Discussing Valentine and I Wouldnt Thank You for a Valentine Essay

Discussing Valentine and I Wouldn't Thank You for a Valentine For this poetry assignment I will be discussing the poems â€Å"Valentine† by Carol Ann Duffy and â€Å" I Wouldn’t Thank You for a Valentine† by Liz Lochhead. The poets have similar views about relationships but express these views in contrasting ways. In order to analyse their contrasting styles it would be beneficial to look at their backgrounds. Carol Ann Duffy was born in Glasgow, Scotland in 1955 but was brought up in Stafford, England. She worked as a free-lance writer in East London, and then she moved to Manchester where she currently teaches creative writing at the Metropolitan University. Collections include â€Å"Standing Female Nude† and â€Å"Selling Manhattan†. Liz Lochhead was also born in Scotland in 1947. She is a well-known Scottish poet, dramatist and performance artist. She began as a lecturer in fine art, but became a full time writer in the 70’s. Collections include â€Å"Memo for spring† and â€Å"The Grimm Sisters†. Both these poets’ backgrounds and upbringings are represented as Liz Lochhead uses Scottish dialectal words and phrases while Carol Duffy does not. Lochhead uses words such as â€Å"auld† and â€Å"canny†. This is not reflected in Carol Ann Duffy’s poem. This is possibly because she was brought up in England so had forgotten the Scottish dialect. The structure of â€Å"Valentine† by Carol Ann Duffy is not that of a regular poem. It is written in free verse and there is no obvious rhyme scheme or rhythm. The lines and stanzas are all completely different and there seems to be no pattern. This gives the poem a more personal touch and possibly shows that the poem was heartfelt and these thoughts were written down as the poet thought them. The lines... ...ould possibly offend a female reader is she is disapproving these ideas- when another lady may love it. For example if a man bought his girlfriend a diamond ring and proposed , Liz Lochhead is rejecting this idea â€Å"If you sent me a solitaire and promises solemn†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦you’d entirely fail to charm me , in fact I’d detest it†. This may put some people off this poem if they find these things sentimental. I find that I relate with Carol Ann Duffy’s â€Å"Valentine† better than â€Å" I wouldn’t thank you for a Valentine† because it has deeper meaning and seems to be more serious and has really came from the heart. Liz Lochhead’s poem still shows true feeling but she doesn’t present it as well as Carol Ann Duffy. Some people may look at â€Å"Valentine† and laugh because the poet is comparing love to an onion but when you read the comparisons they are very true and meaningful.

Health :: science

Health Twenty-five years ago, the great Athenian doctor Hippocrates believed that balance is health and that imbalance is the cause of all illness and pain. For more than three hundred years, this concept has been in disfavour. Now, clinical experiences with Phen/Fen suggest that Hippocrates was right. While both phentermine and fenfluramine have been available since the mid-seventies, patients were generally reluctant to use them because of the always present fear of addiction. During many instances when people did try either one of these new drugs, they could not tolerate the side effects. The pills in fact do work, because they trick the brain into thinking that the stomach is full. But they also seem to affect the brain in other, less desirable ways. The thought process behind creating a ‘superdrug’ such as Phen/Fen, was that by combining the two medications, one could take advantage of their different pharmacologic actions getting, in essence, better effectiveness while hopefully minimizing the "mild" side effects (Michael D. Myers. 1997). Despite the side effects that are still present, drug companies are making lots of money off of Phen/Fen. It is the second fastest growing drug in the country. In 1996, it earned about $191 million for its maker, Wyath-Ayerst (CNN. 1997). Obesity, poor nutrition, and inactivity are estimated to contribute to about 300,000 deaths a year (National Institution of Health. 1996), thus there is an increased demand for such pills as Phen/Fen. In this paper, I will discuss the two drugs that make up Phen/Fen, Fenfulramine and Phentermine, and discuss the side effects for each of the pills. I will introduce Serotonin and Dopamine, two of the brain’s neurotransmitters and the effect of Phen/Fen on them. I will also discuss who should and who shouldn’t use this potentially dangerous diet. Finally, I will look at a case study from Michael D. Myers which makes some very important conclusions about the diet. Fenfluramine Fenfluramine was discovered at approximately the same time as it’s cousin, Phentermine. Fenfluramine has always been strongly associated with many side effects. The most prominent of it’s side effects is Primary Pulmonary Hypertension which is a life threatening complication (Michael D. Myers. 1997). An estimated 1 in 17,000 patients that are treated for longer than 3 months will develop this condition (New England Journal of Medicine. 1996). The symptoms may be vague chest discomfort of development of an insidious feeling of shortness of breath (Abenhaim, L.

