Who I Am as a Teenager

Who am I? This uncertainty has to be one of the most common to go through a teenager’s brain. As a regular teenager, I make mistakes, laugh, cry, smile and love. Every experience in my life good or bad, happy or sad makes me stronger. Each step in my life and each passing moment make me grow into the person I want to be. To understand who I am, I have to talk about things that help to shape my identity like my past, the culture where I come from, the environment where I grow up and my family Our history influences our patriotism and our nationalistic tendencies. As I have been growing up, I notice that my entire background have influenced in who I am. My history helps me to remember where my ancestors came from. By remembering that, I will understand my heritage, more about me, and how I should live my life the best I can. History is not only telling me about how my family’s ancestors lived their lives, but also show me my culture, my tradition, and the way that I think. The family history of everybody marks their past, their present, and their future, because the consequences of the actions remain in time. Our culture influences, to an extent, everything in our lives, from how we are schooled, the morals we are taught and other influences on our lives such as sports we play, foods we eat, clothes we wear, music we listen to and how we feel. All these examples represent my culture. It makes me different and identifies me with my birthplace, and I feel important in this world because of these differences. I was born in a small city in Vietnam, and I did not have any brother or sister. As the only child in my family, I grew up in a very loving, caring and educating family environment. However, grew up in that type of sheltered environment prevented me from seeing the outside world. My only friends were my toys, so when I started pre-school, it was really different for me because there were a lot more kids than I was used to seeing. Since I did not know anyone, I didn’t talk very much. As I grew older and moved through school, I began to have more friends than I did back in pre-school. I was starting to talk more and be more active. I realized that the environment where I grew up had influenced who I am as a person. All this parts of my background make the person that I am. Another aspect of who I am is the hobbies that I enjoy doing. I like to listen to any kind of music except rock and rap. I enjoy playing sports such as soccer, basketball and football with my friends. I also enjoy off-road adventures, and playing with my two three-year old nephews. Another one of my hobbies is reading books especially medical books because I want to be a doctor like my parents. My family is probably the largest reason that makes me who I am today because it decides my personality, bias and character flaws. My dad and my mom are both dentists and although they are busy with their job, they always spend most of the time to take care of me. Being a working housewife, my mom tries very hard to be a good homemaker. She is an adventurous cook, and she is good. Unlike many of my dad’s contemporizes, he is a picture of health and vitality. I admire his dedication to his patients and work. Although my father is a strict disciplinarian, he can be jovial and caring at the same time. When I was sick, my parents would take off work and spend the whole day to pampering me back to health. My dad used to tell me that â€Å"as a human being, everybody made mistakes. Some people would deny to facing it but the smart people would have the courtesy to learn from them and not made them twice. † He also taught me how to be strong. He told me to except things as they happened and moved on. If I spent all day thinking about it, I could miss the things that made me happy. Not only did they teach me good moral values, but they also provided me with examples of good behavior and how to support my family. I was taught that my most important goal in life was to have a good education. My parents used to say that someday they would not be with me anymore, and if I wanted to have an economic independence, I had to have a good education. Then I started to think about that, and I decided to study abroad in America. I knew more friends and got more independent. Through that experience, I had a chance to experience both traditional Vietnamese culture and innovation American culture. I learned how to use my Asian background as a beneficial tool and to see myself as a unique person rather than as a vagrant. I was able to know and learn about each person and their culture; my personality changed from introverted to sociable. Henry Ford once said, â€Å"Life is a series of experiences, each one of which makes us bigger, even though it is hard to realize this. † Each one of us is unique in the way that we interpret the influences on us and decide whether or not to accept these outside interventions in our self-molding. My history, my culture and my family’s environment are the most important parts of my life. They are things that help to shape who I am. I love being me and the person that I am. I am not perfect, and don’t try to be. I go through life with an open mind and take things in as they happen. I am me and that all I can be.

Facebook in Asia, Europe and North America Essay

The purpose of this report is to develop an insight about the growing use of the web and the number of business opportunities that resulted from it. The report describes some online business opportunities along with the pros and cons of stepping into such businesses. This report will later examine how Facebook has become a successful business enterprise and how it continues to develop in the competitive market of social networking. Introduction There are 389 million online users worldwide and most of them have home internet connections. Figure-1 in the Appendix shows internet user ship by world regions. The figure shows that the major chunk of internet users is in Asia, Europe and North America. The user ship among women and senior citizens especially in the US is increasing. The youth in the US spends a major proportion of their income using the internet and spends many times more than adults do via the internet. Businesses have realized that there are many marketing opportunities that can be realized through the internet. It is predicted that the online advertising expenditure will exceed $106 billion in 2011.   Search and Display advertisements will be the major type of internet advertisements and company spending in such advertisements is expected to grow by 50% till 2011. Online Business Opportunities Of Today Below are some types of online businesses opportunities: Affiliate marketing Affiliate marketing is a way of selling goods on the internet through affiliations or partnerships. The affiliate seller earns commissions for selling the other party’s products. The Amazon.com was the pioneer of the affiliate marketing concept(Holzner,2008). Network marketing Network Marketing is a direct marketing technique. The goods are generally promoted directly using word of mouth and references to consumers in return for compensations. Promoters can keep their own sales force and also earn part of the revenues the sales force brings to them. Niche marketing It is not feasible to compete with bigger and established businesses online or otherwise as these businesses have the necessary resources and expertise to drive out smaller competitors. Through niche internet marketing one can identify the areas ignored by these huge companies and cater to them effectively and efficiently. Hence this requires limiting the focus and target customers. Selling a specialty product or service is an example of niche marketing(Goldman,2008). Blogging One can sell advertisements on blogs and make money as viewership increases. Topics such as love and relationships generate more traffic. Selling private label rights products In such a business you have the authority to modify and sell a pre-existing product such as an online book. The seller even has the right to sell the product under his own brand name and keep all the profits earned.   Email marketing This is a great way to promote goods and services using email. Sending personal emails to target customers regarding latest promotions, sending newsletters and carrying out promotions on third party sites are some examples of email marketing. EBook Writing Talented writers can access sites such as elance.com to find customers .Bidding on subjects you are knowledgeable about is the best approach(Gillin,2008). Online Business Advantages Following are the advantages of starting a business online:  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The capital and overhead costs are low as there is no need to acquire new assets.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   You have control over your life. Hence you are your own boss.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Internet connection is easy to acquire. The speed of the internet is a bonus and not a requirement. Internet businesses are often private and do not require too much interaction with the outside world(Jag,2008).  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There is no need to commute to another location.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   There is no fixed timing. Work schedules are flexible. One can take a vacation or work part time.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Internet allows access to millions of people worldwide efficiently and effectively.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The internet provides many promotional opportunities often for free.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   One can start many businesses at once.  ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The internet business does not require good communication and sales skills. However one must be hard working and determined(Gerakines,2008). Online Business Disadvantages Computer Skills The business owner must be computer literate order to work efficiently. This must be so regardless of the fact that he can hire experts to work for him. Privacy issues Even though many good security mechanisms can be used to protect information online, there are still security issues especially with credit card transactions. Confidential information can be hacked and misused relatively easily. Intellectual Property Rights Law enforcing bodies find it hard to impose copyright restrictions on online businesses as effectively as they can on other businesses. This is because internet is without boundaries. A business plan can easily be copied and regardless of its origin(Facebook,n.d.). Waste The internet is accessible to everyone hence focusing communication to the right market is difficult and leads to wastage. Distractions Interruptions from family, friends, pets, television etc can affect productivity( Veer,2008). Motivation Internet businesses require the owners to be self disciplined and self motivated. It is tempting to delay tasks as there is no accountability to anyone but to oneself. Balance Jiggling family, friends and the online business can be even harder when one has a full time job or other online businesses.

Watching TV makes you smarter Essay Example | Topics and Well Written Essays - 250 words

Watching TV makes you smarter - Essay Example Johnson’s argument in support of television programs with more intricate stories can actually have a greater level of intellectual benefits when compared to plainer shows because under the latter case, the viewer’s brain does not explore potential outcomes of the story and the rationale behind such ideological constructs (170). Conversely, Johnson falls short of providing a convincing argument that places television viewing above other ways of gaining intellectual skills such as reading books. In fact, owing to the general spectator roles in television viewers, their inability to take charge of the unfolding events in the programs does not have any impact on their respective intelligence quotients (IQs). The viewers’ cognition is always expected to remain unchanged, irrespective of the content they are exposed to. By contrast, most people need some motivation to clear both psychological and physical fatigue inherent in human life, in an attempt to stimulate learning and cognitive development. In light of this, simple television programs with a higher level of predictability may have a higher degree of improving the IQ of the

The life of William shakespeare Research Paper Example | Topics and Well Written Essays - 750 words

The life of William shakespeare - Research Paper Example Of the five siblings, William had two sisters and three brothers. Edmund Shakespeare, the last born in the Shakespeare family was born when William was in his teenage years, and that’s when he lost one of his sisters. John Shakespeare later became the mayor of the town in which William was born. Shakespeare never had an extensive education life. At the age of six or seven, William Shakespeare attended the King’s new school in Stratford (a school that taught children of prominent citizens) where he leant grammar and got the chance of sharpening his writing skills which laid down the foundation of his career in theater. In his secondary, he studied Latin, literature, rhetoric, logic, and ethics. In his work, there is evidence of Roman comedy, classical mythology and ancient history. This is believed to be his only formal education as there is no evidence to suggest he ever received university training. William might have been withdrawn from the school of grammar due to the increased poverty of his father at the age of thirteen. At that time, his father was a butcher, and William joined him in that business for some time. The business of John Shakespeare had gone from bad to worse, and at the time, William Shakespeare was eighteen, his father was deprived of his mayorship. This happened on 6th of September 1586. Not much is known about the life of William Shakespeare in his youth, but it is evident that at the age of eighteen, he got married to a farmer’s daughter known as Anne Hathaway who was eight years older than him. They married when Anne had William’s pregnancy and she gave birth six months later. It is believed that Shakespeare was forced into marriage by the Hathaway family since he wanted to marry one Anne Whateley who was already married to Wm Shaxpere and that he had previously impregnated Anne Hathaway. William Shakespeare never showed affection to his wife. This is evident because in his first draft of his will,

Labor realations Assignment Example | Topics and Well Written Essays - 500 words

Labor realations - Assignment Example However, CLC preferred to disagree with the proposal as CAW was supposed to one of the biggest private union segment and agreeing to the request of SEIW was expected to trigger certain problems for CLC in terms of privilege support and other benefits related to labor (Niemeijer, 2000). With reference to the above context, it can be stated that the dispute between the SEIW and CAW acted as a certain form of threat for the labor unity and solidarity to union democracy as well. The disagreement was considered more of a threat as CAW was one of the largest local labor union of Canada which involved the support of 234,000 members. In relation to this fact, banning the members of CAW from CLC entailed the possibility of creating certain problems for every labor union which included lack of support in response to the undertaken circumstances, privileges provided by the government and the rise of other unions among others (Niemeijer, 2000). The disagreements among the labor unions such as the dispute between SEIU and CAW can lead to various problems within the nations while acting or performing in favor of the labor rights. The problems which can trigger in relation to the labor union disputes can be identified as lack of unity among the unions present within the nations while dealing with similar problems and assisting the labors of the organizations with benefits and rights as specified in the labor laws. Furthermore, the disputes of labor union can prevent the government of the nation from taking interest in the problems related to labor (Pierce, & Bentham, 2007). Discuss The Issue Of National Autonomy From International Parent Union. How Might Canadian Locals Protect Their National Autonomy While Still Enjoying The Benefits Of Membership In A Large, International Union? The issue of national autonomy from international parent union can be identified in terms of the assistance provided by

