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Category: Writing

  • Provide real-world examples for the following types of intelligences as theorized by Gardner:…

    Provide real-world examples for the following types of intelligences as theorized by Gardner: verbal/linguistic, body-kinesthetic (movement), and logical/mathematical. Explain why each example represents one of the types of intelligence. Present some of the arguments critics have offered against Gardner’s research.
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  • Write a well-developed essay in which you analyze the importance of one of the following documents..

    Write a well-developed essay in which you analyze the importance of one of the following documents from Wood’s “Problems in Modern Latin American History”:
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    “Africans in the American World” by John Thorton (pp. 26-30); “A Day on a Coffee Plantation” by Stanley
    Stein (pp. 35-38); and “A Cuban Slave’s Testimony” by Esteban Montejo (pp. 30-35); “War to the Death” by Simón Bolívar(p. 5-
    7); “The Vision of Father Morelos” by Enrique Krauze [this is the
    correct spelling, your book gets it wrong]
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    (p. 7-10); “What Independence Meant for Women” by Sarah Chambers (pp. 15-
    20).
    These are the things you’ll discuss fromthe document that you’ve chosen:
    a) Tell us all about the document that you’ve chosen;
    b) provide deep historical context from our lectures and
    readings on this topic-i.e. tell us the history behind it. How
    does the document fit into the history of time period that we’re looking at?
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    What is going on this region at the time? How does it fit into
    the course themes? What is the historical significance of this document?
    c) What specific contributions does your document make to our understanding of the history of the modern Americas?
    Be sure to make connections between that documents you’re analyzing
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  • Pecha Kucha Presentation A PechaKucha style of presentation http://www.pecha-kucha.org/involves…

    Pecha Kucha Presentation
    A PechaKucha style of presentation http://www.pecha-kucha.org/involves presenting 20 slides for 20 seconds each; hence only a 6 minute presentation is delivered.
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    PechaKucha involves talking about a topic by presenting images rather than words. While a significant amount of research and thinking occurs prior to the presentation, the presentation is quick – to the point – and is likely to engage the audience. Therefore, using your creativity is encouraged. The presentation may be humorous, as long as you adhere to these guidelines and do not offend any group of people.
    For this assessment you are required to create a presentation either on your own or with group members.
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    The topics and theories are listed below. If you wish to undertake a different topic you must put in a request to your tutor in writing. This is not automatically approved.Confirm with your tutor that it is approved prior to commencing research. Do not embed video material.
    Select a topic from column 1 and then select one or two theories from column 2. The theory provides the underpinning of your presentation. The slides will mainly show the service or experience and the notes section will contain information about the theory.
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    Your verbal presentation will connect the service or experience to the theory as shown in the examples on WebCT and the link above.
    Column 1 Column 2
    Services or experiences Theoretical support
    • Banking (in Australia or elsewhere)
    • Firms promoting fitness and well-being.
    • Retailing.
    • Old-age facilities.
    • Entertainment.
    • Sporting clubs (local or national)
    • Community events
    • Cosmetic industry (beauticians/ cosmetic surgery)
    • Education
    • Music industry • Customer Decision Process
    • Hofstede’s cultural values
    • Perceived risks
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    • Core, supplementary and facilitating services
    • Distribution options
    • Balancing capacity and demand
    • The challenge of intangibility
    • Managing promises and expectations
    • Converting customer expectations into organisational action
    • Customer retention
    • Emotional Labour
    Your presentation could take the perspective of customers, management of the service organisation, service personnel or community.
    Presentations will take place halfway through the semester.
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    Inform you lecturer in of your group members or if you are working alone (3 students per group maximum), the week you will present and your topic and theory.
    Submission requirements:
    • There are some difficulties with uploading Powerpoint presentations to TurnItIn. You are therefore not required to upload the file to Turnitin.
    • Hand in a hard copy of the slides (6 to a page, black and white or colour) and the supporting notes that show the theories you used.
    • You must reference all material either on an additional 21st slide or in your notes.
    • Provide an Assessment Declaration cover sheet.
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  • Sociology cultural diversity Paper instructions: 1. Explain how experience shapes one’s attitude…

