Source Review for Text Essay Example for Free

Source Review for Text Essay In the article â€Å"Unleashing the power of the annual report at DTCC†, Goldstein (2005) points out the reason why communication opportunity and unique marketing should be seized. This article is related to the report of efficiently communicating of the annual report; however, it is not a useful source for its limited relevance and potential bias. This article is about marketing process and communication. Goldstein (2005) argues that annual report cannot reach readers whatever in which form, online or printed, if the report is not modern. In order to support this argument, Goldstein presents several advantages of annual reports. Annual report provides a chance to coherent forward-looking stories and to shows how to perceive a company. A company’s annual report is also the best opportunity to leave a deep impression to shareholders so that staffs can provide a â€Å"unique voice† to tell a clear and consistent story about the direction and increasingly diverse shareholder audience can be resonated with staffs. There is potential bias on the part of the author, which is a decrease to the reliability of the source. Base on his own experience and opinion, Goldstein (2005) makes his opinion subjective. Else, the author is a managing director of Depository Trust and Cleaning Corporations (DTCC); this reduces the reliability of the information since it can be viewed as a form of self-promotion. The limitation is that the author puts himself in DTCC’s position, and it makes his opinion narrow. Although the author offers some suitable advice on making a better annual report, for instance, choosing a central theme and developing a secondary theme, etc. Most of the examples come from author’s personal experience, so there is not enough evidence to prove the author’s opinion. Goldstein, S, 2005, â€Å"Unleashing the power of the annual report at DTCC†, Strategic Communication Management, Vol.9, Issue.3, P30-33.

Water fluoridation

Water fluoridation ABSTRACT The safety and efficacy of water fluoridation has been a topic of great controversy throughout Americas communities. Scientific evidence has shown that ingesting low to moderate levels of fluoride can benefit the dental health of a community, especially those populations in a community that may be classified as having low socioeconomic status. Children in all areas, but especially those with low SES, are at greatest risk for developing dental caries and having a community water fluoridation program (CWFP) will help them reduce their dental caries. Moderation of fluoride ingestion for individuals is the key. Low to moderate daily ingestion of fluoride, averaging 1.0 mg/liter per day is optimum. Dental and skeletal fluorosis can occur if ingestion levels are greater than 3.0 mg/liter per day for long periods of time. This is a discussion on the safety and efficacy of water fluoridation. INTRODUCTION This commentary presents the on-going controversy on community water fluoridation in the United States, and I will attempt to analyze science-based evidence in support of water fluoridation. There have always been questions on the safety and efficacy of fluoride in drinking water, some school of thought believes that fluoridation has some adverse effects to exposed human populations, especially in infants and children. Another school of thought believes that water fluoridation is essential in preventing tooth decay, and therefore the practice should be sustained. According to the Center for Disease Control and prevention (CDC) water fluoridation is one of the 10 great public health achievements of the 20th century in the United States (CDC, 1999), which is attributable for increased lifespan of Americans by 25 years ( Bunker et al., 1994). This paper will discuss science-based evidence that proves the efficacy and safety of water fluoridation among children as well as offer some reco mmendations to the various stakeholders. POSITION STATEMENT Water fluoridation is the adjustment of the concentration level to the optimally regulated level of which the naturally occurring fluoride presents in public or community drinking water supplies. In most cases, deflouridation is needed when the naturally occurring fluoride level exceeds recommended limits. The recommended fluoride concentration in drinking water by the U.S. Public Health Service (PHS) is 0.7-1.2mg/L, to effectively prevent dental caries and minimize the occurrence of dental fluorosis (NRC, 2006). Low decay rates were found to be associated with continuous use of water with fluoride content of 1ppm (Meskin, 1995). There has been serious questions as to the efficacy of fluoride intervention in preventing both tooth decay, as it benefit is said to be merely cosmetic or topical (CDC, 1999). Such topical effect of fluoride can be achieved by the use tooth without the risking the overexposure from ingested fluoride (NRC, 2006). However, it has also been reported that fluor ide exposure provides both systemic and topical protection. Ingested fluoride deposited on tooth surface during tooth formation, and fluoride contained in saliva provides long-lasting systemic protection against booth tooth decay than topical application using tooth paste or fluoride foams (CDC, 2001). WHAT IS FLUORIDE Fluoride is a naturally occurring element. It is found in rocks and soil everywhere. Fluoride can be found in fresh water and ocean water. Naturally occurring fluoride levels ranges from 0.1ppm to over 12ppm (NRC, 2006).Fluoride is present in the customary diets of people and in most portable water sources. The average dietary intake of fluoride is approximately 0.5mg daily from either naturally occurring fluoride in the water or the fluoride found in produce. It is also a normal component of tooth enamel and bone studies have shown that the calcified tissues of both enamel and bone are made up of a combination of hydroxyl- and fluor-apatites of varying composition depending on the abundance of fluoride at the site of formation. These tissues are the principal sites of deposition of fluoride (NRC, 2006). HOW FLUORIDE PREVENTS AND CONTROLS DENTAL CARIES Dental caries is an infectious, transmissible disease in which bacterial by-products (i.e., acids) dissolve the hard surfaces of teeth. Unchecked, the bacteria can penetrate the dissolved surface, attack the underlying dentin, and reach the soft pulp tissue. Dental caries can result in loss of tooth structure, pain, and tooth loss and can progress to acute systemic infection. Cryogenic bacteria (i.e., bacteria that cause dental caries) reside in dental plaque, a sticky organic matrix of bacteria, food debris, dead mucosal cells, and salivary components that adheres to tooth enamel. Plaque also contains minerals, primarily calcium and phosphorus, as well as proteins, polysaccharides, carbohydrates, and lipids. Cryogenic bacteria colonize on tooth surfaces and produce polysaccharides that enhance adherence of the plaque to enamel. Left undisturbed, plaque will grow and harbor increasing numbers of cryogenic bacteria. An initial step in the formation of a carious lesion takes place when cryogenic bacteria in dental plaque metabolize a substrate from the diet (e.g., sugars and other fermentable carbohydrates) and the acid produced as a metabolic by-product