Can Breastfeeding In The First Six Months Prevent Childhood Obesity - Free Essay Example

Sample details Pages: 10 Words: 3040 Downloads: 10 Date added: 2017/06/26 Category Medicine Essay Type Analytical essay Level High school Topics: Childhood Essay Childhood Obesity Essay Obesity Essay Did you like this example? Can breastfeeding in the first six months prevent childhood obesity? Obesity is defined as a body mass index (BMI) of à ¢Ã¢â‚¬ °Ã‚ ¥25kg/m2 (World Health Organisation 2015). In the past decade, throughout much of the world, the rates of obesity in children in particular have increased to epidemic proportions (Lefebvre John 2012, p. 386). Don’t waste time! Our writers will create an original "Can Breastfeeding In The First Six Months Prevent Childhood Obesity" essay for you Create order The World Health Organisation (2015) estimates that 42 million children under the age of 5 years are overweight or obese worldwide and in Britain, overweight and obesity affects nearly one-third of children aged 2 to 15 years (Health and Social Care Information Centre 2009). Since obesity in childhood is strongly correlated with serious disease and increased risk of mortality throughout life (Yan et al. 2014, p. 3), and because of the significant direct costs of obesity on health services and societies globally (Department of Health 2011), strategies to prevent childhood obesity are of paramount importance. Research has suggested that breastfeeding for the first six months may be protective against and, therefore, prevent obesity in childhood (Lefebvre John 2012, p. 386). Through a critical evaluation of this research, this paper will answer the question of whether breastfeeding in the first six months can prevent childhood obesity. The beneficial effects of breastfeeding for chi ldren are well-established in the literature. High-quality studies have demonstrated that children who are breastfed have a reduced risk of ear infections (Duncan et al. 1993, p. 867), respiratory infections (Bachrach, Schwarz Bachrach 2003, p. 237), necrotizing enterocolitis (Lucas Cole 1990, p. 1519), gastroenteritis (Chien 2001, p. 69), diabetes (Owen et al. 2006, p. 1043), atopic dermatitis (Gdalevich et al 2001, p. 520) and sudden infant death syndrome (SIDS) (Vennemann et al. 2005, p. 655). Breast milk is not only rich in protective antibodies and beneficial bacteria, it is nutritionally-balanced and adapts to meet an infants changing needs (National Health Service 2015). Research has therefore suggested that another significant benefit of breastfeeding may be that is acts as a protective factor against obesity in childhood. Kramer was the first to report that breastfeeding may result in a significantly reduced risk of obesity in children (1981, p. 4). In the next two dec ades, a number of similar studies also suggested an association between breastfeeding and a reduction in the risk of childhood obesity. In the mid-2000s this research was collated into three seminal meta-analyses which concluded that, overall, breastfeeding for the first six months did reduce the risk of childhood obesity. For example, Arenz et al. (2004, p. 1247) found that obesity had a small but consistent protective effect against obesity in children. This was supported by Owen et al. (2005, p. 1367), who demonstrated a small positive correlation between breastfeeding and a reduction in the risk of childhood obesity. Harder et al. (2005, p. 397) also found that the duration of breastfeeding was inversely associated with the risk of childhood obesity. These meta-analyses suggested an overall 15% to 30% reduction in odds of overweight from breastfeeding. However, they were widely criticised for major methodological problems, including a failure to deal appropriately or consistentl y with confounding variables such as parental BMI. As a result, the evidence they presented on the relationship between breastfeeding and reduced childhood obesity risk was not widely accepted. However, the potential for a correlation between breastfeeding and a reduction in the risk of childhood obesity continued to be discussed and researched. In the past decade, a small number of high-quality studies have investigated this potential relationship. Evidence from this research is largely conflicting, with results varying depending on the study design used. For example, two large randomised-controlled trials found breastfeeding had no impact on the prevalence of obesity in children aged 6 or 11 years (Kramer et al., 2007, p. 1717; Martin et al., 2013, p. 1005). Similarly, several studies in siblings found no differences in the BMI of breastfed versus non-breastfed children (Evenhouse Reilly 2005, p. 1781; Gillman et al. 2006, p. 112; Colen Ramsey 2014, p. 55). Likewise, two high -quality American studies reported either no (Jiang Foster 2013, p. 628) or small and inconsistent (Jenkins Foster 2014, p. S128) effects of breastfeeding on childhood BMI. Conversely, multiple studies have reported a positive relationship between breastfeeding and a reduction in the risk of childhood obesity. For example, a large UK study concluded that breastfeeding reduced the overall risk of childhood obesity to a degree considered statistically-significant. These findings are supported in high-quality studies from Germany (Grube e tal. 2015, p. 1), Brazil (Assuncao et al. 2015, p. 1) and Japan (Jwa et al. 2015, p. 1527). Furthermore, these studies demonstrate that the length of time a child is breastfeed is proportional to the degree of their reduction in obesity risk, and that the inverse association between breastfeeding and overweight appears to be sustained over time. Part of the problem underpinning these marked differences in study results can be explained by the qua lity of the studies themselves. Randomised-controlled trials à ¢Ã¢â€š ¬Ã¢â‚¬Å" the gold standard of research trials à ¢Ã¢â€š ¬Ã¢â‚¬Å" investigating the effects of breastfeeding are rare, because the well-established benefits of breastfeeding means allocating children into breastfeeding and non-breastfeeding cohorts would raise justifiable ethical concerns (Grube et al. 2015, p. 2). In studies where groups are not randomised, a spurious relationship between breastfeeding and reduced risk of obesity may result as a result of confounding if, for example, mothers who breastfeed also adopt a healthier lifestyle involving a nutritious diet and adequate physical activity for themselves and their children (Centers for Disease Control 2007, p. 3). Reasons for these marked differences in study results can also be explained by the diverse sociocultural context in which both breastfeeding and obesity are grounded. Essentially, sociocultural factors have a significant impact on both breastf eeding and obesity which confounds the relationship between these two variables. For example, a cohort study examining the correlation between breastfeeding and childhood obesity in groups of English and Brazilian children found that breastfeeding was associated with reduced risk of childhood obesity in the English cohort but not in the Brazilian cohort (Brion et al., 2011, p. 670). This study suggests that sociocultural factors have a significant impact on the relationship between breastfeeding and childhood obesity in cohorts with different