Thursday, September 3, 2020

Online Flower Retail for Successful Startu-

Question: Talk about theOnline Flower Retail Store for Successful Startu. Answer: Hi, Mrs. Marcia Holden. I will start with a short examination of the idea of the online exchange industry, the dangers, how to beat such dangers, and the accepted procedures to receive so to sidestep the previously existing rivalry and the expected rivalry from different participants. There are different reasons why individuals incline toward internet shopping over the customary visiting of retail locations, for example, the craving for an assortment of items to browse, an assortment of items, productivity in the conveyance of such blossoms, and the capacity to contrast the stores so as with settle on the best store. To start, it is essential to consider the component of the omni-channel retail and start with the work of effective gadgets to empower exchanges and conveyances for the ability to give the clients what they need when they need it and where they need it (Inside Retail, 2014; Walker, 2016; Wallace, 22017). Online organizations are unique in relation to the running of retails stores due to the reliance of correspondence that doesn't include eye to eye communications. It is therefore that the correct systems are set up, the necessary gear and contraptions bought, and the applicable representatives utilized for smooth running. My proposal for finding such individuals initially is to guarantee that once you dispatch the online business, it sets up itself as a trustworthy store over the others because of its outstanding administrations and great items. The foundation of concurrences with the providers and the transportation business is additionally basic to guarantee that there are no examp les where bothers are caused without substantial explanation and the pertinent move, for example, remuneration made. In Australia, the absence of adherence to the Australia Consumer Law that oversees all exchanges of web based business is deserving of law. That incorporates the away from of the business, nature of the administrations, and the insights regarding the buys and conveyances can draw in punishments (eurologo, 2014). The online bloom industry is at present developing at 2.5 % every year. As per the information introduced by Svala (2017), occasion buys make up the best deals. Valentines (36%), Mothers day (27.4%), and Christmas (15.1%) top the rundown that shows the amount they contribute towards the bloom business. A 2016 official statement demonstrated the general fulfillment with online bloom clients which expanded from 789 to 806 somewhere in the range of 2015 and 2016(Calif, 2016). The elements that bring about progress and fulfillment incorporate serious estimating, the idea of the online assistance, the accessibility of blossoms sought after, the assortment of the items, and great client service(Walker, 2016). There are elements to expect by moving on the web, for example, the dangers that accompany conveyances from providers during appeal seasons where requests overpower the blossoms in stock. Utilizing Porters model, the even rivalry comprises of elements, for example, the danger of substitute items. In spite of the fact that your business presently flourishes with the associations with the occasion organizers and memorial service coordinators, a move onto the online stage requires the enhancement of the normal client base. It additionally requires the fuse of serious techniques that urge other blossom purchasers to buy in to your site. Different clients remember people for need of roses for presents for different events. By and large, such events are additionally spoken to by other regular blessings, for example, chocolates, desserts, Easter eggs, and toys. Ensure that you defeat such substitute items by giving proposals during such occasions that remembers assorted hampers to make enth usiasm for the roses as blessings over the substitutes. Taking your occasions of center (weddings, burial services, and occasions) and the previously existing associations into thought, you will doubtlessly encounter a little size of the opposition from substitute items, for example, counterfeit blossoms and chocolates different items that substitute the endowment of blossoms. Nonetheless, showcase enhancement should substitute the clients lost by going on the web. The effectively settled online merchants are extraordinary rivalry since they have invested more energy constructing their compatibility and picking up prominence. Such merchants might be keen on pounding the new participants and expressing alert is basic. It is hence that information security, and the assurance of all other data coming into and out of the online business stage must be watched. The formation of an alluring portfolio and the conveyance of what is introduced on the site is fundamental. The intensity of the clients clarifies their bartering power. It is another factor in Porters model and decides the likely endurance of a beginning up. The separation advantage regarding expenses and format decide the intensity of the clients. The structure versus the purchaser fixation proportion of the online bloom merchants gives the purchasers extensive bartering power. The blossom business comprises of various choices and goof flower shows on the individual sites. Nonetheless, an examination did by Calif (2016) on whether the online showcases coordinate the conveyances shows the chance of th delievry of totally various blossoms with a quality that doesn't coordinate the presentations. In such occasions, it is basic to construct a notoriety of getting what you see which should expand the haggling powr of your online store. Such are the points of interest that accompany longer introduction in the business and more cooperations with clients. The haggling intensity of the providers fluctuates in the online botanical industry where the providers of the blossoms have the most force and the workers inside the business have the least. Since your business will dispatch itself online just because, it is critical to get qualified individuals to manage the advertising and client assistance to keep away from botches and a discolored notoriety while still new. You have the upside of being set up with a client portfolio set up. Wha shoud be done is the spread of data to the previously existing custoemrs about the online stage and the move from the retail location to the online stage. The providers are not the same number of in Australia and they stay with the dealing power more often than not. In any case, the foundation of a slolid relationshop with some by adhering to their suplpies all through the season. That way, it gets simpler to get the blossoms at loweer costs during top seasong when thhe blossoms are on request. Keeping up lower costs should give your business a more prominent upper hand against other existing flower vendors. With your present associations with wedding organizers, burial service coordinators, and occasion coordinators, joint efforts would be an interesting streak where requesting blossoms from your store for occasions accompanies the alternative of additionally requesting for the administrations of occasion organizers. Start by publicizing the business to your past clients on an individual level and through web-based social networking and banners to the expected clients. It is essential in any case sensible low costs for exemplary administrations and conveyances. Conveying what you present online is additionally enough to get your business up and fruitful as an online seller. As indicated by Walker (2016), one of the most dreaded let-down are conveyances that don't coordinate to the items introduced on the web. It is simpler to accomplish additionally haggling control over the clients when the quality is undeniable. The issues to expect incorporate the duplication of site content by different sites, helpless URL structure, trouble in discovering one of a kind titles, and the absence of page optimization(Digital Marketing, 2016). There is the chance of legitimate issues where the online organizations are run without affirmation of joining. In such cases, it is difficult to make claims when confronted with debasement or misrepresentation. There is the chance of the encroachment of the business by programmers who can even access the budgetary and other private customer data. Contingent upon the seriousness of the hack, it is conceivable to try and have the financial data and funds of the customers hacked. There are additionally issues with the security of data and photos as copyright data. There extra e-business security frameworks that must be viewed as when leading on the web business. It is basic for your online business to adjust encryption innovations and security accreditations for safe use and persuading the customers about the wellbeing of the utilization of such sites. In the event of security penetrates and the hole of classified client data, the moral activity is illuminate the clients about the break and the advancement in the reaction made by the organization corresponding to the equivalent. The thought of the lawful ramifications of such prospects makes it basic to get legitimate exhortation on the most proficient method to deal with such cases in the event that they emerge. It is likewise fundamental to give announcements and statements that separate you from serious legitimate authorizes if there should be an occurrence of incidental security certainty breaks. References Calif, C. M. (2016, 3 25). ProFlowers Ranks Highest in Customer Satisfaction with Online Flower Retailers. Recovered from JD Power: statements/2016-online-blossom retailer-fulfillment report Advanced Marketing. (2016, 4 5). Top 8 Common E-trade SEO Problems and Solutions. Recovered from Digital Marketing: web based business search engine optimization issues and-arrangements/ eurologo. (2014, 7 25). Normal Legal Issues Faced By E-Commerce Businesses. Recovered from Eurologo Marketing: lawful issues-confronted by-web based business organizations/ Inside Retail. (2014, 3 10). Online blossom industry in sprout. Recovered from Inside Retail: ind