demineralizes (i.e., begins to dissolve) the adjacent enamel crystal surface (CDC,2009). Demineralization involves the loss of calcium, phosphate, and carbonate. These minerals can be captured by surrounding plaque and be available for reuptake by the enamel surface. Fluoride, when present in the mouth, is also retained and concentrated in plaque. Fluoride works to control early dental caries in several ways. Fluoride concentrated in plaque and saliva inhibits the demineralization of sound enamel and enhances the remineralization (i.e., recovery) of demineralized enamel (Featherstone, 1999 Koulourides, 1990). As cryogenic bacteria metabolize carbohydrates and produce acid, fluoride is released from dental plaque in response to lowered pH at the tooth-plaque interface. The released fluoride and the fluoride present in saliva are then taken up, along with calcium and phosphate, by de-mineralized enamel to establish an improved enamel crystal structure. This improved structure is more acid resistant and contains more fluoride and less carbonate (Featherstone, 1999). Fluoride is more readily taken up by demineralized enamel than by sound enamel. Cycles of demineralization and remineralization continue throughout the lifetime of the tooth. Fluoride also inhibits dental caries by affecting the activity of cryogenic bacteria. As fluoride concentrates in dental plaque, it inhibits the process by which cryogenic bacteria metabolize carbohydrates to produce acid and affects bacterial production of adhesive polysaccharides. In laboratory studies, when a low concentration of fluoride is constantly present, one type of cryogenic bacteria, Streptococcus mutans, produces less acid. Whether this reduced acid production reduces the carcinogenicity of these bacteria in humans is unclear (Van Loveren, 1990). Saliva is a major carrier of topical fluoride. The concentration of fluoride in ductal saliva, as it is secreted from salivary glands, is low approximately 0.016 parts per million (ppm) in areas where drinking water is fluoridated and 0.006ppm in non fluoridated areas. This concentration of fluoride is not likely to affect cryogenic activity. However, drinking fluoridated water, brushing with fluoride toothpaste, or using other fluoride dental products can raise the concentration of fluoride in saliva present in the mouth 100- to 1,000-fold. The concentration returns to previous levels within 12 hours but, during this time, saliva serves as an important source of fluoride for concentration in plaque and for tooth remineralization (Murray,1993). Applying fluoride gel or other products containing a high concentration of fluoride to the teeth leaves a temporary layer of calcium fluoride-like material on the enamel surface. The fluoride in this material is released when the pH drops in the mouth in response to acid production and is available to remineralize enamel. In the earliest days of fluoride research, investigators hypothesized that fluoride affects enamel and inhibits dental caries only when incorporated into developing dental enamel (i.e., preeruptively, before the tooth erupts into the mouth) (Murray,1993). Evidence supports this hypothesis, but distinguishing a true preeruptive effect after teeth erupt into a mouth where topical fluoride exposure occurs regularly is difficult. However, a high fluoride concentration in sound enamel cannot alone explain the marked reduction in dental caries that fluoride produces . The prevalence of dental caries in a population is not inversely related to the concentration of fluoride in enamel, and a higher concentration of enamel fluoride is not necessarily more efficacious in preventing dental caries (Mcdonagh etal.,2000). The laboratory and epidemiologic research that has led to the better understanding of how fluoride prevents dental caries indicates that fluorides predominant effect is post eruptive and topical and that the effect depends on fluoride being in the right amount in the right place at the right time. Fluoride works primarily after teeth have erupted, especially when small amounts are maintained constantly in the mouth, specifically in dental plaque and saliva (Mcdonagh etal., 2000). Thus, adults also benefit from fluoride, rather than only children, as was previously assumed. RISK FOR DENTAL CARIES The prevalence and severity of dental caries in the United States have decreased substantially during the preceding 3 decades. National surveys have reported that the prevalence of any dental caries among children aged 1217 years declined from 90.4% in 19711974 to 67% in 19881991; severity (measured as the mean number of decayed, missing, or filled teeth) declined from 6.2 to 2.8 during this period (Burt, 1989). These decreases in caries prevalence and severity have been uneven across the general population; the burden of disease now is concentrated among certain groups and persons. For example, 80% of the dental caries in permanent teeth of U.S. children aged 517 years occurs among 25% of those children. Populations believed to be at increased risk for dental caries are those with low socioeconomic status (SES) or low levels of parental education, those who do not seek regular dental care, and those without dental insurance or access to dental services (Meskin,1995). Persons can be at high risk for dental caries even if they do not have these recognized factors. Children and adults who are at low risk for dental caries can maintain that status through frequent exposure to small amounts of fluoride (e.g., drinking fluoridated water and using fluoride toothpaste). Children and adults at high risk for dental caries might benefit from additional exposure to fluoride (e.g., mouth rinse, dietary supplements, and professionally applied products). All available information on risk factors should be considered before a group or person is identified as being at low or high risk for dental caries. However, when classification is uncertain, treating a person as high risk is prudent until further information or experience allows a more accurate assessment. This assumption increases the immediate cost of caries prevention or treatment and might increase the risk for enamel fluorosis for children aged NATIONAL GUIDELINES FOR FLUORIDE USE PHS recommendations for fluoride use include an optimally adjusted concentration of fluoride in community drinking water to maximize caries prevention and limit enamel fluorosis. This concentration ranges from 0.7ppm to 1.2ppm depending on the average maximum daily air temperature of the area (PHS, 1991). In 1991, PHS also issued policy and research recommendations for fluoride use. The U.S. Environmental Protection Agency (EPA), which is responsible for the safety and quality of drinking water in the United States, sets a maximum allowable limit for fluoride in community drinking water at 4ppm and a secondary limit (i.e., non-enforceable guideline) at 2ppm (EPA,1998). The U.S. Food and Drug Administration (FDA) is responsible for approving prescription and over-the-counter fluoride products marketed in the United States and for setting standards for labeling bottled water and over-the-counter fluoride products (e.g., toothpaste and mouth rinse) (ADA,2007). Nonfederal agencies also have published guidelines on fluoride use. The American Dental Association (ADA) reviews fluoride