Buying gold during a rescission its a good idea Research Paper

Buying gold during a rescission its a good idea - Research Paper Example At the same time gold prices are raising sharply and many of the current investors believe that investments on gold may bring better returns to them in future. This paper argues in favor of buying gold as the safe investment option during a recession period â€Å"When you see the Fed start buying their own treasuries from China and Japan, hyperinflation and default will be just around the corner. Gold and Silver provide the peace of mind one will need whenever that day arrives† (Eberhardt, p.26). Even though the prices of gold and silver experienced certain ups and downs in the past, no major collapse of gold prices has been reported yet. Most of the emerging countries like China and India are purchasing more gold and keeping a good gold stock. When we compare the current stock market conditions and the conditions of the banking industry against the current gold industry trends, investments in gold seems to be the right option. â€Å"When it came to the extreme stock market c onditions, people ran to the safe haven of gold† (Eberhardt, p.146). In order to learn more about the potentials of gold as a safe investment option, it is necessary to identify the differences between money and currency. Many people are of the view that both money and currency are the same things. This is an illusion. â€Å"A currency does not store value in and of itself.

Eth3.2DBExperienceLovability Article Example | Topics and Well Written Essays - 750 words

Eth3.2DBExperienceLovability - Article Example In any case, continued practice under harsh conditions predisposes nurses to potential deviation from standards care which in essence puts the practitioner at risk of liability of malpractice or negligence as depicted in a number of industry blogs. To that end, this paper draws valuable insights from an online blog on liability as it seeks to identify four common areas of nursing liability. Common areas of Nursing Liability Primarily, there are numerous areas in which nursing practitioners may be liable for deviation from standard care. However, this paper will only focus on the four common areas including professional negligence, malpractice, breach of professional code of conduct, incompetency. The occurrence of such liability elements are wide in scope and much depends of a number of factors such as they work condition as well as the operational norms or organizational culture of quality care as reiterated by Simon (2006). Some might be unforeseen while others could be inevitable especially where the life of the nurse is endangered by the patient, defective equipment or volatile work environment. In the case of professional negligence, it s is possible to handle a patient with confounding presentations. In addition, some patients may conceal vial information such as use of psychotic drugs in which case, deeper interrogation by the nursing may provoke the patient to turn violent or suicidal (Simon, 2006). That notwithstanding, nurses may overlook minor changes in patient conditions especially when they are understaffed in which case a nurse might be forced to handle many patients thereby resulting in potential delay of intervention. Failure to seek second opinion in complicated cases, or delaying needful medical intervention are indicative of deviation from standard case for which a nurse may face liability charges for negligence (Glabman, 2004; Phillips, 2013). The second area relates to malpractice where a nurse exposes the patient to a faulty or erroneous intervention out of which the patient suffers substantial injury, complication, disability or death. According to Croke (2003), faulty intervention devoid of proper adherence to professional guidelines and hypothetico-deductive clinical reasoning could amount to deviation from standard care. In the event that a similar incident occurs, the nurse in quest shall be held accountable in law. However, some aggrieved patients or their family might descend on the nurse out of anger thus causing the nurse grievous bodily or psychological harm even when the nurse could be having sufficient evidence in her defense. Due to lack of protective legislation like in the case on Montana, assaulted nurse may find not redress of justice for violation inasmuch as they stand perceived liability suit for malpractice as highlighted by Peter (2013). Breach of professional code of conduct is the third common area of liability. There are several clauses that go with professional code of conduct including iss ues of confidentiality, protocol and respect for client autonomy as argued by Simon (2006). Some of the medical emergencies could be life threatening with little time for proper administrative consultation. As a result, the case might warrant a resident nurse to take all practicable measures within her ability and medical judgment in the utmost effort to save life.

Knowledge management, social networks and innovation Coursework

Knowledge management, social networks and innovation - Coursework Example al., 2011). The present day managers are developing their sustainability and competitiveness to meet with the diverse needs of the consumers based on effective management of their knowledge within the organisation. With continuous management of knowledge, organisations are currently developing their status within the business domain (McAdam, 2000). Knowledge Management (KM) has emerged to be a useful tool for developing the overall structure of organisations, further enhancing the ability of organisations to perform. Identifiably maintaining an effective institutional performance and enhancing the same have only were possible with the proper management of knowledge and through nurturing a culture of ongoing learning (Gloet & Samson, 2012). In this regard, the paper elaborates on the different needs of organisations to maintain their leadership with the effective management of knowledge. The paper also proposes to analyse the implication of organisational learning and knowledge management for developing various needs of the dynamic business environment. Organisational Learning (OL) is a process prominent within the present day organisations and is even noted to be affecting the operations that are undertaken by the same. The process follows a trend of creating as well as transferring knowledge to enhance the ability of organisation to perform. This process of learning is largely acceptable among the masses as it enhances the ability of employees to impart and share knowledge that they have gained over the years based on their experiences and knowledge from operations (Dixon, 1999; Torlak, n.d.). The organisations plans to foster the knowledge that employees have gained over the years based on the diverse situations they have faced through the dynamic business environment. Notably, the development of organisational learning has paved way for action-based learning and ability of the individuals to learn has in turn enhanced significantly. With the integration

Analyzing the Similarities between “Hymn to the Aton” and “Psalm 104” Essay Example for Free

Analyzing the Similarities between â€Å"Hymn to the Aton† and â€Å"Psalm 104† Essay The thought that two different works of art written by authors of different countries, different backgrounds, living eight hundred years apart and centering on religion—more [specifically] their portrayal of God and how he is like the sun—[being similar] would [be] deem[ed] [as] impossible [or not likely by many]. [However,] the poems [â€Å"]Hymn to the Aton[† by Akhenaton] and [â€Å"]Psalm 104[† by David are examples of] this very occurrence. [Some scholars assert] that either the latter was copied from the former or that these two works are the result of a cultural split, [due to the] vast difference of [similar] elements [and subject matter that the poems share. ] the poems were fostered within, their similarities in content, and that the poems could not have been creative coincidence. The benefits in understanding that these works have some connection, whether by plagiarism or cultural dissect, provides scholars with more knowledge about the world we live in, helps to decipher some of the myths and mysteries of other cultures with similarities and shows the public all cultures may not be as different from each other as we think, helps to show that propaganda has been used since the earliest of times, and that if societies do not document their findings or creations people will eventually circle back and rediscover them. Collectively, if applied to the modern world, these benefits will advances in many fields of academia and help society at large to become more critical thinkers and problem solvers. [Based on your body paragraphs, I have simplified your thesis map to the following:] [The three clearest similarities of the two poems include their similar discussion of the power of the sun or the notion of the sun as a symbol for the power of God, the similarities of the daily activities of the two cultures and their link to their God, and the emphasis of monotheism.] [Now, provide one or two sentences that explain what current societal issue can be resolved or lessened through the realization of the similarity of these two poems.] The contrast between Hymn to the Aton and Psalm 104 are numerous. Hymn was written by Pharaoh Amenhotep IV around 1300 B.C.E. in order to help support his efforts to convert all of Egypt to monotheism and worship of the Sun, which called Aton. [First, it is uncanny the manner in which both poets use the sun as a point of reference for their God]. In [â€Å"Hymn to the Aton† Akhenaton proclaims] the actual Sun [as] god. â€Å"Thou living Aton the beginning of life!Creator of seed in women, Thou who makes fluid into man, Who maintainest the son in the womb of this mother..† In the psalm, King David writes how God created the sun [to] reflect His greatness. [Provide a quote from â€Å"Psalm 104† that shows David discussing the sun.] â€Å"LORD my God, you are very great; you are clothe with splendor and majesty†¦ But at your rebuke the waters fled, at the sound of your thunder they took flight†. King David’s poem was written about eight hundred years after the hymn and David does not mention much about himself, instead he praises the Lord. â€Å"I will sing to the LORD all my life; I will sing praise to my God as long as I live.† Based on the time and purpose of these poems, they could not have been coincidence, that the poems are similar, there had to have been a purposeful connection between them. [While there are slight variations of how the sun is used, in both poems the writers explain how the sun meets the needs of the people and how that act is a symbol of the greatness and goodness of God.] Understanding this connection helps us to discover more and develop our perception about the world around us. [How so? Explain how it can benefit one group of people to be able to realize similarities with another group of people with whom they have historically seen no connection.] [Next, both poems] list almost identical daily activities in the exact order throughout the works. â€Å"[Provide quotes from both poems.]† Many of these [similarities] seem to be paraphrased and suggest that these writing come from the same source like two eye witness accounts of the same crime. After understanding the differences in the author’s cultures, religions, and time periods these similarities support the claim that the works are connected either by plagiarism or cultural split. This helps [readers] to realize that many cultures may not be as different from one another as [people often] think. [Yes, and how can this realization help our culture or society? What societal issue or problem can be solved or lessened with this realization?] Based upon detailed examination [of] the similarities of the [poems, many scholars assert that the shared elements, especially the support of monotheism, are not] by coincidence. [Provide a quote supporting monotheism from both poems.] Some researchers suggest that Hebrews fleeing from Egypt before the time of Moses, some of them wondered into temples where the hymn was written, and has the walked along the hymn was one songs they sang and it was carried throughout the generations, but not that the psalm is not a plagiarism of the hymn, this only leaves the notion that there was a cultural split. We are not sure at this point how the works are linked, [While scholars disagree on which group influenced the other into embracing monotheism, it is clear that a cultural exchange occurred between the two groups. Thus, this realization of the similarity is another example for scientists and anthropologists showing that cultures have always exchanged ideas. This exchange of ideas becomes even more interesting when we realize that the Jews were enslaved by the Egyptians.] but it could definitely give more light and support to how scientist and anthropologist other academic researchers and make strides in their fields, help us to understand how cultures are linked across the board. [Explain how discovering that these two ancient cultures exchanged ideas can provide a blueprint or inspiration for current cultures and how that blueprint or inspiration can help those cultures solve or lessen a current societal issue.] After deep analysis s of these two poems it is clear that one is either copied from the other or [that there was some mutual exchange of cultural ideas] at some point in history. [Using the two poems to realize this occurrence] helps historians and scientists to make deductions about connections [to] other cultures, [allowing more people to better understand the surrounding world]. [Yes, now explain how society can improve if more people are able to understand and connect to the surrounding world or the people surrounding them