Saturday, August 22, 2020

Applying APA Samples For Essay Writing

Applying APA Samples For Essay WritingThe prospect of using APA samples for essay writing can sound a little daunting. It's very common for people to question if they have the correct skills to use these materials. Fortunately, there are many people who will be able to give you solid advice on how to succeed in this endeavor.The first thing you should do is take the time to find out what the experts are saying about the topics that are going to be covered in your APA samples for essay. Many of the guides that are available for download will have guidelines for working with the different APA packages that are available. The best way to do this is by downloading the free version of one of the programs. Once you have downloaded the guide, it will run a test on your understanding of the material and then allow you to go over the examples in order to determine what areas you need to work on.After you have finished the program, you should go through the individual books that are available. For each book, you should read through the essay and make sure that you have understood the author's point. If you don't understand the content, the guide may need to ask you additional questions about the points you didn't get.When you have completed the individual books, you should now begin compiling your APA sample essays. Many people like to take the time to write a few essays each week and it can be a lot of fun. It is recommended though that you spend as much time as possible writing these, because it is going to be the foundation for the final product.You will also need to make sure that the APA essay samples you have are perfectly written. Some of the materials are intended to be straightforward while others are intended to be more complex. The important thing to remember is that you should never be afraid to write in any format that you feel will make your topic easier to understand.You should also put a great effort into planning your essay. This means that you should ma ke sure that you have all of the right information prepared ahead of time. Many people find that the following activities will make the writing process easier:You will also need to have a number of different kinds of references that you can consult throughout the course of the essay. These references will be located on a page where you will be able to see them when you are working on the essay. You should always look for these items as you go and consider doing so whenever you need them.Finally, you should try to structure your essay in such a way that it flows smoothly. You can do this by putting together your lists, making sure that you have resources on hand, and creating your outline. In addition, it is also important to make sure that you can clearly describe the ideas you have written about.