    Sociology cultural diversity
    Paper instructions:
    1. Explain how experience shapes one’s attitude toward cultural diversity. Give examples.
    2. Explain how experience shapes one’s attitude toward cultural diversity. Give examples.
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    3. Some typical agents of socialization are: family, school, religion, friends, relatives, and mass media. What agents of socialization have influenced you the most? Describe their influence on your attitudes, beliefs, values, or other orientations to life. How have they made you the person that you are today?
    4. Some typical agents of socialization are: family, school, religion, friends, relatives, and mass media. What agents of socialization have influenced you the most? Describe their influence on your attitudes, beliefs, values, or other orientations to life. How have they made you the person that you are today?
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    5. How do group dynamics impact today’s workplace? Does corporate culture and leadership come into play? How so? Discuss.
    6. View the videos “Classic Studies in Psychology” on the Milgram studies in the GCU Library.  Cut and paste the following URL into your browser.
    http://library.gcu.edu:2048/login?url=http://digital.films.com.library.gcu.edu:2048/PortalPlaylists.aspx?aid=12129&xtid=40125
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    Scroll down to videos 12, 13, 14, and 15: “Justification?” “Milgram’s Study of Obedience,” “The Results,” and “Milgram’s Conclusions.” Review the story in the text in Chapter 5.
    Stanley Milgram’s classic experiment of obedience focuses on social control and social conformity. Review Milgram’s experiment. If you were King or Queen of your kingdom, what behaviors would you classify as deviant? How would you make your populace obey and conform? Think about it and formulate a response.
    7. What are some ways in which our American culture stratifies people? See how long of a list you can come up with. Why do societies stratify? What do you think are the functions of stratification?
    8. How do we in the United States measure social mobility?
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    How does social class and life chance play out in social mobility? Where do you see yourself 10 years from now regarding your place in society? Why?
    9. Evaluate the positive and negative effects of Affirmative Action in the United States. Target current issues, trends, and demographics.
    10. Discuss the concept of equality. Do you see equality happening in our society? Why or why not? Describe your personal observations of inequality.
    11. What global forces are affecting the U.S. economy and politics? How do those global forces affect your own life? Discuss.
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    12. Does “Gene Simmons Family Jewels” depict a typical U.S. family? Why or why not? What is going on with the American family today? What historical events have played a role in shaping U.S. family life? What do you see for the future of the U.S. family? How do religion and education impact the future of the U.S. family?
    13. How has technology affected your life? Be specific as to what changes, and in what ways.
    14. Do you believe the long-term consequences of increased technological dependence are going to be good or bad? Explain. How do you see technology’s effect on society 20 years from now?
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  • How to Be a Good Wife” in the module “Gender Roles of the 1950s.” “How to Be a Good Wife” in the…

    How to Be a Good Wife” in the module “Gender Roles of the 1950s.”
    “How to Be a Good Wife” in the module “Gender Roles of the 1950s.”
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    The power point is a list, taken from a 1950′s highschool/home economics textbook. It was a book used to teach young girls
    “how to be a good wife.” This particular excerpt helps us understand how gender roles were created and how they are perpetuated even today. It is not just family and tradition that support
    the continuance of gender roles, it is our institutions.
    For this discussion assignment, please respond to the question: how does this source explain the expectations for men and women today?
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    Also,answer three of the questions I have posted in the
    NOTES section of the power point at the bottom of several slides. There are several questions to choose from and I will allow students to pick which three questions they want to answer but
    make sure the questions come from at least TWO different slides. Do not take all three questions from the same slide.For this discussion, you are answering FOUR questions total, the question
    listed above and three of your choice, taken from the notes on the power point. Also, please respond to at least two other student posts.
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    Please also remember to follow the writing guidelines for assignments, which is posted in the modules section of the site. Use complete sentences, proper punctuation and grammar, and be sure
    to have a minimum of three sentences per answer. Again, I must emphasize, Read the lectures, text, and primary sources. Last but not least, if you use a passage from another source, put
    quotations around the passage and explain IN YOUR OWN WORDS.
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  • Values, Goals and Good Journalism Power of the press… Glory of the byline… Thrill of being among the