sociocultural characteristics. Another similar cohort study confirmed that breastfeeding in particular is a socially-patterned phenomena, and that as a result the relationship between breastfeeding and childhood obesity may differ between cohorts in low- to middle-income and high-income countries (Fall et al., 2007, p. 47). Furthermore, a high-quality meta-analysis found that evidence for the relationship between breastfeeding and childhood obe sity is primarily derived from studies conducted in high-income countries where the correlation between breastfeeding and socioeconomic status is a significant source of confounding in this relationship (Horta Victora 2013). It is apparent, therefore, that the question of whether breastfeeding in the first six months can prevent childhood obesity is largely dependent on sociocultural factors. The sociocultural-dependent nature of the relationship between breastfeeding and childhood obesity is also revealed in studies which have adjusted statistically for other covariates, such as sociodemographic factors and variables concerning birth, pregnancy and parental atopy, etc. For example, in one adjusted study on a German cohort, Grube et al. (2015, p. 1) conclude that breastfeeding might help to prevent childhood obesity. However, in another adjusted study on a Chinese cohort Jing et al. (2015, p. 55) found no statistically significant effect of breastfeeding on reducing the risk of childhood obesity. Because these studies both adjust for a range of sociodemographic and other covariates, sociocultural differences are an important explanation for the differences observed in results. It is exceedingly difficult, perhaps impossible, to control for the diversity of sociocultural variables evident in different populations. The best that can be done is to control for as many other variables, such as sociodemographic factors, as possible. When this is done, the evidence overwhelmingly suggests that breastfeeding in the first six months can reduce the risk of childhood obesity. For example, a meta-analysis by Horta and Victora (2013) concluded that, if only studies which control for confounding are considered, breastfeeding leads to a reduction in childhood obesity of around 10%. This is supported by another large meta-analysis by Yan (2014) which, after examining only studies controlling for confounding, concluded that the risk of childhood obesity was lower in bre astfed children by 22%. It is worth noting that no Cochrane Systematic Review à ¢Ã¢â€š ¬Ã¢â‚¬Å" the gold standard of meta-analysis à ¢Ã¢â€š ¬Ã¢â‚¬Å" has been completed on the relationship between breastfeeding and childhood obesity. However, a Cochrane Systematic Review on evidence for the optimal duration of breastfeeding did conclude that breastfeeding did not confer any protection against obesity in children to the age of 6 years (Kramer Kakuma 2012, p. 5) à ¢Ã¢â€š ¬Ã¢â‚¬Å" a surprising finding, given the conclusions drawn in the previous paragraphs. However, this Cochrane Systematic review looked at obesity in terms of weight gain rather than BMI, the standard measure for obesity. It also did not exclude studies which failed to adjust for confounding. Thus, it is not accurate to compare its results with those of the meta-analyses discussed previously. It is now generally accepted that breastfeeding in the first six months can reduce the risk of childhood obesity. Howev er, complicating this conclusion is the complexity surrounding differences in the concepts of childhood obesity prevention versus risk reduction. The literature widely accepts that breastfeeding reduces the risk of childhood obesity; however, no studies claim that breastfeeding prevents obesity. Thus, in direct answer to the research question it must be concluded that breastfeeding in the first six months does not prevent childhood obesity. However, breastfeeding does reduce the risk of childhood obesity. Moreover, the length of time a child is breastfeed is proportional to the degree of their reduction in obesity risk and the inverse association between breastfeeding and overweight appears to be sustained as the child grows (Centers for Disease Control 2007, p. 4). A variety of research is now being undertaken to further explain the relationship between breastfeeding and a reduction in the risk of childhood obesity. It has been suggested that, due to more normalised concentratio ns of the hormone leptin, breastfed children may have a more well-developed recognition of satiety and an improved ability to self-regulate their energy intake in both early and later childhood (Gillman 2011, p. 681). Hormones in human breast milk may influence this learned self-regulation of energy intake (Savino et al. 2009, p. 397). Additionally, breast fed children have a lower plasma insulin concentration and a shorter insulin response resulting in more regulated body fat deposition (Dietz 2001, p. 2506). Furthermore, the higher protein intake of formula-fed infants may stimulate the secretion of insulin and result in the dysregulation of body fat deposition (Dietz 2001, p. 2506). The conclusion that breastfeeding reduces the risk of childhood obesity is widely accepted by global peak bodies on child health. These peak bodies include the World Health Organisations (2015) UNICEF, whose Baby Friendly Initiative is widely endorsed by maternity hospital and health service in the UK. The relationship between breastfeeding and a reduction in the risk of childhood obesity is also reflected in the policy statements and guidelines of most major paediatric bodies worldwide, including the Royal College of Paediatrics and Child Health (2011) and the American Academy of Pediatrics (2012). Obesity in childhood is a significant problem globally. This paper has concluded that whilst breastfeeding in the first six months does not prevent childhood obesity, there is evidence to suggest that breastfeeding does reduce the risk of childhood obesity. Moreover, the length of time a child is breastfeed is proportional to the degree of their reduction in obesity risk and the inverse association between breastfeeding and overweight appears to be sustained over time. However, it must be remembered that both breastfeeding and obesity are grounded in a range of sociocultural determinants which may confound this relationship. However, since obesity in childhood is strongly corre lated with serious disease and increased risk of mortality throughout life, and because of the significant direct costs of obesity health services and societies globally, a relationship between breastfeeding and a reduction in the risk of childhood obesity is a significant finding. Bibliography Arenz, S, Ruckerl, R, Kiletzko, B von Kries, R 2004, Breast-feeding and childhood obesity: A systematic review, International Journal of Obesity and Related Metabolic Disorders, vol. 28, no. 10, pp. 1247-1256. Assuncao, ML, Ferreira, HS, Coutinho, SB, Santos, LMP Horta, BL 2015, Protective effect of breastfeeding against overweight can be detected as early as the second year of life: A study of children from one of the most socially-deprived areas of Brazil, Journal of Health, Population Nutrition, vol. 33, no, 1, pp. 85-91. Bachrach, VR, Schwarz, E Bachrach LR 2003, Breastfeeding and the risk of