Biopsychosocial Assessment of Dr. A. Elizabeth “Bessie” Delany Essay Example for Free

Biopsychosocial Assessment of Dr. A. Elizabeth â€Å"Bessie† Delany Essay The following information for this biopsychosocial assessment of Dra. Annie Elizabeth â€Å"Bessie† Delany was found from the autobiography of Bessie and her sister, Sadie (Delany, Delany, Hearth, 1993). Bessie Delany was born in 1891, she is the third daughter of Henry and Nanny Delany. she studied at Columbia University and she became the second female dentists in New York. In that time the segregation, violence, and discrimination took a big part of Delany family, and her parent had a very difficult time raising their family. Bessie and her parents were involved in politics social activism known as the civil movement. Bessie’s parents were an example of life for their children and others in their community. By being a family who succeeded in life. In those days, white people thought that the success for black was waste of time since at that time it was unusual for black people to become successful in their life’s. sheets (Delaney, Delaney, Hill Hearth, 1993). In the book, â€Å"Having Our Say†, Bessie and Sadie Delany reflect on their personal, professional, and social experiences. Both Bessie and Sadie would be considered in Older Adulthood as defined by Zastrow and Kirst-Ashman (2010). At the time that the book was written, Bessie was criticizing the positive and negative. She often got upset as she sees that people were doing the right things. Bessie was the younger of the two sisters, she was a leader, her personality showed anger comparing to her sister that she was very calm. Bessie was reliant on her sister Sadie. For example, Bessie didn’t have a pension and depended upon Sadie’s Board of Education pension to live throughout retirement. (Delaney, Delaney, Hill Hearth, 1993). Biological Issues During the adulthood stage, people have many biological issues like when a person reaches this point in life they begin to face aging problems. One of those issues is the senescence that an individual is affected in different parts of the body, at various rates due to some parts of the body being stronger and resist aging. Older people regularly suffer the most visible effects of physical appearances, like shakiness of the hands and legs. Problems with bodily coordination, shoulder struggles, reduced agility, an increase in wrinkles of the skin, and the slowdown of the Psychomotor skills all occur currently (Zastrow Kirst-Ashman, 2010, pg. 588-589-590 According to the textbook, Understanding Human Behavior and the Social Environment, the slowdown of the Psychomotor skill specifies that the central nervous system is slowing down the information processing. Older people may come across problems such as difficulty remembering things as well as learning or retaining new information from memory. Problems can arise in certain activities such as driving a car. This can cause an increase in the risk of accidents while they drive. Even in older adulthood, however, if an individual has a healthy physical and mental state, Psychomotor skills can be highly functioning, and the person doesn’t have to have these challenges. Not everyone ages at the same rate, this is true for biological functioning (Zastrow Kirst-Ashman, 2010, pp. 588-590). Bessie Delany’s Biological Development Based on descriptions of Bessie in the book, there are a few of examples that may show signs of aging in her adult biological development. Bessie was walking along with her sister and mother when a boy called them â€Å"grandmas† because of their grey hair, slow movements, and wrinkles (Delaney, Delaney, Hill Hearth, 1993, p. 250). Her body showed her that her youth was gone because they were walking slowly as elders do. Bessie stopped driving a vehicle because of her body changes as her hand movements are diminished, reflexes are different from when she was young. Because of her age, Bessie had also stopped cutting her trees. She did not feel confident to be climbing a ladder and utilized sheets (Delaney, Delaney, Hill Hearth, 1993, pg. 297). Assess Bessie’s Development Normal or Healthy? Yes, Bessie’s biological development was healthy because she still functioned at a high level. She always ate healthily, ate different vegetables every day, and they also included fruits and vitamins. Usually, in her daily routine, she took Vitamins A, B complex, C, D, E, as well as minerals and zinc. Bessie participated in exercises such as yoga, and she also enjoyed cultivating their garden that helped to maintain mental and active physical conditions. Identified Biological Strengths. Bessie had many strengths, despite her age, and she did not lose her vision. She was very independent, motivates her father to become a professional. Her professional goal became a dentist. (Delaney, Delaney, Hill Hearth, 1993, pg. 297). She decides to be a professional instead of being a mother. She had a very strong character, where she didn’t like what she sees, she will protest, especially when she suffered racial attacks. She had a great memory. As she could remember her early childhood. (Delaney, Delaney, Hill Hearth, 1993, pg. 289). Bessie’s Biological Needs Bessie did not have any outstanding biologicals needs, she was healthy at the age of 101 years old. Reference Delaney, Sarah L., Delaney, Annie Elizabeth, Hill-Hearth, Amy (1993). Having our Say. The Delany Sister’ First 100 years. N. Y. New York. Dell Publishing a Division of Random House, Inc. Zastrow, Charles H. Kirst-Ashman Karen, K. (2010). Understanding Human Behavior and Social Environment. Belmont, CA: Brooks/Cole Cengage Learning

Ilm Al-raml In Islamic And Arabic Culture

Ilm Al-raml In Islamic And Arabic Culture Distant as it may seem, synergizing mathematics with divination systems and religious practices that transcend the realm of rational thought is an almost impossible endeavor. To get a clear understanding of into the nature of amtehatmical knowelegdew Nonetheless, a careful and detailed examination of some Historical Background Ilm Al-raml constitutes an omnipresent divination system in the Arabic and Islamic culture. The literature attributes the Arabic term Ilm Al-raml or ilm Al -khutut to Geomancy. Historically, Geomancy constituted a family of divination systems, including such famous members as Ifa, Fa, Sixteen Cowries (Nigeria and West Africa in general), Sikidy (Madagascar and Comoro Island), Ramalasastra (India), I Ching ( China), Hakata (Southern Africa), ilm al-raml or khutut al-raml (North Africa). According to the most recent historical re-enactments, the Hellenic, Jewish, Persian, African, Indian and Chinese borrowings into the Arabic body of geomancy point to a drafting of the classic, strongly astrological geomantic system in Southern Mesopotamia in an Ismaili context in the tenth century CE. Subsequently, the systems rapid and successful spread over the Islamic and Jewish intellectual world, and hence into Europe, Africa and the Indian Ocean region, was largely due to its being preserved in widely circulated treatises. Of these, perhaps the most famous and successful has been the Kitab al-fasl fi usul ilm al-raml) by the Berber sheikh Muhammad al-Zanati (c. 1200 CE) (Van Binsberg , 1996). A careful examination of the binary mathematical structure of both the Southern African four-tablet divination system, and the more directly Arabian-derived forms of geomancy found in the Indian Ocean region led many historians and researchers to hypothesize a series of historical connections. In Arabic Islamic culture, ilm al-raml or sand-science goes back to IdrÄ «s, the Egyptian third Islamic prophet of Allah who came between the prophets Adam and Noah and resided in Egypt during which he undertaken the mission to show people how to write, to sew, to build cities and to use the Science of the Sand(Al-Tokhi,1991). The narrative tells that Idriss was taught this science by an angel sent by Allah and he taught it to his people who were practicing astrology (Tanjjim). Description and interpretations According to the principles of Idrisian facts, all living creatures are made up of four elements: fire, air, water, earth and four results heat, cold, moist, dry, and four directions east, west, south, and north. Also, looking at peoples activities they found that they basically used four major practices: weighing, counting, planting, and farming (Van Binsberg, 1996). Then everything balances on four corners, four figures, four extremities (e.g. the human body), and four elements on which they have built unlimited configurations. Partly rooted in simple chance procedures and random processes (like hitting the earth, throwing tablets, beans, shells etc.), ilm al-raml is a binary system of 16 figures. Each figure is 4 rows high and each row consists of either one dot or two dots. The figures are determined through various methods both ancient and modern. The procedure is called darb al-raml or the forceful hitting of the sand with a stick, in order to produce a random number of dot tra ces or marks which can then be scored as either odd or even. Four figures are created, and a chart is depicted using simple binary multiplication, and is interpreted based on the meanings of each figure. The 4_(number)four binary elements of each figure allow for 24 or 16 different combinations. As there are 4 root figures in each chart, the total number of possible charts equals 16ÃÆ'-16ÃÆ'-16ÃÆ'-16 or 65536. The charts are also interpreted differently. Depending on the nature of the question, ilm al-raml can be considered as one of the most thorough kinds of divination based on only 16 figures which are extremely simple yet with deep connotations. The marks on the ground are interpreted through a process of transformation and elimination, from one horizontal line, with one or two dots (one for odd, two for even), to a four-line symbol, of which there are sixteen 24 configurations (Van Binsberg , 1996, p.5) : With two dots making a line, the above configurations can be written as: More complex procedures may raise this number to any higher power of 2. A written or memorized key (the catalogue) provides the interpretation of each generated symbol and of their combinations. (Van Binsberg , 1996) The origin of this science is the dot and its secret is the odd number. Each of the four basic elements has a dot representation. Knowing that the element fire is lighter than the element air and that air is lighter than water and the water lighter than sand and knowing that the heavy element carries the lighter and not vice versa, so the elements in ilm al-raml follow this order: fire then air then water then sand (Al-Tokhi, 1991). Moreover, they assigned 4 letters from the alphabets to designate each one of the 4 elements. Fire( naar) Air (hawa) Water (maa) Sand (torab) Ù†  (noun) Ù†¡Ãƒâ„¢Ã¢â€š ¬ (haa) Ù†¦ (meem) Ø ª (taa) Originally, the patterns were created when the munajjim or the geomancer traced dots with a stylus across a board of sand or dust. The geomancer then examines and construes the dots, deriving further patterns, and eventually gives an answer or forecast for his client. Ascribed to this pattern of dots are different meanings and interpretations, related to the colors, months, planets, the four elements, the signs of the zodiac and parts of the body. Conditions when using Ilm al-raml To hit the sand, the hitter or geomancer or Al-Darib should be facing AL Qubla (a place in Mecca where the Muslims do pilgrimage) and should be clean and wearing clean clothes. He should pray, read certain verses from the Quran and place an intention to hit the sand seeking an answer to a question in mind. In the Islamic culture, hitting the sand is not supposed to be done in the following times: during storms or rain, at sunset or sunrise. However, it is preferable to be done after sunset until dawn, the best time is during the night. Also, the hitter shouldnt speak to others while performing the act. He should be joyful and content and should start with hitting the sand from left to right saying these words: Tash 4 torbash 4 shaqoor 4 tazan 4. (Al-Tokhi, 1992). Procedure: How it is done The procedure is administered inductively through a set of pre-determined and systematic series of steps that are embellished by the diviners skill to intensify and epitomize the importance of the act. The series of steps constitutes a decision making algorithm that, upon execution, results in an outcome which is interpreted by the diviner as either good or bad. The steps are illustrated in the following example: Step 1: A customer comes to Al-Darib (the diviner or the person hitting the sand), seeking answers or advice on certain questions. The questions can be related to any type of day-to-day affairs such as marriage/divorce; life/death; finding a thief; pregnancy; happiness; profit/loss, etc.. Step 2: To find the answer, Al-Darib, after fulfilling the above mentioned conditions, makes 4 horizontal lines and on each line he designates 4 rows of random number of dots in such a way that each row has less number of dots than its precedent. Below is a demonstration: Then Al-Darib eliminates the dots two by two, if the remaining is a single dot he puts a dot otherwise he puts a dash sign. This concept is what is known in arithmetic as counting modulo 2. (Ascher, 2002) The above figure is called Al-takht (the board in Arabic) and the resulting 4 shapes or configurations are called the mothers from which the other twelve shapes (4 daughters; 4 granddaughters; 2 off springs; 1 arbitrator; 1 judge) are generated (Al-Tokhi, 1992). Each of the sixteen possible configurations is identified by a name, and for each a number of standard interpretations are given in a catalogue or some type of a written manual. These configurations are derived by a special form of juxtaposition, based on the following computational rules: even x odd = odd, i.e. x = ; odd x even = odd, i.e. x = even x even = even, i.e. x = ; odd x odd = even, i.e. x = In any given shape, the four parts designate from top to bottom: Head; chest; waist; legs. The above takhit produced the following four mothers configurations: Step 3: From the four shapes that constitute the mothers' configuration, four other shapes are generated by taking one shape from the mothers heads, another from their chests, a third from their waists and a fourth from their legs. These four configurations constitute the daughters. Juxtaposing the first two mothers then the second two mothers and the first two daughters and the second two daughters will generate the four granddaughters. The same procedure is repeated with every two granddaughters to get the 2 configurations which are called off springs. Juxtaposing the two off springs together will give one configuration and is called arbitrator. To generate the sixteenth configuration, Al-Darib multiplies the last shape with the first mother shape to get the judge. The sixteen configurations generated are shown below: x x x x Interpretation: Each of the sixteen configurations designates a house which holds the meanings on which interpretations are made. The houses are different from the configurations itself. While the configuration or shape is the piling up of 4 layers of dots and dashes, the houses are the locations in which these configurations fall (Al-Tokhi, 1992). The first house represents the life of the client, the second house is the house of capital, the third for the brothers, the fourth for the parents, the fifth for the children, the sixth for disease, the seventh for marriage, the eighth for death, the ninth for travel, the tenth for luxury and fame, the eleventh for hope, the twelfth for enemies, the thirteenth for the asker, the fourteenth for the sponsors, the fifteenth for balance and equilibrium and the last shape is for judgment . The shapes in the sand speak to Al_Darib: When he sees distressful or tragic configurations he pronounces bad news irrespective what the object of consultation is. When he sees a mixed configuration he pronounces middle results. When he sees happy configurations he pronounces good news and success. Kinship relations: A number of researches indicate that the mothers here do not primary stand for a kinship reference, but for fundamental cosmological entities such as planets or elements, However, in hitting the sand, the client has to give the name of his mother and not the father. (Al-Tokhi, 1991). This in turn makes the descent series mothers/ daughters/ off springs distinctly matrilateral. (Van Binsberg , 1996) Calendar: The sixteen shapes or configurations are divided among the days, weeks, months, and years. For the days of the week, the shapes are distributed as follows: Sunday Thurs. night Friday Tues. night Wed Sat. night Wed Fri. night Sat. Wed. night Thurs.Mon. night Tues. Sat. night Sat. rest of days Adopted from Al-Tokhi (1992). Al-usul wa al-wosoul fi ilm al-raml.(Translated from Arabic) Also, the first twelve of these sixteen configurations are identified with the twelve astrological houses and are interpreted accordingly, taking into account the usual correspondences and conventional meanings of the twelve houses, the planets and the zodiacal signs. The planetary and zodiacal associations of each of the sixteen names are listed in the following table: Adopted from Van Binsberg, The Astrological Origin of Geomancy, 1996, p.43. Closure Ilm al-raml in Islamic, Arabic culture is a complex cosmological tradition that is still practiced and is highly popular in most Arab countries today. Although it is highly contextual and mostly spread out among the more underprivileged, poverty stricken people, it is nonetheless highly sophisticated with a systematic set of procedures that underlies its implementation and interpretation. As a divination practice, Ilm al-raml encompasses a range of mathematical ideas that are embedded in the daily life of indigenous people and play an unprecedented role in impacting the decisions they undertake in their everyday encounters. Concomitantly, such an inductive, semiotic system is based on mathematical and probabilistic principles that are constantly proposed as vital in the mathematics school curricula. Introducing students to such cultural practices can help embed mathematics in meaningful and novel contexts and consequently build a more positive attitude toward mathematics.