products for caries prevention through its voluntary Seal of Acceptance program; accepted products are listed in the ADA Guide to Dental Therapeutics (ADA, 2007). A dosage schedule for fluoride supplements for infants and children aged 16 years, which is scaled to the fluoride concentration in the community drinking water, has been jointly recommended by ADA, the American Academy of Pediatric Dentistry (AAPD), and the American Academy of Pediatrics (AAP) (Meskin,1995). In 1997, the Institute of Medicine published age-specific recommendations for total dietary intake of fluoride. These recommendations list adequate intake to prevent dental caries and tolerable upper intake, defined as a level unlikely to pose risk for adverse effects in almost all persons. COST-EFFECTIVENESS OF FLUORIDE MODALITIES Documented effectiveness is the most basic requirement for providing a health-care service and an important prerequisite for preventive services (e.g., caries-preventive modalities). However, effectiveness alone is not a sufficient reason to initiate a service. Other factors, including cost, must be considered. A modality is more cost-effective when deemed a less expensive way, from among competing alternatives, of meeting a stated objective (Garcia,1989). In public health planning, determination of the most cost-effective alternative for prevention is essential to using scarce resources efficiently. Dental-insurance carriers are also interested in cost-effectiveness so they can help purchasers use funds efficiently. Because half of dental expenditures are out of pocket (Garcia, 1989), this topic interests patients and their dentists as well. Potential improvement to quality of life is also a consideration. The contribution of a healthy dentition to quality of life at any age has not been quantified, but is probably valued by most persons. Although solid data on the cost-effectiveness of fluoride modalities alone and in combination are needed, this information is scarce. In 1989, the Cost Effectiveness of Caries Prevention in Dental Public Health workshop, which was attended by health economists, epidemiologists, and dental public health professionals, attempted to assess the cost-effectiveness of caries-preventive approaches available in the United States (Downer et al., 1981). Community Water Fluoridation Health economists at the 1989 workshop on cost-effectiveness of caries prevention calculated that the average annual cost of water fluoridation in the United States was $0.51 per person (range: $0.12$5.41) (Burt, 1989). In 1999 dollars, this cost would be $0.72 per person (range: $0.17$7.62). Factors reported to influence the per capita cost included: size of the community (the larger the population reached, the lower the per capita cost); number of fluoride injection points in the water supply system; amount and type of system feeder and monitoring equipment used; amount and type of fluoride chemical used, its price, and its costs of transportation and storage; and expertise of personnel at the water plant. When the effects of caries are repaired, the price of the restoration is based on the number of tooth surfaces affected. A tooth can have caries at >1 location (i.e., surface), so the number of surfaces saved is a more appropriate measure in calculating cost-effectiveness than the number of teeth with caries. The 1989 workshop participants concluded that water fluoridation is one of the few public health measures that results in true cost savings (i.e., the measure saves more money than it costs to operate); in the United States, water fluoridation cost an estimated average of $3.35 per carious surface saved ($4.71 in 1999 dollars). Even under the least favorable assumptions in 1989 (i.e., cities with populations A Scottish study conducted in 1980 reported that community water fluoridation resulted in a 49% saving in dental treatment costs for children aged 45 years and a 54% saving for children aged 1112 years (Downer et al., 1981). These savings were maintained even after the secular decline in the prevalence of dental caries was recognized. The effect of community water fluoridation on the costs of dental care for adults is less clear. This topic cannot be fully explored until the generations who grew up drinking optimally fluoridated water are older. School Water Fluoridation Costs for school water fluoridation are similar to those of any public water supply system serving a small population (i.e., Assessment of the Adverse Health Effects of fluoride Evidence of the adverse health effects of prolonged exposure to high concentrations of fluoride are well documented by several peer reviewed studies, which are examined in this paper. Higher concentrations of total ingested fluoride from potential sources like drinking water, food and beverages, dental-hygiene products such as toothpaste, and pesticide residues can have adverse health effects on humans (NRC, 2006). Some of the adverse health effects of fluoride in drinking water are enamel fluorosis, skeletal fluorosis, bone cancer and bone fracture. (NRC, 2006, PHS, 1991). Fluorosis is caused mainly by the ingestion of fluoride in drinking water (Viswanathan et al., 2009). Fluoride has high binding affinity for developing enamel and as such high concentration of cumulative fluoride during tooth formation can lead to enamel fluorosis, a dental condition from mild to severe form characterized by brown stains, enamel loss and surface pitting (DenBesten Thariani, 1992). These dental ef fects are believed to be caused by the effects of fluoride on the breakdown rates of early-secreted matrix proteins, and on the rates at which the degraded by-products are withdrawn from the maturing enamel (Aoba Fejerskov, 2002). Children are much more at risk of enamel fluorosis, especially in their critical period from 6 to 8 years of age, than adults. Fluoride uptake into enamel is possible only as a result of concomitant enamel dissolution, such as caries development (Fejerskov, Larsen, Richards, Baelum, 1994). There is a 10% prevalence of enamel fluorosis among U.S. children in communities with water fluoride concentrations at or near the EPAs MCLG of 4 mg/L (NRC, 2006). The CDC estimates that 32% of U.S. children are diagnosed with dental fluorosis (CDC, 2005). Today, there are convincing evidence that enamel fluorosis is a toxic effect of fluoride intake, and that its severe forms can produce adverse dental effects, and not just adverse cosmetic effects in humans (NRC, 200 6). Burt and Eklund (1999) states: â€Å"The most severe forms of fluorosis manifest as heavily stained, pitted, and friable enamel that can result in loss of dental function†. Epidemiological data from both observational and clinical studies have been examined. Sowers, Whitford, Clark Jannausch (2005) investigated prospectively for four years bone fracture in relation to fluoride concentrations in drinking water in a cohort study, by measuring serum fluoride concentrations and bone density of the hip, radius, and spine. The authors reported higher serum fluoride concentrations in the communities with fluoride concentrations at 4 mg/L in drinking water; and higher osteoporotic fracture rates in the high fluoride areas that were similar to those in their previous studies in 1986 and 1991. It is unclear in their recent study whether existing