Saving Private Ryan Essay -- Film Movies

Saving Private Ryan In his review of the film â€Å"Saving Private Ryan†, N.Cull claims that the film presents†¦ â€Å"a realistic depiction of the lives and deaths of G.I’s in the European theatre in World War II†. Do you agree with his assessment of the film? Argue your case. N.Cull’s assessment of the film Saving Private Ryan in that it portrays â€Å"a realistic depiction of the lives and deaths of G.I’s in the European theatre in World War II† is an accurate one. Director Stephen Spielberg brings to the audience the â€Å"sheer madness of war† and the â€Å"search for decency† within it. That search ends for a group of soldiers whose mission it is too save Private Ryan. Although the film shows horrific and realistic battle scenes along with historically correct settings and situations with weapons and injuries true to their time, the film’s portrayal of war goes a lot deeper than that. The expressions and feelings of soldiers along with their morals and ideology are depicted unifyingly with the horror of war. The lives and deaths of American soldiers in the immediate part of the invasion of Normandy are illustrated more realistically than ever before. Saving Private Ryan captures the â€Å"harsh reality of war as authentically as possible†. The films historical accuracy of the Omaha beach landing begins with the â€Å"angry sea† and the timing of the attack, taking place at dawn. The film starts with Ryan in old age remembering his fallen comrades and then the story goes back in time to the events from there. A group of armed soldiers aboard a transport vessel look almost discarnate as the boat is tossed around the ocean. The soldiers do not pay attention to the orders they are given. (Perhaps a cause of why there is so much confusion and disorganisa... ...Ryan may not be a complete representation of the invasion of Normandy because of its need to provide a storyline and make a profit at the cinemas. Yet its accurate historical detailing enables N. Culls assessment of the film to be â€Å"a realistic depiction of the lives and deaths of G.I’s in the European theatre in World War II† Bibliography Primary Sources D. Breger. Private Breger in Britain. London, 1944 J. Robert Slaughter. D-Day, 1944. Source analysis. Sir W. Churchill. Words at War. June 15, 1940 Secondary Sources American Historical Review. Vol 103 no 4. October 1998 R. Wolfson. Years of Change 1891-1995. Hudder and Slaughton. London, 1993. S. Spielberg. Saving Private Ryan: The Men. The Mission. The Movie. http://www80.homepage.villanova.edu/james.dion/over.html 18/09/2001 T. Edwards. D-Day. Wayland Publishers. London, 1975.

Childhood Obesity: The Causes And Health Problems Essay

The topic that I have chosen for my paper is addressing the issue of childhood obesity. According to Merriam-Webster (2010) obesity is a condition where there is excessive accumulation and storage of fat in the body. I think that childhood obesity is an epidemic that the United States of America is facing as a major issue for children health. Childhood obesity is one of the fastest growing health concerns in the United States. The definition of an epidemic according to Encyclopedia Britannica (2011) is the occurrence of disease that is temporarily of high prevalence. The childhood obesity rate has more than tripled in the United States over the last 30 years( Center for Disease Control, 2010) I will prove that there are ways to prevent the causes of childhood obesity. Research will be focusing on the causes, the health concerns, and the ways to prevent childhood obesity. The resources that will be using for the research are: internet research, case and research reports, and interviews. So far research findings are showing that there are many causes and effects of childhood obesity. Childhood obesity is difficult health problem because it has biological, behavioral, social, economic, environmental, and cultural causes (Koplan, Liverman, Kraak, 2005, pg 340). Each one of the causes stated above can have many different influences for a child in this country. An economic example is when the recession caused a lot of people to lose their jobs. The recession caused a lot of people to lose their income, which caused a lot of families to not be able to afford the necessities of life. People had to choose between making their house payment or buying food. The number of people also has something to do with how a family eats. The number of people that are in the family determines the amount and the cost of food needed. A family income also has an important role in a family. If the family size is larger and the income level is low then the  family may have problems buying healthier food. A social example would be their peers influencing what they eat when they are away from their house. Children could be more likely to eat what their friends eat when they are not home as well. The community has a role in this as well. The reason the community has a role in this is due to the restaurants that are in the area and the food those places offer. If your community only offers fast food then the child is more likely to eat that food, which is high in fat. The education level and number of parents may also affect childhood obesity. Research shows that the higher level of education and if both parents are in the home then it is less likely that a child will be obese ((Koplan, Liverman, Kraak, 2005, pg 216). A cultural example would be how we advertise products in the United States. Companies are advertising towards children. For example at a fast food restaurant the child meal comes with a toy. With children watching more and more TV these days the retailers are making commercials for the children that are watching them. The child’s ethnicity is an important factor as well. The traditions that the parents grow up