Friday, August 21, 2020

Bram Stoker Essays - Dracula, Golders Green Crematorium, Bram Stoker

Bram Stoker Abraham (Bram) Stoker was conceived November 8, 1847 at 15 The Sickle, Clontarf, North of Dublin, the third of seven youngsters. For the initial 7 years of his life Stoker was confined to bed with a heap of youth sicknesses which managed him much time to perusing. When he attended a university, Stoker had by one way or another beat his youth illnesses and keeping in mind that at Trinity College, Dublin, the respect understudy was associated with soccer and was a long distance race running hero. He was additionally associated with different abstract and sensational exercises, a forerunner to his later interests in the theater and his association with the rising activity Henry Irving, whose presentation he had investigated as a understudy at Trinity. After graduation from school, and in his father's strides, he turned into a government employee, holding the position of junior representative in the Dublin Castle. His artistic profession started as right on time as 1871 and in that year he took up a post as the unpaid show pundit for the Night Mail, while simultaneously composing short stories. His first abstract achievement came a year later when, in 1872, The London Society distributed his short story The Crystal Cup. As right on time as 1875 Stoker's one of a kind brand of fiction had gone to the bleeding edge. In a four section sequential called the Chain of Destiny, were topics that would turn into Stoker's trademark: repulsiveness blended in with sentiment, bad dreams and reviles. Stoker experienced Henry Irving once more, this time in the job of Hamlet, 10 years after Stoker's Trinity days. Stoker, still particularly the pundit (and as yet holding his common assistance position), gave Irving's presentation a great survey. Dazzled with Stoker's survey, Irving welcomed Stoker back stage and the resultant kinship went on until Irving's demise in 1905. The Stoker/Irving association hardened around the year 1878. During this time Henry Irving had assumed control over his own performance center organization called the London Lyceum, yet he didn't care for the administration, and along these lines moved toward Stoker to deal with business, so, all things considered Stoker surrendered his administration work and turned into the acting director of the theater. A brief timeframe after Stoker started his new profession, the distributing place of Sampson, Lowe reached him communicating enthusiasm for an assortment of Stoker's accounts. Under the Sunset was distributed in 1891 and was generally welcomed by a portion of the pundits, however others thought the book excessively startling for youngsters. Stoker was at that point interested with the idea of the limits of life and passing (Leatherdale, p.63) which made this book unreasonably alarming for kids at any rate in a portion of the commentator's brains. When Stoker had gotten positive surveys for his romance book The Snake's Pass (1890), he was previously making notes for a novel with a vampire topic, and by 1894 he had returned to grim topics. It appeared to be just a whiz result that Dracula would follow and was distributed in June 1897. Audits on Dracula were blended, and the book never yielded a lot cash for Stoker. In an ideal audit the Every day Mail thought about it with Frankenstein and Poe's The Fall of the House of Usher. The Bookman thought that it was agreeable in spots yet remarked that the depictions were terrible and loathsome. (Leatherdale, p.68) For the following scarcely any years after Dracula's distribution, occasions took a descending winding for both Irving and Stoker. There were inconveniences with Irving's foundation and a fire devastated some portion of the theater (counting some significant view) and Irving in the long run sold it. Stoker managed anyway to distribute The Jewel of the 7 Stars in 1903, and it was a novel dependent on the data given to Stoker by an Egyptologist. In 1905 Henry Irving passed on, leaving the maturing Stoker without a consistent scribble without precedent for his life. A year in the wake of Irving's passing Stoker expressed Individual Memories of Henry Irving. Stoker figured out how to compose other books after this point until the hour of his demise in 1912 at the age of 64.

Tuesday, June 16, 2020

Does Adherence Predict Weight Loss An Examination of an IDEA - Free Essay Example