factors in the population like smoking rates, hormone replacement and physical activity were examined as potential cofounders for fractures. Fasting serum fluoride concentrations are considered a good measure of long-term exposure and of bone fluoride concentrations (Whitford, 1994; Clarkson et al., 2000). Findings by t he Sowers studies were complemented in several ways by Li et al. (2001) in a retrospective cohort ecologic study. The combined findings of Sowers et al. (2005) and Li et al., (2001) lend support to the biological gradients of exposures and fracture risk between 1 and 4 mg/L of fluoride concentration. Evidently, the physiological effect of fluoride on â€Å"bone quality† and the fractures observed in the referenced animal studies are consistent with the effects found in the observational studies. RECOMMENDATIONS Before promoting a fluoride modality or combination of modalities, the dental-care or other health-care provider must consider a persons or groups risk for dental caries, current use of other fluoride sources, and potential for enamel fluorosis. Although these recommendations are based on assessments of caries risk as low or high, the health-care provider might also differentiate among patients at high risk and provide more intensive interventions as needed. Also, a risk category can change over time; the type and frequency of preventive interventions should be adjusted accordingly. Continue and Extend Fluoridation of Community Drinking Water Community water fluoridation is a safe, effective, and inexpensive way to prevent dental caries. This modality benefits persons in all age groups and of all SES, including those difficult to reach through other public health programs and private dental care (CDC, 2001a). Community water fluoridation also is the most cost-effective way to prevent tooth decay among populations living in areas with adequate community water supply systems. Continuation of community water fluoridation for these populations and its adoption in additional U.S. communities are the foundation for sound caries-prevention programs. In contrast, the appropriateness of fluoridating stand-alone water systems that supply individual schools is limited. Widespread use of fluoride toothpaste, availability of other fluoride modalities that can be delivered in the school setting, and the current environment of low caries prevalence limit the appropriateness of fluoridating school drinking water at 4.5 times the optimal concentration for community drinking water. Decisions to initiate or continue school fluoridation programs should be based on an assessment of present caries risk in the target school(s), alternative preventive modalities that might be available, and periodic evaluation of program effectiveness (CDC, 2001a). Frequently Use Small Amounts of Fluoride All persons should receive frequent exposure to small amounts of fluoride, which minimizes dental caries by inhibiting demineralization of tooth enamel and facilitating tooth remineralization. This exposure can be readily accomplished by drinking water with an optimal fluoride concentration and brushing with fluoride toothpaste twice daily(CDC, 2001a). Supervise Use of Fluoride Toothpaste among Children Aged Childrens teeth should be cleaned daily from the time the teeth erupt in the mouth. Parents and caregivers should consult a dentist or other health-care provider before introducing a child aged Use an Alternative Source of Water for Children Aged 8 Years Whose Primary Drinking Water Contains >2 ppm Fluoride In some regions in the United States, community water supply systems and home wells contain a natural concentration of fluoride >2ppm. At this concentration, children aged 8 years are at increased risk for developing enamel fluorosis, including the moderate and severe forms, and should have an alternative source of drinking water, preferably one containing fluoride at an optimal concentration. In areas where community water supply systems contain >2ppm but 8 years. For families receiving water from home wells, testing is necessary to determine the natural fluoride concentration (CDC, 2001a). Label the Fluoride Concentration of Bottled Water Producers of bottled water should label the fluoride concentration of their products. Such labeling will allow consumers to make informed decisions and dentists, dental hygienists, and other health-care professionals to appropriately advise patients regarding fluoride intake and use of fluoride products (CDC, 2001). CONCLUDING POSITION STATEMENT When used appropriately, fluoride is a safe and effective agent that can be used to prevent and control dental caries. Fluoride has contributed profoundly to the improved dental health of persons in the United States and other countries. Fluoride is needed regularly throughout life to protect teeth against tooth decay. To ensure additional gains in oral health, water fluoridation should be extended to additional communities, and fluoride toothpaste should be used widely. Adoption of these and other recommendations in this paper could lead to considerable savings in public and private resources without compromising fluorides substantial benefit of improved dental health. What is consistent from the literature review is the fact that infants and children are much more at risk of overexposure and the development of adverse health effects. A community water fluoridation program (CWFP) is very safe and efficient, not only in terms of reducing dental caries, but also on the communitys budg et (CDC, 2001a). A CWFP can especially help those communities who have populations in the low SES category. These populations have children whose parents or guardians dont always have access to dental insurance and so regular dental checkups to curb the dental caries is not always an option. Reducing dental caries before they lead into more extreme oral morbidity can be very beneficial to these children. Implementing a fluoridated water program can also be beneficial to a whole community in terms of saving communities thousands and millions of dollars. Implementing a water program would follow strict guidelines set by the EPA, so the optimum level of fluoride would be followed, staying in the range of 0.7 to 1.2, where people would ingest no more than an average of 1 mg/liter of fluoride per day. Moderation is the key. There are studies confirming that ingestion of fluoride greater than the optimum level could produce dental fluorosis. Though unconfirmed by studies, individual reports have even suggested that ingestion of fluoride >8 mg/liter per day over a long period of time could produce skeletal fluorosis. However, with proper surveillance and reporting of fluoride in water systems, the greater population could be served, increasing the dental health of all individuals, especially the youth and saving dollars from excessive health care costs (ADA, 2009). Remember, a little prevention now can go a long way later. REFERENCES ADA (2005).Fluoridation Facts: ADA statement commemorating the 60th anniversary of community water fluoridation. Retrieved October 19, 2009 from www.ada.org/public/topics/fluoride/facts/fluoridation_facts.pdf ADA.(2007). ADA Guidelines to Dental Therapeutics. Retrieved October 23, 2009 from http://www.ada.org/prof/resources/pubs/advocacy.asp ADA (2009). Fluoride: Natures tooth decay fighter. J of the Am. Dental Ass., 140(1), 126-126. Alphajoh, C.