GlenGarry Glen Ross :: essays research papers

Psychology   Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Glen Gary Glen Ross I thought was interesting. There were many different kinds of characters in this film. The salesmen in this movie are all after the same goal money and power. There is a constant competition between the salesmen to see who can close more deals to earn the top leads. The Glen Gary leads are the best leads and they become the symbol in this movie. They symbolize the greed that is in each one of these salesmen’s eyes. In the movie there are bosses and managers standing in the way of the men achieving their goals. The head boss played by Alec Baldwin has the most power in the company because he is the owner of the company. He is a cocky man who shows off his power.   Ã‚  Ã‚  Ã‚  Ã‚  In the first scene of the movie, Alec Baldwin’s character is in the office with the three other salesmen. Alec being that he is the boss is talking down to the employees and treating them like garbage. Alec talks to them this way because money and power has taken over his body. He has no idea what employee moral means. He gets a kick out of treating people like this. When the employees respond to him he makes a smart remark and yells at them. He acts this way because he knows that they will follow anything he says because he is the boss. When Jack Lemon’s character questions him about something Alec tells him off because Alec does not want to hear any complaints. Alec just wants the job done and if they cannot do the job he will find people that can. Alec is screaming at them to try to get them to comply with his orders and if they do not he will fire them because he does not need employees slowing him down.

War and Influenza Epidemic :: Creative Writing Essays

A View from the Chelsea Naval Hospital BOSTON, September 12, 1918 Dear Journal, The Great War rages on. An influenza epidemic claims the lives of several Americans. But, the Boston Red Sox have done it again. Last night, in a 2-1 victory over the Chicago Cubs at Fenway Park (thanks to Carl Mays' three-hitter), the Boston Red Sox won their fifth World Series championship--amid death and disease, a reason to live ... Babe Ruth and the 1918 Red Sox. If I die today, at least I lived to see the Sox win the championship. For, it could be a long, long, time before this happens again. From the Chelsea Naval Hospital, overlooking the Boston Bay, I sip on a cup of Joe and browse over the Sports Section of the Los Angeles Times. Earlier this month, three Bostonians dropped dead from influenza. In examining the extent of the epidemic, Surgeon-General Blue commented to the Times , "People are stricken on the streets, while at work in factories, shipyards, offices or elsewhere. First there is a chill, then fever with temperature from 101 to 103, headache, backache, reddening and running of the eyes, pains and aches all over the body, and general prostration." I gaze out my window, the sun seems brighter than usual and the town more radiant. It must be the victory, for the threat of death due to influenza is pervasive. Outside, children jump rope. With every skip of the jump rope they chant. "I had a little bird." Skip. "Its name was Enza." Skip. "I opened up the window." Skip. "And in-flu-enza." Here at the Chelsea Naval Hospital, the influx of patients arriving home from the war inflicted with "battle wounds and mustard gas burns," has created a shortage of physicians and it is becoming increasingly difficult to fight this influenza. Even our own physicians are falling ill from the disease and dying within hours of its onset. Today I received a letter from Dr. Roy, a friend and fellow physician at Camp Devens, who describes a similar situation: "We have lost an outrageous number of Nurses and Drs., and the little town of Ayer is a sight. It takes Special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce, we used to go down to the morgue (which is just back of my ward) and look at the boys laid out in long rows . War and Influenza Epidemic :: Creative Writing Essays A View from the Chelsea Naval Hospital BOSTON, September 12, 1918 Dear Journal, The Great War rages on. An influenza epidemic claims the lives of several Americans. But, the Boston Red Sox have done it again. Last night, in a 2-1 victory over the Chicago Cubs at Fenway Park (thanks to Carl Mays' three-hitter), the Boston Red Sox won their fifth World Series championship--amid death and disease, a reason to live ... Babe Ruth and the 1918 Red Sox. If I die today, at least I lived to see the Sox win the championship. For, it could be a long, long, time before this happens again. From the Chelsea Naval Hospital, overlooking the Boston Bay, I sip on a cup of Joe and browse over the Sports Section of the Los Angeles Times. Earlier this month, three Bostonians dropped dead from influenza. In examining the extent of the epidemic, Surgeon-General Blue commented to the Times , "People are stricken on the streets, while at work in factories, shipyards, offices or elsewhere. First there is a chill, then fever with temperature from 101 to 103, headache, backache, reddening and running of the eyes, pains and aches all over the body, and general prostration." I gaze out my window, the sun seems brighter than usual and the town more radiant. It must be the victory, for the threat of death due to influenza is pervasive. Outside, children jump rope. With every skip of the jump rope they chant. "I had a little bird." Skip. "Its name was Enza." Skip. "I opened up the window." Skip. "And in-flu-enza." Here at the Chelsea Naval Hospital, the influx of patients arriving home from the war inflicted with "battle wounds and mustard gas burns," has created a shortage of physicians and it is becoming increasingly difficult to fight this influenza. Even our own physicians are falling ill from the disease and dying within hours of its onset. Today I received a letter from Dr. Roy, a friend and fellow physician at Camp Devens, who describes a similar situation: "We have lost an outrageous number of Nurses and Drs., and the little town of Ayer is a sight. It takes Special trains to carry away the dead. For several days there were no coffins and the bodies piled up something fierce, we used to go down to the morgue (which is just back of my ward) and look at the boys laid out in long rows .

