annulled regulations. Right from the time China became the member of the WTO, it has hastened its activities of revising its current laws and regulations. according to available literature reviews, china had by the year 2002 revised 37 administrative regulations and 14 laws, annulled a total of 12 administrative regulations, changed about 1,000 departmental rules and measures, and suspended a total of 34 relevant documents. At the time being, china had to timely adopt

Interim Assessment Report Research Proposal Example | Topics and Well Written Essays - 1500 words

Interim Assessment Report - Research Proposal Example Research objective Research objectives are the most important elements of a study. It is often regarded as the foundation of a research work (Babbie, 2012; Kumar, 2005). Moreover, the scope of the research is also established on the basis of the objectives of the study. This study principally aims to examine the impact of mobile search &social media on brand awareness, marketing and liberalization in Saudi Arabia. However, the study also has other objectives as well. The different objectives are presented below: - To identify the influence of mobile search & social media on brand awareness, marketing and liberalization in Saudi Arabia. To recognize how social media can drive customers towards a business and how it can help companies to embrace loyal customers. To identify the best or the most popular social media in Saudi Arabia. To explore how the indentified social media is helpful for the common people and business houses of Saudi Arabia. To identify how mobile search & social med ia can be used by business houses to investigate the business environment and simultaneously bring innovation to the business. To create an independent model to survey the business environment by employing mobile search & social media. ... In the similar context, O'Leary (2004) put emphasis on the fact that what used to be defined with ease 30-40 years back has now become exceedingly complex in the recent times. One of the obvious reasons is the rapidly changing business scenario and arrival of different type of research methods. Thus, which used to hold true 30-40 years back, not hold fully acceptable or not at all acceptable in the present days. In general, there are two broad research paradigms namely positivism and interpretivism. Positivism is often referred to as a scientific method of doing a research. A researcher believing in this philosophy considers realism as true and can be expressed from the viewpoint of an objective (Tobin &Joseph, 2006). Another significant differentiating factor between the two philosophies is that positivists considers quantitative analysis as the more reasonable and helps to draw a logical solution of the subject of concern. Researches believing in this philosophy often consider ques tionnaire survey, online polls, surveys as the best way of collecting data (Blaxter, Hughes & Tight, 2006; Scharff, 2002). The interpretivism philosophy on the other hand believes in anti-positivism concept. They do not consider reality to be stable or reality is articulated from the objective viewpoint. On the contrary, they regard reality is not stable and is constantly changing (Creswell, 2003). Furthermore, they also believe that the behavior of human being is constantly changing as the surrounding in which they exist, strongly impacts them. The researchers belonging to this category also tries to unearth the perception of people about the circumstances in which they exists (Mukherji & Albon, 2009). The differentiating

Scenario Consider Essay Example for Free

Scenario Consider Essay Operant conditioning is based on the premise that behavior can be formed and even modified with the aid of consequences. The main defining difference between operant conditioning and the classical or Pavlovian conditioning is the fact that it is concerned with change or development of voluntary behavior (Kirsch, Lynn, 2004). It is important to note that under operant conditioning the main variable of concern is the environment that is acted upon and is affected by given variables (Dalla, Shors, 2009). The consequences of the operant therefore play an important role in ensuring that a behavior that has been developed or modified is maintained. Under operant conditioning reinforcement and punishment are the key factors that determine the direction that behavior will be redirected to. Negative Vs Positive Reinforcement a) Similarities The core similarity between positive and negative reinforcement is that they are all aimed at ensuring high frequency of target behavior The use of a stimulus that is introduced into or removed from the environment under consideration is another factor that is shared by the two forms of reinforcement (Wenger, Schmidt, Davisson, 2004). It is important note that the key goal in both forms of reinforcements is to increase the frequency of the expected or observed behavior b) Contrast The key difference between the two modes of reinforcement is the type of stimulus used. In positive reinforcement the stimulus used is favorable and negative reinforcement employs an aversive stimulus (Myers, 2004). Another notable difference is that in most cases negative reinforcement involves removal of a stimulus whereas positive