(2009). (PhD Student). Service Learning Activity: Environmental Health. Walden University. Assessed November 13, 2009 from http://environmentalhealthtoday.wordpress.com/2009/05/13/commentary-and-position-statement-on-the-safety-and-efficacy-of-water-fluoridation/ Aoba, T., Fejerskov, O. (2002). Dental fluorosis: Chemistry and biology. Crit. Rev. Oral. Biol. Med., 13(2), 155-170. Bowden, G.(1990). Effects of fluoride on the microbial ecology of dental plaque. J Dent Res 1990; 69(special issue):653—9 Brunelle, J.(1987. The prevalence of dental fluorosis in U.S. children. J Dent Res.(Special issue) 68:995. Bunker, J.P., Frazier, H.S., Mosteller, F. (1994). Improving health: measuring effects of medical care. Milbank Quarterly,72, 225-58. Burt, B. (1989).(Ed.). Proceedings for the workshop: Cost-effectiveness of caries prevention in dental public health, Ann Arbor, Michigan, May 1719, 1989. J Public Health Dent 1989; 49(special issue):3317. Burt, B.A., Eklund, S.A. (1999). Dentistry, dental practice, and the community. Philadelphia, Pennsylvania: WB Saunders Company, 204-20. CDC (1999). Ten great public health achievements United States, 1900 1999. MMWR,48(12), 214-243. CDC (2001a). Promoting oral health: intervention for preventing dental caries, oral and pharyngeal cancers and sport-related craniofacial injuries a report on recommendations of the Task Force on Community Preventive Services. MMWR 2001, 50(21), 1-12. CDC. (2001). Recommendations for using fluorideto prevent and control dental

Tsunami :: physics tsunami

Tsunamis, commonly called tidal waves by the general public, are large sea waves or surges. These waves can carry a lot of energy from one side of the globe to the other, reeking havoc where ever they make landfall, and as shown by the December 26, 2004 SE Asian event, tsunami's can claim thousands of lives and cause millions of dollars worth of damage to property. * Many people picture large, breaking waves when they hear the word tsunami. This is usually not the case, however. * Most tsunamis make landfall as little more than a gigantic surge, as if the tide just moved in way too far way too fast. * This surging nature of tsunamis is mostly due to the extremely long wavelength, generally on the order of 100-200km. * A tsunami can turn into a locally, large and breaking wave if the wave energy is concentrated, shortening the wavelength and increasing the amplitude. * This often happens if the wave enters a bay, fjord or similar feature. * Tsunamis can be regional, like the recent tsunami in SE Asia, or localized, like the megatsunami in Lituya Bay, Alaska in 1958. * Regional scale tsunamis are general caused by crustal rebound after a large earthquake, usually associated with a subduction zone * Localized tsunamis are also generally associated with earthquakes, but the physical cause of the wave is usually due to a landslide or pyroclastic flow. There are several geologic events that can trigger the propagation of a tsunami * Earthquakes: generally tectonic rebound at or near a subduction zone, when there is a vertical component to crustal movement that displaces a large volume of the overlying water * Landslides: often earthquake or volcanically triggered, can be purely submarine or the slide could begin on land and slide into the water (i.e. a collapsing volcano) * Volcanic activity: usually subaerial, could be pyroclastic flows, lahars, nuees ardants, or collapse of the mountain side * Impact of a large meteor or asteroid * A tsunami behaves as a shallow water wave. * Tsunami's travel in much the same way as your garden variety, wind-propagated water waves: with some combination of transverse and longitudinal movement.

Functions of Human Resource Department Essay -- Employment Employee De

Functions of Human Resource Department One of the main functions of Human Resource Department is training and development beside recruitment, selection and placement. It isn’t enough to recruit employees into the skills or knowledge they currently posses, but rather for their ability to learn and adapt through training as conditions change or business needs. Employees are very important resources where some organizations assign huge budget to train them. However, this budget is taken out when organizations have financial problems. Here comes HR role to lighten top management that Training and Developing strategy is a vital investment to show commitment and ensure competency of employees’. Pfeffer references growing evidence that the loss of skills and increased use of contract employees have hurt productivity and even safety in organizations and industry (1998, P172). In this report we’ll talk about Training and Developing policy in UAE based company known as Tawteen. We’ll examine the effectiveness of this policy, describe its operation, show the policy outcomes and review the employees’ feedback on the policy. Before we go ahead with our analysis we should look at the policy in other regions rather than UAE. Also we’ll summarize an overview of our company and its internal operations to have a complete picture. Outside UAE: In USA we have â€Å"open career systems where individuals are given considerable freedom to manage their own careers. In such settings we find a chance to bid on jobs and training opportunities† (Towers 1996, p. 31) . However, Japanese companies operating in USA and UK â€Å"Job Training is typically provided internally, though at least in the early stages of operations there has been a tendency to buy-in managerial talent† (Towers 1996, p. 55). On the other hand, In European companies there is an â€Å"increase in training at all levels†. â€Å"Training and development is increasingly seen as a critical part of an organization’s HR strategy† (Towers 1996, p. 83). For example, in UK it is estimated that business spends 16 billion on training and developing their employees each year (Rana, 2000a). In UAE where business is growing very fast and we have huge number of skilful expatriates’ workers. Excluding enterprise companies, medium and small size companies don’t have training and development strategy. As ... ...ged and developed at work has major effects upon quality, customer service, organizational flexibility and costs’. By providing a framework for training and developing employees, Tawteen as a training and recruitment is contributing in the Emiratisation strategy by training UAE Nationals and maintaining the quality of training. References Bown B. 2000, Recognizing and Rewarding Employees, McGraw-Hill, New York. Harrison R. 1992, Employee Development, IPD, London. Laila Murad, HR Officer in Tawteen, Dubai, 2005 Marchington M. & Wilkinson A. 2003, 2nd Edition, People Management and Development. , Chartered Institute of Personal and Development (CIPD House), London. Pfeffer J, 1998, The Human Equation: Building Profits by Putting People First, Harvard Business School, Boston. Rana E. 2000, ‘IIP revamp aims to cut back on bureaucracy’, People Management, 13th April 2000, P14. Saif Sultan, System trainer in Tawteen, Dubai, 2005 Sanders D. 2000, ‘The Pros and Cons of Computer based learning’, Employee Development Bulletin 123, March 2000, P6-8. Towers B. 1996, 2nd Edition, The Handbook of Human Resource Management, Blackwell Business, Oxford.