What is knee osteoarthritis (OA)? Knee osteoarthritis is a disease characterized by deterioration and inflammation of the knee joint.6 Knee OA can be identified with radiographic evidence or by symptomology. The Kellgren-Lawrence (KL) grading scheme is the radiographic reference standard for defining knee OA.6 The severity of osteoarthritis is determined by the presence of osteophytes on the knee joint, joint space narrowing, sclerosis of the subchondral bone, and deformity of the femoral head.7 Scoring of the KL grading scheme ranges from 0 to 4. Minimal, but definitive, knee OA is defined by the presence of an osteophyte, equating to a KL grade of 2 or higher.6,7,10 Symptomatic knee OA is characterized by radiographic evidence of OA accompanied by pain, aching, or stiffness in the affected joint. Pain occurring on most days of a recent month is representative of symptomatic knee OA.2,6,8 Epidemiology of knee OA Data from the 2011-2012 National Health Interview Survey (NHIS) indicates that 15.1 million United States (U.S.) adults have symptomatic knee OA. An additional 8.6 million adults are classified with KL grade 3 or 4 advanced symptomatic knee OA.1 The prevalence of knee OA has dramatically increased in the past one hundred years. Wallace et al. compared the prevalence of knee OA among American adults from the early industrial and postindustrial periods. The prevalence of knee OA (16%, 95% CI: 14-19%) was 2.6 times higher among the postindustrial sample (95% CI: 2.1-3.4) compared to the early industrial sample (6%, 95% CI: 5-7%). 10 Prevalence data for knee OA differs across studies depending on the definition of osteoarthritis. Studies using the radiographic definition of osteoarthritis trend towards higher prevalence as compared to the symptomatic definition.4,11,12 In the Framingham Osteoarthritis study, 27.4% of adults over sixty-three had radiographic knee OA. However, only 7% of adults within this sample had symptomatic OA.9,13 Similarly, the prevalence of radiographic knee OA was almost 10% higher than the prevalence of symptomatic knee OA among middle-age adults in the Johnston County OA Project (27.8% vs. 16.7%).9,11 The population being studied can also impact estimates of knee osteoarthritis. Whereas two studies found that non-Hispanic whites had the highest rates of knee OA, other articles reported highest rates in African Americans.1,9,11,13 Age and sex also influence the prevalence of knee OA. Osteoarthritis is a chronic disease whose prevalence increases across the lifespan. The prevalence of knee OA increases from 1-2% in adults 25-44 years old to 14% in adults over 65 years.1,9,13 According to Murphy et al., the overall lifetime risk of developing symptomatic knee OA by age 85 is 44.7%.2 Across age groups, females are more likely to have knee OA and have more severe knee OA when compared to men. Women over 50 years old were 1.68 (RR 95% CI 1.37-2.07) times more likely than men over 50 years old to have knee OA.5 Furthermore, diagnosed knee OA in women over 55 years old was more severe than knee OA in men of the same age range (standardized mean difference 0.20, 95% CI 0.11-0.28).14 Healthcare Burden Knee osteoarthritis places a large strain on a countrys economy. U.S. adults spend roughly 28 years living with symptomatic knee OA.15 Treatment for knee OA comes in various forms and at various price points. The minimum treatment strategy consisting of a physician visit, physical therapy, knee braces, and medications costs $684 annually.15 Many adults will spend years using medications and non-surgical treatments before seeking advanced care. The standard care treatment for end-stage knee OA is total knee arthroplasty (TKA).16 The TKA is widespread due to its life expectancy and relative safety. In 2010, 658,000 knee arthroplasties were performed, with 92% of surgeries being TKAs.16 Direct and indirect medical costs associated with knee OA create a large burden on the individual and on society. As of 2013, a primary TKA cost $20,293 in the United States.15 Individuals undergoing revision TKA spend an average of $49,360 and 5 days in the hospital.16 On a larger scale, the hospital charges associated with revision knee arthroplasties accounts for nearly $2.7 billion in U.S. healthcare spending.16 From a national viewpoint, the U.S. spends $139.8 billion dollars annually (95% CI 83.7-195.9) on direct costs attributable to knee OA.17 Indirectly, the disability associated with knee OA impacts workplace productivity. The U.S. loses nearly $164 billion each year (95% CI, 85.2-242.3) in earnings attributable to arthritis. Between direct medical costs and productivity loses, arthritis accounts for $303.5 billion in healthcare spending.17 Risk Factors for Knee Osteoarthritis Predisposing factors for knee OA are divided into systemic risk factors and local risk factors. Systemic risk factors include age, gender, race/ethnicity, and genetics. Age is one of the strongest systemic risk factors for knee OA due to loss of muscular strength, thinning of articular cartilage, and oxidative damage to the knee joint.6 Local risk factors for knee OA include previous injury, physical activity, and obesity. The risk of developing knee OA increases by 183% (RR 2.83, 95% CI 1.91-4.19) in adults who have suffered a previous knee injury when compared to adults who have not had a previous injury.5 Roughly 5% of cases of knee OA could be avoided if knee injuries could be prevented in adults.5 The relationship between knee OA, physical activity, and overweight/obesity is more complicated. Adults engaging in at least four hours per day of heavy physical activity were significantly more likely to have radiographic knee OA when compared to adults engaging in no heavy physical activity (OR 7.0, 95% CI 2.4-20, p0.001).18 Further analysis of the influence of weight status revealed the highest risk of developing radiographic knee OA was in obese adults engaging in heavy physical activity (OR 13.0, 95% CI 3.3-51) .18 Although frequent and heavy physical activity may be associated with knee OA, a sedentary lifestyle and subsequent weight gain may also elevate the risk for developing knee OA. Overweight and obesity is a strong predictor of knee OA in adults. Being overweight or becoming overweight as an adult increases the lifetime risk of developing symptomatic knee OA by nearly 30%.2 The literature often uses the World Health Organizations (WHO) classification of overweight and obesity, which defines overweight as a body mass index (BMI) of †°? 25 – †°Ã‚ ¤ 29.9 kg/m2 and obese as a BMI †°? 30 kg/m2.19 Evidence suggests there is a curvilinear relationship between BMI and risk of knee OA. One meta-analysis quantified the pooled risk of developing knee OA as a factor of increasing BMI across twelve studies. Having a BMI of 25 kg/m2 is associated with a 59% (RR 1.59, 95% CI 1.34-1.81) increased likelihood of developing knee OA.20 A second study found ones likelihood of developing knee OA to rise by 35% (RR 1.35, 95% CI 1.18-1.53) for each 5 kg/m2 increase in BMI.21 Disease progression and severity are also affected by weight status. A prospective study of 354 adults found overweight individuals to be 9.1 (95% CI, 2.6-32.2) times more likely to develop K/L grade 1+ knee OA within 5 years. Additionally, being overweight increased the likelihood of progressing to moderate knee OA (K/L grade 2+) within 5 years by 18.3 times (95% CI, 5.1-65.1).22 In addition to disease progression, weight status affects an individuals symptoms. Being overweight or obese is associated with a 2.66 (95% CI, 2.03-3.48) times higher risk of being diagnosed with symptomatic knee OA.23 Overweight (OR 1.69, 95% CI 1.36-2.11) and obese (OR 2.58, 95% CI 1.74-3.58) individuals are also more likely to experience persistent knee pain than normal weight adults.23 Treatment Recommendations for Knee OA Weight Loss Although being overweight or obese increases the likelihood of developing knee OA, weight reduction can improve clinical and functional outcomes. The Osteoarthritis Research International (OARSI) guidelines committee recommends weight loss as a core management strategy for overweight and obese patients with knee OA (strength of recommendation 96%, 95% CI 92-100).24 Weight loss has been shown to have positive effects on pain, joint stiffness, and disability in adults with knee OA. A meta-analysis of four randomized controlled trials (RCTs) reported a small improvement in knee pain resulting from weight loss (ES = 0.20, 95% CI 0-0.39). The literature supports a dose-response relationship between the amount of weight lost and reductions in knee pain. An intensive 18-month diet and exercise intervention found significantly lower self-reported pain scores with at least 10% (3.71, 95% CI 3.09-4.34) and 20% (2.79, 95% CI 1.87-3.71) weight loss when compared to 5% weight loss (4.46, 95% CI 3 .81-5.11, p = 0.006).25 Knee joint stiffness is also alleviated by weight loss in overweight adults with knee OA. The results of two RCTs support a small decrease in joint stiffness as a result of weight loss (ES = 0.36, 95% CI -0.08, 0.80).24 Reductions joint stiffness associated with weight loss may also be related to improvements in physical function. A meta-analysis of three RCTs found an average weight loss of 6.1kg (95% CI 4.7-7.6kg) was associated with a small improvement (ES = 0.23, 95% CI 0.04-0.42) in self-reported disability.26 The relationship between weight loss and increases in physical function is also supported by objective measures. Overweight adults with knee OA who lost an average of 5.2kg (95% CI 0.85-9.55) demonstrated significant improvements in both six-minute walk distance (?