hospitalization for respiratory disease in infancy: A meta-analysis, Archives of Pediatric and Adolescent Medicine, vol. 157, no. 3, pp. 237-243. Brion, MJ, Lawlor, DA, Matijasevich, A, Horta, B, Anselmi, L, Araujo, CL, Menezes, AM, Victora, CG Smith, GD 2011, What are the causal effects of breastfeeding on IQ, obesity and blood pressure? Evidence from comparing high-income w ith middle-income cohorts, International Journal of Epidemiology, vol. 40, pp. 670-680. Centers for Disease Control 2007, Does breastfeeding reduce the risk of pediatric overweight?, Centers for Disease Control, Atlanta, Georgia, viewed 27 August 2015, https://www.cdc.gov/about/default.htm Chien, PF Howie PW 2001, Breast milk and the risk of opportunistic infection in infancy in industrialized and non-industrialized settings, Advances in Nurtitional Research, vol. 10, pp. 69-104. Colen, CG Ramsey, DM 2014, Is breast truly best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the United States using sibling comparisons, Social Science Medicine, vol. 109, pp. 55-65. Department of Health 2011, Obesity: General information, Department of Health, London, UK, viewed 27 August 2015, https://webarchive.nationalarchives.gov.uk/20130107105354/https://www.dh.gov.uk/en/Publichealth/Obesity/DH_078098 Dietz, WH 2001, Breastfeeding may help prev ent childhood overweight, Journal of the American Medical Association, vol. 285, pp. 2506à ¢Ã¢â€š ¬Ã¢â‚¬Å"2507. Duncan, B, Ey, J, Holberg, CJ, Wright, AL, Martinez, FD Taussig, LM 1993, Exclusive breast-feeding for at least 4 months protects against otitis media, Pediatrics, vol. 91, no. 5, pp. 867-872. Evenhouse, E Reilly, S 2005, Improved estimates of the benefits of breastfeeding using sibling comparisons to reduce selection bias, Health Services Research, vol. 40, 1781-1802. Fall, CH, Borja, JB, Osmond, C, Richter, L, Bhargava, SK, Martorell, R, Stein, AD, Barros, FC Victora, CG 2011, Infant-feeding patterns and cardiovascular risk factors in young adulthood: data from five cohorts in low- and middle-income countries, International Journal of Epidemiology, vol. 40, pp. 47-62. Gdalevich, M, Mimouni, D, David, M Mimouni, M 2001, Breastfeeding and the onset of atopic dermatitis in childhood: A systematic review and meta-analysis of prospective studies, Journal of t he American Academy of Dermatology, vol. 45, no. 4, pp. 520-527. Gillman, MW, Rifas-Shiman, SL, Berkey, CS, Frazier, AL, Rockett, HR, Camargo, CA Jr, Field, AE Colditz, GA 2007, Breast-feeding and overweight in adolescence: Within-family analysis, Epidemiology, vol. 17, 112-114. Gillman, MW 2011, Commentary: Breastfeeding and obesity, International Journal of Epidemiology, vol. 40, pp. 681-684. Grube, MM, von der Lippe, E, Schlaud, M Brettschneider, AK 2015, Does breastfeeding help to reduce the risk of childhood overweight and obesity? A propensity score analysis of the data from the KiGSS Study, PLoS ONE, vol. 10, no. 3, pp. 1-16. Harder, R, Bergmann, R, Kallischnigg, G Plagemann, A 2005, Duration of breastfeeding and risk of overweight: A meta-analysis, American Journal of Epidemiology, vol. 162, no. 5, pp. 397-403. Horta, BL Victora CG 2013, Long-term-effects of breastfeeding. A systematic review, World Health Organisation, Geneva, Switzerland, viewed 27 Augus t 2015, https://www.who.int/maternal_child_adolescent/documents/breastfeeding_long_term_effects/en/ Jenkins, JM Foster, EM 2014, The effects of breastfeeding exclusivity on early childhood outcomes, American Journal of Public Health, vol. 104, no. S1, pp, S128-S135. Jiang, M Foster, EM 2013, Duration of breastfeeding and childhood obesity: A generalized propensity score approach, Health Services Research, vol. 48, pp. 628à ¢Ã¢â€š ¬Ã¢â‚¬Å"651 Jing, H, Xu, H, Wan, J, Yang, Y, Ding, H, Chen, M, Li, L, Lu, P, Hu, J Yang, J 2014, Effect o breastfeeding on childhood BMI and obesity: The China Family Panel studies, Medicine, vol. 93, no. 10, pp. e55. Jwa, SC, Fujiwara, T Kondo, N 2014, Latent protective effects of breastfeeding on late childhood overweight and obesity: A nationwide prospective study, Obesity, vol. 22, no. 6, pp.1527-1532. Kramer, MS, 1981, Do breast-feeding and delayed introduction of solid foods protect against subsequent obesity?, The Journal of Paedi atrics, vol. 98, pp. 883-887. Kramer, MS Kakuma, R 2012, Optimal duration of exclusive breastfeeding, Cochrane Database of Systematic Reviews, viewed 27 August 2015, https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003517.pub2/epdf Kramer, MS, Matush, L, Vanilovich, I, Platt, RW, Bogdanovich, N, Sevkovskaya, Z, Dzikovich, I, Shishko, G, Collet, JP, Martin, RM, Davey Smith, G, Gillman, MW, Chalmers, B, Hodnett, E Shapiro, S 2007, Effects of prolonged and exclusive breastfeeding on child height, weight, adiposity, and blood pressure at age 6.5 years: Evidence from a large randomized trial, American Journal of Clinical Nutrition, vol. 86, pp. 1717-1721. Lefebvre, CM John, RM 2014, The effect of breastfeeding on childhood overweight and obesity: A systematic review of the literature, Journal of the American Association of Nurse Practitioners, vol. 26, no. 7, pp. 386-401. Lucas, A Cole TJ 1990, Breast milk and neonatal necrotising enterocolitis. Lancet, vol. 336, pp .1519-1523. Martin, RM, Patel, R, Kramer, MS, Guthrie, L, Vilchuck, K, Bogdanovich, N, Bogdanovich, N, Sergeichick, N, Gusina, N, Foo, Y, Palmer, T, Rifas-Shiman, SL, Gillman, MW, Smith, GD Oken, E 2013, Effects of promoting longer-term and exclusive breastfeeding on adiposity and insulin-like growth factor-I at age 11.5 years: A randomized trial, Journal of the American Medical Association, vol. 309, pp. 1005-1013. National Health Service 2015, Why breastfeed?, National Health Service, London, UK, viewed 27 August 2015, https://www.nhs.uk/conditions/pregnancy-and-baby/pages/why-breastfeed.aspx Owen, CG, Martin, RM, Whincup, PH, Smith, GD Cook, DG 2005, Effect of infant feeding on the risk of obesity across the life course: a quantitative review of published evidence, Pediatrics, vol. 115, no. 5, pp. 1367-1377. Owen, CG, Martin, RM, Whincup, PH, Smith, GD Cook, DG 2006, Does breastfeeding influence risk of type 2 diabetes in later life? A quantitative analysis of publ ished evidence, American Journal of Clinical Nutrition, vol. 84, no. 5, pp. 1043-1054. Royal College of Paediatrics and Child Health 2012, Position statement: Childhood obesity, viewed 27 August 2015, Royal College of Paediatrics and Child Health, London, UK, https://www.rcpch.ac.uk/sites/default/files/page/obesitypositionstatement.pdf Savino, F, Liguori, SA, Fissore, MF Oggero, R 2009, Breast milk hormones and their protective effect on obesity, International Journal of Pediatric Endocrinology, EPUB. Vennemann, MM, Findeisen, M, Butterfass-Bahloul, T, Jorch, G, Brinkmann, B, Kopcke, W, Bajanowski, T Mitchell EA 2005, Modifiable risk factors for SIDS in Germany: results of GeSID, Acta Paediatricia, vol. 94, no. 6, pp. 655-660. World Health Organisation 2015, Overweight and obesity, World Health Organisation, Geneva, Switzerland, viewed 27 August 2015, https://www.who.int/mediacentre/factsheets/fs311/en/ Yan, J, Lin, L, Zhu, Y, Huang, G Wang, PP 2014, The associatio n between breastfeeding and childhood obesity: A meta-analysis, BMC Public Health, vol. 14, no. 1, pp. 467-490.