Race, Urban Poverty, and Public Policy Essay -- Urban Decay, Urban Poor

The problems of race and urban poverty remain pressing challenges which the United States has yet to address. Changes in the global economy, technology, and race relations during the last 30 years have necessitated new and innovative analyses and policy responses. A common thread which weaves throughout many of the studies reviewed here is the dynamics of migration. In When Work Disappears, immigrants provide comparative data with which to highlight the problems of ghetto poverty affecting blacks. In No Shame in My Game, Puerto Rican and Dominican immigrants are part of the changing demographics in Harlem. In Canarsie, the possible migration of blacks into a working/middle-class neighborhood prompts conservative backlash from a traditionally liberal community. In Streetwise, the migration of yuppies as a result of gentrification, and the movement of nearby-ghetto blacks into these urban renewal sites also invoke fear of crime and neighborhood devaluation among the gentrify ing community. Not only is migration a common thread, but the persistence of poverty, despite the current economic boom, is the cornerstone of all these works. Poverty, complicated by the dynamics of race in America, call for universalistic policy strategies, some of which are articulated in Poor Support and The War Against the Poor. In When Work Disappears, William Julius Wilson builds upon many of the insights he introduced in The Truly Disadvantaged, such as the rampant joblessness, social isolation, and lack of marriageable males that characterized many urban ghetto neighborhoods. In the class discussion, Professor Wilson argues that it is necessary to disassociate unemployment with joblessness, as the former only measures those still s... ...or-eliminating technology -- they are unlikely to be plausible policy alternatives in the current political and high-technology-oriented context. What all these analyses and policy recommendations do require is a universalistic strategy, backed by a broad-based multi-ethnic, multi-class coalition which cuts across ideological and political lines in order to address the problems of race and urban poverty at the dawn of the 21st century. Works Cited David Ellwood Poor Support Herbert Gans The War Against the Poor: The Underclass and Antipoverty Policy Notes 1 Wilson, 28. 2 Ibid, 75-8. 3 Ibid, 216-18. 4 Newman, 292-293. 5 Rieder, 79. 6 Ibid, 173. 7 These definitions of social organization are also found in Wilson, 20. 8 Anderson, 144-45. 9 Wilson, 62. 10 Ibid, 113. 11 Ellwood, 238. 12 Gans, 110-112.

Blue Cross and Blue Shields Association Essay

Blue Cross and Blue Shield Association is one of the many major health insurance companies in the United States. The company was started by a man named Dr. Justin Ford Kimball in 1929. Kimball started the program because he noticed that teachers had a huge burden of medical bills in his area. He started a plan for teachers to be able to have a three week hospital stay covered for as little as fifty cents a month. The first plan was a hit when over 1250 teachers enrolled at once (Blue Cross and Blue Shield Association History). The plan started to spread throughout the United States. In 1934, E.A. van Steenwyk designed the Blue Cross name and symbol. By 1938 there were 38 Blue Cross plans in the United States with a total enrollment if 1.4 million (Blue Cross and Blue Shield Association History). Blue Shield was developed in 1939 in California and was designed to cover the costs of physician’s services. In 1948, Blue Cross and Blue Shield merged and because what we know it as t oday as Blue Cross and Blue Shield. Since 1998, Blue Cross Blue Shield has over 3,012,571 customers insured (Health Insurance). Since the start of the company in 1929, Blue Cross and blue shield has expanded all across the United States and offers many insurance products. Blue Cross and Blue Shield offers a variety of different plans to meet a families’ or an individuals needs. Blue Cross and Blue Shields has over thirty eight independently ran and locally operated companies from Hawaii all the way to New York. The companies offer a variety of plans for medical, dental, and vision. There are many different options to choose from and plenty of resources available online to choose which is best. One plan the companies offer is the Consumer Directed Health (CDH) Plan. This is a high deductible plan that employers offer to their employees that have lower health costs for their employees because the employers cover part of the costs (Consumer Directed Health Plans). Some key highlights of the plan are lower monthly premiums, higher annual deductibles, preventive care at no cost or with modest copay, and combined deductible for medical and pharmacy  expenses (Consumer Directed Health Plans). There are two plans that can be combined with the CDH whi ch are Health Savings Accounts (HSA) and Health Reimbursement Arrangements (HRA). Both of these are where the employer helps the employee pay out of pocket expenses for medical care. There are a few other plans that the company offers such as Healthy Reward 2.0 which encourages employees to live a healthier lifestyle and earn rewards by doing so. Another plan is the Blue Choice Advantage Plan that allows the insured to go to any doctor they choose without a referral (Blue Choice Advantage). These are only a few of the health care plans offered by Blue Cross and Blue Shield and there are many more to choose from. Blue Cross Blue Shield also offers a variety of dental plans for the family or for an individual. The first program is called the CareFirst Blue Choice Discount Dental Program. This program offers twenty to forty percent off of all dental needs using the list of providers who accept this program. Another program that Blue Cross Blue Shield offers is the Dental Health Maintenance Organization (DHMO) which offers preventative and corrective dental care at a predictable price. CareFirst BlueCross BlueShield (CareFirst) Preferred (PPO) Dental offers the insured to pick any provider they would like, but have the option to use an in network provider and have cheaper costs. There are a few more plans offered for dental just requires research to find the best option for a family or an individual. The company also offers a few different options for a vision plan that fall along the same lines as the dental. The plans give you the option to use in network providers that are offered at a cheape r cost or you can choose any provider you desire just a little more out of pocket costs. There are a few special programs that the insurance company offers such as Premium-Only Plan (POP), Flexible Spending Accounts (FSA), and BlueWorldwide Expat (BWE). â€Å"The POP allows employees to designate their monthly health, dental, and vision premiums as â€Å"pre-tax, easy to set up and requires very little administration, reduces FICA withholdings for the employer and employee, and converts after-tax contributions to pre-tax contributions. Contributions to FSAs means lower taxes for members and employer it lowers FICA taxes, controls