Zara: Fast Fashion Case

Create a diagram that illustrates the linkages among Sara's competitive choices. Firstly, everything is connected through centralized hubs. Ezra has its main operations in Spain, but with each expansion into a new country, that country has its own centralized Ezra facility. This allows for local factors to be considered in each market, but gives Ezra an excellent line of communication and ultimate control of all operations. The in-house designs are sourced this way, through representatives in each country bringing forth new fashion concepts for the upcoming season.These incepts are then whittled down by cost, feasibility, and market trends. Then the designs are prototyped and manufactured. The manufacturing is also mostly owned by Sara's parent company, helping reduce costs and lead times. From manufacturing, products are then packaged and labeled back at headquarters for shipping. Most of the shipping is via trucks. Overseas shipping is by air, which meaner the prices are adjusted s o that overseas customers bear this cost. The retail storefronts are setup so that products aren't on the shelves for more than 3 weeks. This along with careful inventory control create the illusion of scarcity.The marketing is also related in that Ezra only places ads twice a year, around the sales seasons. This helps to prevent over-exposure, so that the fashion-forward customers feel trendy. The scarcity factor also helps reduce loss. If a product bombs in one store, it's pulled immediately, to either be sold in another location or discounted to local partners. This meaner that if a product isn't doing well, it doesn't sit forever in the store wasting space that could be used to display a profitable product. 2. How do the distinctive features of Sara's business model affect its operational structure?The interconnectedness of these systems in Sara's operations gives it a hive-like structure. Every employee in every store works together to support the â€Å"queen† central hu b in Spain. Keeping most operations internal allows for very fast response times in each system. The speed meaner mistakes are learned from quickly and corrected. Owning the meaner of production is more cost-effective for Ezra, which allows the firm to maintain reasonable prices for its target market. Ezra also takes care of its employees and is socially responsible, which draws forth enthusiastic loyalty in all interactions. Why might Sahara â€Å"fail†? How sustainable is its competitive advantage? Sara's capable of failing Just like anyone else. I believe if the company loses its cohesion, makes major fashion blunders, raises its prices, begins to make customers or employees feel cheated, missteps in a Joint venture, loses its quick turnaround, or enters a market that is not suited to its business model, it could easily have unrecoverable loss. It's wise for the decision makers at Inedited to maintain the other companies, and not Just focus on Ezra. Ezra: Fast Fashion Case By knish_sass

A Causative Agent of Food-borne Poisoning

Bacillus cereus is an aerobic and facultative anaerobic, gram-positive bacteria causing toxin-mediated food poisoning. Optimum temperature for its growth is 30-37Â °C. However, it can also tolerate a wide range of temperature; some strains can grow up to 55Â °C while others can grow at temperatures as low as 4 to 5Â °C (Microbial Pathogen Datasheets, 2001). Many strains from dairy products are able to thrive at lower temperatures. The minimum pH requirement for growth is 4. 3, while maximum pH is around 9. 3.This bacterial population grows best in the presence of oxygen (Microbial Pathogen Datasheets, 2001). Nevertheless, since this species is facultative anaerobic it also grows well in anaerobic conditions (Louisiana Office of Public Health, 2004). Toxin production has been found to be much lower under anaerobic conditions. Bacillus cereus is a spore-forming micro-organism which occurs naturally in most foods. It causes two different and distinct forms of food poisoning: an emeti c illness and a diarrhoeal illness (Louisiana Office of Public Health, 2004).Bacillus cereus causes food-borne emetic illness by producing a highly stable toxin that survives high temperatures and exposure to trypsin, pepsin and pH extremes. Bacillus cereus levels in foods associated with emetic form of food poisoning have ranged from 1,000 to 50 billion colony-forming units (cfu)/gram (Louisiana Office of Public Health, 2004). High numbers of bacterial population have been also detected in faecal samples from affected persons. Diarrhoeal illness is mediated by a heat- and acid-labile enterotoxin produced during growth of vegetative cells in the small intestine (Granum, 1994).Four different enterotoxins have been characterized. Two are protein complexes such as non-haemolytic enterotoxin (NHE) and haemolysin BL (HBL) and two are enterotoxic proteins such as enterotoxin T (bc-D-ENT) and cytotoxin K (Lund, DeBuyser & Granum, 2000). The occurrence of the diarrhoeal-type syndrome has be en largely reported in the US and Europe, where the disease has been greatly associated with foods such as meat, vegetable, poultry, desserts and sauces (Giannella and Brasile, 1979).Prevalence of the vomiting type syndrome has been reported in the United Kingdom, Canada and USA, food borne poisoning is commonly associated with the consumption of cooked fried rice (Mortimer and McCann, 1974). Serotyping studies conducted by Taylor and Gilbert (1975) showed that strains from incidents of food poisoning in US and Europe characterised by a longer incubation period and with diarrhoea as the main symptom have provided serotypes 2, 6, 8, 9 and 10, whereas those which caused the rice-associated emetic illness in United Kingdom, Canada and USA were serotypes 1, 3 or 5.Bacillus cereus food poisoning is mostly associated with rice dishes, and sporadically with other food stuffs such as meat, vegetable, pasta, dairy products, sauces, soups and sweet pastries. Bacillus cereus food-borne poisoni ng is also associated with pudding, cream, spices, dry milk, dry potatoes and spaghetti sauces. Bacterial contamination of the food product by the large occurs prior to cooking. Even after cooking the microbial population thrives because vegetative forms can grow over a wide range of temperatures from 25Â °C to 42Â °C and are also capable of producing endotoxins.Endospores have the ability to survive extremely high and low temperatures. When they are allowed to cool fairly gradually, they once again begin to germinate and multiply. Spores are highly resistant to dry heat than moist heat. Emetic toxins are also extremely resistant to heat. They can survive 90 min at 126Â °C, while diarrhoeal toxins are inactivated at 56Â °C in 5 min. Clinical Description Bacillus cereus is widely known as the etiological agent of food-borne poisoning, causing both gastrointestinal and non-gastrointestinal diseases.Both diarrhoea and emesis can be clearly distinguished by their clinical features. Diarrhoea is provoked by heat-labile enterotoxins, while emesis is caused by a heat-stable depsipeptide toxin called cereulide (Ehling, Fricker & Scherer, 2004). The clinical syndromes associated with the diarrhoeal form of illness are longer incubation about 6 to 24 hours period, very watery diarrhoea (similar to that of C. perfringens), presence of moderate to severe abdominal cramps, nausea and vomiting in some patients, duration of illness ranges from a minimum of 20 hours to a maximum of 36 hours.Clinical features associated with the emetic form of illness are shorter incubation period of about 1 to 6 hours, presence of vomiting and abdominal cramps; diarrhoea is not severe and is present in only about a third of affected individuals (similar to poisoning by S. aureus), duration of sickness ranges from 8 to 10 hours. In both types of syndromes, fever is exceptional and disease is usually docile. Bacillus cereus also can cause other diseases such as local skin and wound infectio ns, ocular infections, fulminant liver failure.Invasive disease, including bacteraemia, endocarditis, osteomyelitis, pneumonia, brain abscess, and meningitis are also caused by Bacillus cereus. Ocular involvement includes panophthalmitis, endophthalmitis, and keratitis (Louisiana Office of Public Health, 2004). Apart, it can bring about other infections namely, pneumonia, meningitis, encephalitis, in addition to brain and liver abscesses (Drobniewski, 1993). It is a rare cause of endocarditis (Fowler et al. 2005) reported in patients with prosthetic heart valves, rheumatic heart disease, intravenous drug use (IVDU), and in patient with leukaemia.Food Poisoning by other Bacillus species Toxic food poisoning is not only caused by Bacillus cereus, several other Bacillus species have also been implicated in food poisoning incidents. The most important species are B. subtilis and B. licheniformis. These organisms are capable of producing an extremely heat-stable toxin which seems very si milar to the emetic type produced by B. cereus (Kramer and Gilbert, 1989). These species are widely associated with food products like meat, vegetable, flour, pastry, sausage rolls, meat pies and pastries, curries and various ethnic dishes with rice, and stuffed poultry.Bacillus subtilis is associated mainly with meat, vegetables in pastry, poultry products, and occasionally with bakery items such as bread, crumpets, sandwiches, and ethnic meat or seafood dishes. Food poisoning syndrome associated with B. subtilis causes acute onset nausea, vomiting and stomach cramps, incubation range is 2-5 hours, often with diarrhoea. Poisoning due to B. licheniformis shows the following symptoms; diarrhoea is more common than vomiting, incubation period is about 8 hours. Another species which was isolated in high numbers from rice associated with a food poisoning outbreak was B.pumilus. Symptoms were consistent with those similar for food poisoning by other Bacillus species than B. cereus. C. pe rfringens food poisoning produces a heat-labile toxin which caused predominantly lower gastrointestinal (diarrheal) disease about 12 hours after ingestion much similar to the diarrheal type syndrome caused by B. cereus. Case Studies In August 2003, five children of a Belgian family became sick after eating pasta salad. The pasta salad prepared on a Friday was taken to picnic on Saturday. The leftovers had been stored in the refrigerator.The following Monday evening the pasta was served for supper to the children. Since the pasta had an unusual odour three children (aged 14, 10 and 9) did not eat much, they ate very little quantities. After 6 hours the youngest child (aged 7) started vomiting and complained of respiratory distress. She was immediately rushed to the hospital. Upon arrival at the hospital the other 3 children also felt nauseous and started vomiting. The condition of all the children began to worsen; hence they were transported to the University Hospital in Leuven.Howev er, during transfer, the child (aged 7) had severe pulmonary haemorrhage, quickly followed by coma, diffuse bleeding, and severe muscle cramps. She died within 20 minutes, at 13 hours after the intake of pasta. Autopsy report revealed the presence of Bacillus cereus in her gut content. The other 3 children were kept under treatment for 8 days and they gradually recovered (Dierick et al. 2005). This case elucidated the probable severity of the emetic illness, also stressing on the importance of sufficient refrigeration of cooked food. Some B.cereus strains are known to be sychrotrophic and these strains have the maximum emetic toxin production between 12 and 15Â °C. In the present case, the temperature of the refrigerator where the pasta salad was stored was 14Â °C. This probably allowed B. cereus strains to multiply quickly to attain a count of more than 108 CFU/g in 3 days along with a very high toxin production (Dierick et al. 2005). Food borne poisoning was reported in a milita ry camp in Jurong, Singapore. This food poisoning outbreak involved 19 army personnel who became unwell after breakfast.All these army personnel had been served fried rice by a food stall in a civilian canteen. The illness was characterized by vomiting (89. 5%), abdominal cramps (52. 6%), diarrhoea (47. 4%), headache (47. 4%) and fever (10. 5%) (Tay, Goh & Tan, 1982). The incubation time extended from 13/4 hours to 51/2 hours. Bacillus cereus was detected in the vomitus of the affected soldiers (Tay, Goh & Tan, 1982). This makes it clear that Bacillus cereus is a causative agent for the food borne poisoning resulting in emetic and diarrhoeal illness. This species contaminates food products, especially cooked rice and refrigerated products.It is therefore essential to follow proper cooking and refrigeration methods. Proper cooking and storage of foods, especially rice cooked for later use, will facilitate to thwart food borne epidemics. For the most part B. cereus food borne outbreak is an outcome of eating cooked foods which are cooled slowly and stored the wrong way. Generally food should be stored at temperatures higher than 60Â °C or quickly chilled to less than 10Â °C immediately after cooking. Bibliography Dierick, K. , Coillie, E. V. , Swiecicka, I. , Meyfroidt, G. , Devlieger, H. , Meulemans, A. , Hoedemaekers, G., Fourie, L. , Heyndrickx, M. & Mahillon, J. (2005). Fatal Family Outbreak of Bacillus cereus-Associated Food Poisoning. Journal of Clinical Microbiology, Aug. 2005, 43(8), pp. 4277–4279. Drobniewski, F. A. (1993): Bacillus Cereus and related species. Clin Microbiol Rev. 6(4), pp. 324-38. Ehling-Schulz, M. , Fricker, M. & Scherer, S. (2004). Bacillus cereus, the causative agent of an emetic type of food-borne illness. Mol. Nutr. Food Res. 48, pp. 479–487. Fowler, V. G. Jr. , Miro, J. M. , Hoen, B. , Cabell, C. H. , Abrutyn, E. , Rubinstein, E. , Corey, G. R. , Spelman, D. , Bradley, S.F. , Barsic, B. , Pappas, P. A. , Anstrom, K . J. , Wray, D. , Fortes, C. Q. , Anguera, I. , Athan, E. , Jones, P. , Meer, J. T. van der, Elliott, T. S. , Levine, D. P. & Bayer, A. S. (2005) Staphylococcus aureus endocarditis: a consequence of medical progress. JAMA. 2005 Jun 22. 293(24), pp. 3012-21. Giannella, R. A. and Brasile, L. A. (1979). Hospital foodborne outbreak of diarrhea caused by Bacillus cereus. Clinical, epidemiological and microbiological studies. J Infect Dis. 139, pp. 366 – 370. Granum, P. E. (1994). Bacillus cereus and its toxins. J. Appl. Bacteriol. Suppl.23, pp. 61S–66S. Kramer, J. M. & Gilbert, R. J. (1989) Bacillus cereus and other Bacillus species. In Foodborne Bacterial Pathogens, Doyle MP, ed. Marcel Dekker Inc. New York. pp 21-70. Louisiana Office of PublicHealth. (2004). Bacillus cereus – Toxi-infection. Infectious Disease Epidemiology Section- Infectious Disease Control Manual. Available from: http://www. dhh. louisiana. gov/offices/miscdocs/docs-249/Manual/BacillusCereusManua l. pdf Lund, T. , DeBuyser, M. L. & Granum, P. E. (2000). A new cytotoxin from Bacillus cereus that may cause necrotic enteritis. Mol. Microbiol.38, pp. 254–261. Mortimer, P. R. and McCann, G. (1974). Food poisoning episodes associated with Bacillus cereus in fried rice. Lancet. 1, pp. 1403 – 1405. Microbial Pathogen Datasheets. Bacillus cereus. (2001). May 2001. Retrieved from: www. nzfsa. govt. nz/science/data-sheets/bacillus-cereus. pdf Tay, L. , Goh, K. T. and Tan, S. E. (1982). An outbreak of Bacillus cereus food poisoning. Singapore Medical Journal. 23(4), pp. 214 – 217. Taylor, A. J. and Gilbert, R. J. (1975). Bacillus cereus food poisoning: A provisional serotyping scheme. J. Med. Microbiol. 8, pp. 543 – 550.