The Discovery Of Oil And Its Effects On The World With Energy

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Nursing Implications of Using Double Gloves During the Surgery

Question: Discuss about theNursing Implications of Using Double Gloves During the Surgery. Answer: Introduction Health workers experience to high risks in their work, especially in the operating room. Deadly viruses are prevalent. Thus the nurses should be adequately protected from them. Gloves safeguard their body from coming into contact with the victim's blood and fluid, and this minimizes their chances of infection. However, gloves can't withstand the long periods of operation due to tear and wear. Additionally, surgical teams do not change gloves during surgical operations. During this time the risk of contamination is high, and they need to use double gloves to reduce perforation and enhance protection from this blood bore pathogens (Partecke et al. 2009). According to Korniewicz El-Masri, (2012), they noted that double gloving was essential in reducing the number of surgical cross?infection. Health workers in their daily work experience to many risks of getting into contact with pathogens. Operation room must have high standards of cleanliness and the gloves to be used by the experts must be sterilized. These acts ensure no infection of the patients from the surgical team and also the team from the patients. Close contact with the blood increase the chances of infection. Double gloving have mainly two merits according to them. Firstly, it protects the workers from contamination by minimizing the contact with the victim's blood and fluids. Secondly, double gloving reduces the number of holes made to the innermost gloves. The holes may act as a passage for the pathogens to the worker's body. The inner glove is the barrier and protector of the worker. Although the study they conducted did not suggest that lack of double gloving caused c ontamination, the results indicated some possibility due to the perforations of the outer glove. Surgical wound contact with the surgical team member may result from infection from the microorganisms. The intact gloves are very useful ha they prevent this. Comparison between the use of single gloves and the use of single gloves by Laurikainen, Rintala, Kaarto Routamaa, (2016) shows the puncture rates of the gloves and the rates which the puncture of gloves was unnoticed during the operations periods. The study indicated that the holes in the single gloves were many than the double gloves used by the surgical team. The puncture in most cases went on unnoticed, and this is a significant exposure to danger to both the workers and the patients. In orthopedic and trauma surgery the surgeons using single gloves are in 13 times risk of blood infection than those using double gloving. The holes made to the inner gloves are also very few in double gloving. It is, therefore, important to use double gloving for ultimate protection (Uckay, Hoffmeyer, Lew Pittet,2013). According to Misteli et al. (2009), the surgical site infection increases when holes made in the gloves during the surgical operation. The surgical infection rate was 4.5%, and this showed that punctured gloves were hazardous. However, applying antibiotics to the gloves, the rate of infection was significantly low than without antimicrobial prophylaxis. These were the visible indication that absence antimicrobial prophylaxis the glove perforation increased the surgical site infection. Health workers have the duty to ensure that all people live the healthy life free from disease and suffering. From the above case studies, it is clear that health workers are exposed to infections as they carry out their daily activities of ensuring healthy living conditions. They are exposed to blood from the patients, and in the event, it is infected they may end up being infected with diseases. Not only workers are the risks of infections but also surgical wounds of patients may be infected in case of contact with the dirty environment and germs in the patient's bodies. It is ethical to ensure clean operations rooms for the safety of all the people. Gloves protect contamination but due to long hours in the surgery rooms by surgical teams they may end up having holes due to friction during work. This holes may cause infection, and therefore the workers should use two or more gloves to reduce contaminations in a case of puncture of the outer glove. Currently, diseases have emerged which are very dangerous and other with no cure like Ebola and HIV/AIDS respectively. These diseases claim many lives and their treatment are very costly to the people. The workers work in conditions where they are exposed to blood hence the high danger of contamination. Hospitals and health centers should ensure the protection of their works from infections. Surgical teams should use two, three or more gloves during the surgical operation instead of one glove. Double gloving reduces contact of the body of workers with the patients' blood and fluids during operations (Childs,2013). Surgical workers argue that double gloving has many disadvantages. Some argue that gloves make them feel uncomfortable when working. Majorly the reason behind the surgical team not using double gloving is based on lack of information and misconceptions. It is, therefore, crucial for the government and the health stakeholders to educate the health workers the benefits of double gloving in infection reduction. Using more gloves does not cost the workers anything, and therefore they should consider it. In the case of infections due to negligence and ignorance, the individuals will incur more expenses and may also die if infected by incurable diseases like HIV/AIDS. These can lead to emotional stress and poverty to the relatives. As they ensure healthy lives of also people, they should also monitor they lives to ensure continued service to the community (Papageorgiou,2015). In conclusion, double gloving reduces chances of infection compared to in cases of intraoperative glove perforation and needle stick injuries. Infection of the health workers is an occupational danger and therefore the staff should use double gloving to reduce any chances of infection. In summary, there is a lot of literature evidence that should double gloving reduces disease, and therefore the surgical team should use it. Prevention is better than cure and therefore all the people should campaign for double gloving. In the case of any accidents, quick actions should be taken to ensure good health of the health professionals. Care and attention should be made in all surgical operations. References Alexander, J. W., Solomkin, J. S., Edwards, M. J. (2011). Updated recommendations for control of surgical site infections.Annals of surgery,253(6), 1082-1093. Childs, T. (2013). Use of double gloving to reduce surgical personnels risk of exposure to blood borne pathogens: An integrative review.AORN journal,98(6), 585-596. Korniewicz, D., El-Masri, M. (2012). Exploring the benefits of double gloving during surgery.AORN journal,95(3), 328-336. Laurikainen, E., Rintala, E., Kaarto, A. M., Routamaa, M. (2016). Adherence to surgical hand rubbing directives in a