benefit costs, manages compensation, and employees pay for expenses with pretax dollars. The BWE offers Comprehensive indemnity-based products  for employees and dependents, centralized administration and claims payment, 24-hour medical assistance and customer service, medical evacuation and repatriation, cashless access to inpatient services, multilingual assistance, access to more than 25,000 internationally credentialed providers, and access to Blue Card indemnity network of providers while traveling to the U.S., flexible benefits, and currency conversion† (Medical). In today’s economy it is essential to find affordable health insurance. There are hundreds of websites online that can give you free quotes and help find affordable health insurance. It is best to research as much as possible to find out what all is offered and which plan is best for the family or an individual. Blue Cross Blue Shield has been around since 1929 and is widely used across the United States and has thousands of providers so it is easy to find a provider close. The company is i n thirty eight states and has over three million insured and growing every day. With our healthcare system changing everyday it is nice to see some names that have been around for a long time. Hopefully, companies like Blue Cross Blue Shield will be around for many more years to come. Bibliography 1. Blue Cross and Blue Shield Association History. (n.d.). History of Blue Cross and Blue Shield Association à ¢ FundingUniverse. Retrieved from http://www.fundinguniverse.com/company-histories/blue-cross-and-blue-shield-association-history/ 2. Blue Cross Blue Shield. (2012, May 14). Health Insurance. Retrieved July 15, 2012, from http://www.ehealthinsurance.com/ehi/healthinsurance/bcbs?allid=Goo28708 3. Consumer-Directed Health Plans. (n.d.). CareFirst BlueCross BlueShield. Retrieved from https://employer.carefirst.com/wps/portal/Employers/CDHPlans?WCM_GLOBAL_CONTEXT=/wcmwps/wcm/connect/Content-Employers/CareFirst/GAPortal/ProductOverviews/Tab/cdhWhatisaCDHPlan 4. Blue Choice Advantage. (n.d.). CareFirst BlueCross BlueShield. Retrieved from https://employer.carefirst.com/wps/portal/!ut/p/c5/jc7BDoIwEATQLzKdAq3lCKbQDQYkCgIXw8GYJgIejN8vvRkj6u7x7WSHdWzesX_YS3-309hfWcM6eQozWXAKfRR1CFAmqIjy2kMlZm9fPDWJAAXpTlFZcij5T3qTRiZYbwHoQwwvF3qfxIqD_B_po2u7fKHlm39o5_zbf-dYmAgsN9NwZrehamBp9QSM0lTI/d l3/d3/L2dJQSEvUUt3QS9ZQnZ3LzZfOUs2TzFJOTMwRzVIQTBJUzZVMkI0UTIwODY!/?WCM_GLOBAL_CONTEXT=/wcmwps/wcm/connect/content-employers/carefirst/gaportal/

Action research bully

â€Å"Bullying involves an initial desire to hurt, this desire is expressed in action, someone is hurt, the action is directed by a more powerful person or group, it is without justification, it is typically repeated, and it is done so with evident enjoyment. † Ken Rugby (1998). The future of the youth is formed and developed within the confines of their own respective homes. It is in the home that the youth acquires basic skills, habits, and attitudes for this home molded personality. Home is the starting point of one's development into a full grown adult.Home environment is the very first place where teenagers nowadays learned how to socialize and integrate themselves with others. When a child is born he/she becomes a member of an already established social institution. He/she becomes a member of his/her own family with its already existing sets of cultural patterns and sets of social, moral, and religious values. The child also carries with it the raw materials for the deve lopment of its peculiarly unique individual personality. Once attitudes have been learned, they determine to a large extent to what an individual perceives and how he/she behaves.So, it is clear that an individual can perceive things based on the way he/she was trained in congruent with his/her primary group. It is assumed that the personality develops and changes differently in each type of the family. So whatever kind of family a child belongs, it will certainly reflect on his/her attitudes towards his/her own self and others. Bullying and being bullied have been recognized as health problems for children and teenagers because of their association with adjustment problems, including poor mental health and more extreme violent behavior.It is therefore important to understand how bullying and being bullied affect the well-being and adaptive functioning of youth. We sought to use multiple data sources to better understand the psychological and social problems exhibited by bullies, vi ctims, and bully-victims. Of today's living, family conflicts or stormy relationships consisting within the family could be one of the factors that cause the misbehaver of students in and out of the home. Their place of learning or school environment serves as the outlet of their emotions and feelings.In connection with this, the researchers, found it interesting and worthy to study he veracity behind this issue. To find out what are the factors in the home environment that can possibly contribute to the change of the bully behavior and how this would affect his/her relationships and attitudes towards other people. Background of the Study Home is the place where the child initially learns or can learn his most basic values, aspirations and attitudes. Because of its major role as transmission belt, there is concern not only for what the family does but also for what it fails to do.Consciously and unconsciously, a parent sets patterns in their children on the basis of which their soci al growth is guided. Children absorb from their parents certain attitudes toward interpersonal or social relationships, getting an education, religion and others. The social personality of the child depends greatly upon the nature of these behaviors. The growing youngsters need to become accustomed increasingly to enable them to apply, to persons and groups outside the family, the sympathetic interest and the creative-partnership process which have been cultivated within the family circle.Statement of the Problem The study attempted to determine the influence of home environment on the behavior of the bullies to the students. More specifically, it attempts to answer the following questions: 1 . What is the level of behavior of the respondent? 2. How do the level of influences of the following compared when group according to the given characteristics: 2. 1 Home environment 2. 