reinforcement involves its introduction. Most Effective Reinforcement Positive reinforcement is more effective than negative reinforcement. This choice is guided by the fact that reinforcements though included in the operant conditioning set up may in fact lead to forced adoption. It is important to note that the key goal in operant conditioning is to impact on the environment and not the organism being observed (Myers, 2004). Thus negative reinforcement which is in most cases included in the set up when behavior is being observed and removed once frequency has been heightened may lead to wrong results by impacting on the organism. On the other hand, positive reinforcement is not aimed at avoidance of a negative effect and therefore the behavior observed is likely to be of high level of accuracy. Â  a two year old who is continually crying with minimal provocation. Crying is behavior and provocation is a stimulus that impacts on this behavior The main aim in this scenario is to reduce the frequency of his or her outbursts with the introduction of a stimulus and a form of reinforcement. The stimulus under this consideration is to continually tell the child that crying is bad and may attract dangerous animals into their home. This may impact on the child perception of crying by affecting his sphere of thought or more accurately the environment. A reinforcement may also be required to increase the frequency with which a child responds positively (does not cry with minimal provocation). Reinforcement Schedule Candies are any childs favorite and will therefore play an important role in reinforcing behavior It is important to note that candies are not within the environment when a child is provoked and therefore do not impact on behavior rather it is introduced later. After the first lecture, the child is presented with a candy when he resists crying after being slightly provoked. This cycle is continued with no increase or decrease in the number of candies that the child is presented with. It is important to note that the form of reinforcement used under this scenario is positive due to the age of the subject and ethical concerns. Reference Dalla, C. , Shors, T. J. (2009). Sex differences in learning processes of classical and operant conditioning. Physiology Behavior, 97(2), 229-238. Kirsch, I. , Lynn, S. J. (2004). The role of cognition in classical and operant conditioning. Journal of Clinical Psychology, 60(4), 369-392. Myers, D. G. (2004). Exploring Psychology. London: Worth Publishers. Wenger, G. R. , Schmidt, C. , Davisson, M. T. (2004). Operant Conditioning in the Ts65Dn Mouse: Learning. Behavior Genetics, 34(1), 105-119.

Nursing Shortage in the United States

Nursing Shortage in the United States NURSING LABOUR FORCE IN THE U.S. HEALTH CARE SYSTEM Abstract The well-anticipated demographic change attributed to the ageing of the baby boomer population in the USA will led to a significant demand on the healthcare industry in the long run. Important resources such as the nurse work force will be required to provide quality health care services to the population. This research paper will provide a brief description and statistics of the nurse labor force in the USA, the educational requirement needed to be a nurse, the challenges face by the nurses in the healthcare system. The last part of the paper identifies the nursing shortage and the solutions for the short and long run, the recommendations and finally, the conclusion. LABOR FORCE IN THE U.S. HEALTHCARE SYSTEM The healthcare system in America is a complex and unique setting comparing to the other 34 countries in the Organization for Economic Co-Operation and Development (OECD). In 2016, The United States spent $3.3 trillion on health care benefits, or 10,348 per person annually, which represents17.9 % of the total GDP and remained at top of all OECD countries for the healthcare expenditures. About 30% of the cost was spent on hospital care, 20% on physician and clinical services, 10% on prescription drugs and 5% on nursing care. However, the life expectancy is 78.6 years which ranked 22nd of the OECD countries (Medicare & Services, 2015). Meanwhile, problems such as growing population, aging and shortage of physicians and nurses are causing the increasing demand for healthcare benefits (Levit & Patlak, 2009). In 2016, there were 5,534 registered hospitals including 4,840 community hospitals in the U.S, most of the healthcare facilities are owned by private companies and 60% of the community hospitals are non-for-profit organizations, 20% are for-profit and 20% are owned by government. In U.S, the most value of healthcare system in America is the health professional, also considered as health providers (AHA, 2018). THE NURSING WORKFORCE According to U.S Bureau of Labor (2018), the total labor force was around 160 million. Nurses are playing an important role in the healthcare system. Nursing demographic consists of: 1.5 million certified nursing assistant (CNA), which represents about 1% of the U.S labor force who are responsible supporting patients’ daily activities such as taking vital signs, dispensing prescribed medications, bathing and transporting patients. Certified nursing assistant is concerned as nursing assistant as general or patient care assistant. CNA is like medical assistants that both assist physicians, nurses and such healthcare providers. Usually, CNAs are assigned in an inpatient hospital and residential facilities such as nursing home and day care centers. Till 2016, the average salary for CNA was $26,590 while VA hospitals might offer better salary, around $37,450. Alaska pays the highest average salary which was $17.81/hour while it was $11.6/ hour in West Virginia. In fact, the market expected the demand for CNAs would increase about 11% during 2014 to 2024. 