hospital district of Southwest Finland*.Infectious Diseases,48(2), 116-121. Misteli, H., Weber, W. P., Reck, S., Rosenthal, R., Zwahlen, M., Fueglistaler, P., ... Marti, W. R. (2009). Surgical glove perforation and the risk of surgical site infection. Archives of Surgery, 144(6), 553-558. Papageorgiou, M. (2015). Double gloving in the operating theater: The benefits and the potential drawbacks. Australian Medical Student Journal, 6(2). Partecke, L. I., Goerdt, A. M., Langner, I., Jaeger, B., Assadian, O., Heidecke, C. D., ... Huebner, N. O. (2009). The incidence of micro perforation for surgical gloves depends on the duration of wear. Infection Control Hospital Epidemiology, 30(05), 409-414. Partecke, L. I., Goerdt, A. M., Langner, I., Jaeger, B., Assadian, O., Heidecke, C. D., ... Huebner, N. O. (2009). Incidence of micro perforation for surgical gloves depends on duration of wear.Infection Control Hospital Epidemiology,30(05), 409-414. Uckay, I., Hoffmeyer, P., Lew, D., Pittet, D. (2013). Prevention of surgical site infections in orthopedic surgery and bone trauma: state-of-the-art update.Journal of Hospital Infection,84(1), 5-12.

The representation of the working class northern man in Billy Elliot and The Full Monty Essay Example

The representation of the working class northern man in Billy Elliot and The Full Monty Paper Everyone has a stereotyped view about some one else, we prejudge people all the time, whether its because of their background, how they look or where they come from. In Billy Elliot and The Full Monty the director challenges the stereotype of the working class northern man; we see the men as the typical stereotype and the ways in which they over come it as the film progresses. I intend to explore the representation of these men in the two films, and show how the working class northern man alters to our stereotype on them. We get stereotypes from a number of different places, the way we are brought up and what our parents tell us has a major influence on what we think of them. We are also brain washed by the media, newspapers have their own opinions on the working class northern man and we also see it on television programs such as Coronation Street which is also set up North. My personal views on the working class northern man and the opinion I have accumulated from such sources are that, they find it hard to express their emotions and are quite aggressive and violent. We will write a custom essay sample on The representation of the working class northern man in Billy Elliot and The Full Monty specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The representation of the working class northern man in Billy Elliot and The Full Monty specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The representation of the working class northern man in Billy Elliot and The Full Monty specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The stereotype also includes that the working class northern man is sexist for example believing that the role of a women is in the house doing the typical household chores- which we see reference to this in The Full Monty. The stereotype also includes that they are proud, prejudice, traditional and not very well educated- speaking with a dialect, a lot of these men are quite poor so wouldnt be able to afford to go to school and would have to be out to work at a young age. No stereotype is false without truth behind it, we still see aspects of the stereotype in the film but we also see them overcoming these stereotypes and in a way, becoming modernised and less traditional. Beginning with Billy Elliot, the film is set in the 1980s during the miners strike which as can be imagined, caused a lot of poverty, tension and distrust between the strikers, police and scabs ( the name given to those who carried on working in the mines during the strike). The whole situation was very violent, every day police had to escort the scabs to the mines in fear of them being hurt by the strikers. The first time we see the picket line, the miners are shown in a de-humanised way. As there are so many of them, the director has given a birds eye view of the picket line, portraying the men as animals. We also see close ups of some of the men, de-picking expressions of their faces, the hatred and the anger they are feeling, giving the viewer a closer, more personal look at what emotions are going through these men at the time. This scene shows how masculine these men are, how aggressive and true to the stereotype there are by being abusive and violent- hurling fruits at the buses full of scabs. This scene is a good insight to Billys life, and as we see, further on in the film how his life is split between the dancing and his family in the miners strike. As I mentioned before, the common stereotype of the northern class working man, is that he is the man of the house, he is the one that earns the money and puts bread on the table, this is typical in Billy Elliot. Jackie is the father and in charge of the family, he has a lot of pride and has his own prejudice of, that it is a mans job to earn the money. The miners strike would have effected everyone, in particular the men, they were the ones that went out to work in the mines and once on strike no money would be coming in, we see this in Billy Elliot- the family are on strike and therefore have very little money to buy food. This brings out a lot of anger and frustration in both Jackie and Tony. Following on with Billys character, he is the central role and even though he is not fully a working class northern man. I would like to explore the way, as a young boy or a child in this type of society, he still differs from his family, yet keeping some traits that he accumulated from his up bringing. Billy is a caring boy, the way he is the only one that looks after his grandmother, he makes her food and takes care of her. He is understanding towards her being senile. His mother is dead, and later on in the film we see him looking after her grave and always remembering her by playing the piano, he trys hard at boxing even though hes rubbish so he doesnt let down his dad, and towards the end of the film we see him giving Michael a kiss good bye. He is not afraid to show his emotions and is very caring for a young boy, especially compared to his brother and father. However, he does have some parts of the stereotype in him, he can be quite aggressive, as we see when hes at the ballet school and hits the young boy. He has prejudices on other people, although not as much as his father and brother have. At the beginning of the film he is determined that boxing is for boys and ballet is for girls, once he crosses over to like ballet. We see a change in him and wants to make sure that Just cos I like ballet doesnt mean Im a puff which he tells Michael at Christmas, when he starts getting the wrong ideas! Billy has more self-control in himself than his father and how you would typical say a working class northern man has. His life is split in two, with his ballet life and his home life. A good example of how we see this is the way that every time he is dancing or happy his life switches back by a sudden noise. When he enters the house after his meeting with the