2 Behavior 3. How does the level of influences of the home environment compared to the level of behavior of the respondents?Purpose of the study This research primarily aims to know the influences of the home environment on the behaviors of the bullies. This study influences according to their characteristics and home environment, and behavior. Significance of the study Since the development of the child is to a great extent dependent on the influence of the home, if the home is not self-sufficient to provide personality development of the child, the school therefore, enters as necessary complement and supplement of the home.In connection with this, the findings of the study will be useful and of great help to parent and teachers in understanding the attitudes of the students in and out of the school premises. It will help determine the needs of the students physically, emotionally and socially. It is also helpful in strengthening parents and hill's relationship as a whole. Furthermore, this study is important not only to the parents but also to teachers because it will help them understa nd their work better so that they can cooperate in helping the child's active participation in social living.The findings of this study are also relevant to the students themselves, for they may be guided in realizing the extent of their deviation from the group average in their personal and social relationships. Such realization may lead them to deeper insights and ultimately to self-direction and self-realization. Scope and Delimitation of the Study This research focused on the influences of the home environment on the behaviors of the bullies. The researchers limit their study only to the identified bullies in the students.Methods of Research and Procedure This chapter includes the method and procedure that will be used in gathering the data, the subjects of the study, the sampling techniques, and the statistical treatment employed in the interpreting data. Research Methodology The researchers will use the Descriptive Method, which is the type of study design to gain more informa tion in order to come up with a systematic method of data gathering and analysis. It aims to identify the relationship of self-esteem and reputation of the bullies. Subjects of the Study The researchers used a total of 203 students from different courses.Not all of them are bullies. The researchers disregarded 98 students because they are not identified as not bully so, they only 105 students were used as their subject. Sampling Technique The Purposive Sampling will serve as a sampling technique for all the 2nd year students. The subjects of the study in this particular sampling process has a unique characteristic, hence, not Just anybody can be included as sample for the study. Consider this research, only the â€Å"bullies† are considered as the sample for this study. Procedure and Data Gathering Another set of questionnaires were given to the subjects.Primary data are the data collected by the researchers come from the respondents who answered the questionnaires. A review of related literature and studies from books, internet, and reference materials are used to gather information. 1 . The researchers conducted instruments that were validated through the professors. 2. The researchers inquired the total population of enrolled second year students in Science and Technology. . Permission and willingness to participate from the respondents were secured before conducting the actual study.Methodology This chapter presents, analyzes and interprets the data gathered from bullies in college students as to the influences of the home environment to their behavior in school. The various data gathered are analyzed and interpreted in the following tables to answer the specific questions posed in this study. The Demographic Profile of the Respondents This answers the question that would present the respondent's profile such as age, sex, course, family status, birth order, no. F siblings, and the family monthly income. Table 1. 1 Frequency Distribution of the Respo ndent's Age Age Frequency Percentage 19 15 14. 18 43. 8 17 36. 2 16 6 5. 7 Total 105 As seen in the table of the frequency and percentage distribution of the respondent's age, out of the 105 respondents, 46 or 43. 8% of them are 18 years old, 38 or 36. 2% of the respondents are 17 years old, 15 or 14. 3% of the respondents are 19 years old, and 6 or 5. 7% of the respondents are 16 years old. This only shows that majority of the respondent's age is 18 years old while minorities of them is 16 years old. Table 1. 2 Frequency Distribution on the Sex of the Respondents Gender Male 56 53. 33 Female 49 46. 7 respondent's sex, out of the 105 respondents, 56 or 53. 33% are males and 49 or 46. 67% are females. This only shows that majority of the respondents are males and minorities of them are females. Frequency Distribution on the Level of Socio-Economic of the Respondents Socio- Economic High 25 23. 8 Average 39 37. 1 Low 41 39. 0 As seen in the table of the frequency and percentage distri bution of the respondent's socio-economic status, out of the 105 respondents, 41 or 39% of them are not disturbed about their socio-economic status, 39 or 37. Of the respondents are slightly disturbed about their socio-economic status, and 25 or 23. 8% of the respondents are slightly disturbed about their socio-economic status. This only shows that majority of the respondents are not disturbed with their socio-economic status. Summary, Conclusion and Recommendation This chapter includes the discussion of the summary of the study and generalizations in the form of conclusions and recommendations for the solution of the problem in the study addressed to those concerned.The research employed the use of the descriptive method which involved the analysis of the relationship between the level of social estrangement to the level of anxiety and level of depression of the respondents. Summary of findings There is no significant effect in the level of behavior of the respondents when grouped according to their sibling relationship, parents' relationship, parent relationship, and socio-economic status, while there is a significant difference in the level of behavior of the respondents in terms of their parenting styles.There is no significant effect in the level of parents' relationship of the respondents when grouped according to their age, sex, course, family status, birth order, no. F siblings, and the family monthly income. There is no significant effect in the level of parent relationship of the respondents when grouped according to their age, sex, course, family status, birth order, no. Of siblings, and the family monthly income. Conclusion There is no significant effect in the level of behavior and the home influences of the respondents as regards to their characteristics.There is no significant effect in the level of behavior of the respondents when grouped according to their sibling relationship, parents' relationship, parent relationship, and socio-economic sta tus, hill there is a significant difference in the level of behavior of the respondents in terms of their parenting styles. Recommendation Based on the summary of findings and conclusion the researchers recommend the following to the readers of this study. For the students to be more sensitive enough.Many students who bully do not consider their behavior as bullying because they are not conscious about the little things that they do to offend others. For the teachers, mentors and guidance counselors to determine the possible cause of the bully behaviors. For the parents to have knowledge of the influences that a home environment can bring to their sons and daughters and to be aware of the proper parenting style they must provide their children. For future researchers to give a broader picture of what home environment can do to our behavior.