with will be taught to the child and passed down to the next generation. The community again is important factor for this cause as well. People adapt to where they are living. For example if a family moves to from a neighborhood that had more restaurants than fast food, and then the family moves to a neighborhood that has nothing but fast food and there is no other place to eat they may change their diet. A behavioral example would be that a young child that does not want to eat their vegetables at lunch because they say they do not like them. Portion size is a very important factor for childhood obesity. If the portion size of an unhealthy food is too big then the child is more likely to become overweight. When a child is eating fast food or processed food or if they are drinking soda and juice, then they are consuming more sugar and calories than someone that may be eating vegetables or fruit. When a child intakes more calories or sugar, then does not exercise then the child is not burning off the extra intake off. Some children also play a lot of video games and  a child may watch a lot of TV, instead of playing outside. A biological example is if someone has a medical condition where it makes their metabolism not work the best and it causes them to have trouble losing weight or they just gain weight easily. Every person has a different metabolism level as well. Some people may have an over active metabolism and then there are others that have a metabolism that is very slow. Metabolism is how fast the body burns off calories or energy that the body takes in. Another factor is genes or heredity. Genes or heredity is something that you get from your parents of other people in your family. This gets passed down from generation to generation and there is nothing that can be about it, except trying to offset it buy changing diet or level of physical activity. An environmental example would be looking at the ease of accessing processed or fast food near a child’s home. The food that a parent fixes their child is an important factor. This is important due to the fact if the parent is fixing processed or just bringing fast food home then the child will be in taking more calories per meal which could affect the child’s weight in a negative way. The foods that a school offers are also a factor. A school that offers healthier choices may help the student choose the healthier food. When a child chooses a healthier food then they are more likely to continue their diet as an adult but this will also help the child’s weight then too. The state that a child lives in could also be a factor. Each state has their own specialty that almost everyone fixes. If the child is living somewhere, where foods are fired then they are in taking more fat and calories. There are so many health concerns that come with childhood obesity. Some of the health concerns are type 2 diabetes, cardiovascular disease, high blood pressure, lower life expectancy, stress, depression, and low self-esteem. According to the Center of Disease Control (2010) children that suffer from childhood obesity are more likely to get the above health problems when they get older to have these diseases as adults. If some kids are left to manage their own health then they will be unhealthy as an adult because their  lifestyle will not change. This is a very important health concern for our children because they are the future leaders of this country and this is causing them to die earlier than their life expectancy. Cardiovascular disease is one disease that is affecting children with childhood obesity. Cardiovascular disease is relating to or involving the heart and blood vessel in the body(Merriam-Webster, 2011). According to the Center of Disease Control, 70% of children that are obese have at least one risk factor for cardiovascular disease. One contributing factor is cholesterol to the above statistic. Kids are eat more and more fast food in this generation which is increasing their weight and cholesterol levels. Children are also not exercising or doing cardiovascular exercises like: swimming and running. This disease can also lead to many other health problems in adulthood. Another health concern for children that are obese is high blood pressure. Keeping your blood pressure in a healthy level is important because high blood pressure can lead to a heart attack or stroke. High blood pressure is known as hypertension. Hypertension is abnormally high arterial blood pressure (Merriam-Webster, 2011). According to Rob Stein (2007) â€Å"increases so far have been small — just 2.3 percentage points for early hypertension and 1 point for full-blown hypertension — they translate into hundreds of thousands more children developing what often becomes a chronic, lifelong condition†. High blood pressure can lead to other health concerns such as: heart disease, stroke and kidney troubles. The next major health issue that can come from a child being obese is type 2 diabetes. According to the University of Michigan Health System it could take up to 10 years before an obese child shows the development of type 2 diabetes. Type 2 diabetes is when the body can not process the insulin in the body produces. There are many things that can contribute to a child having type 2 diabetes. The level of exercise can help lower the risk of type 2 diabetes because when you exercise it helps the body burn the energy that is consumed. There are some complications for health when you have diabetes, those complications are blindness and amputations of the arms  and/or legs. Stress can also have an effect on a child’s health. Stress can cause many health issues because it takes energy to be stressed and many people worry when they are stressed. According to Merriam-Webster (2011), stress is a physical, chemical, or emotional factor that causes bodily or