dancing teacher, the bang of the door and its like a sudden flash, back to reality- as if hes living in his own little world, a sharp noise and it snaps him back to real life and his situation. His dancing is to escape his problems at home, the miners strike, his poverty it makes him feel electric like electricity. Its a means of expressing what he is feeling, without shouting or violence. We see this on numerous occasions during the film. Take, for example, the scene where the dance teacher comes to tell Jackie and Tony about Billys dancing audition. They cant believe he likes ballet and an argument arises between Tony and the dance teacher. Theres a good use of scene cutting here, we see Billy standing on the table above everyone else as hes not like this and wont rise to shouting. The scene then cuts to him in an outdoor loo, the director gives the sense that he is caged in, using metaphor, as this is exactly what he is. As the shouting gets more and more between Tony and dance teacher, Billy erupts and breaks the walls of the loo, bursting out dancing. Hes, in a way, erupting out of his brain, out of his life, hes so frustrated that he just wants to dance and prove to everyone. This is the turning of the film, once everyone realises that hes serious we start to see a change in Jackie and Tonys attitude towards him. Furthermore, as I mentioned before, Billys way of expressing is feelings is to dance. The very first private lesson with his teacher is a key scene in the film language of the film. We first see a long shot of the dance teacher by the window, the director has shown how lighting techniques and camera angles can give different atmospheres. In this scene all this contributes to a sense of nervousness and anticipation, a contrast to the noise and excitement of the boxing during the morning in the previous scene, this is a lot more mysterious and secretive. Even though Billy is never typically like the common stereotype of the working class northern man, he still has traits, which of course he would have considering his background. He still swears and gets aggressive at time, is determined in his dancing. Nethertheless we still see a change in him, he still had to overcome his prejudices in believe ballet was for girls, being quite sexist. By the end of the film, he is not afraid to show his emotions, he understands what Michael is (are references to his sexuality during the film). We still see how he is un-educated and hasnt got a very broad mind than others in the audition scene. Theres a lot of tension and embarrassment in the fact that Billy doesnt really know what to say or understands what he is being asked replying with dunno all the time. Coming from a poor working class background and speaking with a dialect makes him different from people living in London, he has his stereotyped views on people there thinking that there are snobbish and cant really understand them. Like when we see him punch the boy after his audition, we really see the difference between people in London- upper class families to those in the North in working class families. Billy is the one character though out the film, that differs from every one else. Hes young and interested in the world around him, he wants to make something of himself and get away from the poverty that surrounds him. In my opinion hes the one that changes people, he makes Tony and Jackie realise where there prioritys lie and that not everything evolves around the miners strike. He changes and becomes even more independent, not afraid to ask and to show what he is. And by the end of the film we see how he is, hes done what he wanted to do, gained respect. Grown from a boy to a man. And hes not a puff! Following on with Jackies character, Billy and Tonys father. He is very much the man of the house; hes had to take on the role of the mother and father, after his wife has died. He is what you would call the typical working class northern man. Hes proud in believing that its his job to earn the money, and wont accept charity from the dance teacher to pay for the journey to London. Hes sexist in saying that ballet is for girls, lads do boxing, football wrestling, not frigging ballet. He cant understand why Billy would want to do ballet instead of boxing like he and his father did. His pride has been hurt, and he probably thinks Billys doing it against him, hes traditional in this way as well. Hes also aggressive and quite violent, when we see him with all the other miners on the picket line hurling abusive at the scabs. When see him shouting at Billy on several occasions at the start of the film, when Billy is playing the piano and Jackie shouts at him, and during the middle of the film we see the incident where he hits Tony. I think he sometimes struggles to keep his status and needs to make sure that everyone knows whos boss. In contrast to this, we do see Jackies sensitive side and the part that goes against the stereotype. After the scene with him shouting at Billy we see him change and put a 50p on the fridge for his boxing, so he doesnt go out the house feeling angry with him. We see this side from very early on but only does it change further on in the film when he realises Billy is serious on ballet. He overcomes his personal views about the issue and trys to talk to Billy about it. An extremely powerful scene with Jackie is when he decides to go back to work, be a scab, so that he can get money for Billy to go for his audition. He wants to do whats right and help Billy, he realises that he doesnt know anything about Billy he could be a genius for all we know. When Tony realises what his father his doing he chases after him, Jackie breaks down. He knows the situation he is in, Tony re- assures him that well get the money some how. Jackie is the father, and knows he is the only one that can provide for the family, hes older and is less excited than Tony about the strike. Hes wise and wants to do whats best. Throughout the film we see Jackie cry a total of 3 times, on the picket line, at Christmas and happy crying when he sees Billy in London in a show. The director challenges his stereotype the most, we all know he is the character that most typically resembles the working class northern man. To show how he differs from it, the director as made him change. Making the viewer see how he isnt totally like the brand, we have put on him. He has a sensitive side, and on those 3 occasions isnt afraid or embarrassed to show it. He is only human, after all! The third male in Billys family and that can be classed, as a working class northern man is Tony. He is a lot older than Billy and therefore hasnt got very many things on common. Hes a rebel and excited for the strike, to him its a game and he wants to use violence and abuse at the scabs. In several scenes we see that hes very negative and thinks hes right he blocks out Billy incredibly and only when Jackie accepts the ballet does Tony. One of the scenes that reflects Tonys character and the position he is in, is the scene where we see him running away from the police. Music is used effectively here, The Clashs London Calling- a loud a rebellious song, a perfect choice reflecting upon Tonys character and the scene