    Values, Goals and Good Journalism Power of the press… Glory of the byline… Thrill of being among the first to know… These are just some of the legendary benefits that a person gets when he or she takes journalism for a profession. The public looks up to journalists as those who do very interesting things – meeting the rich and famous, having access to powerful people, experiencing heady encounters and getting paid for doing these things. However, power is always accompanied by a corresponding responsibility. Ideally, a journalist should present the truth about an event or issue. He must be well­grounded in the standards and ethics of journalism before he even attempts to write a story. He must bear in mind the importance of confidentiality, objectivity and fairness. He must understand that journalism is a presentation of facts and facts alone. There really are some instances when a writer tends to inject personal bias in the story he is writing. These happen when he inserts personal feeling and opinion and when he sees himself not as an observer but a participant in the event that he is covering. There are also cases when a journalist stacks the facts so as to prove one side of the story or to take the position the paper prefers. Personal biases must be set aside when presenting a news. What one writes reflects who he is. If his commitment to journalistic principles and public service is compromised with financial gains, this may lead to offenses such as libel, sensationalism, invasion of privacy, obstruction of justice, and obscenity. To prevent getting charged of any of these, the good values of a journalist must urge him to exercise good judgment which eventually shapes credibility. The best way to be the best writer, however, is to treat journalism as a vital calling. Every writing must be inspired by the manner the Bible was written. The Bible emphasizes the necessity of objectivity in reporting. As Luke writes: Since I myself have carefully investigated everything from the beginning, it seemed good also to me to write an orderly account so that you may know the certainty of the things you have been taught. Objectivity must be transparent in all kinds of reporting. In recent years, priests’ involvement in sex scandals had been a sensitive topic worldwide. This is just right as journalists must carry out their duty of presenting even the dark side of the news. The Bible describes God as a creator and man as His image­bearer. Sometimes, a journalist needs to report on the contrast between man’s sinfulness and God’s holiness. Journalists do not have to preach in stories; however, they can work towards honest selection of details. There is no question about God’s involvement in human history. In Deuteronomy 29, Moses addressed the Israelites: Your eyes have seen all that the Lord did in Egypt to Pharaoh, to all his officials and to all his land. With your own eyes, you saw those great trials, those miraculous signs and great wonders. But to this day, the Lord has not given you a mind that understands or eyes that see or ears that hear. In writing his own piece, a writer must provide the context but must follow the Bible in depicting God’s grace and man’s sinfulness. If in the Bible Jesus says to Thomas, “Blessed are those who have not seen and yet have believed,” same goes to a journalist who does not go to press even when ten people tell him the same thing. In conclusion, good journalism entails truth­telling even when it hurts. For him to become the best journalist he can be, a journalist must possess only two things: commitment to truth and a biblical worldview in apprehending reality accurately.

  • Question Anatomy 1. Backward effects of left-sided heart failure include: A. Pulmonary congestion B.