738,000 licensed practical nurse (LPN), which represents about 0.5% of U.S labor force, who are responsible for administering injections, surgical preparation and communication between patients and physicians. LPNs also do assistant works such as recording and maintaining communication with patients, registered nurses and physicians. LPNs are directly assigned to take care of patients that keep patients comfortable. Sometime, LPNs are assigned to take blood pressure, insert catheters and such activities. LPNs usually work in hospitals, nursing homes, doctor’s offices and any healthcare facilities. In fact, LPNs are the direct contact between patients and physician that they are responsible for keep patients’ knowledge about treatment and procedures. The average salary for an LPN was $44,000 and the number is expected to increase. Connecticut state pays the highest average salary which was 24.30/ hour, comparing to the lowest paying state West Virginia with $14.25/ hour or $29,640 per year. 3 million registered nurse (RN), which represents the largest group of all types of nu rse and 1.9% of U.S labor force, who are qualified with license to make nursing diagnoses and work as a supervisor of CNAs and LPNs. RNs work with physician and healthcare teams to improve healthcare quality and treatment quality. RNs also educate patients for their health conditions and support patients and their family members on further living. Since it is the largest group, the competition is fierce. Depending on the specialty, education and experience, the average salary was around $70,000 in 2015. Some hospitals might offer better payment to $100,000. California owns the largest number of RNs, which was around 300,000 and it pays the highest salary in America, which was $98,400 on average. The market expected a 16% increase of RNs from 2014 to 2024.151,000 advanced registered nurse practitioner (ARNP), who received additional education with master’s degree or post graduate degree and additional medical experience. ARNPs work as clinical nurse specialist and nurse anesth etists that they are certified to diagnose, prescribe medication and therapy, provide treatment and counsel to patients. ARNPs are specify into multiple types such as acute care, nursing information, nurse administrator, travel nursing, family nursing, psychiatric nurse, neonatal nurse and pediatric nurse. The average wages for ARNPs was $95,000 or $46.40/ hour. During the first decade of 21st century, the job opportunities in the healthcare segment of United States grew with a pace of 20% while, in all other segments of the industries nationwide, the same growth was merely 3%. The growth rate has boomed in the US healthcare market, demanding for more and more registered nurses and nursing professionals in the current decade as well. These opportunities have created various job profiles so far in the evolving hospital settings. New hospitals and home care-based jobs are also emerging rapidly. â€Å"It is anticipated that the rate of employment in the health care sector will grow faster than the rate of employment in all other sectors between 2014 and 2024, with projected increases of nearly 22% and 5%, respectively. Other service sectors are projected to grow by about 8% during the same time period .†Ã‚  (Martiniano, Chorost, & Moore, 2017). Currently there are more than six million of the staff available across states in the healthcare settings for RNs and NPs working in various administrative positions in United States. The growth rate is also having positive rays of hopes in terms of having future job employments because of the fact that between 2014 to 2024, it is estimated that the home care based jobs are expected to increase by 60% while jobs in the offices of the healthcare practitioners are also said to have the increase of 25% because as of now, there are more than 4 million of jobs that are available in the same position—the job positions are subjected to be vacant and filled at the same time, depending on the conditions of the nurses who are employed and leave their jobs due to unforeseen conditions (Martiniano et al., 2017). Researches showed that there would be a 1 million shortage of RN in 2020 because of the dropping economic situation in America. In fact, the shortage has been ongoing since 1998 that it has been always a lack of supply. The supply was higher than the increase of demand. There were several reasons behind the shortage. Ageing of nurses might be the most concerned issue in recent that many nursing practitioners are getting older. Since 2012, the 50-60 year-age group represented the largest group on RNs and these group is expected to retire before 2025 but they are the ones who are the most experienced for taking care of patients (Levit & Patlak, 2009).   