LEGAL AND ETHICal issues in health Assignment Example | Topics and Well Written Essays - 1250 words

LEGAL AND ETHICal issues in health - Assignment Example The case above is classified as voluntary euthanasia or assisted suicide because the patient requested for the drug to alleviate pain, induce sleep and eventually end her life. The main considerations for this case would relate to the four ethical principles as laid out by Beauchamp and Childress (2001). These ethical principles include: autonomy or self-determination, beneficence, non-maleficence, and justice (Beauchamp and Childress, 2001). The ethical principle of self-determination or autonomy indicates that all individuals have the right to determine their own future, and in this case, the right to die (Kerridge, Lowe, and Stewart, 2009). This ethical principle would provide support for the patient’s decision because she has the right to die and the right to determine the direction of her life. Supporters of assisted suicide declare that not allowing the patient to die violates the patient’s freedom. They also believe that any competent and terminally-ill patient must have the right to choose death. Under these conditions, they choose the time and the means by which to die, and therefore are able to lend a semblance of dignity to their d eath and the end of their life (Kerridge, et.al., 2009). The patient is in severe pain however, she is still in a logical and lucid state of mind, sufficient to support a sound decision about her life. This right to self-determination must not therefore be denied her. Inasmuch as the right to self-determination fully supports the patient’s right to die, this contrasts sharply to other ethical principles, including the principles of beneficence and non-maleficence. From a certain point of view, beneficence may support the right of the patient to opt for assisted suicide, especially as it is an act which would benefit the patient (Beauchamp and Childress, 2001). The principle of beneficence highlights the fact that

Managing Sexual Harassment at Workplace Essay Example | Topics and Well Written Essays - 1250 words

Managing Sexual Harassment at Workplace - Essay Example I managed to learn that sexual harassment is just the manifestation of unmet sexual needs while, the belief of supremacy in males causes the featured behavior to increase manifold. Moreover, I also found that the attitude of management towards the issue significantly moderates its nature and intensity. However, the workplaces with closed doors are suspected to have higher degree of the demon. Yes, I have developed a new understanding of the issue as I came to know that the behavior is associated with deformation of the sacred concept of marriage, people are considering it the means of satisfying sexual needs, and therefore, the holy notion of procreation has been placed on the backburner. I have faced significant level of hardships in conducting of the research because the topic was unique, people were reluctant to talk about it, and therefore, I had to conduct intensive literature review on the topic. But, the effort was fruitful and I reached to a better understanding of the social issue. I enjoyed the phase when I have managed to link the presence of sexual harassment with managerial attitude. At first, I thought that the behavior is committed on an individual level. But, to my surprise, it is a social and communal behavior. The topic does not concern me personally but I was annoyed by the attitude of males that compelled them to consider sexual harassment as part of the game for females. But, in reality, it is not the case because the behavior is the representation of the masculine belief that females are created for fulfillment of counter-sex’s sexual needs. Finally, I would like to conclude that I am very much satisfied with my effort because it increased my knowledge and it is a reward in itself for a student. Yours Sincerely Student Name Signature Managing Sexual Harassment at Workplace Introduction The issue of sexual harassment is quite prevalent in all parts of the world regardless of national level scientific and economic development. The phe nomenon is defined as a mechanism that is working in order to tame the female professionals to submit to the institutional and cultural strength of the males. It is often recorded that male supervisors do not allow their female subordinates to perform their roles and responsibilities until they fulfill the higher authorities’ sexual wishes. But, the sexual harassing behavior is quite common in all parts of the globe. The issue is stemming from males’ misconception that females are primarily created to meet the sexual requirements of their male fellows. In major number of workplaces, the female staff has to kneel in front of the dominating male force in order to keep their bread and butter intact (Barling, Rogers and Kelloway pp. 260). Nevertheless, the researchers and policy makers have been known to be working to find a neutral solution to the abovementioned problem. The idea is to safeguard the professional and personal integrity of the females while protecting manag ement’s image as an equal opportunity provider. The employers do not have the luxury to afford the allegation of gender biasness (Lach and Gwartney-Gibbs pp.109). The demon of sexual harassment grows stronger when management does not consider it an issue of great importance while on the other hand; it can be needlessly aggravated when females become extremely sensitive. However, according to classical research, it can be established that sexual harassment is directly related to the management’s behavior towards the problem (Fitzgerald pp.1073). The office environment with separate and opaque offices and cabins is rated as an ideal atmosphere for subliminally supporting the sexual oriented

Building models for integration in counseling Essay Example for Free