itself giving it atmosphere and character. We can see how Tony is excited and enjoying the chase, running through houses and washing. This is probably the only scene that we see Tony acting slightly younger than he is through out the film, this chase is like a game to Tony- like a small child. The whole chase seems quite childish, and is a nice link to Billy, as we see Billy running a lot- the director has shown that despite all their arguments Tony and Billy have some similarities. The scene ends with the police catching up with Tony, this time they are being de-humanised, stand all in one big mass, beating on their shields sounding quite tribal, a massive difference from the chase minutes before- which was quite fun, it has now turned rather nasty. We see this a lot during the film, how Billys life changes suddenly from being happy with the dancing, to the natural truth of his life- his familys situation in the miners strike. Similarly to Jackie, Tony has trouble when dealing with his emotions, and prefers to be abusive than talk for example when Billy asked what Tony thought about death he just replied with F*** off. This giving the impression that he was quite arrogant and thought he was better than Billy (because hes older), and doesnt want to answer his questions or even talk to him. Two key scenes reflect Tonys sensitive, one with Jackie as he breaks down on the picket line and right at the end when Tony mouths Ill miss you to Billy. Like is mentioned before the scene with both Jackie and Tony on the picket line is a very powerful emotional scene. We see how the roles are reversed and Tony has to comfort his father reassuring him that everything will be ok. On the other hand, in my view he seems rather embarrassed and slightly worried about what hes friends would think if his father became a scab. However, we do see this caring side to him, along with the scene at the end, as Billy departs on his way to ballet school. Tony trys to act hard through out the film, trying to maintain his stereotype. The director has represented him as a fill in to the family, he is in between Jackie and Billy. Despite his very masculine approach to everything and thinking hes better than every one else, we see a different side to him in the scene when his father hits him. Personally, I find that there is quite a struggle between Jackie and Tony as to who is man of the house, both of them are un-employed and that weakens Jackie. This scene is powerful, there is no music and its set in the darkness of the kitchen, creating an atmosphere. Tony wants to go out and do some damage to the scabs but Jackie wont let him, he calls him a disgrace and tells him your nothing since mum died, this is the trigger and Jackie hits him. Its an action to punish him for what he has said and also to put him in his place. Jackie wants to make sure Tony realises whos boss and he does, Tony doesnt hit him back after a pure sign of respect. Tony is probably the one person that I feel doesnt change as much as Billy or Jackie, we do see him differing from his stereotype but not as much. Hes still very much, the aggressive, abusive, rebellious person you would imagine. None the less, he does begin to respect Billy and he loses his prejudices of ballet, whereas before he thought that, like Jackie did, ballet is for girls. We see a more caring and sensitive side to him as the film progress, he becomes more understanding and more adult- realises his situation and position, like Jackie does. There are a couple of other characters in Billy Elliot film that should be mentioned because there are working class northern men and I would like to show how not all are typically like their stereotype. Take for instance Michael. Hes the complete opposite to how the stereotype is, hes very feminine and not afraid to show it, hes caring and compassionate towards Billy. We see him experimenting with his sisters make-up and clothes, and puts on a tu-tu that Billy gets for him, at Christmas. He has his own prejudices, as he thinks that because Billy likes ballet he must be homosexual. Hes really not what you would expect from a person in that society but of course it happens and the director has given Michael as a good example of this. Even in that situation some people are different and have hardly any qualities of the stereotyped view of the working class northern man. Another person in Billy Elliot classed as the northern class working man, who actually, because of his situation, differs from the classic stereotype. The dance teachers husband is a middle-class man, they live in a good area, with a bigger house than Billys family, however he has been made redundant. Which shows that it wasnt just the working class people that were unemployed in the 1980s, middle class people were made re-dundatent maybe because of the lack of produce beign sold and not being able to pay for extra employees? In this example, the roles are reversed and the dance teacher is still at work whereas her husband isnt, she is the main earner in the house, this going against the stereotype as being the man is proud and is the provider. The dance teachers husband, doesnt seem to mind, he realises the situation the miners are in and is disinterested. A common feeling men would have been feeling in that situation ( as we see later in The Full Monty) some men just seemed to give up believing that, that was it. Looking at film language in Billy Elliot, I have found that each character is represented in a different way, Billy is always wearing quite bright colours and in lots of scenes with him in there is music which reflects upon is personality. Whereas Jackie and Tonys characters are more mysterious and even though there is a scene where everyone is dancing to the same tune there isnt as much happy filming with them. The use of scene cutting between the miners and Billy dancing is used to great effect creating a massive contrast between the two, making the miners scene more powerful and effective. The use of long shot camera angle is good as well, the classic part in the film of Billy running up the hill and later with his father doing the same. Looking at the very last scene of the film, an extremely moving piece. The film has moved on about 7-10 years, we see Jackie has aged, having grey hair. They have come to watch Billy in a performance of Swan Lake (a link from when the dance teacher took Billy to played him the piece of music). Little is said by Billy as he waits in the wings, the music of the ballet piece is played and we see Billy warming up and getting ready to go on. The music and the way Billy is acting builds up incredible tension and enthusiasm. The scene cuts to Jackie and back again, we see Billy rush on stage and the scene cuts back to Jackie where he gasps/crys in amazement. We see a close up on his face to see his sense of pride and astonishment. The film ends with a picture of Billy mid air, in a jump. Personally, I feel this last scene is the most memorable of the whole film, I was really into it. The way it has been filmed really gets the viewer to actually believe what is going on. It feels as if your Billy and Jackie, feeling nervous, excited and amazed. Best part of the film for me!