† from baseline = 61.61m, 95% CI 35.90-87.32) and stair climb time (?† from baseline = -2.54s, 95% CI -4.13, -0.95).27 Exercise Weight loss should not be considered independently of physical activity. The OARSI group recommends regular aerobic activity and resistance training as an adjuvant treatment for knee OA.24 Engaging in regular aerobic activity can serve as a non-pharmacologic pain reliever for individuals with knee OA. A meta-analysis of 13 RCTs on aerobic activity has shown support for a moderate improvement in pain (ES = 0.52, 95% CI 0.34-0.70).24 Aerobic activity can also improve physical function in people with knee OA. Individuals with knee OA who take part in aerobic activity experience moderate improvements in self-reported disability (ES = 0.46, 95% CI 0.25-0.67).24 Muscle strengthening has also been identified as a core recommendation for the management of knee OA. Small reductions in pain (ES = 0.32, 95% CI 0.23-0.42) and self-reported disability (ES = 0.32, 95% CI 0.23-0.41) have been reported with quadriceps training.24 Combined Weight Loss Plus Exercise Interventions Multiple studies have examined the relationship between weight loss and clinical outcomes in overweight adults with knee OA. The Arthritis, Diet, and Activity Promotion Trial (ADAPT) was an 18-month RCT comparing standard care to dietary weight loss, exercise, or combined diet plus exercise on physical function, pain, and mobility. Individuals in the diet plus exercise group lost the largest amount of body weight (mean 5.20kg, 95% CI 0.85-9.55), followed by those in the diet only group (mean 4.61kg, 95% CI 0.38-8.84) when assessed at 18-month follow-up.27 Physical function, pain, and mobility were significantly improved for individuals in the diet plus exercise group after 18 months. Weight loss of 5% baseline body weight was associated with a 24% reduction (95% CI 2.63-8.83) in physical function scores and a 30% reduction in pain scores. Additionally, mobility improved as noted by increased 6-minute walk distance (477.76  ± 13.12m, p Whereas a weight loss goal of 5% was established for the ADAPT study, the Intensive Diet and Exercise for Arthritis (IDEA) study had a weight loss goal of at least 10% body weight.28 IDEA was an 18-month RCT that compared the effects of dietary weight loss, exercise, or diet plus exercise on clinical outcomes. Participants in the diet plus exercise group lost an average 10.6 kg (95% CI -14.1, -7.1) compared to an average 1.8 kg (95% CI, -5.7-1.8) loss in the exercise only group.28 Although IDEA participants in the diet plus exercise group had a higher percentage of body weight loss, a similar trend was reported for physical function, pain, and mobility scores after 18 months. Physical function scores decreased by nearly 42% (?†_18month = -10.3, p 0.001), pain scores decreased by 45% (?†_18month = -3.0, p = 0.02), and 6-minute walk distance increased by 15% (?†_18month = 70, p 0.001).28 Rather than analyzing the impact of weight loss on clinical and functional outcomes, one study analyzed whether weight loss could prevent the onset of knee pain in overweight adults with diabetes. White and colleagues randomized participants to one of two treatment conditions: 1) intensive lifestyle intervention focusing on aerobic activity and weight loss, or 2) diabetes education and support comparison group. Individuals randomized to the intensive exercise and weight loss program were 15% (RR = 0.85, 95% CI 0.74-0.98) less likely to develop knee pain within 1-year when compared to individuals in the comparison group.29 Participants who met the 7% weight loss target were 37% (RR = 0.63, 95% CI 0.46-0.88) and 38% (RR = 0.62, 95% CI 0.47-0.83) less likely to develop knee pain within 1 and 4 years, respectively.29 Collectively, these three studies strengthen the conclusion that the combination of dietary weight loss and exercise is associated with positive clinical outcomes. Predictors of Weight Loss Due to the strong evidence of the benefits of weight loss in overweight adults with knee OA, researchers have sought to identify predictors of weight loss. Predictors of weight loss can be grouped as individual factors or factors pertaining to the intervention. Internal Factors Self-Efficacy Self-efficacy is the belief in ones ability to accomplish a specific task or goal.30 Within the weight loss literature, self-efficacy can divided into exercise self-efficacy and dietary self-efficacy. Having a high exercise self-efficacy at baseline was associated with achieving the 7% weight loss target among adult participants involved in the Diabetes Prevention Program (DPP).31 Among overweight adult women, both exercise self-efficacy (r = -0.32, p Depressive Symptoms An individuals general affect can influence their willingness to engage in behaviors that may lead to weight loss. Pre-treatment depressive symptoms may influence weight loss if the individuals negative affect stems from unhappiness with their current weight status. Among obese adults, lower levels of baseline depressive symptoms are associated with weight loss success after 1 year.34 Additionally, baseline depression scores among overweight, older veterans with knee OA were predictive of weight loss after a 6 month intervention.35 It should be noted, however, that both studies used inventories measuring depressive symptoms rather than identifying individuals with clinical depression. Participants who are clinically depressed are often excluded from weight loss studies because they may be taking medications that impact their ability to lose weight.36 Programmatic Features Social Support The social aspect of participation in a research study may be a contributing treatment-related factor for weight loss. Individuals who participated in a group-based commercial weight loss program lost more weight than individuals who participated in one-on-one dietary counseling sessions (-4.3  ± 6.1 kg vs. -1.3  ± 6.1 kg, p Attendance The relationship between attendance at a diet or exercise intervention and weight loss is intuitive for the general population. As a result, studies have sought to find evidence to support this conclusion. Among overweight adults receiving a modified version of the Diabetes Prevention Program (DPP), attendance at counseling sessions was a significant predictor of weight loss ( = -0.609, p = 0.003).33 Evidence from a RCT comparing self-help to a commercially based weight reduction program for adults found higher self-reported attendance at sessions was significantly associated with weight loss after 1 and 2 years (p Adherence Definition of Adherence To date, there is no consensus on the operational definition of adherence. In simplistic terms, adherence is defined as a percentage of the number of sessions completed divided by the total number of sessions offered.27,28,40 However, more complex definitions of adherence necessitate the need to first answer the question: adherence to what? Exercise adherence can be defined by attendance rates and by goal achievement. Two community-based RCTs in overweight adults with knee OA have used on-line attendance logs to track exercise adherence.27,28 Among adult participants in the Healthy Weights Initiative, meeting the goal for exercise frequency, intensity, or duration was the criteria for exercise adherence.41 Adherence to a dietary intervention depends on the behavior being measured. Multiple studies have used attendance rates to define adherence to a diet class.27,28,41 Other studies have defined adherence by the frequency of food tracking over a specific period of time. Jacobs and colleagues defined adherence as logging a meal within its specified time frame, but also separated from a consecutive record by at least 30 minutes.40 A separate study expanded the time constraint of an adherent period to no longer than 4 days between consecutive food logs.42 Aside from defining adherence by attendance rates frequency of food tracking, adherence may also be defined as an individuals agreement to the prescribed dietary intervention. One study defined dietary adherence as the percentage of discrepancy between ones actual daily kilocalorie loss divided by their expected daily kilocalorie loss.43 The definition of adherence is often driven by the way that adherence is measured.