Building models for integration in counseling Essay As we begin this second week of Coun  506 we are going to concentrate on building models for integration in counseling. Our beginning point in this is to understand more specifically how our  worldview impacts the models that we use in counseling. The way we interpret behavior has a lot to do with our worldview, and a lot to do with our expectations of our clients. One of the first steps in applying worldview questions to counseling is that we have to begin to think in terms of the bigger questions that are involved, starting off with: â€Å"Who am I? Those who approach the question of human nature from a theological perspective think of people as created in the image of God. The focus of those who are theologically-trained and oriented is the belief in people being a free creation imbued with a free will, but also as fallen beings created for a purpose. This is true even when we see a person in a counseling situation and it is clear by the problems they are having or created for themselves that they are far from achieving the purpose for which they were created. It does not remove the fact that this is a person with a purpose for which they are created. From a psychological standpoint the question †Who Am I? † raises the issue of rationality; the idea of humans as essentially â€Å"a self,† not a creation but a rational self. Some theories of psychology stresses that when people begin their lives, they begin as â€Å"blank slates† where from the moment they are born, their experiences, their environment, and their relationships begin to fill the â€Å"pages† of their mind and lives. So there is a sense in psychology that people are akin to â€Å"self-creating social organisms† that interact with people and systems around them. From the perspective of Christian spirituality, identity questions are phrased in terms of the spirit, in terms of the God-breathed life. Recall the image in Genesis where God forms Adam from the ground and breathed life into him. That is an image specific to Christian Spirituality: the notion of human beings as children of God and temples of the Holy Spirit. Next we look at the worldview question: â€Å"Where am I? † referring to the world in which we live. From a theological perspective the world is considered to be a good creation by God: â€Å"In the beginning God created the eavens and the earth and God saw that it was good†; that phrase is repeated many times in that first chapter of the book of Genesis. When God created human beings he saw that it was very good. So it is a good world created by God that while still under His sovereignty, He has charged us to have dominion over the world. From the perspective of psychologists, the question is addressed in terms of two environments: one being the internal environment of the person, or their individual heredity; and the second being the external: the physical, social, and relational environment in which they live. For Spirituality, the world is described as a â€Å"community,† while for us who are believers in Christ, our fundamental identifying terms of our environment is as members of the â€Å"Body of Christ. † It also emphasizes that the world in which we live and see is not one realm, but that we exist in a two-realm world: the physical world and the spiritual world. Rarely does anyone come to counseling simply for the fun of it, or because they have nothing else to do. Anytime you see a client, it is because they are having a problem. Theologians looking from the â€Å"What’s wrong with the world? perspective, refers to problems in the terms of sin and rebellion to God’s law. Jay Addams emphasize this in â€Å"nouthetic counseling†: that anytime a person comes to you with a problem, the problem is sin. This problem of sin shows up not only in that individual’s rebellion to God’s law, but also in terms of the larger work of Satan and the p resence of evil in their life. Psychologists on the other hand emphasize that when a person is having problems, the fundamental issue is pointing toward some type of disorder, or their failure to cope in adequate ways, or they are living in a dysfunctional environment. In spirituality, when there is a problem in life, the problem is broken relationships and alienation from God, self, and others. The problem is also phrased in cosmic terms: that in fact part of the problem in life is really the result of spiritual warfare or the result of quenching God’s guiding and comforting Holy Spirit. So where does that lead us in seeking solutions to our problems? In terms of theology, the way to deal with problems are solutions that only come from God. The grace of God is freely given to us, with the correct human response being repentance. Repentance leads to redemption in Christ, and then we can embark on the life-long process of becoming sanctified, or more like Christ. From a psychological perspective, the solution to problems is known as â€Å"self-actualization,† or the notion that we are self-controlled persons who need to unleash â€Å"the self† within us. Then we can understand and conquer our problems and recover through psychological interventions. Spirituality speaks of the solution to human problems in terms of communion with Christ, and reconciliation with others coming through abiding in the Spirit and through the power of prayer. Next we need to look at a change that has taken place over time from what is known as a â€Å"modern† worldview to a â€Å"post-modern† worldview. Here you see a simple typology comparing the two. This sort of typology is very important in counseling, especially concerning the various generations of our clients. Those who were born in the first part of the 20th century are much more likely to have a dominant â€Å"modern† view. Those born in the latter part of the 20th, or are just coming into adulthood now in the 21st century, typically lean toward the