    Question Anatomy 1. Backward effects of left-sided heart failure include: A. Pulmonary congestion B. Jugular vein distention C. Dependent edema in the legs D. Bounding pulses Anatomy 2. In performing a physical assessment, the nurse notes the patient has a ?barrel? configuration to the chest. This is a consequence of: A. Reduced intrapleural pressures B. Bronchial airway expansion C. Increased vital capacity D. Increased residual lung volume Anatomy 3. Ausculation of the chest reveals bilateral fine crackles in the bases bilaterally, indicating: A. Right-sided heart failure B. Left-sided heart failure C. Pneumonia D. Acute respiratory distress syndrome Biology 4. The signs and symptoms of anemia are all related to what common pathophysiologic feature of the condition? A. Increased oxygen consumption by tissues B. Decreased blood oxygen content C. Vasodilation D. A shift in the oxyhemoglobin dissociation curve Biology 5. In addition to hypertension, preeclampsia is characterized by: A. Nausea and vomiting B. Fatigue and lower back pain C. Protein in the urine and edema D. Retinal changes and rates in the lungs Biology 6. Common manifestations of bacterial pneumonia include all of the following except: A. Fever B. Productive Cough C. Tachypnea D. Hyperinflation Biology 7. Closed drainage systems work to re-expand a lung after pneumothorax by: A. Re-establishing the normal negative intrapleural pressure. B. Creating a positive pressure in the pleural space C. Removing excess fluid from the pleural space so that there is room for lung expansion. D. Pulling oxygen into distal air sacs to re-expand lung tissue Biology 8. Patients with chronic renal failure usually exhibit: A. Bradycardia B. Hypokalemia C. Hypocalcemia D. Hematomas Biology 9. The diet of a patient in end-stage kidney disease is restricted in all of the following except: A. Fluid B. Potassium C. Protein D. Calories Anatomy 10. Which of the following is true of the biological functions of progesterone? A. Progesterone is the most important hormone associated with pregnancy. B. Progesterone directs male sexual characteristics. C. Levels of progesterone increases if the egg is not fertilized. D. Levels of progesterone remain stable if the egg is not fertilized. Anatomy 11. Which of the following is true of the biological functions of testosterone? A. Testosterone is not secreted by the ovaries. B. Testosterone is needed for development of female secondary sexual characteristics. C. Testosterone stimulates ovulation. D. Testosterone is needed for development of male secondary sexual characteristics. Anatomy 12. Which of the following is true of the biological functions of estrone? A. Estrone is required for proper development of male secondary sexual characteristics. B. Level of estrogen degreases if the egg is not fertilized. C. Estrone is required for proper development of female secondary sexual characteristics. D. Estrone affects only the reproductive organs. Biology 13. What is the function of hemoglobin? A. Hemoglobin is the protein in red blood cells that is responsible for carrying oxygen to the cells of the body. B. Hemoglobin is a lipid in red blood cells that is responsible for carrying oxygen to the cells of the body. C. Hemoglobin is a protein in white blood cells that is responsible for carrying oxygen to the cells of the body. D. Hemoglobin is a protein in red blood cells that is not responsible for carrying carbon dioxide to the cells of the body. Biology 14. Why is heat an effective means of sterilization? A. Heat is an effective means of sterilization because it destroys the proteins of microbial lifeforms, including fungi, bacteria, and viruses. B. Heat is an effective means of sterilization because it destroys the proteins of anaerobic microbial lifeforms, including fungi, bacteria, and viruses. C. Heat is an effective means of sterilization because it destroys the lipids of microbial lifeforms, including fungi, bacteria, and viruses. D. Both (B) and (C). Chemistry: 15. List the enzymes whose levels are elevated in the blood serum following an MI. A. CPK, LDH, AST, and SGOT B. LDH, AST, and SGOT C. CRE, AST, and ALT D. None of the above Chemistry 16. What is the physiological function of gluconeogenesis? A. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel. B. Gluconeogenesis is production of glucose from noncarbohydrate molecules in times when blood glucose levels are high. This ensures proper function of brain and white blood cells, which only use glucose as fuel. C. Gluconeogenesis is production of glucose from carbohydrate molecules in times when blood glucose levels are low. This ensures proper function of brain and red blood cells, which only use glucose as fuel. D. None of the above Chemistry 17. What effect does glycogen metabolism have on glucose levels? A. Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels. B. Glycogen metabolism traps glucose within liver cells and increases storage of glucose in the form of glycogen. These processes increase blood glucose levels. C. Glycogen metabolism releases glucose within liver cells and increases storage of glucose in the form of glycogen. These processes decrease blood glucose levels. D. None of the above Chemistry 18. Carbon monoxide binds tightly to the heme groups of hemoglobin and myoglobin. How does this affinity reflect the toxicity of carbon monoxide? A. Since carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen enhancement result in what divers call the ?bends.? B. Because carbon monoxide binds the heme groups of hemoglobin, it is easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation. C. Because carbon monoxide binds tightly to the heme groups of hemoglobin, it is not easily removed or replaced by oxygen. As a result, the effects of oxygen deprivation result in suffocation. D. None of the above Pathophysiology 19. Which of the following may be a reason to order an ABG on a patient? A. The patient suddenly develops shortness of breath B. An asthmatic is starting to show signs of tiring C. A diabetic has developed Kussmaul?s respirations D. All of the above Pharmacology 20. How do sulfa drugs selectively kill bacteria while causing no harm to humans? A. Folic acid is a vitamin required for the synthesis of a coenzyme needed to make the amino acid methionine and the purine and pyrimidine nitrogenious bases for DNA and RNA and folic acid is produced by humans. B. Sulfa drug binds to the enzyme, no product is formed, folic acid is made and the biosynthesis of methionine and nitrogenous bases increases. C. Humans are not harmed because they do not synthesize their own folic acid. It is obtained in the diet. D. None of the above Pharmacology 21. What occurs when glycogen metabolism is stimulated by insulin? A. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. B. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates removal of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase. C. Insulin stimulates glycogen synthase, the first enzyme in glycogen synthesis. It also stimulates uptake of glucose from the bloodstream into cells and phosphorylation of glucose by the enzyme glucokinase. D. All of the above Pharmacology 22. What is the medical application of cortisone? Cortisone is used to treat: A. Rheumatoid arthritis, asthma, gastrointestinal disorders, and a variety of skin conditions. B. Kidney disease, high blood pressure, and osteoporosis. C. Muscle disorders, tuberculosis, and thyroid disorder. D. All of the above Anatomy 23. Oxygen saturation is likely to be lowest when an asthmatic with a diagnosis of pneumonia is positioned: A. In a high Fowler position B. Lying on the left side C. Lying on the right side D. Lying supine with the head of the bed flat Chemistry 24. Laboratory test results indicative of thrombocytopenia, in addition to a low platelet count, would be: A. Increased PT B. Prolonged bleeding time and poor clot retraction. C. Increased aPTT D. Decreased RBC count. Pharmacology 25. The purposes of epinephrine injection include all of the following except: A. Stabilizing mast cell membranes. B. Relaxing bronchial smooth muscle. C. Supporting arterial blood pressure. D. Blocking histamine receptors. Pharmacology 26. Therapeutic interventions focused on increasing the oxygen supplied to the heart and decreasing the heart?s demand for oxygen include: A. Antiplatelet drugs B. Anticoagulants C. Morphine sulphate D. Thrombolytic drugs Pharmacology 27. An intervention that would contribute toward the healing of a peptic ulcer is: A. Steroid administration B. Blocking or neutralizing of acid secretion C. Surgical removal of the ulcer D. Intravenous nutritional support Pharmacology 28. Aspirin and NSAIDs are causative factors for the development of peptic ulcer disease because they: A. Increase acid secretion B. Allow proliferation of H. pylori C. Damage the mucosal barrier D. Alter platelet aggregation Pharmacology 29. Your patient is interested in trying medication to improve low mood/depression. All of the following medications might be appropriate except: A. Selective serotonin reuptake inhibitors B. Amitriptyline C. Serotonin and norepinephrine reuptake inhibitors D. Benzodiazepines

