Is state government an effective form of government Essay

Is state government an effective form of government - Essay Example This is a step forward in the process of decentralization out of federal power and of achieving efficiency by the state governments. Dr. Weiher stated that there are four general purposes of a written Constitution: "(1) Create a Form of Government; (2) Limit Governmental Power; (3) Define Who is a Citizen; and (4) Identify society's central values" (Weiher, 2002). This last point has to be emphasized. The values of any given society change frequently from territory to territory. People from different states have very different sets of values and a written Constitution is a reflection of the diversity of values among citizens of different states. For example, people from Utah have in common their unique religious beliefs. The same can be said of other people from other states. The federal government provides the unity within the diversity, and each state is a symbolic pluralistic unit in the spectrum of all the states bound together under the U.S. Constitution. The Wikipedia points out that "the most obvious advantage of a codified constitution is the coherent and easily understood body of rules. A codified constitution at the least is simple to read, being a single document.

Netflix’s Business Model and Strategy Essay Example for Free

Netflix’s Business Model and Strategy Essay Netflix is the largest subscription service for sending DVD’s by mail and streaming movies and TV episodes over the internet. Netflix’s revenues grew from $500 million in 2004 to $519.8 million in 2010. Company’s net income increased from $21.6 million in 2004 to $141-156 million in 2010. It attracted 1.6 million subscribers in 2004 and had to 15 million subscribers by 2010. Reed Hastings founder and CEO of Netflix have pushed the company to outcompete its movie rental competitors by building the world’s best internet movie service. Netflix is the world largest online entertainment subscription service and revolutionized the way that people rent movies. Netflix has outcompete its rivals on the basis of differentiation features, with their higher quality, wider product selection, added performance and services, and has superior technology. Netflix has a large selection of DVDs to choose from. It maintains relationships with entertainment providers to expand the title selection. Movies are prescreened for customers based on peer reviews. This allows Netflix to increase their inventory with movies chosen by viewers. There are no late fees. Netflix technology is superior because movies and TV episodes can be streamed directly onto nearly any device in a matter of seconds. Netflix business model and strategy can be analyzed with the 5 competitive forces in the movie rental marketplace: 1-substitute, 2- buyers, 3- suppliers, 4- potential for new entrants, 5- rivalry Substitute-It does not matter who sells the movie or the TV episode at the end the end user is getting the same product whether he got it from Walmart or Blockbuster. Substitute for Netflix and a potential threat is pirating movie files from the internet and illegal. This is a substitute that is inexpensive or free copy of the file. Buyers- Have the power to select where they are going to get movies or TV episode. They are going to look provides the best price and best quality. Buyers are not loyal and can get this product from other vendors. Competitors compare industry prices and quality. They will reduce cost in order to attract the buyer. Suppliers-Such are Hollywood are likely to increase cost if the industry profits increase. Suppliers have the capability to make movies and TV episodes harder to get by limiting license agreements. In order for suppliers to maximize their revenues they sell large number of movies and TV episodes the outcome results in competition and does not allow supplier to have much power on the product. Potential for new entrants- Blockbuster, and Netflix are the dominant retailers in the market it is very difficult for new entrants to succeed. Rivalry- Consumers have multiple sellers they can buy or rent movies and/or TV episodes. Main competitors are online subscription services internet movies and TV episode provider, kiosk services, and DVD rental outlets. From SWOT analysis we found the Strengths as followed, by operation on line is very flexible and very low cost, it has high customer satisfaction levels, and strong knowledge base and brand identity. Weakness are the industry, it is constantly changing at a fast speed, it is supplier dependent, postage is a variable cost (increases), customers need to have internet access and or DVD players. Opportunities are: It can expand globally to international markets because its internet access, new technology. Threats: If it’s not able to adapt or keep up with technology, rivals such as Walmart.com or Blockbuster have capital to compete against Netflix. There are some issues Netflix is facing Netflix needs to watch out for growing competitors with deep pockets and need to keep up with the fast growing changes with technology. It is recommended that Netflix increases its customer base (subscribers). This income will offset the ongoing costs. Netflix should move away from DVD rental, it creates a large percentage of its operating cost. Netflix should find out why people are still ordering DVD’s Netflix should educate customers with their streaming and downloading and focus on encouraging customers to stay with the service. Blockbuster advantage over Netflix is that they are able to release new released titles. Netflix needs to negotiate with entertainment providers to get new releases earlier than the competitors. Finally it is suggested that if Netflix is able to get new releases earlier they should pass a cost for the newest release (separately from subscription download monthly fee).