â€Å"post-modern† viewpoint. For those who come from the â€Å"modern† worldview, their focus is on the rational. If they can figure it out and think it through, THEN they have the direction to live. They seek to discover the â€Å"truth,† and from that truth they THEN know how to live and make decisions. The priority is on the individual, learning to be responsible for yourself and your own, not looking to others for help. Modern people believe that there is objective truth, and that we can be objective in our search for that truth. Modernists tend to think that there is a correct way to live, and that there is the possibility of living a moral life. On the other side, â€Å"post-modernists† feel that life is much more experiential. The real source in life is their experiences, not thoughts or reasonings. For example, my experiences are not the same as your experiences so my experiences are THE authoritative source for ME. Because of their emphasis on experience, they seek to understand life from their experiences and then to discern truth FROM those experiences. In other words their experiences become the means for understanding truth. More and more they place an emphasis on community rather than individuality, which can be seen as a positive shift in the sense that seeking counsel from another person is acceptable instead of embarrassing. Also, post-modern people see life in subjective terms, in that there are many ways to live, all of equal value, and that it is arrogant to speak in terms of there being only one way to live. Now please keep in mind that what was just presented to you is a simple typology, a way of conceptualizing the shifts in thinking so if you see things a little differently from this, it is okay. It is simply a quick way to help you process the shifting of worldviews that is occurring in our lifetime. Be aware that there are five keys to a Christian integrated worldview that you will be hearing about throughout this course. To study a bit deeper on this, refer back to Entwistle’s book. The first as has been mentioned before that â€Å"all truth is God’s truth†; this is key to a Christian worldview. The second is the notion that â€Å"human abilities are gifts from God†: meaning we are not completely independent beings but are creations of God, so our abilities are gifts from our Creator and given to us for a purpose. A third key is the belief that â€Å"human life is a unified whole,† where clients are to be approached holistically and as part of a family and community. The fourth key focuses on the â€Å"reality of sin,† meaning human sin IS a limiting factor in all of our pursuits. This fifth and final key is â€Å"humans and our behavior can be understood to a great degree through rational means,† meaning through empirical observation, through scientific methods, and through the revelation we receive from God. Unfortunately, the way in which we interpret those facts is going to be limited and flawed because of our fallenness.

Gated DIBH for Left Sided Breast Cancer Patients

Gated DIBH for Left Sided Breast Cancer Patients Chapter III: Methodology 3.1 Research Objectives The research project examines left-sided breast cancer patients receiving therapy with gated DIBH technique using the commercially available RPM system. The primary objective of this research is to evaluate whether left-sided breast cancer patients will benefit from gated DIBH. The interest in performing this research arises from having many left-sided breast cancer patients that have large volume of heart in the treatment field, and hence are at risk for cardiac toxicities in the future. The secondary objectives of this research is to look at patient’s comfort and understanding, and radiation therapist’s workload. This chapter will discuss the sample selection, ethical issues, instrumentation, data collection procedures, data analysis, limitations, expected results, budget and timeline. 3.2 Sample selection and description The expected sample size was calculated using the formula (Chan, 2003) for paired samples as seen below, Total sample size = where c is 10.5 for 90% power, ÃŽ ´ is the standardised effect size, given by the formula (Chan, 2003): where ÃŽ ¼1 and ÃŽ ¼2 are the means of the two treatment groups, and ÏÆ' is the common standard deviation. The 90% power represents the probability of rejecting the null hypothesis when it is false (Chan, 2003). It is postulated that a good treatment difference () between the 2 groups is 0.2 units with an SD (ÏÆ') of 0.5 units (Chan, 2003). With these values, the expected sample size is 68. Sixty-eight left-sided breast cancer patients will be selected for this research using a simple random sampling method. The patient population will be chosen at random to create a diverse group of patients with variable breast and heart volumes. The criteria for this sample would be female patients with left-sided breast cancer below the age of 70. In addition, the patients must be able to hold their breath. These patients will be recruited after being screened by the oncologists. The oncologists will do a simple breath-hold test with patients to determine if they are able to hold their breath for at least 20 seconds. This is because patients will be required to hold their breath during the CT scan for a duration of 18 seconds. This research will require 2 sets of computed-tomography (CT) scans from each patient of which one is at free breathing and the other at DIBH. Both sets will have identical patient setup. Patients will be lying supine with both arms above head on a posirest, having the visual goggles on (see Appendix M, image A) with a 6-reflective markers block on patient’s anterior abdominal surface (see Appendix H). With the goggles, they are able to view the screen, as seen in image B in Appendix M, in order to see their breathing patterns. For each patient, 2 treatment plans will be generated: one using the CT images at free breathing with photon electron match technique and the other using the CT images at DIBH with gated DIBH technique using RPM with 3-mm intervals. 