Adam Lanza’s Smashed Hard Drive Doesn’t Erase His Digital Footprint Essay Sample free essay sample

Before traveling on a homicidal violent disorder last hebdomad. Adam Lanza reportedly took a dramatic measure to wipe out his digital history: He removed the difficult thrust from his computing machine and smashed it with either a cock or screwdriver. By making so. he may hold destroyed valuable grounds that would assist research workers understand his motivations for killing his female parent. 20 first-graders and six school employees at a Sandy Hook Elementary School in Connecticut Friday. But in the age of cloud computer science and multiple Internet-connected devices. governments have no deficit of ways to follow his online footmarks for hints. from geting his electronic mails and hunt history to obtaining his online correspondence while he reportedly played â€Å"Call of Duty† on Xbox. experts said. â€Å"Your Internet history is really revealing. † said Monique Ferraro. an lawyer and digital forensics expert. â€Å"Even without a difficult thrust. if he was on the Internet. We will write a custom essay sample on Adam Lanza’s Smashed Hard Drive Doesn’t Erase His Digital Footprint Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page and most people are. research workers will be able to state rather a spot about what he was making. where he was traveling and what he was believing. † Lanza. 20. was reportedly expert at computing machines. belonging to a engineering nine at his high school. harmonizing to the Associated Press. Yet he besides left research workers with a comparatively light digital trail to follow. In add-on to destructing his difficult thrust. hereportedly did non hold a Facebook or Twitter history. Lanza’s difficult thrust would hold been valuable because it probably stored paperss and records of his Web browse history. said Jeff Pederson. the company’s director of informations recovery operations Kroll Ontrack. Kroll Ontrack. which specializes in informations recovery. has retrieved grounds from difficult thrusts damaged by inundations. fires. and even a liquid disc thrust from the infinite bird Columbia. which was destroyed in 2003. Whether or non a difficult thrust can be salvaged depends on the extent of harm to what are called â€Å"platters. † the little phonograph record where the information is stored. Pederson said. If those phonograph records are shredded or broken. â€Å"the opportunities are really slender that we’re traveling to be able to make something with that. † Pederson said. By damaging his difficult thrust. Lanza made it â€Å"tremendously more difficult† for research workers to patch together his online activities. said David McGroty. manager of forensic operations at Flashback Data. But non impossible. If he owned a tablet or smartphone. research workers could utilize informations extraction package to see his contacts. calendar information. text messages. images. location history. and shoping history. And if. for illustration. Lanza used Google for electronic mail or Web hunt. jurisprudence enforcement functionaries will probably subpoena the company to derive entree to the content of his electronic mails or what sites he visited after carry oning a Google hunt. harmonizing to experts. As the recent electronic mail dirt affecting retired Gen. David Petraeus highlighted. it’s really hard to conceal the inside informations of correspondence from jurisprudence enforcement — even for the manager of the CIA. What’s more. Lanza’s reported compulsion with â€Å"Call of Duty. † a first-person taw picture game. may besides offer hints. Microsoft’s Xbox allows participants to join forces with each other online while playing the game. Such conversations. if they exist. are likely stored in the game console and could supply research workers with information that he sent other participants and subjects they discussed. Ferraro said. â€Å"They’re traveling to be looking at all of his material. his thumb thrusts. any removal media where he may hold stored anything. † Ferraro said. â€Å"They’ll expression at his Internet activity and see a batch of circumstantial grounds about what he was making in the last several months. †

See If Vitamin C Is an Organic Compound

See If Vitamin C Is an Organic Compound Yes, vitamin C is an organic compound. Vitamin C, also known as ascorbic acid or ascorbate, has the chemical formula C6H8O6. Because it is comprised of carbon, hydrogen, and oxygen atoms, vitamin C is classified as organic, whether or not it comes from a fruit, is made within an organism, or is synthesized in a laboratory. What Makes Vitamin C Organic In chemistry, the term organic refers to carbon chemistry. Basically, when you see carbon in a compounds molecular structure, this is a hint youre dealing with an organic molecule. However, simply containing carbon isnt sufficient, as some compounds (e.g., carbon dioxide) are inorganic. Basic organic compounds also contain hydrogen, in addition to carbon. Many also contain oxygen, nitrogen, and other elements, although these arent essential in order for a compound to be classed as organic. You may be surprised to learn vitamin C isnt just one specific compound, but rather, a group of related molecules called vitamers. The vitamers include ascorbic acid, the ascorbate salts, and oxidized forms of ascorbic acid, such as dehydroascorbic acid. In the human body, when one of these compounds is introduced, metabolism results in the presence of several forms of the molecule. The vitamers act primarily as cofactors in enzymatic reactions, including collagen synthesis, antioxidant activity, and wound-healing. The molecule is a stereoisomer, where the L-form is the one with biological activity. The D-enantiomer is not found in nature but can be synthesized in a lab. When given to animals that lack the ability to make their own vitamin C (such as humans), D-ascorbate has less cofactor activity, even though it is an equally potent antioxidant. Vitamin C From Pills Man-made or synthetic vitamin C is a crystalline white solid derived from the sugar dextrose (glucose). One method, the Reichstein process, is a combined microbial and chemical multi-step method of producing ascorbic acid from D-glucose. The other common method is a two-step fermentation process. Industrially synthesized ascorbic acid is chemically identical to vitamin C from a plant source, such as an orange. Plants typically synthesize vitamin C by enzymatic conversion of the sugars mannose or galactose into ascorbic acid. Although primates and a few other kinds of animals dont produce their own vitamin C, most animals do synthesize the compound and can be used as a source of the vitamin. So, organic in chemistry has nothing to do with whether a compound was derived from a plant or an industrial process. If the source material was a plant or animal, it doesnt matter whether the organism was grown using organic processes, such as free-range grazing, natural fertilizers, or no pesticides. If the compound contains carbon bonded to hydrogen, its organic. Is Vitamin C an antioxidant? A related question concerns whether or not vitamin C is an antioxidant. Regardless of whether its natural or synthetic and whether its the D-enantiomer or the L-enantiomer, vitamin C is an antioxidant. What this means is that ascorbic acid and the related vitamers are capable of inhibiting oxidation of other molecules. Vitamin C, like other antioxidants, acts by being oxidized itself. This means vitamin C is an example of a reducing agent.

Creating quality manual Essay Example | Topics and Well Written Essays - 500 words

Creating quality manual - Essay Example Mcginn Knightsbridge's assurance to quality begins with using the most luxurious European fabric that resists wrinkles and stays in shape at all times. Every product reflects our strong passion for quality and commitment towards excellence. Our commitment to quality and value ensures that the products the customers purchase from Mcginn Kightbridge provide superior performance day-in and day-out. Most of the fabrics are imported, and all fabrics are tested carefully. Especially for the wool pant, Mcginn Kightbridge uses high-twist wool, known for its extra-long fibers spun into a silky finish for an excellent drape. Since Mcginn Kightbridge uses best fabric in the Mcginn Kightbridge use tested fabrics. The testing process is divided into three different sections, like abrasion resistance, strength for "durability" test, absorbency for "comfort" test, and resiliency and pilling resistance for "appearance" test. After these steps, we have testing such as Test method 111, Test method 192 and Test method 107 etc. At Mcginn Kightbridge every test and step that is required to ensure 10% customer satisfaction, is carried out. Mcginn Kightbridge uses computer management system for achieving higher proficiency. Mcginn Kightbridge use different dying systems depending on fabrics, and trims.