National Concern †North Korea Essay Example for Free

National Concern – North Korea Essay ‘What do you think is the most important international concern right now? ’ Out of curiosity, I conducted a small survey and asked that very question to people on the streets. As I expected, most of them revealed it was the conflicts in North Korea. There are many ways to describe North Korea. It is a country under a dictator leadership, a country with a very serious poverty problem, and a country that recently became notorious with its defense for nuclear weapons. However, I would like to describe the country as a child – a poor, desolate, and lonely child. It is true that many people are scared of North Korea and the activities it is involved with, such as nuclear testing. However, I am more worried than afraid about the country. As I mentioned above, I think North Korea is like a child a child that needs a guardian to lead it back onto the right path. And because such child was left alone since the Korean War and was forced to grow up by itself, it now wants attention from other countries. Many politicians are offering solutions for North Korea and for its actions. Many are suggesting for war since North Korea is disrespectful and very egoistic. Others want peace, without any bloodshed. I personally agree with the peaceful method because I know we can solve this problem by conversation. And I do not want to fight against the land my family came from. I think the unification of North and South Korea would help the country to develop and mature itself. I know it will take time to equalize the country both, politically and economically. I also do not expect another miracle to happen like Germany. But if such unification is possible, then the world would have succeeded in achieving more world peace. Another solution is to have a world conference to understand each other better, rather than to just tell each other what they want and what they do not. I know how sensitive all countries are these days, with conflicts happening daily and with the world getting increasingly complicated and crowded. However, if the countries could step back from their own problems and look into the heart of the mater of global issues for a minute, they would be able to understand each other better and help solve the North Korea’s problem with a willingness to see world peace. If both methods do not happen in the next 5 years which is highly possible I am ready to join the United Nations to help struggle the peace for Korea. I am a person who thinks that life is too short and that I want to try and experience as much as I can to reach my goals. Thus, if politicians do not make any actions, I will step in to achieve my ultimate life’s goal: Korean Peace. I will join the United Nations, the organization that has helped to bring in peace for many countries. I am a firm believer that endless endeavor can bring in success. Many people will probably find my solutions childish and idealistic. After all, the world is a far more complex place than a teenager may think. However, one thing I know for sure: my passion for world peace is stronger than most people. And if the passion remains as I mature mentally and intellectually over the next few years, I am certain that I will make a difference for both, North Korea and the world. And for that embodied child of Korea, it will some day grow up a unified, matured and peaceful person like how I always dream it would be. Nothing is impossible without hope, faith and determination.

Effective Hand Washing Program Nursing Essay

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

The Yellow Wallpaper as a Guide To Insanity and Madness -- Yellow Wall

The Yellow Wallpaper as a Guide To Insanity   Ã‚   "There comes John, and I must put this away- he hates to have me write a word" (p659). As evident by the above quote, Gilman places the narrator of "The Yellow Wallpaper" as secluded as she could be; she is placed in a large house, surrounded only by her husband and by little help (Jennie), when it is unfortunately clear that her relationship with her husband is based on distance and misunderstanding: "It is so hard to talk with John about my case, because he is so wise, and because he loves me so"(p 663). Gilman further confines her narrator as it becomes clear that the poor soul has absolutely no one to talk to; that is, no one who can understand her. The narrator is cornered by her loved ones, she is isolated from the world under her husband-doctor orders, she is thus physically confined to her shaky mental realm.   Ã‚  Ã‚  Ã‚   The next aspect of the narrator that zooms us into her state is her tone: "I really have discovered something at last.... The front pattern does move- and no wonder! The woman behind shakes it!" (p 666). Gilm...