3.3 Ethical Issues and Informed consent Any research involving human subjects conducted in the hospital would require adherence to ethical standards. The procedure requires the collation of a list of investigators in the department that intends to conduct clinical trials (see Appendix N), and to apply and attend the Singapore Guideline for Good Clinical Practice (SGGCP) course. This Course ensures that the conduct of clinical trials follows internationally acceptable ethical and scientific standards (see Appendix O). The ethics review will be carried out by the National Healthcare Group domain specific review board which is an independent committee constituted of medical, scientific and non-scientific members, whose responsibility is to ensure the protection of the rights, safety and well-being of human subjects involved in a research study by reviewing, approving and providing continuing review of research studies, and of the methods and materials to be used in obtaining and documenting informed consent of the research su bjects (National University Health System, 2010). When a principal investigator submits an application via the research online administration and management system, it is automatically routed to the department representative for endorsement, and subsequently the institution representative for endorsement, before it is delivered to the domain specific review board secretariat (National University Health System, 2010). All research studies submitted will be classified under one of the following review categories: exempt review, expedited review, full Board review (see Appendix P) (National University Health System, 2010). Based on the definitions in Appendix P, this study is classified as an expedited review. Ethics approval for research is required for several reasons. Firstly, ethical norms promote the aims of research, such as knowledge, truth, and avoidance of error (Resnik, 2011). Secondly, ethical standards promote the values that are essential to collaborative work, such as trust, accountability, mutual respect, and fairness (Resnik, 2011). For example, guidelines for authorship, copyright and patenting policies, data sharing policies, and confidentiality rules in peer review, are designed to protect intellectual property interests while encouraging collaboration (Poortmans, 2013). Ethical norms in research also help to build public support for research as people are more likely to fund research project if they can trust the quality and integrity of research (Resnik, 2011). Finally, many of the norms of research promote a variety of other important moral and social values, such as social responsibility, human rights, compliance with the law, and health and safety. This also protect the rights and welfare of participants and minimise the risk of physical and mental discomfort and harm from research procedures (Canterbury Christ Church University, 2006). Ethical lapses in research can significantly harm human subjects especially if the researcher fails to abide by the regulations and guidelines relating to radiation or biological safety (Resnik, 2011). Informed consent is the process by which the patient voluntarily confirms her willingness to participate in this research, after being informed of all the aspects of the research that are relevant to her decision-making (National Healthcare Group, 2013). The informed consent is documented by means of written signatures, date informed consent form and the language used during the explanation to the patient by the oncologist. In the consent, there should be 3 signatures: the patient’s, the doctor’s and the witness’ signature. For patients who cannot read and speak English, a qualified translator will be around during the signing of the consent. 3.4 Research design and instrumentation This research is a mixture of qualitative and quantitative research methods (see Appendix Q). Quantitative research corresponds to a deductive scientific method of research which uses data in the form of numbers and statistics to test hypotheses, using a large and randomly selected sample that is a representative of the population (Pearce, et al. 2013; Johnson Christensen 2010). This is in contrast to the qualitative approach which corresponds to an inductive method of research which uses words, pictures or objects to examine a phenomenon, requiring only a small and non-randomly selected sample (Pearce, et al. 2013; Johnson Christensen 2010). Patients will be scanned using Toshiba Aquilion Large Bore CT-simulator (Toshiba, 2014). The treatment plans will be generated using Varian Medical Eclipseâ„ ¢ Treatment Planning System and patients will be treated with DIBH technique using RPM from Varian Trilogy linear accelerator (Varian Medical System, 1999-2014). 3.5 Data collection procedures The same radiation oncologist will perform all the delineation of the clinical target volume, the heart and LADCA for consistency purposes (see Appendix R). The delineation will be done according to radiation therapy oncology group (RTOG) breast contouring recommendations (Goksel, et al., 2013). Patient’s CT images at breath hold will be used to plan for DIBH technique while the one at free breathing will be planned for photon electron match technique. The treatments will be planned such that the clinical target volume’s coverage of the dose distribution is kept between 90% and 110% of the prescribed dose. For each plan, heart and LADCA volumes were calculated in cm3. Dose volumes to the heart and LADCA will be normalized by dividing with the total organ volume. Heart and LADCA volumes receiving 5Gy to 50Gy (V5-V50) will be generated for comparison of treatment techniques. Dose distributions can be presented as DVHs and representing the statistical dose