mental tension and may be a factor in disease causation. Stress can come from home, school, friends, and family. When someone is stressed they may eat for comfort and this can cause extra calories being taken in and not burned off. Stress can be linked to heart disease, stroke, high blood pressure, and many more. Low self-esteem is another important factor for children. Low self-esteem is a confidence and satisfaction in oneself. Low self-esteem can be from children bullying, making fun of each other, and stress. When a child has trouble making friends they may form a low self-esteem. Low self-esteem can cause an eating disorder. According to Susan Okie (2005, p 73), obesity is a risk factor for the development of an eating disorder. A child overweight could have a poor self-image and that could lead to an eating disorder. There is also a lower life expectancy with children that are obese. Life expectancy is referring to the age that a person lives to base on sex, ethnicity, and other factors. There are many factors that contribute to this. One factor is suicide. Children that have a low self-image or ones that have given up could resort to suicide. Another factor is the health issues that the obese child has. As the child gets older and if they already have heart disease, high blood pressure, or type 2 diabetes are likely to have the complications with those diseases earlier in their adult life. One way that Americans are trying to prevent childhood obesity is having schools offer more gym class time. Another way that Americans are trying to incorporate exercise is that the TV network Nickelodeon has a day that they turn off the cartoons and encourage children and their parents to go outside and play, they call it the national day of play. There are many health  programs also ran by the government trying to help low income families with providing their children with a balanced diet. The biggest thing that a parent can do is change their own lifestyle and pass it to the child. A parent leads by example showing their children how to live, act, and what to believe. A parent can start a daily activity with the family included and make this routine for the family. The parent can also change the food bought at the store and what is fixed at home. A child can be given a much smaller portion size and then if they are still hungry they could ask for more and the parent would determine the portion size of the extra the child would get. School are not out of the woods on this subject matter either. Schools offer processed food which are higher in calories, fat, and maybe sugar. Schools need to change their menu to offer healthier lifestyle choices. Schools would also help prevent childhood obesity by increasing the amount of time the student gets physical exercise during the school day. Another item the school should change to help prevent childhood obesity is the portion size of food their offering to a child. A community could ban together to prevent childhood obesity as well. The community could offer to have a campaign. These campaigns would be able to use multiple strategies,such as: media campaigns , community mobilizations, education programs for health professionals and the general public, modifications of physical environments, and health screenings and referrals (Koplan, Liverman, Kraak, 2005, pg 196). The community could also build a bike or walking trail in a park. Having the bike or walking trail will encourage the citizens of the community to get out and exercise. The community could also build a community center that has exercise equipment or a program ran thru the building to help teach parents to eat right. When the parents know what to do to help then they can pass the information down to the children. There are also many government ran programs to help low income families. One good example is the WIC program which stands for Women, Infant, and  Children. This program helps low income people that are pregnant or they have children under the age of five and they also have to meet the income guidelines for the size of the household. Income guidelines vary depending on what state in which the family resides in. WIC only offers certain foods to families. They offer formula for a baby, but the formula has to be on a state approved list (USDA, 2011). If there is a pregnant woman in the household, WIC then offers the household milk, whole grain bread, peanut butter or dry beans, fruit, approved cereal, and 100% fruit juice(USDA, 2011). If the woman is breastfeeding the baby then she is offered tuna and carrots for the nutritional value those foods give (USDA, 2011). Another government program is Food Stamps which help low income families buy food. There are income guidelines that someone would have to meet before getting assistance with this program. There is not much of a requirement of what food to buy on this program but they do have items that you are not allowed to buy. The recipient cannot buy taxable items such as diapers, paper towels, or toilet paper. The recipient cannot buy alcohol either. When a person on food stamps goes to a store to buy groceries the register will notify the cashier what is food stamp eligible and what is not. Anything that is not eligible the consumer must pay for. Without these programs the United States could have lots of hungry people that could starve to death. Research is stating that childhood obesity is preventable when proper diet and exercise are incorporated into a child’s life from a young age. If a child does not eat healthy foods and does not exercise then that child is more likely to be obese. When a child is obese, then the child is at risk for some serious medical diseases that may not show up until they are an adult. If a child has a serious medical disease young then they more likely to have a more severe condition