The U.S government also supports foreign-born nurses in order to fill the gap between supply and demand. In 2008, international nurses represented 15% of the nursing workforce. One concern was the communication that international nurses might have problems on communicating with patients and doctors even thought they had passed the English language test such as TOEFL and IELTS. In fact, foreign-born nurses on average cost less than American born nurses and they contribute extra value on international patients (Levit & Patlak, 2009). NURSING PROFESSION’S QUALIFICATION With the expansion of the ACA, allowing more people access to health care and insurance coverage, and the aging of the population, which increases the nationwide rate of terminal illnesses such as heart failure and cancer, the demand for care is higher than ever and there prompts the big question of whether the current health care workforce can adequately meet that demand. To fill the obvious gap that will occur, non-physician providers will be needed. Potential candidates for the positions are no other than advanced trained nurse. In the1990s, funding for nursing education drew the attention of policymakers as people realized there would be substantial shortfalls of nurses in the next decades. Efforts to increase funding for nursing education have been intermingled with advocacy for increased emphasis on baccalaureate entry-level education. In the past, many RNS were educated in hospital-based diploma programs, but most of these programs has been converted to associate or bachelor’s degree programs. The shift in nursing education from hospitals to universities marked the importance of the body of knowledge that the nursing profession should possesses. More essentially, it defined nursing as something much more than assistant to the physician. As an effort to alleviate a looming cycle of nursing shortage, community colleges and technical schools started offering nursing program in the 1970s. Since then, the nursing education has greatly evolved to better prepare their students for the ever-changing and challenging world of health care system. The two most common paths for people pursuing a nursing degree is either obtaining a 2-year associate degree (AND) or a 4-year baccalaureate program (BSN). Many community and technical colleges offer ADN programs and they are more attractive to prospective nurses because of their affordability and a shorter time period to finish. Graduates from the programs are qualified to sit for the National Council Licensure Examination for Registered Nurse (NCLEX-RN). This type of program provides a solid foundation for entry-level nursing positions at a wide array of health-related establishments, including hospitals, primary care clinics, and nursing homes. In addition, nurses can later register for the RN-to-BSN bridge programs to obtain their BSN. The 4-year BSN, while more time consuming, opens up more opportunities for nursing students upon their graduation. BSN candidates receive intensive training not only in the clinical field, but also in leadership and communication skill. The goal is to provide more professional development to their students through a comprehensive curriculum that covers some of the most pressing issues within the profession, such as public health, social sciences, nursing research, and management and leadership. Most of nursing programs are not recommended to be taken online as they are hands-on profession. Averagely, nursing program costs $15,000 per academic year (Registered Nursing Degrees, 2018). In the 1990s, nurses once passed their board licensing received the same licenses and often hired to perform the same jobs. Their background education, whether they had an associate degree (ADN) or a baccalaureate degree in nursing (BSN), did not differentiate the task they performed in any health care facility. While the practices and educational differences between ADN and BSN were proven to exist, there was a general but often weak correlation in patient outcomes based on the initial education preparation of the RN providing the care (Kovner & Schore, 1998). A meta-analysis done in 1988 by Joyce Johnson pointed out that BSN RNs attained higher scores in the field of communication, problem solving, and professional role when compared with AND RNs. Contrariwise, these associations decreased when experience was taken into account, and no distinguishing result existed in measuring level of leadership and autonomy between BSN and ADN RNs.  Time has changed and so as the complexity of the health care system. The role expectations and educational outcome differences for ADN and BSN has been more clarified. Although the health care system required nurses prepared at both levels of education, the graduates of these programs hold different competencies and should be valued for those differences (N/A, 1995). A study done in 2003 further proved this notion by showing the connection between higher levels of nursing human capital and improvement in patient outcomes – a 10 percent increase in nurses with baccalaureate degree yielded a 5 percent decrease in patient mortality and complications (Kutney-Lee, Sloane, & Aiken, 2013). This clarification in the roles of ADN and BSN nurses are vital to the delivery of high quality care and require the restructure of their education curriculum as well as validation in the systems in which these graduates are employed.      