  • Solution Description Read the Following Attached Project Proposal and write a solution description:.

    Solution Description
    Read the Following Attached Project Proposal and write a solution description:
    Proposed Solution
    Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention.
    Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If it is, you may need to go back and make changes to your PICOT before continuing.
    Organization Culture
    Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.
    Expected Outcomes
    Explain the expected outcomes of the project. The outcomes should flow from the PICOT.
    Method to Achieve Outcomes
    Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.
    Outcome Impact
    Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient-centered quality care, efficiency of processes, environmental changes, and/or professional expertise.

  • Health care Chapter 1 Scarcely a news report goes by that does not address the number one health…

    Health care Chapter 1 Scarcely a news report goes by that does not address the number one health concern in the United States, obesity. Obesity has long been a concern of the healthcare industry, and the focus on children is increasing. Obesity is considered the number one health risk for children in the United States today. Research demonstrates it is not only a concern but one that is now reaching epidemic proportions. The number of children who are overweight has doubled in the last two to three decades; currently, one child in five is overweight. Research further indicates that if a child is overweight at age 6, his or her likelihood of adult obesity is more than 50 percent. Obesity presents numerous health problems for children; hypertension and Type II diabetes, coronary heart disease, stress on weight­bearing joints, low self­esteem, and the risk for chronic health problems in adulthood. One of the most severe problems is sleep apnea (interrupted breathing while sleeping), which, in some cases, can lead to problems with learning and memory. (Blasi, 2003) Problem Statement, Purpose and Rationale Childhood obesity has become an epidemic in recent years, with more than 9 million children labeled obese, and the decrease in physical education requirements may be affecting the health of children. Children need to maintain a regular rate of physical activity to maintain optimal health and this activity should be present in the physical education program. The purpose of this study is to determine if participating in a routine exercise program can help reduce excess weight and maintain optimal fitness, by designing and implementing a daily fitness program for students. Obesity is defined as body weight, which is more than normal for a particular age, gender, and height. Obesity can be measured through BMI (Body Mass Index) calculations that are based on a person’s height and weight. Obesity is the end result of a person taking in more calories than they expend in a day. Even a small imbalance between energy input and output can lead to significant weight gain over time. Most obese children demonstrate a slow but consistent weight gain over several years. Eating too much and moving around too little are the main causes of obesity. Most experts agree that watching excessive amounts of television is a significant risk factor associated with obesity. Research has demonstrated that almost half of children ages 8­16 years watch three to five hours of television daily. Extreme cases of obesity are generally contributed to inactive children, eating too many snacks with a high fat content. (Blasi, 2003) Possible Causes The simple answer to the problem of childhood obesity is more calories are taken in than are expended in a day, which when accumulates results in obesity. However there are a variety of factors that affect and may contribute to obesity and the solution may be as complex. Increasing physical activity to meet or exceed daily dietary intake is something that people can control and therefore have an impact. This study will focus on the increase in physical activity for students and monitor their progress throughout the duration of the study. There is no longer a question about whether or not childhood obesity exists. It does. Environmental conditions, such as television, video games, and computers can have an influence if children don’t take part in other physical activities. Certainly, the increase in fast food diets and the intake of sugar has an impact on a child’s weight, particularly if not balanced with other foods and activities. Soft drinks have become a mainstay in the daily diet of American children. A recent long­term research study examined soda consumption and its effect on children’s body weight. The study found that “for each additional daily serving of a sugarsweetened soft drink, the incidence of obesity was significantly increased. Researchers also discovered that the odds of becoming obese increased 1. 6 times for each additional glass of sugar­sweetened soft drink consumed above the daily average. ” (Blasi, 2003) In 1998, The National Association for Sport and Physical Education issued guidelines stating that young children should strive for 60 minutes of physical activity each day to promote health and well­being. Clearly, this is a valuable goal for both children and adults, but may not be the only contributing factor for obesity. The factors that contributing to obesity are complex, and can include economic, social, cultural, behavioral, nutritional, psychological, and genetic factors. However, individual differences make it unclear the extent to which each of these factors contributes to obesity. An individual’s genetic makeup combined with the environment in which the person lives may have an impact. Eating and activity patterns have been shown to be consistently related to obesity. These are also the two factors that we can most readily have an impact on. (Blasi, 2003) Most states require students to participate in some type of physical education program, the time spent in physical education declines with each subsequent grade. “About one third (39. 7 percent) of elementary schools require physical education in kindergarten, one half (50 percent) of elementary schools require physical education in grades 1 through 5, one fourth (25 percent) in grade 8, and only 5 percent in grade 12. ” (Garbe & Hoote, 2004) This is in conflict with recommendations made by the American Academy of Pediatrics (AAP). The AAP recommends that K­12 students have daily opportunities for physical education. The National Association of State Boards of Education (NASBE) backed this notion with the development of guidelines, stating that elementary school students should have at least 150 minutes per week of physical education and at least 225 minutes per week when they reach middle/ junior and senior high school. The School Health Policies and Programs Study (SHPPS), conducted in 2000, found that only 8 percent of elementary schools, 6. 