distribution in a volume of interest. These statistical data will be recorded and presented in tables. Patient education is a very important component in DIBH technique using RPM to reduce anxiety and increase their confidence about receiving radiation therapy (Halkett Kristjanson, 2007). Patient education tools can be in many forms such as video or pamphlet (Halkett Kristjanson, 2007). For this research, a pamphlet have been created to educate patients on DIBH technique using RPM (see Appendix S). A qualitative research method such as face-to-face interview is chosen to assess patient’s comfort and understanding at the middle of the treatment and on the last day of treatment as this only require the patients to speak the same language in which the questions are asked, and to have basic verbal and listening skills (Bowling, 2009). The primary objective of this standardised and open-ended interview (Valenzuela Shrivastava, n.d.) is to determine the degree of understanding as well as patient’s comfort. The questions (see Appendix T) will be asked by the oncologist durin g the middle of the treatment and on the last day of treatment. The advantages of face-to-face interviews are that reading and writing skills are not required, interviewers are able to probe fully for responses and clarify any ambiguities, they can ask more complicated and detailed questions, and patients are able to clarify if they do not understand the questions (Bowling, 2009). This would be a better technique than self-administered questionnaires because pre-coded response choices may not be sufficiently comprehensive and patients may be ‘forced’ to choose inappropriate pre-coded answers that might not fully represent their views (Bowling, 2009). This causes the data to be bias as the patient’s replies are influenced by the design of the pre-coded response choices. Self-administered questionnaires also assumed that the questions are worded in a way that is understood by the patients (Bowling, 2009). Patients may misinterpret the questions and reply based on their own interpretation and questionnaires may be a problem for p atients who are unable to read or write (Bowling, 2009). Most importantly, one-to-one interviews with standardised questions appeared to have the highest reliability (University of Leicester, n.d.). The radiation therapist’s workload will be measured in terms of training hours, and the comparison of treatment duration and manpower required for gated DIBH using RPM and photon electron match technique (see Appendix U) will be recorded and presented in charts. 3.6 Data analysis Paired samples t-test will be used to determine whether there is a significant difference between the average dose to the heart and LADCA values made under photon electron match plan and gated DIBH using RPM plan (Norman Streiner, 2008). This is used because the data are measured at the scale level and the data are related (Hawkins, 2009). The amount of radiation received by the heart can be recorded by comparing the DVHs of the photon electron match with gated DIBH using RPM. The statistical figures can be analysed using Statistical Package for Social Sciences (SPSS) (Yavas, et al., 2012). Paired samples t-test will be used to determine whether there is a significant difference between the average dose to the heart and LADCA values made under photon electron match plan and gated DIBH using RPM plan (Easton McColl, 2014). A p-value of Patient’s understanding and comfort The questions (see Appendix T) from the standardised and open-ended interview were developed by a team of 2 radiation oncologists, a nurse and 2 radiation therapists. The areas of discussion were based on the group’s clinical experience with left-sided breast cancer patients and their extensive knowledge on DIBH using RPM. The interview aims to determine the patient’s level of comfort and understanding of the gated DIBH using RPM. The design of the questionnaire will determine the reliability and validity of the opened-ended interview to measure patient’s level of comfort and understanding. Reliability is defined as the extent to which questionnaire will produce the same results on repeated trials (Miller, n.d.), and is measured by its equivalence and stability. Equivalence reliability assesses the consistency of the judgement of the patient’s answer by the interview (Miller, n.d.). It is improved by pre-empting a range of responses that might be given by the patients and give a pre-determined rating to each response so that the interviewers will have the same level of ‘judgement’ (Miller, n.d.). For example, _____________- Stability reliability is correlated to the repeatability of the patient’s response under the same conditions after a period of time (Miller, n.d.). For this interview, the patients will be interviewed twice, once during mid-treatment and the other on the last day of their treatment. Their responses from both sessions will be compared to determine if there are any deviance. This assumes that the characteristics that is measured doesn’t change with time, and that the time period is long enough that the memories from the 1st interview will not influence the responses of the 2nd interview (Miller, n.d.). The validity of the interview is the extent to which the interview questions measures what it purport to measure, and it generally takes the form of content validity (Miller, n.d.). Content validity is the degree to which the questions fully assess or measure the intention of the interview (Miller, n.d.). This was determined by letting the team review the individual questions for readability, clarity and comprehensiveness and come to some level of agreement as to which items should be included in the final interview questions. The interview questions (see Appendix T) were reviewed and accepted by the team prior to the conduct of the interview. The treatment duration will be recorded as seen in Appendix U and a paired samples t-test similar to appendix V will be used to determine whether there is a significant difference, where the null hypothesis (H0) is there is no difference between the treatment time with photon electron match technique and DIBH using RPM technique. The radiation therapist workload will be analysed based on the minimum number of manpower required for gated DIBH using RPM as compared to photon electron match technique and in terms of training hours. This will be discussed among the radiation therapists and presented in charts. 