ISSUES IN THE NURSING LABOR FORCE Like many other health care professional, the nursing workforce has many problematic areas that need to be resolved. One of the most pressing one is the shortage in labor force. The Patient Protection and Affordable Care Act (ACA) since its enactment in March, 2010, has successfully provided insurance coverage for around 19.2 million people and dropped the number of uninsured population from 20.5 percent to 12.2 percent in 2016 (Garrett & Gangopadhyaya, 2016). This influx of new patients has driven up the demand for nurses with the U.S. Department of health and Human Services projected a shortfall of over one million nurses by 2020 (DHHR, Resources, Workforce, & Analysis, 2017). However, the current state of the workforce is gradually depreciated due to several factors. The aging baby boomer nurses reaching their retirement ages contributes as the first factor in this shortage crisis. This aging workforce has been dealing with increasing pressure due to higher work demand resulted fr om nursing shortages, and their health suffers tremendously with a significant higher number of senior nurses experiencing chronic pain, tiredness, and exhaustion among the group (Gabrielle, Mannix, & Jackson, 2008). An obvious fix to this problem is to increase the number of qualified nurses in the labor market through nursing school recruitment campaign. Unfortunately, the majority of nursing schools nationwide do not have the capacity to accept new candidates due to a lack of faculty, budget constraints and limited clinical sites for students to practice. While all schools reported reaching their full capacity and even going over their students limit each year, many applicants got rejected, with 78 percent of ADN applicants and 62 percent of BSN candidates, all of them had qualified credentials, were turned away from nursing school in 2016 (Nursing, 2016). This would directly reduce the chance to generate enough nursing graduates to meet the upcoming demands facing the health car e industry. Beside the restricted nursing enrollment rate, health care providers only preferred nurses who already had several years of experience and turned down many potential applicants only because they newly graduated. Another realistic alternative to fill the gap in nursing staff is by hiring foreign-educated nurses. However this solution is poorly received since it stirs up concerns regarding the level of competency of nurses trained outside the U.S. and immigration issues (Williams, 2014). A shortage of nurse will ultimately lead to a change of nurse staffing pattern in care centers, with one nurse tending for more patients. A study by Cummings and Estabrooks (2003) pointed out the negative effects the change in nurse staffing patterns had brought upon the remaining nursing staffs’ health and their competency to provide quality care. Other research literature also reported imbalance nurse staffing pattern can drive up the rate of preventable medical errors and adverse events (e.g. hospital-acquired pressure ulcers, wrong blood transfusion) (Cho, Ketefian, Barkauskas, & Smith, 2003). The predominant effects of hospital restructuring on nurses are mostly negative with a decrease in efficacy and ability to provide quality care, reduction in job satisfaction, and disparity in teamwork among care providers, which resulted in an increase in turnover rate. Cost containment initiatives in many health care establishment can also further deplete the nursing workforce. The U.S. health care expenditure has skyrocketed over the past decade and accounted for 17.9 percent in the overall share of gross domestic product (GDP) and more than $10,000 per capita in 2016 (Llanos & Rothstein, 2007) (CMS, 2016). Regardless, the U.S. index for health care outcomes such as life expectancy, maternal mortality, child and infant mortality are far behind other OECD nations (Institute of Medicine, 2007). As a result, several health reform programs were introduced in an attempt to increase access-to-care for the population, reduce the health care cost, and improve the quality of health care. The implementation of these pilot programs put tremendous pressure on health care providers and organizations to contain their cost while maintaining optimum treatment to their patients. Many care facilities decided to restructure their workforce by decreasing the overall labor pool. As one of the largest personnel group in the health care workforce and oftentimes claimed for the largest piece of the hospital budget pie, approximately 33 percent of hospital operation cost (Walston, Burns, & Kimberly, 2000), nursing positions were the primary target for cost-containment strategies in many organization. The result was an increase in substitution for lower credential nursing position, such as Licensed Practical Nurse which only required two years of associate degrees, or even unlicensed personnel like patient-care technicians. This shift in work force in the 1990s, however, had driven up the rate of medication errors, patient injuries and infection (Kunen, 2001). To better adapt to the ever changing environment of health care bureaucracy