4 percent of middle/junior high schools, and 5. percent of senior high schools provide daily physical education for the entire school year for all grades. (Garbe & Hoote, 2004) Both the school environment and the family environment must absorb the responsibility for childhood obesity. While the school cafeteria provides food choices, the physical education program determines the time allocated to physical activity, and the school curriculum controls opportunities to learn about the relationship between personal behaviors and health. Away from school, the family environment strongly influences child health. Chapter Two Literature Review According to the Centers for Disease Control and Prevention, 15 percent of young people in the United States are overweight, defined as a body weight at or above the 95th percentile on Body Mass Index­for­age percentiles. An additional 15 percent of children (those above the 85th percentile) are classified as being “at risk of overweight. ” The health risks of obese children cannot be overstated. The risks in terms of physical health include hypertension, heart disease, diabetes, and increased risk of obesity in adulthood. The cumulative effects of obesity don’t stop there. “Obesity also exerts a heavy psychological toll on children: the likelihood of impaired quality of life for obese children is 5. 5 times greater than for healthy children. ” (Anderson & Butcher) Increasing childhood obesity is related to increasing adult obesity. Although the obese share of the population is expected to increase with age, obesity today is increasing with age more quickly than it did thirty years ago. (Anderson & Butcher, 2006) Although a public school cafeteria has not traditionally provided the healthiest of meals, the problems continue to grow with the introduction of fast foods, such as McDonalds, Taco Belle and Pizza Hut, to the lunch offerings. “In addition, hundreds of under­funded school districts have negotiated “pouring rights” contracts to sell brands of soda and allow young people easy access to vending machines during recess breaks. Soda consumption among adolescents has nearly tripled between 1977­78 and 1994. ” A 12­ounce serving of carbonated soda contains the equivalent of 10 teaspoons of sugar. Soda consumption has been shown to be an independent risk factor for obesity in children. In addition to sodas becoming readily available during school time, vending machines are present in a majority of schools. (Staveren & Dale, 2004) Currently, there are minimal opportunities for children to be physically active during school time. Recent budget cuts have resulted in cuts to physical education. Physical Education is necessary if children are going to maintain a healthy body weight and good health. Children should receive at least 60 minutes, and up to several hours, of age­appropriate exercise on all or most days of the week. Few schools offer any structured physical activity outside of the physical education classes. (Staveren & Dale, 2004) Simply adding physical education opportunities may not be enough to make significant impact or reduction in childhood obesity. Children who are obese are not comfortable in the physical education class. Not only is it physically challenging, but embarrassing as well. Obese children may feel more vulnerable in the physical education class than they do anywhere else in the school. Due to the number of overweight and obese children, it is obvious that physical education programming needs to be restructured and adapted to suit this population. An obese child is not going to benefit from being made to run laps that they are not physically capable of doing. Physical Education may have to take more of an individual approach with students, helping them to identify goals, and then designing a fitness plan to meet those goals. More wellness information should be incorporated into the curriculum, benefiting all children. The competitive nature of physical education needs to be re­evaluated in order to meet the needs of obese children. Focus should be place on health. Physical education instructors will also need to motivate children, and finding activities that they enjoy and then building on those may provide the motivation necessary. (Irwin, et. Al. , 2003) Physical educators are confronting a growing need for developmentally appropriate movement education among very young children. Children are more sedentary and more obese, on average than their counterparts 20 years ago, and they need to develop. movement skills and habits for healthy, active lifestyles. (Helm & Boos, 1996) Researchers at the University of California at San Diego tried to determine how excess weight affects obese children and their ability to perform normal activities. The study, surveyed 106 obese children (57 boys and 49 girls; average BMI of 34. 7) between the ages of 5 and 18 years. They were asked questions such as whether they ever experienced problems due to participating in physical activities, bathing themselves, other kids not wanting to be their friends, or being unable to pay attention during class. The interview also asked how often they felt depressed or worried and whether they ever missed school because they did not feel well. The results of each interview were graded on a scale of 100 and then compared to the published data on healthy children and children with cancer who were receiving chemotherapy or had chemotherapy recently. The average score for obese children (67) was drastically lower than healthy children (83) and even slightly less than children with cancer (69). The biggest difference in the scores between the obese children and the other two groups was related to their social functioning–20 points lower than the healthy group and 9 points lower than the children with cancer. One major reason obese children had lower scores in this area is because they get picked on and teased at school, while children with cancer usually receive sympathy. More often than not, the obese children had a physical or emotional problem: 65 percent had at least one medical condition, 37 percent had high cholesterol or a similar condition, 13 percent had either depression or anxiety, and 4 percent had diabetes. It may be due to these complications that obese children are on average absent from school four days a month, while healthier children miss on average less than a day a month. (JOPERD, 2003) A growing need in physical education is to help young people enjoy the rewards of exercise through participation. This need could be addressed by teaching students the health benefits derived from maintaining active lifestyles. Additionally, physical educators could emphasize the results of exercise which appeal to young people, such as improved physical appearance. For example, improved physical appearance can be included in a discussion of body fat reduction. This exercise benefit should not be the only focus of the discussion, but could certainly be a part of it. (Douthitt & Harvey, 1995)