like cardiovascular disease when they are an adult. There are many government and community programs to help the low income families that are in need of assistance. Preventing childhood obesity is a concern for parents, schools, communities, and government to solve together with all of the programs available. References Center of Disease Control. (2010, June 3). Childhood Obesity. In Health Topics (par. 2) [Fact Sheet]. Retrieved from http://www.cdc.gov/healthyyouth/obesity/#5 Epidemic. (2011). In Encyclopedia Britannica. Retrieved from http://www.britannica.com/EBchecked/topic/189776/epidemic Institute of Medicine (U. S.) Committee on Prevention of Obesity in Children and Youth. (2005). Confronting the Childhood Obesity Epidemic. In V. A. Kraak, J. P. Koplan, & C. T. LIverman (Eds.), Preventing Childhood Obesity: Health in the Balance. (p. 196). Retrieved from http://site.ebrary.com/lib/ashford/Doc?id=10075881&ppg=196 Institute of Medicine (U. S.) Committee on Prevention of Obesity in Children and Youth. (2005). Confronting the Childhood Obesity Epidemic. In V. A. Kraak, J. P. Koplan, & C. T. LIverman (Eds.), Preventing Childhood Obesity: Health in the Balance. (p. 216). Retrieved from http://site.ebrary.com/lib/ashford/Doc?id=10075881&ppg=216 Institute of Medicine (U. S.) Committee on Prevention of Obesity in Children and Youth. (2005). Confronting the Childhood Obesity Epidemic. In V. A. Kraak, J. P. Koplan, & C. T. LIverman (Eds.), Preventing Childhood Obesity: Health in the Balance. (p. 340). Retrieved from http://site.ebrary.com/lib/ashford/Doc?id=10075881&ppg=340 Merriam-Webster Dictionary (Ed.). (2011). Merriam-Webster. Retrieved from http://www.merriam-webster.com/medical/cardiovascular Merriam-Webster Dictionary (Ed.). (2011). Merriam-Webster. Retrieved from http://www.merriam-webster.com/dictionary/hypertension Merriam-Webster Dictionary (Ed.). (2011). Merriam-Webster. Retrieved from http://www.merriam-webster.com/dictionary/obesity?show=0&t=1297741121 Merriam-Webster Dictionary (Ed.). (2011). Merriam-Webster. Retrieved from http://www.merriam-webster.com/dictionary/self-esteem Merriam-Webster Dictionary (Ed.). (2011). Merriam-Webster. Retrieved from http://www.merriam-webster.com/medical/stress Merriam-Webster Dictionary (Ed.). (2011). Merriam-Webster. Retrieved from http://www.merriam-webster.com/dictionary/type+2+diabetes?show=0&t=1298313788 Okie, S. (2005). Size, Health, and Self Esteem. In Fed Up! Winning the War Against Childhood Obesity (pp. p 73). Retrieved from http://site.ebrary.com/lib/ashford/Doc?id=10075869&ppg=73 Stein, R. (2007, September 17). More Kids Developing High Blood Pressure. The Washingtion Post, par 3. Retrieved from: http://www.washingtonpost.com/wpdyn/content/atricle/2007/09/10/AR2007091001349.html?hpid=topnews University of Michigan Health System (2008, July 12). Coming Epidemic Of Type 2 Diabetes In Young Adults. ScienceDaily. Retrieved fromhttp://www.sciencedaily.com/releases/2008/07/08070819329.htm USDA. (2011). Women Infants and Children [Brochure]. Retrieved from http://www.fns.usda.gov/wic

Poetry and Lady

I have chosen the poem, Lady Feeding the Cats by Douglas Stewart, to explore how the poet has used Australian visions to explore ideas about Australia. Douglas Stewart a poet who brings texts to life and shapes meaning giving them a distinctly visual image. He conveys this by using visual imagery and descriptive language in his poems this is conveyed in Lady feeding the cat. â€Å"Lady Feeding the Cats†, a poem links to the AOS- Australian Vision. The poem is really meaningful and deep as the cats described the old lady at the end to be a gracious and sweet queen of the cat† .The lady in this poem is a poor person who lives in the slum and wears the bedraggled bonnet and clothing but she is the queen in those cats' mind. In the poem, Douglas has described Domain and Moreton Bays as a part of Australia; it makes us aware that they lived in Australia and the behaviours from the lady who lives in bad conditions and is a poor person but still treats others well, especially t he wild cats. The title, Lady Feeding the Cats, is appropriately chosen as symbolises a sense of volunteering and mateship.As shown in the text it claims that to feed those outlaws, represents and shows a metaphor for the great Australian values of volunteering and mateship. The poem lady feeding the cat has a sense of loneliness and links man and nature. Lady feeding the cat portrays a poor women living in the slums of Sydney and comes to the domain everyday to feed the cats. Stewart uses visual imagery throughout the first stanza â€Å"broken shoes†, slums weather stains. Douglas uses this technique to explain and paint an image in the readers’ head of this women’s economic standing in the world.In the first stanza Douglas uses alliteration Shuffling-shoes-slums All the three words are interconnected showing someone who is ‘shuffling’ generally old – connected to shoes because he is hobbling along – slums shows the person shuffling i s not just wearing old shoes but also lives in slums indicating poverty. Douglas Stewart also uses simile by stating like a pine in the rain- often pine trees are not grown very symmetric but rather looks straggly especially when it has been raining and everything is wet and drooping.In the second stanza it says â€Å"they rub at her legs for the bounty that never fails† its shows the connection and the friendship between the lady and the cats exploring the Australians values about the mateship. The lady in this poem gets her salvation from these cats without the cats she would have nothing, the cats also rely on the lady without this lady they would not get fed. The metaphor â€Å"If she has fed their bodies, they have fed more than the body in her†, revels that the lady fed the cats but the cats have fed her with love.