Monday, May 18, 2020

Early Detection Of Mental Health - 1423 Words

The moment a broadcast interrupts the ongoing program over the radio or television announcing there has just been a shooting at an elementary school may weigh heavy on ones heart. Whether you have children or do not have children, it is a very heart breaking story to hear about such young lives being lost in such a tragic way. To hear the stories from the ones involved, who had to hide their students from the shooter, or tried to keep those poor crying scared babies quiet, or even watched small innocent children shot to death right before their eyes is absolutely gut wrenching. Research has been done on school shooters in the past and they have all showed signs of mental illness even signs of violent behavior. If a program was to be put into place to test students for mental illness the students who did have a mental illness could then be monitored and it would lower the school shooting rates. Early detection of mental health issues in students will decrease school shootings. Children who have mental disorders are more likely to become violent and unable of channeling anger and depression in the right way. Heller’s research says â€Å"A 2002 study conducted by the Secret Service determined that most school shooters engaged in some behavior prior to the incident that caused others concern or indicated a need for help† (2014). Although, not all children who have a mental disorder will become violent, studies have shown previous shooters did have a history of mental illnessShow MoreRelatedThe Cost Of Not Caring For Those With Mental Illness1498 Words   |  6 Pagesfor those with Mental Illness Mental health issues are on the rise, especially among the youth, 6 out of 10 young people do not receive mental health treatment for major depression. Currently, there are over 40 million Americans are dealing with a mental health issue and 56 percent of them are not receiving proper treatment. (mentalhealthAmerica). In addition, 33 percent of all homeless individuals have a mental illness and do not receive treatment. With the rise of mental health issues, the fundingRead MorePrinciples of Mental Health1258 Words   |  5 PagesRunning Head: FOR A DEEPER UNDERSTANDING Principles of Mental Health The World Health Organization (2012) defines mental health as a state of complete physical, mental and social well-being, and not merely the absence of disease. WHO establishes the connection of mental health to the promotion of mental well-being, the prevention of mental disorders and the treatment of mental disorders and the rehabilitation of those afflicted with these disorders (WHO). The Council for Accreditation of CounselingRead MoreScenario Based Essay1352 Words   |  6 PagesPromoting Individual Health The aim of this plan is to maintain and promote Molly’s mental health as she goes through an important and potentially difficult postpartum period of her life, where her mental state is more vulnerable to possible decline. It is important for Molly to remain mentally stable and well during this period because any deterioration in her mental health can have serious, negative effects on her new child’s development, both in the short and long term. This plan outlines theRead MoreBehavioral And Emotional Problems Of Adolescent And Adolescent Population939 Words   |  4 Pagesemotional, behavioral, developmental, psychosocial, or educational concerns and 75% of children and adolescents with psychiatric disorders are seen in the primary care office. Approximately 50% of adults with behavioral health problems report that their disorders emerged in early adolescence. 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With early identification and referral for diagnosis, much of the later treatment can be avoided. Intervention for behavioral health occurs in four stages – detection, medication, counseling, and continuity of care. Currently, all four areas have a deficit. Detection should be increased with primary care physicians. Medications should be more accessible. Counseling shouldRead MoreRhetorical Analysis to Defend Mental Health in Schools Act Essay876 Words   |  4 Pagesfloods, and devastating fires, which have had an immense impact on our children’s physical and mental well-being. I felt an obligation to take part in supporting laws that would help address the underlying causes of such tragic events. One of those causes I believe is lack of early detection, prevention, and intervention of mental health issues in our society. I feel we should genuinely value the mental health of our children in our society if we want to mend this great Nation. 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Detection rates of fetal aneuploidies can be done in the first and/or second trimester – as early as 4 weeks of gestation, however, most accurate results are found at 7 weeks of gestation. The high accuracy rate of detection of NIFTY/NIPT at 99% and low false positive rates of 1-3% has increased the number of pregnant females to actively seek such diagnostic tests. NIFTY/NIPT has been commercialized worldwide as a result of its high accuracy and detection rates and is actively