  • PICOT Question: Population : Bariatric adolescents considering or undergoing gastric bypass surgery.

    PICOT Question:
    Population
    : Bariatric adolescents considering or undergoing gastric bypass surgery.
    Intervention
    : The nurse’s role as a primary member of the multidisciplinary team regarding perioperative care of the bariatric adolescent patient.
    Comparison
    : The nurse’s role as a secondary member of the multidisciplinary team without any specialized training and is only involved in perioperative care of the bariatric adolescent patient.
    Outcome
    : When the nurse is involved as one of the primary members in the multidisciplinary team approach, the bariatric adolescent patient has better continuity of care.
    Time:
    perioperative including the 6 weeks post recovery.
    PICOT Question
    : Does the bariatric adolescent patient undergoing gastric bypass have better continuity of care perioperatively and postoperatively when the nurse is a primary member of the multidisciplinary team versus when the nurse is a secondary member whose only role is in providing perioperative care and has no specialized training?
    2. Intervention PICOT Question, an Intervention example:
    In adult patients with total hip replacements (Patient population) how effective is PCA pain medication (Intervention of interest) compared to prn IM pain medication (Comparison intervention) in controlling post operative pain (Outcome) during the perioperative and recovery time?
    Note: The IM pain medication would be called the control group. It would be unethical to have a control group that received NO pain medication. Many times the control group means they get “business as usual!” or the current standard of care.
    3. Therapy PICOT Question, a non-intervention example:
    What is the duration of recovery (O) for patients with total hip replacement (P) who developed a post-operative infection (I) as opposed to those who did not (C) within the first six weeks of recovery (T)?
    4.  Etiology PICOT Question:
    Are kids (P) who have obese adoptive parents (I) at Increased risk for obesity (O) compared with kids (P) without obese adoptive parents (C) during the ages of five and 18 (T)?
    5. Diagnostic PICOT Question:
    Is a PKU test (I) done on two week old infants (P) more accurate in diagnosis inborn errors in metabolism (O) compared with PKU tests done at 24 hours of age (C)? Time is implied in two weeks and 24 hours old.
    6. Prevention PICOT Question:
    In OR nurses doing a five minute scrub (P) what are the differences in the presence and types of microbes (O) found on natural polished nails and nail beds (I) and artificial nails (C) at the time of surgery (T)?
    7. Prognosis/Prediction PICOT question:
    Does telelmonitoring blood pressure (I) in urban African Americans with hypertension (P) improve blood pressure control (O) within the six months of initiation of the medication (T)?
    8. Meaning PICOT Question:
    How do pregnant women (P) newly diagnosed with diabetes (I) perceive reporting their blood sugar levels (O) to their healthcare providers during their pregnancy and six weeks postpartum (T)?