Essay on Kids, Schools and Guns :: Argumentative Persuasive Topics

Kids, Schools and Guns Guns. The word itself conjures up images of bloodshed and death. Yet instead of instilling fear into people, American society has embraced guns and placed them in numerous homes under the pretence of protection. Add to that image - children. Children and guns should never have any association, yet has become somewhat commonplace because of the many incidences that involve the two. In the age bracket of 10 to 19 years, guns are the second leading cause of deaths, after automobile accidents, in America. Of the 5751 deaths in 1993, 3661 were homicides while 1460 were suicides. One American in that age group dies every 92 minutes regardless of cause, and for every child killed, four are injured. Between 1996 and 1997, 6000 school children were expelled for bringing guns to school. (http://www.handguncontrol.org/) In April 1999, two boys in Littleton, Colorado went on a rampage at Columbine High School where 12 students and a teacher were killed. Almost 20 other students were hurt during this incident. They turned the guns on themselves after the shooting was over. Then in May, a 15-year-old boy opened fire at Heritage High School in Conyers, Georgia injuring six students. He had taken a rifle and pistol from a cabinet of weapons in his home. (http://www.angelfire.com/wa) In May 1998, in Springfield, Oregon, a 15-year-old, expelled from Thurston High School, returned to the school and opened fire in the cafeteria, killing two students. His parents were later found shot dead in their home, believed to have been killed by the son. The latest shooting took place in Michigan this past February where a six-year-old boy shot dead a classmate. Kayla Rolland, 6, was shot through the neck and died later in hospital. The boy was under the care of his aunt, living in a house where guns were within reach, and drugs were traded for stolen weapons. The six-year-old, suspended from school three times prior to the shooting, once for stabbing a student with a pencil, got the loaded gun from under some blankets on a bed at the house in which he was living. One might imagine that after all these unnecessary deaths, gun laws would be revised to ensure guns are kept out of the hands of children. In America, the Brady Law states that anyone under 21 cannot legally purchase handguns from licensed dealers. There is, however, a loophole whereby 18 to 21-year-olds can purchase handguns from private or unlicensed dealers.

Employee Engagement and Grievance Handling Essay

Title of the Project Employee Engagement and Grievance Handling Process Statement about the Problem This topic has been chosen because in every organization, employee engagement activities are conducted as employee  productivity  is clearly connected with employee engagement. It is a  business management  concept. An â€Å"engaged employee† is one who is fully involved in, and enthusiastic about his work, and thus will act in a way that furthers their  organization’s interests. Thus, engagement is distinctively different from employee satisfaction, motivation and organizational culture. An integral part of employee engagement is a strong grievance handling mechanism. Objectives and Scope of Study a. Analyze the Employee Engagement activities that are being done at ‘Indigo’and the outcomes of these activities. b. Understand the process mapping for employee engagement. c. Techniques used for engaging employees in our organizationd. Grievance handling process e. Introduction and types of grievances. f. Discuss the grievance handling process at organizational, process, project ; individual levelg. Methods used in grievance handling h. Understand how Employee Engagement activities and Grievance Handling processes go hand in hand. Methodology Research methodology talks about data collection of the project work. The data collection as such is divided into:I. Primary Data a. Questionnaire survey b. Face-to-face discussion with existing employees who are there in the organization for more than six months or so. c. Discussion with Human Resource specialists. II. Secondary Data 1) Journals 2) Company records and reports 3) Internet Searches 4) External websites 5) On line survey conducted by company.