Employment Law and Labor Relations Issues Essay

Equal opportunity is a descriptive term for an approach intended to give equal access to an environment or benefits, such as education, employment, health care, or social welfare to all, often with emphasis on members of various social groups which might have at some time suffered from discrimination. This can involve the hiring of workers and other such practices. Social groupings generally emphasized in such a way are those delineated by aspects of gender, race, or religion. In my workplace the Equal Employment Opportunity Policy is posted on almost every wall in the building. There are several issues that need to be addressed in my workplace. I work for a not-for-profit agency contracted with the Florida Department of Children and Families. We are an agency that tries to help families reunite once they have entered into the Family Law system. My job as a social worker is to promote social justice and social change with and on behalf of clients. â€Å"Clients† is used inclusively to refer to individuals, families, groups, organizations, and communities. Social workers are sensitive to cultural and ethnic diversity and strive to end discrimination, oppression, poverty, and other forms of social injustice. These activities may be in the form of direct practice, community organizing, supervision, consultation, administration, advocacy, social and political action, policy development and implementation, education, and research and evaluation. Social workers seek to enhance the capacity of people to address their own needs. Social workers also seek to promote the responsiveness of organizations, communities, and other social institutions to individuals’ needs and social problems. The main issue that needs to be addressed within my company is some issues pertaining to the Fair Labor Standards Act, holiday pay, and having an Human Resources Representative at our local site. I believe that my organization needs to take the time to explain to its employees what their rights are and what the laws of the state require. The Human Resource department for our agency is run out of Bethesda, Maryland. So every issue and or concern has to go through them. Because of the distance, it is very hard and time consuming for local employees at this agency to get things done in a timely manner, so a lot of things that should be addressed at employee orientation are not addressed until maybe the third month of employment when the HR administrator decides to take a trip to Florida. There are a lot of questions that we as employees have about holiday pay practices and what are the legal requirements. For example, I did not know that an employer is obligated to provide reasonable accommodation for the religious practices of its employees, unless it can show that the accommodation would result in undue hardship for its business. Many employers offer a â€Å"floating holiday† in addition to the regularly scheduled holidays. This allows an employee to take time off for religious observances that are not covered by the employer’s established holiday schedule. Courts addressing the issue of religious accommodation generally agree that unpaid time off can be a reasonable accommodation, as can allowing an employee to use a vacation day to observe a religious holiday. Generally, employers require that floating holidays be taken in the same year they are granted and do not allow these days to be carried over into the next year. Employees usually are required to give adequate advance notice of their intention to take a floating holiday. I also did not know that an employer doe s not have to pay hourly employees for time off on a holiday. An employer is only required to pay hourly employees for time actually worked. On the other hand, exempt employees (salaried employees who do not receive overtime), who are given the day off, must be paid their full weekly salary if they work any hours during the week in which the holiday falls. This requirement for exempt employees did not change under the new federal overtime regulations. Both of these statements can be very helpful when our employees what to take some time off or just to check to make sure they are treated fairly. There are a handful of labor laws that do generally protect U.S. workers. It’s probably fair to say that most employers adhere to these basic laws, because they’d be foolish not to if they want to stay out of court. But, that’s typically at the HR and legal-department levels, where the employees are properly trained in such matters. Companies are also made up of other employees, who might never have heard of labor laws or fully understand their significance. That’s one way problems occur, especially if HR and legal departments don’t bother to properly train those in control, like jerky bosses. Another way problems occur is that, for obvious legal reasons, HR and legal departments are unlikely to openly admit that employee complaints and accusations have merit, and the company is  liable. Worse, they might even protect the perpetrators more than the victims. In conclusion, it is very important that companies keep their policies up-to-date and follow them. Written policies tell your employees how they can expect to be treated and give you guidelines for applying the policies consistently. However, the policies must comply with legal requirements and you must follow them, or they may be used against you as evidence of violations of the law. Having these problems addressed in my organization could help it many ways, starting with establishing a good relationship between upper management and current employees and also establishing a steady line of communication. But this issue cannot be addressed until a local Human Resources department is establish at every local office so if employees do have question about employment law or current labor relation issues they can be addressed right then and there.