Wednesday, May 6, 2020

William Blake s The Lamb And The Tyger - 1473 Words

While Blake’s â€Å"The Lamb† and â€Å"The Tyger† contrast each other as the innocence and experiences that happen in the world, they also reflect on how our Creator could create such evil and purity in the same world. The same of Wordsworth’s representation of his past self vs. his present self, both are necessary to understand â€Å"the life of things† more deeply. Innocence is the foundation upon which experience is built meaning that experience and tragic parts of life start from the innocence of a person. The human mind is made to continually grow, never to reach a point of complete understanding, and questioning the things in life in which does not make sense to a person. â€Å"The Lamb† and â€Å"The Tyger† by William Blake was written in 1794 which†¦show more content†¦Blake has a thought of how humans react to the cycle of life and the different choices made in life. The image of the lamb could mean to choose God and to choose to follow him for a life full of a righteousness and sinless life. On the other hand, the image of the tiger is to choose a life full of delinquency and a sinful life. Also, both types make the world a balanced place. In order for the cycle of life to continue spinning, the world must have good and unfortunately evil. â€Å"The Lamb† portraying the good in life and â€Å"The Tyger† portraying the evil. Childhood is a precious time and state of protected innocence from the world which in Blake’s â€Å"The Lamb† paints a picture that the lamb is the voice of a child through the mind of innocence. The lamb is a creature made by Christ that is a mild, gentle version of creation. Blake chooses to use words such as, â€Å"Softest clothing wooly bright;/Gave thee such a tender voice,† (Blake 6-7) to provide an image of the innocent lamb and also Jesus. The lamb can be compared to Jesus Christ who is also known as â€Å"the lamb of god†. The creator and origin of the lamb is questioned by Blake asking who made it so the child questions the lamb to ask, â€Å"Little Lamb, who made thee?/Dost though know who made thee?/† (Blake 1-2). The child does not receive an answer so he decided to tell the lamb where he came from. He says, â€Å"Little Lamb, I’ll tell thee!† (12). Jesus once was a child and so the speaker says, â€Å"I a child thou a lamb/we areShow MoreRelatedWilliam Blake s The Lamb And The Tyger1493 Words   |  6 Pageswriters who recorded their artistic and emotional responses to the natural world, William Blake explores the concept of life’s dualities and how this concept applied to life in 18th Century Bri tain, as well as to the relationship between the body and spirit, in his most popular works, Songs of Innocence and of Experience: Showing the Two Contrary States of the Human Soul (1794). Two standout poems, â€Å"The Lamb† and â€Å"The Tyger,† respectively taken from Songs of Innocence and Songs of Experience, demonstrateRead MoreWilliam Blake s The Tyger And The Lamb 940 Words   |  4 Pagesthe ages many writers have come and gone, and with them brought many ideas or viewpoints on life and the human soul. Undoubtedly, William Blake was indeed one of those monumental writers who paved the way for new thinking. A thinking of the human soul and two intricate parts that join to fulfill a soul. Both pairs of the soul are illustrated in both The Tyger and The Lamb. Both poems being commonly referred to as staples of poetry, can allude to different ideas. Man believe they deal with the questionsRead MoreWilliam Blake s The Lamb And The Tyger873 Words   |  4 Pagesde scribed as pure, tender, and innocent. Even in the Holy Bible, lambs are talked about in such high honor that they were even used to be holy sacrifices during biblical times. William Blake describes the young sheep in similar characteristics in the poem â€Å"The Lamb† and â€Å"The Tyger†. A tiger as we know its characteristics to be is fierce and mysterious. Always lurking around, waiting for the perfect opportunity to strike. In William Blake’s two separate poems he ties each of the poems together withRead MoreThe Tyger By William Blake Essay969 Words   |  4 PagesThe Tyger is a six-stanza poem written by an American poet, William Blake. This poem has many interpretation, in a way you could say it is a biblical as well as a symbolic poem, as ‘The Tyger’ is actually the contrast to one of Blake s other poem, The Lamb, both poems are from the book of â€Å"Songs of Innocence and Experience†. If you are familiar with the Christian Bible , it states â€Å"Jesus is the Lamb of God.† The Tyger is comprised of unanswered questions as to who could have created a terrifyingRead MoreThe Lamb and The Tyger by William Blake Essay863 Words   |  4 Pagesin The Lamb and The Tyger by William Blake his idea that there are two different types of people in this world yet we need both for balance. His next poem The Chimney Sweeper has many hidden meaning within his poem about his views on society. Then he goes on in his poem titled Infant Sorrow to reveal his thoughts on non-conformists. William Blake makes a different criticism of society in his four poems The Lamb, The Tyger, The Chimney Sweeper and Infant Sorrow. To begin, William Blake uses hisRead More Analysis of The Lamb and The Tyger by William Blake Essay1641 Words   |  7 PagesWilliam Blake was a first generation Romantic poet. Many of his poems were critical of a society who thought themselves to be almost perfect, a society run by, not their own free will, but the use of technology. He wanted people to question what they had always done, and whether it was morally right. He did so by using varying techniques that set up clashes between ideologies and reality. His poems allow us to see into ‘the eternal world of the spirit’ and his dreams of the sacred EnglandRead More The Underlying Message of The Tyger by William Blake Essay1461 Words   |  6 PagesThe Underlying Message of The Tyger by William Blake Blake’s legendary poem â€Å"The Tyger† is deceivingly straightforward. Though Blake uses â€Å"vividly simple language† (Hirsch, 244), the poem requires a deeper understanding from the reader. There are many misconceptions concerning the symbols in â€Å"The Tyger† (specifically the tiger itself). This often leads to confusion concerning the underlying message of the poem. Compared to Blake’s â€Å"meek† and â€Å"mild† lamb, the tiger is hard to accept. It is a symbolRead MoreEssay about Analysis of â€Å"the Tyger† and â€Å"the Lamb†1290 Words   |  6 PagesIn â€Å"The Tyger,† William Blake explains that there is more that meets the eye when one examines the Creator and his creation, the tiger. The character is never defined. All throughout the poem the character questions the Creator of the tiger to determine if the Creator is demonic or godlike. The poem reflects mainly the character’s reaction to the tiger, rather than the tiger ‘s reaction to the world. The character is inquiring about the location of the Creator of the tiger when he says, â€Å" In whatRead MoreWilliam Blakes The Tyger1115 Words   |  5 PagesJacob Lopez Period: 2 English 4 The Tyger Analysis It was said once that â€Å"Who wants flowers when you’re dead? Nobody.† Many times our own misconception can lead us to different perspectives and different point of views that cause a disunity between our ways of thinking. However nothing can be further than the truth and staying true to yourself. As for William Blake this is the exact concept efforted in his poem â€Å"The Tyger† as he introduces the concept of life’s creation and questioning the creatorRead MoreWhitman And Blake Vs. Blake889 Words   |  4 PagesWhitman and Blake both use animals to symbolize humankind’s experience of Nature The theme of the work is â€Å"Whitman and Blake both use animals to symbolize humankind’s experience of Nature†. To begin with I’d like to tell some information about Whitman and Blake’s life and work. Walt Whitman was an American poet, publicist and reformer of the American poetry. Whitman was the singer of the world democracy†, positive sciences, love and the association without social borders. He was also an innovator