and population health priorities with finite capital and human resources, all health-related establishments should develop strategies with emphasis in organization and culture restructure that has positive impact on the outcomes of patients and nurses. Beside financial incentives, political advocacy from both the federal and state government, as well as professional opinion and standard setting can further make changes to the recruitment and retention of qualified nurse workforce. THE GOVERNMENT’S EFFORT IN SOLVING THE ISSUE OF NURSE SUPPLY One of the problems the healthcare system in the U.S. is facing is that of shortage of nurses. Some factors which contribute to this shortage is the fact that women have more options in choosing their career path in society today when compared to the past. From an economic point of view, this problem of shortage is cause more by the supply side rather than the demand side thus, making it a more complex shortage (B. & J.I., 2001). This shortage of nurses might worsen in the long run if the government do not develop and implement solutions to solve this problem. Some economic solutions where developed in the past to help solve this problem such as relocation coverage, new premium packages and sign on bonuses; however, they were all short-term solutions which helped in redistributing the supply of nurses instead of increasing it (B. & J.I., 2001). Due to the shortage of nurses in the healthcare system, the government has developed and implemented solutions which will be examined below. The government is trying to recruit more students and educators in the nursing field to combat with the increasing demand in the workforce. For some years now, recruitment of students in the school of nursing has been declining. According to the American Association of College of Nursing, the number of nursing students who enrolled in the bachelor’s degree program had been declining in the past five years (Larson, 2016). In 1999, the number of nursing students felt by 4.6% nationwide. Nursing master program also suffered the same fate with a decline of 1.9% in some states (Larson, 2016). To better utilize the current aging workforce, healthcare circles decided to recruit the old and retired practicing nurses who can no longer administer treatment to the growing population and appointed teaching positions to them in nursing schools. They came to a conclusion that this ageing nurse’s will better teach the students as they are teaching out of experienced and it is said exp erienced is the best teacher (Johnson et al., 2006). Practice and experience are two important factors that teachers most acquired in order to teach students effectively. Also, in San Diego, six hospitals donated $ 1.3 million to support a program known as â€Å"Nurses Now†, which will be an opportunity to add faculty members and additional nursing students in the San Diego University (Costantini, 2016). Moreover, in order to support students to do nursing, the Texas hospital donated $ 425,000 in scholarships to local students to do their bachelor’s degree program in nursing. Moreover, in New Jersey the Board of Free holders donated scholarships to local students who accepted to work in the long term care facility in the USA (Costantini, 2016). These are examples of some successful collaborative efforts between healthcare organizations, nursing schools and the USA government to help solved the problem of nursing shortage in the USA. Moreover, in order to solve to problem of shortage, hospitals are re-implementing intensive training programs for nurses in various specialities. This has gone a long way to retain nurses who are seeking for a transfer and has also help build a vocation development path for nursing staff. A research that has been done on Magnet hospitals indicate that some of the organizational characteristics that create a centre of attention and retain nurses are professional practice models for delivery of healthcare with independence and responsibility to make decisions (B. & J.I., 2001). Moreover, effective managerial structure, quality patient services and investment in nurses’ professional development in the healthcare system are very necessary and important. Nurses must be involved in developing and implementing the practice of care in hospitals since they are very close to patients. Some of this practise includes; participating in the financial management of the hospital and developin g new strategies in hospitals. If healthcare leaders developed intensive programs for nurses in each specialities, it will motivate them to realize that they are very important in the healthcare system thus, encouraging them to remain in their various specialities in nursing. Furthermore, healthcare leaders need to developed models of care in order to solve the problem of nurses shortage in the USA, the government need to implement regulatory and policy issues (Johnson et al., 2006). Some regulatory and policy problems could also cause the nursing shortage such as federal and state laws, licensure and nursing practice act, and requirements from reimbursement organizations, private organization and the government (Johnson et al., 2006). Inside an organization, insistent process developments initiatives can assist standardize and simplify documentation. Healthcare leaders should drive this problem with some consultation from some internal experts in reimbursement, patient documentation and risk management. Furthermore, nursing trainers should use technology as one of the training tool.  