Alternative Communication Intervention In Children Health And Social Care Essay

Children and young person who sustain a traumatic encephalon hurt ( TBI ) and/or spinal cord hurt ( SCI ) may hold impermanent or lasting disablements that affect their address, linguistic communication and communicating abilities. Having a manner to pass on can assist cut down a kid ‘s confusion and anxiousness, every bit good as enable them to take part more actively in the rehabilitation procedure and therefore, retrieve from their hurts. In add-on, effectual communicating with household, attention staff, equals, instructors and friends is indispensable to long-run recovery and positive results as kids with TBI and SCI are integrated back into their communities. This article describes how rehabilitation squads can utilize augmentative and alternate communicating ( AAC ) and assistive engineerings ( AT ) to back up the communicating of kids retrieving from TBI and SCI over clip. 1. Introduction Children and young person who sustain a terrible traumatic encephalon hurt ( TBI ) and/or a spinal cord hurt ( SCI ) frequently experience sequealae that can impact their ability to pass on efficaciously. In early stages of recovery, many kids with TBI and SCI are unable to utilize their address or gestures for a assortment of medical grounds related to their hurts. As a consequence, they can profit from augmentative and alternate communicating ( AAC ) intercessions that specifically address their ability to pass on basic demands and feelings to medical forces and household members and inquire and react to inquiries. AAC attacks may include holding entree to a nurse ‘s call signal ; schemes to set up a consistent â€Å" yes † â€Å" no † response ; techniques that help a kid â€Å" oculus point † to simple messages ; low-tech boards and books that encourage interaction with household members and staff ; communicating boards with images or words ; and speech bring forthing devices ( SGDs ) with preprogrammed messages, such as â€Å" I hurt † â€Å" Come here, † â€Å" Help me delight! † â€Å" When ‘s ma coming? † As kids with TBI and SCI recover from their hurts, many no longer will necessitate AAC. However, some kids face residuary motor, address, linguistic communication and cognitive damages that affect their ability to pass on face-to-face, write or usage mainstream communicating engineerings ( e.g. , computing machines, electronic mail, phones, etc. ) . A few may necessitate AAC and assistive engineering ( AT ) throughout their lives. Having entree to communicating through AAC and AT enables these kids to take part actively in the rehabilitation procedure and finally, in their households and communities. Without an ability to pass on efficaciously, kids with TBI and SCI will confront unsurmountable barriers to instruction, employment, every bit good as set uping and keeping relationships and taking on preferred societal functions as grownups. All AAC intercessions aim to back up a kid ‘s current communicating demands while be aftering for the hereafter ( Beukelman and Mirenda, 2005 ) . However, the class of AAC intervention for kids who sustain TBIs and SCIs is different because of the nature of their hurts is different. In add-on, the focal point of AAC intercessions will differ for really immature kids ( e.g. , shaken babe syndrome ) who are merely developing address and linguistic communication and for those who were literate and have some cognition of the universe prior to their hurts ( e.g. , 16 year-old involved injured in a motor vehicle accident ) . For immature kids, the AAC squad will concentrate on developing their linguistic communication, literacy, academic, emotional, and societal accomplishments, every bit good as guaranting that they have a manner to pass on with household members and rehabilitation staff. For older kids, AAC intercessions build on residuary accomplishments and abilities to assist re ctify address, linguistic communication and communicating damages every bit good as provide compensatory schemes that support face-to-face interactions and finally communicating across distances ( phone, electronic mail ) with squad members, household and friends. AAC intercession ends seek to advance a kid ‘s active engagement in household, instruction, community and leisure activities and purpose to back up the constitution and care of robust societal webs ( Blackstone, Williams, and Wilkins, 2007 ; Light and Drager, 2007 ; Smith, 2005 ) . While a assortment of AAC tools, schemes and techniques are available that offer communicating entree, successful AAC intercessions for kids with TBI and SCI besides require that medical staff, household members and finally community forces know how to back up the usage of AAC schemes and engineerings because the demands of these kids change over clip. Speech-language diagnosticians, nurses, occupational healers, physical healers, physiatrists, baby doctors, and rehabilitation applied scientists work collaboratively with the kid ‘s household and community-based professionals to set up, keep and update effectual communicating systems. Ultimately, the end is for kids to take on coveted grownup functions ; AAC can assist them recognize these ends. 2. Pediatric TBI and AAC AAC intercession for paediatric patients with TBI and terrible communicating challenges is an indispensable, complex, on-going and dynamic procedure. AAC is indispensable to back up the alone communicating demands of kids who are unable to pass on efficaciously. It is complex because of the residuary cognitive shortages that frequently persist and because many kids with TBI have co-existing address, linguistic communication, ocular, and motor control shortages ( Fager and Karantounis, 2010 ; Fager and Beukelman, 2005 ) . AAC intercessions are ongoing and dynamic ( Fager, Doyle, and Karantounis, 2007 ) because kids with TBI experience many alterations over clip and undergo multiple passages. Light et Al. ( 1988 ) described the on-going, three-year AAC intercession of an stripling who progressed through several AAC systems and finally regained functional address. DeRuyter and Donoghue ( 1989 ) described an person who used many simple devices and a sophisticated AAC system over a seven month period. Extra studies describe the recovery of natural address up to 13 old ages post onset ( Jordan, 1994 ; Workinger and Netsell, 1992 ) . 2.1. AAC Assessment and Intervention Appraisal tools can assist place and depict the cognitive, linguistic communication and motor shortages of patients with TBI and supply a model for AAC intercessions. The Pediatric Rancho Scale of Cognitive Functioning ( adapted by staff at Denver Children ‘s Hospital in 1989 ) is based on the Ranchos Los Amigos Scale of Cognitive Functioning ( Hagan, 1982 ) . Table 1 describes general degrees of recovery, based on the Pediatric Rancho Lost Amigos Scale, and gives illustrations of AAC intercession schemes that rehabilitation squads can use across the degrees as described below. Levels IV and V. AAC Goal: Determining responses into communicating In the early stage of recovery, paediatric patients at Levels IV and V on the Pediatric Rancho Scale are frequently in the PICU, the ICU, acute infirmary or acute rehabilitation environment. At Level V ( no response to stimuli ) or Level IV ( generalized response to stimuli ) AAC intercessions focus on placing modes that kids can utilize to supply consistent and dependable responses. For illustration, staff can utilize simple switches ( e.g. , Jelly BeanA ® , Big RedA ® and Buddy Button from AbleNet ) , latch-timers ( e.g. , PowerLinkA ® from AbleNet ) and individual message devices ( e.g. BIGmackA ® and Step CommunicatorA ® from AbleNet ) to back up early communicating ( see Table 1 for some illustrations ) . Because kids ‘s early responses may be automatic instead than knowing, the household and medical/rehabilitation squad can besides utilize AAC engineerings to promote more consistent responses. Families provide valuable input about the sorts of music, games and f avourite toys a kid finds actuating. The squad can so utilize these points to arouse physical responses from the kid. For illustration, if the household identified the battery-operated plaything ElmoA ® from Sesame StreetA ® , the rehabilitation squad might show Elmo singing a Sesame Street vocal and so detect to see if the kid ‘s responds. If the kid begins to turn her caput when ElmoA ® sings, the squad might attach a switch with a battery interrupter to the plaything and inquire the kid to â€Å" hit † the button and â€Å" play the ElmoA ® vocal † . In making so, the squad can larn several things. For illustration, the squad may observe that a kid is able to follow bids, bespeaking cognitive recovery. The squad may besides get down to see alternate entree methods for kids with terrible physical damages, i.e. , head motion may go a dependable manner to run an AAC device or computing machine in the hereafter. It is hard to foretell whether a kid will re trieve natural address during early phases of recovery. 2.2. Middle Levels II and III: AAC Goals: Increase ability to pass on with staff, household and friends and support active engagement in intervention Pediatric patients at Levels III ( localized response to centripetal stimulations ) and II ( antiphonal to environment ) go more occupied in their rehabilitation plans as they recover some cognitive, linguistic communication and physical abilities. During this stage, long-run shortages that affect communicating become evident ( e.g. , dysarthria, apraxia, aphasia, attending, induction, memory, vision, spasticity ) . Dongilli, Hakel, and Beukelman ( 1992 ) and Ladtkow and Culp ( 1992 ) besides report natural speech recovery in grownups after TBI at the in-between phases of recovery. Continued trust on AAC schemes and engineerings is typically due to relentless motor address and/or terrible cognitive-language shortages ensuing from the hurt ( Fager, Doyle, and Karantounis, 2007 ) . AAC intercessions at these degrees focus on utilizing a kid ‘s most consistent and dependable response to pass on messages, promote active engagement in the rehabilitation procedure and increase interactions with household and staff. AAC intercessions ever take into history the kid ‘s developmental degree and involvements. Table 1 gives some illustrations of AAC engineerings employed during these Levels III and II. For illustration, Jessica was admitted to the infirmary at 18-months with jolted babe syndrome. At Level II, she began reacting to her parents by smiling and express joying and besides began to pull strings playthings with her non-paralyzed manus when staff placed a plaything within her integral field of vision. However, she did non exhibit any address or imitative vocal behaviours and her speech-language diagnostician noted a terrible verbal apraxia. Nursing staff and household members noted that Jessica seemed frustrated by her inability to show herself. Prio r to her hurt, she could call over 30 objects ( playthings, pets, favourite sketch characters ) and was get downing to set two word sentences together ( Momma adieu, Daddy place ) . AAC intercessions included the debut of a BIGmackA ® , a single-message address bring forthing device ( SGD ) that enabled the staff and household members to enter a message that Jessica could so â€Å" speak † during her day-to-day activities ( e.g. , â€Å" more † , â€Å" adieu † , â€Å" turn page † ) . Because the BIGmackA ® is a colourful, big and easy to entree SGD, Jessica was able to â€Å" press the button † despite her upper appendage spasticity and important ocular field cut. Within a month, Jessica had progressed to utilizing a MACAW by ZygoA ® , an SGD with eight-location sheathing that staff programmed with words she had used prior to her hurt ( e.g. , mommy, daddy, more, bottle, book, adieu ) . Staff besides designed extra sheathings to promote her linguistic communication development by supplying vocabulary that enabled her to build two-word combinations ( e.g. , â€Å" more crackers † ) . Jessica began to show herself at a developmentally appropriate degree, but she had residuary memory shortages that required cuing and support from her communicating spouses. For illustration, ab initio, she did non remember how to utilize her AAC system from session to session so staff needed to re-introduce it each clip. However, after several months, Jessica began to â€Å" seek † for her SGD to pass on. Jessica, like many kids with TBI at this degree, was able to larn processs and schemes with repeat and support ( Ylvisaker and Feeney, 1998 ) . 2.3. Level II and Level I. AAC Goals: Support passages, recommend AAC schemes and engineerings for usage at place and in the community As paediatric patients passage from Level II ( antiphonal to environment ) to Level I ( oriented to self and milieus ) , they frequently move from an ague rehabilitation installation to an outpatient scene, place or a attention installation. Thus, before discharge, AAC squads will carry on a formal AAC appraisal and supply long-run recommendations for AAC schemes and engineerings that can enable kids to be integrated successfully back into community environments. Table 1 illustrates the types of AAC engineerings and schemes employed at Levels II and I, as described below. For kids who continue to utilize AAC and AT when they return to their communities, the rehabilitation squad identifies a long-run communicating advocator. This individual, frequently a household member, becomes actively involved in AAC preparation and collaborates with rehabilitation staff to fix the kid ‘s educational staff, extended household and other health professionals ( Fager, 2003 ) . Having a nexus between the rehabilitation squad and community professionals is indispensable because most instructors and community-based clinicians have limited experience working with kids with TBI and may necessitate support to pull off the cognitive and physical shortages frequently associated with TBI. For illustration, McKenzie, a 12 year-old with a terrible TBI secondary to a auto accident, was quadriplegic with terrible spasticity and no upper appendage control. She besides had cortical sightlessness and important communicating and cognitive damages. As she recovered, McKenzie used a assortment of AAC systems ( e.g. , thumbs up/down for â€Å" yes † â€Å" no † , two BIGmacksA ® to pass on picks, and a scanning Cheap Talk by Enabling Devicess with four messages to take part in structured activities ) . Prior to dispatch, the rehabilitation squad conducted a formal SGD rating and recommended the Vmax by DynaVox Mayer-Johnson, a voice end product device. McKenzie was able to entree the device via a caput switch mounted to the side of the caput remainder on her wheelchair. Using audile scanning, she could make and recover messages. Because she was literate anterior to her hurt and could still spell, the staff set up her device to include an alphabet page every bit good as several pages with pre-programmed messages incorporating basic/urgent attention demands, gags and societal remarks. Family and friends participated in her rehabilitation and learned to utilize tactile and verbal prompts to assist her participate in colloquial exchanges. Due to h er residuary cognitive shortages, nevertheless, McKenzie had trouble originating conversations and retrieving where pre-stored messages were in her device. When prompted, she would react and originate inquiries and could prosecute in conversations over multiple bends. Over clip, she began to take part in meaningful, societal interactions, frequently spelling out two-three word novel phrases utilizing her alphabet page While her parents were restituting their place to manage her wheelchair, McKenzie transitioned to a regional attention installation that specialized in working with immature people with TBI. The ague rehabilitation squad identified McKenzie ‘s aunt as her AAC advocator because she had participated actively in earlier stages of McKenzie ‘s recovery, was adept with the care ( bear downing, set-up and basic trouble-shooting ) of the Vmax and could custom-make and plan new messages into the system. The attention installation staff met with McKenzie ‘s aunt weekly so they could larn how to back up McKenzie ‘s usage of the SGD. Specific developing aims included care and basic trouble-shooting, set up, switch-placement and how to plan new messages to utilize in specific and motivative activities. Staff learned how to modify the arrangement of her switch when McKenzie became exhausted or her spasticity increased. Additionally, McKenzie ‘s school staff ( particul ar instruction coordinator, speech-language diagnostician, occupational healer, and one of her regular schoolroom instructors ) visited McKenzie at the rehabilitation and the attention installations to assist fix for her return place and learned how to back up her in school, given her physical and cognitive restrictions. 