Acc 509. Springfield Express Essay

Springfield Express is a luxury passenger carrier in Texas. All seats are first class, and the following data are available: Number of seats per passenger train car 90 Average load factor (percentage of seats filled) 70% Average full passenger fare $ 160 Average variable cost per passenger $ 70 Fixed operating cost per month $3,150,000 a.What is the break-even point in passengers and revenues per month? b.What is the break-even point in number of passenger train cars per month? c.If Springfield Express raises its average passenger fare to $ 190, it is estimated that the average load factor will decrease to 60 percent. What will be the monthly break-even point in number of passenger cars? d.(Refer to original data.) Fuel cost is a significant variable cost to any railway. If crude oil increases by $ 20 per barrel, it is estimated that variable cost per passenger will rise to $ 90. See more:Â  Social Satire in The Adventures of Huckleberry Finn Essay What will be the new break-even point in passengers and in number of passenger train cars? e.Springfield Express has experienced an increase in variable cost per passenger to $ 85 and an increase in total fixed cost to $ 3,600,000. The company has decided to raise the average fare to $ 205. If the tax rate is 30 percent, how many passengers per month are needed to generate an after-tax profit of $ 750,000? f.(Use original data). Springfield Express is considering offering a discounted fare of $ 120, which the company believes would increase the load factor to 80 percent. Only the additional seats would be sold at the discounted fare. Additional monthly advertising cost would be $ 180,000. How much pre-tax income would the discounted fare provide Springfield Express if the company has 50 passenger train cars per day, 30 days per month? g.Springfield Express has an opportunity to obtain a new route that would be traveled 20 times per month. The company believes it can sell seats at $ 175 on the route, but the load factor would be only 60 percent. Fixed cost would increase by $ 250,000 per month for additional personnel, additional passenger train cars, maintenance, and so on. Variable cost per passenger would remain at $ 70. 1.Should the company obtain the route? 2.How many passenger train cars must Springfield Express operate to earn pre-tax income of $ 120,000 per month on this route? 3.If the load factor could be increased to 75 percent, how many passenger train cars must be operated to earn pre-tax income of $ 120,000 per month on this route? 4.What qualitative factors should be considered by Springfield Express in making its decision about acquiring this route? 5.

Nursing Shortage

Six years prior to the publication of Spetz and Given, reports of the US media indicate a shortage of registered nurses (RNs) in the US. In that article too, forecasts see the continuity of this trend, such as that of the Bureau of Health Professions projecting a shortage of 800,000 nurses by 2020. However, Buerhaus et. al. suggests that the nursing shortage may actually be satiated, with hospital RNs’ employment and earnings â€Å"increasing sharply in 2002.† No matter how we look at it, whether or not the shortage is easing, the problem of shortage is there. The question now is, what causes the shortage of registered nurses? Spetz and Given discusses four reasons that account for the shortage of registered nurses, first of which are licensure delays. Since World War II, nursing shortages have occurred cyclically, and this led to the birth of studies regarding labor markets. They (Spetz and Given) found most of these studies agreeing on the point that â€Å"the delay between people’s choice of the nursing profession and the time they are licensed as nurses is a central reason for these recurrent shortages.† Poor working conditions also account for the shortage of RNs, and this includes wage and benefits in general. Not much was mentioned by Spetz and given, but they have cited that these are â€Å"a primary cause of nursing shortage.† Aiken et.al. gives a more detailed explanation, stating that nurses spend an â€Å"inordinate amount of time in nonnursing tasks† resulting from â€Å"poor work design, underinvestment in information and other nurse-saving technologies.† They further add that is associated with high levels of nurse burnout and dissatisfaction. The third reason for the nursing shortage is comprised of wages and demand. Spetz and Given maintains that â€Å"demand for RNs should decline as RNs’ wages increase during a shortage,† and they have seen evidences showing that wages do affect demand. However, there are reasons for demand to be not responsive in today’s labor market. Two of these reasons are the reluctance of health care institutions to reduce staffing, and the growing number of RN Unions that want to maintain, if not to expand, the current staffing levels. Another scenario relating to the issue of wages and demand is seen in Aiken et.al., where it was mentioned that â€Å"the Philippines is the leading primary source country for nurses internationally by design and with the support of the government.† A motivator for Philippine nurses to migrate to other countries is higher wages, which cannot be earned in the local setting. This may account for the shortage that the country itself was experiencing, as Aiken et.al. found that â€Å"there are more than 30,000 unfilled nursing positions in the Philippines.† Last of the causes of the nursing shortage, as discussed by Spetz and Given, are exits from the RN workforce. According to them, the magnitude of retirements poses the question of whether it is possible to raise the number of new RNs to meet future demands. One solution to the nursing shortage, and maybe the most popular today, is to recruit foreign nurses. Spetz and Given consider this to be only a short-term option as it is expensive and the WHO reports majority of the countries experiencing nurse shortages, thereby putting a pressure on hospitals to limit foreign recruitment. Buerhaus et. al. goes farther to discuss other issues relating to the employment of foreign RNs to meet US health care demands. They cite impediments such as â€Å"likely negative impact on wages,† â€Å"quality of care,† and foreign policy. Another solution suggested by Buerhaus et. al. is to retain older RNs. In order to do this, facilities of health care systems should be designed so as to minimize physical strain. According to them, â€Å"altering schedules (working fewer hours), developing new roles (becoming mentors to younger RNs), and offering economic incentives can help to retain older RNs.