3.7 Limitation This research can only sample from a small size due to constraint of resources where there is only 1 treatment unit that has the RPM equipment required for DIBH technique. The expected sample size calculated is only an estimate as the treatment difference and standard deviation are never known in advance (Norman Streiner, 2008). As such, the actual sample size may be slightly smaller than 68. 3.8 Expected Results The results from this research are expected to show optimal radiation exposure volumes and doses for the heart and LADCA when treated with gated DIBH using RPM compared to photon electron match technique at free breathing. These results are expected to be compatible with findings from previous studies (Pedersen, et al., 2004; Korreman, et al., 2005; Shim, et al., 2012; Mast, et al., 2013). As such, showing that patients with left sided breast cancer will benefit from gated DIBH using RPM. Treatment time duration for gated DIBH using RPM is expected to have a significant difference and be faster than photon electron match technique. As gated DIBH using RPM is new to the radiation therapists, the workload is expected to be heavier in the beginning. 3.9 Budget There will be no additional cost for this research as the RPM equipment is already available together with the linear accelerator from Varian (Varian Medical System, 1999-2014). There will be no cost for training on the usage for RPM by Varian as it was included in the package when the linear accelerators were bought in 2013. Patients recruited for this research will be charged the same cost as photon electron match treatment technique. 3.10 Expected Timeline This research aims to commence from January 2015 till December 2015. The work plan for both the principal investigator and research assistants can be seen in Appendix W. Chapter IV: Conclusion This research aims to review gated DIBH using RPM as a treatment technique for left-sided breast cancer patients as compared to photon electron match in terms of the radiation dose received by the heart and LADCA. Paired t-test is chosen to measure the significant difference between the dose received by the heart in photon electron match technique and DIBH using RPM technique. Based on literatures that were review, the results are expected to be in favour of gated DIBH using RPM. Interviews will be conducted to assess patient’s comfort and understanding about gated DIBH using RPM. And data collection will be done gauge the workload of the radiation therapist. The results from interview and data collection will allow us to gauge further if it is really practical to implement gated DIBH using RPM in our department. If the results are clinically significant and positive, gated DIBH using RPM will be implemented into our department. 4.1 Recommendation For future recommendation to try contrast-enhanced CT scan in left-sided breast patients so that the LADCA can be seen clearly in the scan and able to be delineated by the doctor effectively (Yu, et al., 2013). This is to increase the accuracy of the delineation of LADCA as well as the accurate amount of radiation dose received by it. After this research, another study can be done in the future on the reproducibility of patient’s breath holding level for every fraction using a cine acquisition mode (CAM) of a linear accelerator during treatment (Goksel, et al., 2013).

Baby Sitting :: essays research papers

Four-year-olds can be a nightmare or a gold mine if you know what to do. Most of us have had encounters with a few of them whether they be our brother's and sisters or our neighbors' children. Next time you have an encounter with one you might want to consider the following tips. Toddlers have LOTS of energy, they might run you around the table for hours before they tire. I can honestly say that every child has some sort of favorite character from Batman to Barbie to tellietubbies they will always have one. It might help to find in advance what their favorite TV Show is and there favorite characters so you can plan to watch a video or play with some figures of there favorite character. To help the kids to get into their nightclothes you might want to bribe them into it. Like for example you might say "I'll let you have a pop-sickle or some popcorn if you can get ready for bed." But one thing you must ALWAYS remember is to never ever ever under any circumstance give them sugar before bedtime. Now that you understand how to get them calmed down you should relax by letting them watch a Disney movie or a TV show. Kids under five should be in bed by no later than eight thirty no matter what the kids say. I think parents and any experienced baby-sitter will agree this is the most difficult task of the night. Almost all kids will fight to the death to avoid going to sleep. Some methods can vary from child to child depending on the attitude of the kids. First things first to avoid some conflict you should tell them at least an hour in advance when they will be going to bed, this gets rid of the argument "you never told me I had to go to bed at eight o clock." Next as bedtime arrives you should make sure they are ready for bed, teeth brushed, is your bed ready do you have your nightclothes on? Now for the most dreaded thing "Okay Marco and Amy its time for bed," is the way it should sound in a nice calm soothing voice.