Although most of the section in nursing learning is clinical experience, most of the classroom teaching can be done through the new technology we have today such as internet teaching, distance education, and accelerated educational programs.  As the healthcare of patients become more associated to technological improvement, routine nursing performance can drilled by utilizing the same technology. Technology improvement could also be use to test and certified nursing educators (Larson, 2016). All these new methods of teaching nurses through technology advancement will motivate younger adults who like using the internet and other forms of technology to learn to join the nursing field thus, helping to solve the problem of nursing shortage. In addition, to help solve the problem of nurse shortage in the USA, healthcare leaders should concentrate on training our own nursing and retaining them from traveling to other countries such as Canada. One good approach to solve this problem is to employ bachelors and masters students who are already in the faculty programs and provide them with qualified training and prepared them as well-trained nurses to be employ in the nursing field (Buchan & Aiken, 2008). Guidance into the clinical faculty is one of the best in this context, and this will improve nursing student’s capacity to do their work in the nursing field efficiently. The main idea is to guide them to grow into the nursing profession and eventually make nursing their profession of choice. This strategy will work well to the nursing field advantage because, it will encourage students to choose nursing as a career thus, increasing the number of nurses for the future. To continue, to solve the problem of nursing shortage in the USA, the government should augment the supply of nurses by using tax credit. For example, three bills where pass to permit the creation of refundable tax credit for all register nurses (Johnson, Posner, Biermann & Cordero, 2006). This is a positive impact that would have help retain nurses in the profession and it will also help to increase their salaries. Moreover, it will motivate them to maintain their various positions in hospitals thus, working positively in reducing the problem of nurse shortage in the USA. More so, in order to solve the problem of nursing shortage in the USA, hospital managers should offer bonuses to nurses who accept and sign up to work in that hospital for a long period of time. For example, in St. Paul hospital in Minnesota, the hospital leaders are giving out bonuses of about $8,000-$10,000 to nurses with essential care experience who have sign up to work in the hospital for a long period (Larson, 2016). This strategy has help St. Paul hospital to keep most of it nurses. If more hospitals could adopt this method, it will help solve the problem of nurse’s shortage in the USA. Moreover, in order to solve the problem of nurse shortage in the USA, the government need to increase the salaries of nurses. The work load of nurse’s especially register nurses is much as they are the ones who spend most of the time taking care of patients (B. & J.I., 2001). Most of them leave the nursing field because they are not well pay for the work they do and most of the time, some are not pay for the extra work they do. In order to solve this problem, the USA government has increased the salary of nurses for example in California; the salary of register nurses went up to $94, 120 per year (B. & J.I., 2001). This has motivated many people to join the nursing field. According to experts’ projections from the Bureau of Labour Statistics, by 2022, the nursing field will experience an increase in the number of register nurses of about 526,800 (B. & J.I., 2001). This is a good sign for the healthcare field for the future – absolutely a field with good prospects . ALTERNATIVES FOR THE SHORTAGE IN NURSING SUPPY Nurses form an essential part of the working force in the healthcare system in the USA and the great role they play cannot be ignored. This explain why the USA government, over the years have been trying to solve the problems nurses are facing in the healthcare system in order to motivate more people to join the nursing field. Due to all this, some recommendations are made to help improve the nursing working force. One of the recommendations is that, healthcare leaders should change consumers’ knowledge of healthcare services. Most patients like meeting register nurse for them to take care of them whereas; they are other nurses in the hospital who can take care of them better. Healthcare leaders’ need to change this perception some patients have concerning the choice of nurses. More so, some patients believe that nurses who are well paid do the work better than nurses who are less pay. That is why patients keep traveling from one state to another in order to seek for hospitals where nurses are been well pay. For example, most Americans travel to big states such as California in order to receive treatment from physicians and nurses. This believes is not good because it