† But among the three broad types of policy responses that Buerhaus et.al. suggested, I find increasing the flow of RNs in the workforce to be the most responsive, because that is exactly called for by the situation. This can be done either privately or by the government through raising money to increase faculty salaries and scholarship grants, and expand the physical learning space of nursing students. WORKS CITED: Aiken, Linda, Buchan, James, Sochalski, Julie, Nichols, Barbara, and Mary Powell. â€Å"Trends in International Nurse Migration.† Health Affairs 23.3 (2004): 69-77. 25 November 2008, http://content.healthaffairs.org/cgi/content/full/23/3/69?maxtoshow=&HITS=60&hits=60&RESULTFORMAT=&fulltext=nursing+shortage&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Buerhaus, Peter, Staiger, Douglas, and David Auerback. â€Å"Is The Current Shortage of Hospital Nurses Ending?† Health Affairs 22.6 (2003): 191-198. 25 November 2008, http://content.healthaffairs.org/cgi/content/abstract/22/6/191 Spetz, Joanne, and Ruth Given. â€Å"The Future of the Nurse Shortage: Will Wage Increases Close the Gap?† Health Affairs 22.6 (2003): 199-206. 25 November 2008, http://content.healthaffairs.org/cgi/content/full/22/6/199 Nursing Shortage This paper aims at analyzing the consequences of understaffing nurses. Some of the outcomes I observed this semester are nurse burnout and dissatisfaction that arise due to nurse shortage. The focus of this context is on the socio-economic impact in the nursing field, ethical bias, legality of the matter and psychological interference that have adverse impact to the nurses, patients, clinical working field and the nursing sector. In this paper, I will look at some of the problems associated with the nursing profession. NURSES WORKING AND CONDITIONS These are stipulations and circumstances, which enhance persistence and commitment to work comfortably as a nurse, with all due satisfaction and dignity for human life, for better supply of work force toward a proper medical care to the patients. NURSE BURNOUT This is a character associated with nurses when they become psychologically or emotionally exhausted to attend the patients. This is because of being overworked, exploited, due to fatigue or due to dissatisfaction in their field of work. INTRODUCTION In order to curtail on the trauma of nurse shortage, I would like to say that nurses’ shortage only creates some awareness that patients are at risk of substandard health care and the working nurses are being overworked. This is because in this semester, I have observed that small nurse/patient ratio does not guarantee for better patients’ outcomes and assurances of proper health services. When nurses become physically exhausted due to being overworked, they cannot perform their duty efficiently. Nursing is a professional course and a career that need to be addressed from all perspectives, to encourage proper working conditions for the nurses in order to have a maximum labor output for the wellbeing of the patients. EXECUTIVE DISCUSSION Actually, overworking nurses by allowing them to work for long hours and overtime makes nurses to be susceptible to making prescription errors. This is highly exaggerated when the salary income does not correspond with the work nurses do. However, if these errors occur, it is contrally to the nurses’ professional ethics, it is illegal to prescribe a wrong dosage to a patient and again there is abuse of human rights in that the patient can suffer psychological torture if he realizes that he was specified a bad prescription. This is what raises the legal issue of nurses. Because of such mistakes, nurses are forced to spend too much money in hiring private lawyers or insuring themselves against such bias. Beside legal issues, wrong prescriptions of drugs leads to wastage of medicines that could be used by another patient effectively, hence wastage resources since medicines are among the most expensive items. Additionally, Wrong prescription of drugs can lead to loss of life, retardation or other body malfunction. This can cause more harm to the Nation by losing individuals. If overall effects of such errors were analyzed, the conclusion would be wastage of time when prescribing wrong dosage, wastage of resources and drugs, loss of human labor and abuse of human rights. Therefore, there would be bleach of law, socio-economic impact and denial of safe health care. Eventually, this would be a great loss to the nation and the impact is felt in the near future. Therefore, means of solving the above problems need to be realized. I think labor motivations, recruitment of more nurses and retention of the registered nurses should be encouraged in order to maintain successful dedication of nurses to their nation as they work smoothly without strain. Understanding of the staffs’ requirements and avoidance of understaffing in this sector is of paramount importance. According to the article on â€Å"Allied Health Source and ProQuest Nursing†, the executive summary is that nurses are not satisfied in their career. Due to this outcome, some of the repercussions are that physically exhausted nurses do prescribe wrong dosage to patients or they may prescribe right drug but misguide patients on how to use the drugs. Another outcome is that most nurses are leaving the nursing profession and pending nurses are not willing to join the sector. Low level of job satisfaction is the main reason as to why most nurses are migrating to other fields of employments. This again leads to understaffing of hospitals leading to high death rate, failure to provide safe and effective care to the patients. Eventually this results to failure to rescue the patients from undesired death especially in the surgical