Affirmative Action :: essays research papers

When people talk about the civil rights movement, the first thing that comes to mind is the famous speech â€Å"I have a dream† by Martin Luther King. His dream in short was to have equality among human beings. For the past thirty years, this country has been revolutionizing humanitarianism because there is greater concern for human welfare than one hundred years ago. The revolution began during the 1960’s, and during that era this country was drastically involved in changing the civil rights of minority groups. From this concern, a program called affirmative action evolved. Like other civil right movements, the affirmative action movement was implemented to promote equality. Like some Americans, I am strangely confused when anyone talks about affirmative action. The reason that I have such confusion is the way people word the term affirmative action. If you ask one person who is in favor of affirmative action, his or her response is going to be different from someone who is against it. So when I am asked what I think about affirmative action, my answer seems to be twisted because I really don’t know what affirmative action is. The only exposure I have had to the term affirmative action is that which is taught in the classroom. Since this was such a controversial subject, the scope was very narrow, mostly terms. My key understanding is that of a definition, which I can hardly recall. I don’t know whether affirmative action is a law or if it is a subset of a bunch of different laws that were passed during the civil rights movement. I am also unaware if people protected under this program like the special treatment if there is any. My attempts to answer the question of what I think I know start with the idea that since affirmative action evolved from the civil rights movement, its aim is to protect certain minority groups as well as women. I think that the idea is used in a business context because there are other discriminatory laws in place to protect outside of work. I can remember from past schooling that there was a Supreme Court case that a white male sued a school institution because he was anti discriminated against because the school had a affirmative action program in place. I would like to know exactly what affirmative action is and then decide a stance on whether I support or oppose the use of affirmative action programs.

Traffic Problems

[pic] A research Report on Traffic problems in Big Cities (Islamabad) [pic] By: Aqsa Shahzadi (100827) Basharat Jamil (100811) Kaneez Amna (100869) Sidra Tul Muntaha (100809) Hamza Ashraf (100803) Submitted to: Mr. Naveed Ahsan Business communication BBA-3B [pic] Air University Islamabad [pic] Table of Content Contents Page No 1. Introduction3 1. 1 Core issue:3 1. 2 Purpose:3 1. 3 Scope3 1. 4 Methodology3 1. 4. 1 Findings5 3. Traffic jams in different areas of Islamabad city8 4. Causes of Traffic Problem. 9 5. Solutions to Traffic Problems10 6. Limitations11 7. References11 8. Interview Questions. 12 [pic] 1.INTRODUCTION 1. 1 CORE ISSUE: Our core issue is traffic problems at the entrance areas of Islamabad. Why mostly traffic jams in these area and how traffic is controlled in those areas by the traffic police. 1. 2 PURPOSE: People suffer a lot of problem due to traffic jam. We must give solutions to control traffic and avoid traffic jams. Students, teachers, office workers face prob lems because sometimes due to coming late they miss their meetings and face other problems as well. 1. 3 SCOPE: We are working at the entrance areas of Islamabad i. e. Barakow and Golra. Sometimes due to heavy protocols people face traffic jams.Major traffic jams are at school and office timings. We also face traffic problem on Friday. We will give solutions to the problems to solve this issue. 1. 4 METHODOLOGY: We adopted two types of methodologies which are as follow: 1. Quantitative methodology. 2. Qualitative methodology. [pic] QUANTITATIVE METHODOLOGY: We collect data through questionnaire. Our sample space is 30. We distributed 30 questionnaires among the students of Air University. We collected data from both male and female students. 15 questionnaires were filled by female students and 15 were filled by male students. We will also give the analysis report of our survey. pic] [pic] 1. 4. 