creates nurses shortage in big states compare to small states (Costantini, 2016). The USA government should develop and implement public health programs that will help educate the population on how to prevent certain illnesses. This will help reduced the number of people who get sick, thus reducing the number of patients, nurses have to take care of. People should do more of physical activities and eat healthy in order to avoid unnecessary illnesses which could be avoided by doing this. Also, the population should be sensitize about the problem of nursing shortage in the country. This will motivate them to take good care of themselves in order to avoid falling sick. Based on the execution of these recommendations, it will assist to achieve healthy people 2020 objectives. These recommendations are strategic plans that can be utilize by the government, people, private and public health providers and communities to improve the health of the population thus making the USA government to achieve its goal of healthy people 2020. CONCLUSION Nurses play a very significant role in providing medical treatment to patients and they also help to re-enforce the physician’s shortage labour force in the USA. Many health care organizations can not do with out nurses as they play a significant role. If the shortage of nurses worsens, many patients will no longer have access to care thus, creating a huge problem in the country. The USA government need to take the problem of nursing shortage in the country very serious as the baby boomer nurses retirement will cause a serious shortage. With the fast growing population of America, as many immigrants are coming in, it is necessary for the USA government to attract more nurses into the health care system. It there is surplus of nurses in the country, it will help the government, Medicare & Medicaid and other health organizations contain healthcare cost which is very expensive. It will also increase quality and access to medical care. REFERENCES B., N., & J.I., E. (2001). The nursing shortage: solutions for the short and long term. Online Journal of Issues in Nursing, 6(1), 4. Cho, S.-H., Ketefian, S., Barkauskas, V. H., & Smith, D. G. (2003). The effects of nurse staffing on adverse events, morbidity, mortality, and medical costs. Nursing Research, 52(2). CMS. (2016). National Health Expenditure Data. Retrieved from https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html Costantini, S. D. (2016). Challenged by a Nursing Shortage? Consider These Short-Term Solutions and Long-Term Strategies. Avant Healthcare. 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Rational Emotional Behavior Therapy Case Study Conceptualization and Tr

Rational Emotional Behavior Therapy Case Study of Sarah: A Conceptualization and Treatment Plan Rational emotive behavior therapy, REBT, was developed by Albert Ellis and holds the central belief that the events in our lives do not cause our disturbances but that they are instead caused by our view of the events (Murdock, 2009). Murdock (2009) states that â€Å"people are seen as responsible for their behavior† (p. 279) but, because they are constantly changing and processing, their value or worth is not measured by their behavior. According to REBT, healthy individuals function with rational beliefs (Murdock, 2009). Sarah’s needs can best be met through the use of REBT as the therapist incorporates the interventions of role-playing and disputing, stop and monitor, and recognizing and changing irrational thought patterns, while striving for the goal of eliminating irrational thinking, dysfunctional emotions, and behaviors and teaching Sarah the philosophy of REBT. REBT will allow Sarah to overcome and replace her irrational beliefs and in turn experience healthy consequences and emotions. Presenting Concerns Sarah James, a 26-year-old Caucasian female, is seeking counsel in response to the unveiling of a family secret. Upon learning of the existence of an older brother and the, in her mind, poorly handled events surrounding the secret, Sarah is questioning her relationships and views of her family members. Sarah is unsure of what to do with the information she has been presented and is reevaluating her childhood, which she once thought had been near perfect. She is feeling confused, frustrated, angry, and isolated and these feelings and emotions have brought her to seek counsel over the situation. Case Conceptualization Ba... ... and religion. Professional Psychology: Research and Practice, 31 (1), 29-33. Jones, S.L., & Butman, R.E. (1991). Modern psychotherapies: A comprehensive Christian appraisal. Downers Grove, IL: InterVarsity Press. Lega, L.I., & Ellis, A. (2001). Rational emotional behavior therapy (REBT) in the new millennium: A cross cultural approach. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 19 (4). 201-222. Minor, J. (2007). Some reasons why I use REBT in my private practice and personal life. Et Cetera, 64 (4), 320-323. Murdock, N.L. (2009). Theories of counseling and psychotherapy: A case approach (2nd ed.). Upper Saddle River, NJ: Merrill-Pearson. Ziegler, D.J. (2000). Basic assumptions concerning human nature underlying rational emotive behavior therapy (REBT) personality theory. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 18 (2), 67-85.