department where the patients are not rescued. From the same article on nurse staffing and hospital outcomes (Linda H. and Julie S.),it is found that the dissatisfaction is caused by law salary income, poor working conditions such as nonflexible hours of work that do not give married nurses time to look after their siblings. Another finding is that starting salary or wages do not increase with the prolonged period of work, therefore, there is successive exploitation to the nurses. According to the article on â€Å"Allied Health Source and ProQuest Nursing†, work conditions that affect the outcomes of nurses involve lack of labor motivations such as baby boomer packages, failure to provide flexible working hours for the nurses, failure for the government to provide scholarship to nurses who want to advance their knowledge on this career. According to the same article by Linda H. and Sean P. pg 4, nurse burnout is the main consequence of overworking staffs and it can lead to more outcomes. Actually, patients/nurses ratios that are more constructive result to lower nurse burnout and high job satisfaction among the registered nurses. Understaffing nurses can extremely influence patients’ outcomes. Working conditions that affect the outcome of nurses include poor working conditions such as understaffing that leads to overworking the nurses without paying them their due overtime. (Agency for Healthcare Research and Quality (AHRQ) < www.ahrq.gov> Another condition that affects nursing profession is failure by the health ministry to provide encouraging packages to the nurses and other benefits. These benefits involve giving nurses flexible working hours such that they can concentrate on their family matters or providing nursing homes for their children and care. Other factors include lack of offering free seminar services to the nurses in order to update and sensitize them on the need and benefits to be a nurse and to encourage those leaving the sector to rejoin it. Lack of recognizing their efforts and contributions to this sector is another issue that does not address their working conditions. Nurses must also be insured in order to safeguard their wellbeing and protection in their line of duty. Finally, lack of labor motivations to the nurses such as gifts, prizes and awards to the best performing nurses is something that derails their morale and dedications to be a nurse and can lead to nurse burnout. In this semester, I have also observation that there is high nurses work overload and low technology application. Therefore, there is need to mitigate death rate and increase retention of staffs (nurses) in hospitals. More number of nurses to patients’ ratio can lead to a better patient outcome. Therefore, work force balance for the nurses is maintained in order to enhance proper working conditions for the nurses. PERSONAL EXPERIENCE My experience with the nursing profession tells me that nursing career is not an easy profession the way most people perceive. It needs a call to be dedicated in this service. Note that nursing involves taking care mostly to sick people from casualties to labor ward and mostly contamination is a loaming threats to the nurses. Therefore, the nurse should have a maternal feeling and concern of the high level in order to safe lives strictly obeying the code of ethics. PROPOSAL FOR CREATIVE SOLUTIONS Mostly labor motivation is the main tool to fight decrease of nurses from nursing sector. These will include providing nurses with proper and flexible working hours or services that are more rewarding. Another way is by means of helping them to solve family matters or factors that lead to their failures to work comfortably. These include if possible giving nurses services of caring for their children, the aged or by providing nursing homes to them with free or minor charges. Another solution is to offer aided scholarship to those nurses willing to advance their career especially in areas where more nurses are needed e.g. in gerontology and provision of geriatric clinicians. Again, nurses should be hired or employed from different regions irrespective of ethnicity and racial segregation. Application of latest technologies in nursing sector and outsourcing can be tried to improve working conditions in this sector. Some of the proposals that address outcomes for the nurses are varied to improve the outcomes for the patients. Understaffing of nurses indirectly affects the outcome of the patients. Therefore, proposals for outcomes of the nurses are determining factors to improve the outcomes of the patients.   Mostly labor motivation is the main factor to fight decrease of nurses from nursing sector and this can improve the outcomes of the patients. These will include providing nurses with proper and flexible working hours or services that are more rewarding. By allowing nurses to work comfortably, nurse burnout can be avoided, hence patients can be attended with all due care because nurses wont be exhausted. Patients should be allowed to interact freely with the nurses to air their problems and complications. Again, patients should accorded all due respect in their treatment and assured of life continuation through proper medical care. Application of latest technologies in nursing sector and outsourcing can be tried to improve working conditions in this sector. CONCLUSION Some of the problems associated with the nursing profession include poor working conditions that have effects to both the nurses, patients and the nursing sector at large. After analyzing these problems, I have decided to draw a conclusion that creative solutions and labor motivations are the major factors that need to be addressed in order to safe the situation as far as nursing career is concerned. REFERENCE: Burnout, staffing and outcomes of nurses, retrieved on 7TH NOVEMBER 2007, available at www.ahrq.gov Dohm A, â€Å"Gauging the Work Force Effects of Retiring Baby-Boomers,† Monthly Labor Analysis (July 2000):17-25 National union for Nursing, retrieved on 7TH NOVEMBER 2007, available at www.discovernursing.com   Strategies to repeal the New Nursing scarcity, retrieved on 7TH NOVEMBER 2007, available at www.aacn.nche.edu