Bronze Arts Award Part B Essay Example For Students

Bronze Arts Award Part B Essay Having attended quite a few circus before and having seen ones before of very high standard, Went in with quite critical thinking.. As soon as I saw the circus I could tell instantly it was not going to be great They say dont judge a book by its cover but fifth outside looked dull with limited decoration, only could come to the instant assumption that the inside would be similar. As correct in thinking so because as soon as entered, the word cheap came into mind. The ringside looked old, chipped paint, rusted and sitting n them was excruciatingly uncomfortable. The chairs surrounding the ring were not lined neatly, rather in a messy arrangement which made getting to certain seats a task (though this could possibly be not their fault, but the fault of the audience who may have moved them getting to their seats). The ring itself was of small size which was fairly surprised about since Im used to seeing much bigger. Staff did not wear the kind of clothes was used to seeing at a circus, instead of being eye-catching and bright they were the complete opposite. The start themselves were also limited which was another thing I noticed when the how began. The show began straight affidavit a clown, whos comedy act -in my opinion- was far from funny, and by the silence of the audience, I guess they agree. However, later when youd got used to the visual sense of humor he used (since he didnt really talk), he was easier to laugh at and young children erupted in giggles at his act. There were not a large amount of performers, and many doubled up, doing more than one act which would have worked better if they at least changed their outfits in between. On the other hand at least they worked with limited staff to the best of their ability and found performers with lit talents Which would decrease their costs and increase their profit. Another fault in the show was that often, the music playing would not match up to the act and in effect destroyed the atmosphere. For example, during a muscle man breaking free from a chain act, there was a slow, graceful piece playing, which did not create the right troposphere. Additionally the sound quality itself was not the best, and only came from two speakers situated at the front of the ring instead of around the tent, which was not a major issue and not one the children would have noticed. Lighting also was not great and only came from two rigs, nowhere else, and was limited in colors. The lighting also did sudden rapid on/off flashes quite often, which I think should have came with a health warning (for those who are affected by flashing lights). Rules were not given at the beginning of the show, so it was unclear whether flash photography was allowed, and there was no saying to turn your phones tot (though this may be sell explanatory). On the positive side, the staff appeared to be very friendly,prices were reasonable, as was the service and despite its many faults it offers what a circus should Entertainment.