1 FINDINGS After survey the responses of male and female students with percentage is give n below: |Â  Q. NO. |QUESTIONS |MALE |FEMALE | | | | YES | NO | YES | NO | |1. |Buses and trucks creating traffic problem. |93. 33% |6. 67% |86. 67% |13. 33% | |2. |Signals helping to control traffic. |86. 67% |13. 33% |93. 3% |6. 67% | |3. |Traffic police performing his duty well. |80. 00% |20. 00% |53. 33% |46. 67% | |4. |Long routes creating a lot of problems. |33. 33% |66. 67% |46. 67% |53. 33% | |5. |Traffic problems are cause of accidents. |80. 00% |20. 00% |93. 33% |6. 67% | |6. |More roads reduce traffic jam. |80. 00% |20. 00% |80. 00% |20. 00% | |7. |Small roads and number of cars are the causes of traffic |100. 00% |0. 00% |80. 0% |20. 00% | | |problems. | | | | | |8. |Are you satisfied from the process of selecting players for |100. 00% |0. 00% |93. 33% |6. 67% | | |different games? | | | | | |9. |More cars due to bank financing are also causes of traffic |60. 00% |40. 00% |66. 67% |33. 33% | | |problem. | | | | | |10. Old cars and trucks are creating traffic problems. |66. 67% |33. 33% |66. 67% |33. 33% | |11. |Lack of traffic sense among people is also a cause of traffic |100. 00% |0. 00% |93. 33% |6. 67% | | |problems. | | | | | |12. |Government is taking steps to avoid traffic jams. |33. 33% |66. 67% |40. 00% |60. 00% | |13. |Government is creating awareness among people about traffic. |33. 33% |66. 7% |33. 33% |66. 67% | |14. |Civil administrations fail to solve traffic problems. |66. 67% |33. 33% |66. 67% |33. 33% | |15. |Non-custom vehicles contributing to increase traffic. |80. 00% |20. 00% |100. 00% |0. 00% | [pic] The following graph is showing the responses of males in Yes/No and also in percentage. [pic] [pic] The following graph is showing the responses of females in Yes/No and also in percentage. [pic] QUALITATIVE METHODOLOGY: We interviewed one of the police officers at Golra.The questions we asked from him are attached at the end of this report. [pic] 3. TRAFFIC JAMS IN DIFFERENT AREAS OF ISLAMABAD CITY [pic] [pic] [pic] [pic] 4. C AUSES OF TRAFFIC PROBLEMS: 1. Small roads for the number of cars and motor cycles. 2. Broken roads in some areas as people don’t like to move from the broken part so traffic increases on rest of the road. 3. More cars due to bank financing. Now everyone can afford a car so more cars are there on the road. 4. Old cars and trucks. Government doesn’t have a clear policy about old cars and trucks. Even 30 years old cars are still running on roads like foxy & Suzuki. . Lack of traffic sense amongst the people. People don’t have traffic sense. Traffic police and media should play their role in creating traffic sense amongst the people. [pic] [pic] 5. SOLUTIONS TO TRAFFIC PROBLEMS: 1. First we have to use more often the public transport. This is the best solution. Also we would recommend to walk a little more or to ride a bicycle. 2. Have a proper public transport system and it is in our hands to reduce the use of our car every day by using public transport. 3. Make th e conditions of roads good, Make more lanes on the road and making alternative routes. 4.Create traffic awareness amongst the people though media and other sources. 5. Traffic problems can be reduced by either increasing road capacity (supply), or by reducing traffic (demand). 6. Different timing of starting and closings of offices and schools to avoid the rush in the morning, afternoon and evening on roads. 7. Make strict laws make them force able through traffic police. Government should put their best efforts to avoid traffic jams and other traffic problems. 8. Old cars should be scrapped and bank financing should be for commercial cars only. [pic] [pic] [pic] 6.LIMITATIONS: 1. Convince Problems. 2. Non availability of traffic police officer. 3. Hard university scheduled. 4. Police officer was not willing to give interview. 7. REFERENCES: ? www. google. com ? www. wikipedia. com ? Police officer [pic] 8. INTERVIEW QUESTIONS. 1. What difficulties do you face in controlling the tra ffic? 2. Do people follow the rules and regulations? 3. Do people cooperate? How is their behavior? 4. How do you manage the traffic when there is a rout? 5. How do you act when there is accident and what are your precautions? 6. Rush hours create a problem for you. How do you manage?