2.4. AAC subjects in TBI When working with paediatric patients with TBI, three AAC â€Å" subjects † emerge. 1. Recovery from TBI is dynamic and takes topographic point over clip. In early phases of recovery, most kids with TBI have physical, address, linguistic communication and cognitive shortages that affect their communicating accomplishments. Depending on the nature and badness of their hurts, nevertheless, most recover functional address, although some will hold life-long residuary address, linguistic communication and communicating shortages. Acute rehabilitation squads can use AAC intercessions to back up communicating, every bit good as proctor the kid ‘s altering communicating abilities and needs over clip. 2. The cognitive-linguistic challenges associated with TBI make AAC intercessions peculiarly disputing for rehabilitation staff, every bit good as for households, friends and school forces. Because of the complex nature of the residuary disablements caused by TBI, coactions among rehabilitation specializers, household members and community-based professionals are indispensable. Some kids with TBI require AAC supports throughout their lives. Family members, friends and school forces seldom know how to pull off their terrible memory, attending and/or induction shortages that can impact long-run communicating results. 3. There is a demand to be after carefully for passages. Children with TBI will undergo many passages. While research depicting these passages in kids is non available, studies of the experiences of grownups with TBI describe multiple passages over clip. Penna et Al. ( 2010 ) noted that grownups with TBI undergo a important figure of abode passages peculiarly in the first twelvemonth following hurt and Fager ( 2003 ) described the different passages ( acute attention infirmary, outpatient rehabilitation, skilled nursing installation, place with grownup day care services, and finally assisted life ) for an grownup with terrible TBI experienced over a decennary, documenting important alterations in his cognitive abilities, every bit good as his communicating spouses and support staff. Children with TBI are likely to see even more passages over their life-times. 3. Pediatric SCI and AAC Pediatric patients with SCI frequently have integral cognitive accomplishments and terrible physical disablements that can interfere with their ability to talk. In add-on, they frequently have important medical complications and may be left with terrible motor damages that make it hard, if non impossible, for them to compose, entree a computing machine or take part in the gambling, online and remote societal networking activities embraced by today ‘s young person ( e.g. , texting, electronic mail ) . A subgroup may besides show with a attendant TBI sustained as a consequence of the autumn, auto accident or other traumatic event that has changed their lives. For them, AAC intervention must reflect guidelines that take into history both SCI and TBI. As with TBI, the growing and development inherent in childhood and adolescence and the alone manifestations and complications associated with SCI require that direction be both developmentally based and directed to the person ‘s particular demands ( Vogel, 1997 ) . Initially, AAC intercessions typically focus on guaranting face-to-face communicating when address is unavailable or really hard ; over the long term, nevertheless, enabling kids to compose and prosecute in educational, recreational and pre-vocational activities utilizing computing machines and other mainstream engineerings becomes the focal point. 3.1. AAC Assessment and Intervention The ASIA standard neurological categorization of SCI from the American Spinal Injury Association and International Medical Society of Paraplegia ( 2000 ) is a tool that rehabilitation squads often use to measure patients with SCI because it identifies the degree of hurt and associated shortages at each degree. This can assist steer the rehabilitation squad ‘s clinical decision-making procedure for AAC intercessions. As shown in Table 2, kids with high tetraplegia ( C1-C4 SCI ) have limited caput control and are frequently ventilator dependant. They frequently require oculus, caput, and/or voice control of AAC devices and mainstream engineerings to pass on. While switch scanning is an option for some, it requires higher-level cognitive abilities, endurance, and watchfulness and may be inappropriate for really immature kids and those who are medically delicate ( Wagner and Jackson, 2006 ; McCarthy et al. , 2006 ; Peterson, Reichle, and Johnston, 2000 ; Horn and Jones, 1996 ) . Ch ildren with low tetraplegia ( C5-T1 SCI ) demonstrate limited proximal and distal upper appendage control. If fitted with splints that support their arm and manus, some are able to utilize specially adapted mouse options ( e.g. , control stick mouse, switch-adapted mouse, trackball mouse ) , big button or light touch keyboards and switches to command engineering. These kids are besides campaigners for caput trailing and voice control of AAC devices due to the weariness and physical attempt involved in utilizing their upper appendages. For illustration, a multi-modal entree method to AAC engineering and computing machines may include voice control to order text, manus control of the pointer with an adaptative mouse to execute other computing machine maps ( e.g. , unfastened plans ) , and an adaptative keyboard to rectify mistakes that are generated while ordering text. This multi-modal attack can be more efficient and less thwarting than utilizing voice control entirely for these kid s. Table 2 provides illustrations of appropriate entree options to AAC and mainstream engineerings. 3.2. Supporting face-to-face communicating For kids with high tetraplegia, being dependent on mechanical airing is scaring particularly when they are unable to digest a speaking valve ( Padman, Alexander, Thorogood, and Porth, 2003 ) . Therefore, supplying these kids with a manner to pass on is indispensable to their recovery and sense of wellbeing. As kids with lower degrees of hurt are weaned from a ventilator, they may see decreased respiratory control and be unable to talk ( Britton and Baarslag-Benson, 2007 ) . Medical specializers can supply entree to AAC schemes and engineerings, which enable these kids to pass on their wants, demands and feelings throughout the twenty-four hours. This allows them to interact with direct attention staff, participate in their rehabilitation procedure, and keep relationships with household and friends. Pediatric rehabilitation squads may utilize a scope of AAC schemes and engineerings to back up face-to-face communicating in kids with SCI. Some illustrations include low tech communicating boards used with oculus regard or oculus pointing, partner-dependent scanning, an electro voice box with intra-oral adapter, or laser light indicating to a mark message or missive on a communicating board ( Britton and Baarslag-Benson, 2007 ; Beukelman and Mirenda, 2005 ) . Introducing AAC and AT engineerings early in the recovery procedure, peculiarly for kids who demonstrate high tetraplegia, will besides get down to familiarise them with attacks they may necessitate to trust on extensively throughout their lives, even after address returns. For illustration, Jared, a 17-year-old high school senior, sustained a SCI in a skiing accident at the C2 degree. In add-on to his hurts, he developed pneumonia and a terrible tail bone lesion during his hospitalization, which lengthened his infirmary stay. He was unable to digest a one-way speech production valve due to the badness of his pneumonia and reduced oxygenation during valve tests. Although Jared had minimum caput motion, he was able to command an AccuPointa„? caput tracker to entree his place laptop computing machine and spell out messages he could so talk aloud utilizing speech synthesis package. He used his AAC system to bespeak his medical demands to health professionals and subsequently reported that holding the ability to pass on helped relieve some of the anxiousness he experienced due to his status and drawn-out hospitalization. After Jared recovered the ability to utilize a speaking valve, his work with the AccuPointa„? focused on computing machine ent ree to run into written and societal communicating demands. Once his lesion had healed, he was able to return place 11 months subsequently. At that clip, all of his schoolmates had graduated. Using the AccuPointa„? , Jared was able to finish his GED at place and enrolled in on-line categories at the local community college. 3.3. Supporting written communicating and instruction At the clip of their hurt, some paediatric patients with SCI are pre-literate, others are developing literacy accomplishments, and others have extremely developed literacy accomplishments. However, most kids with tetraplegia will necessitate the usage of assistive engineerings to back up written communicating because their hurts preclude them from utilizing a pencil and/or typing on a traditional computing machine keyboard. In a study depicting the educational engagement of kids with spinal cord hurt, 89 % of the kids with tetraplegia relied on AAC to back up written communicating demands ( Dudgeon, Massagli, and Ross, 1996 ) . For illustration, Max, a 6 year-old male child who suffered a C6 SCI after an All Terrain Vehicle accident, was reading age-appropriate sight words and developing his ability to compose individual words prior to his hurt. After the initial recovery period, formal testing revealed that Max had no residuary cognitive or linguistic communication damages. However, he faced important barriers non merely to his continued development of age-appropriate reading and composing accomplishments, but besides to his ability to larn and make math, societal surveies, scientific discipline, drama games, use a cell phone, etc. Due to his tetraplegia, he needed ways to entree text and write, calculate, draw and so on. Max learned to entree a computing machine utilizing a big button keyboard, control stick mouse, and adaptative hand-typers ( turnups with an affiliated stylus that fit on the ulnar side of the manus and let the user to press the keys of a keyboard ) to back up composing activities and com puting machine entree. During rehabilitation, he was able to go on with his school assignment by developing the accomplishments to utilize the engineering and maintain up with his schoolmates. He returned place during the summer and participated in an intense place tutoring plan. By the autumn, he was able to fall in his schoolmates and was able to execute at grade degree in all categories. Essential to Max ‘s future educational success and development, every bit good as his future employment, may good depend on his ability to compose, calculate and possibly even pull utilizing a assortment of assistive engineerings that support communicating. 3.4. Support societal engagement and pre-vocational activities Entree to assistive and mainstream engineerings non merely facilitates engagement in instruction, but besides has deductions for future employment as these kids passage into maturity. Assistive and mainstream engineerings are now available at modest cost that can assist persons with SCI to counterbalance for functional restrictions, overcome barriers to employability, heighten proficient capacities and computing machine use, and better ability to vie for paid employment In add-on, these engineerings besides provide entree to life-long acquisition, recreational activities and societal networking activities. Specifically, computing machines are described as â€Å" great equalisers † for persons with SCI to prosecute in employment chances and distant communicating ( McKinley, TewksBury, Sitter, Reed, and Floyd, 2004 ) . Social engagement in the current technological age includes more than face-to-face communicating. Social engagement has expanded with the popularity of societal networking sites ( e.g. , Facebook a„?and MySpacea„? ) , video web-based communicating ( e.g. , Skypea„? ) and instant communicating and messaging ( e.g. , Twittera„? ) . Progresss in the field of AAC have allowed persons with the most terrible hurts entree computing machine engineerings to prosecute in these societal communicating activities. For illustration, Crystal was a 10-year-old who sustained a C1 SCI due to a autumn. Crystal ‘s hurt left her with no head/neck control and her lone consistent entree method to computerise engineering was through oculus trailing. With an ERICA oculus regard system from DynaVox Mayer-Johnson, Crystal rapidly became independent with computing machine entree. She emailed and texted her friends and household daily, communicated via her Facebooka„? history, and engaged in on-line gambling plans with her friends and siblings. This engineering allowed her to get down to pass on once more with her school friends while she was still undergoing acute rehabilitation. Keeping these societal webs is an indispensable constituent to emotional accommodation kids with SCI go through after prolonging a terrible hurt ( Dudgeon, Massagli, and Ross, 1997 ) . Additionally, Crystal ‘s friends began to understand that while her damages were terrible, she was basically the same individual with the same involvements, wit, ends, and outlooks as before her hurt. 3.5. AT/AAC subjects in SCI When working with paediatric patients with SCI, three AAC â€Å" subjects † emerge. 1. For those with high tetraplegia, AAC may ease face-to-face every bit good as distant and written communicating demands, depending on the developmental degree of the kid. Introducing AAC engineering early, when face-to-face communicating support is needed, helps the kid become familiar with the engineering they will necessitate to trust on after natural address has recovered. 2. Return to an educational environment is a primary end with many kids with tetraplegia returning to school within an norm of 62 yearss post discharge ( Sandford, Falk-Palec, and Spears, 1999 ) . Development of written communicating accomplishments is an indispensable constituent to successful educational completion and future vocational chances ( McKinley, Tewksbury, Sitter, Reed, and Floyd, 2004 ) . 3. Introduction to methods of written and electronic communicating provides an chance for patients with SCI to prosecute in societal webs through electronic mail, texting, and societal networking sites. As these kids with terrible physical disablements face a life clip of possible medical complications ( Capoor and Stein, 2005 ) , the ability to keep and develop new societal connexions via electronic media allow them to remain connected during times when their medical conditions require them to be house or hospital-bound. 4. Decision Communication is indispensable for continued development of cognitive, linguistic communication, societal, and emotional accomplishments. Children with TBI and SCI have physical and/or cognitive-language shortages that interfere with typical communicating abilities. Their communicating demands are supported through AAC schemes and engineerings. A myriad of engineering options are available that non merely back up face-to-face interactions, but every bit of import distant societal networking and educational activities. AAC intercessions in the medical scene that non merely back up communicating of basic medical demands, but besides facilitate battle in societal, educational, and pre-vocational activities will ensue in successful passage to place, school and community environments for these kids.