Health Plan For A Healthy Lifestyle - 1374 Words

Throughout the past two years of health class, I have learned that a healthy lifestyle is the key to living a long life. Although the class focuses on general ideas, it s still teaches that each individual student should have a different health plan, as they each come from different backgrounds. One’s health plan would be based off their family history with injury, illness, and disease. When creating my health plan, I took into consideration how my grandmother (on my mother’s side) died of breast cancer, my grandfather (on my mother’s side) has developed Huntington’s disease, and my grandfather (on my father s side) had Parkinson s disease. To reduce the chances of developing any of these diseases, I must take into consideration different healthcare options, nutrition plans, physical activity regimens, stress factors, environmental factors, and be aware of what I use as a consumer. It is estimated that about 12% of women will develop breast cancer at some point in their life. Your chances of this are even more increased if a family member has been diagnosed with the disease. So, if someone in your family has had the cancer, it is recommended you live a cautious lifestyle. This is how I will have to live, as my grandmother died of breast cancer. She was diagnosed twice, after thinking she had beaten the cancer once. The second time it developed, it metastasized into her lymph nodes, killing her. To avoid the same fate, I will have to make sure to live the healthiestShow MoreRelatedFad Diets : Obesity And Obesity1382 Words   |  6 Pageslose weight. Fad diets have become very popular for this reason. Fad diets allow people to simply sit back and take a pill to provide quick weight loss but this weight loss only lasts temporarily. (Fad Diets). On the other hand, few people choose healthy dieting methods, which take longer to see results and include more work but overall are smarter, more efficient methods (Saragih D.R.). A fad diet is any diet that cuts out any particular food group, promises quick weight loss, and requires dailyRead MoreGoals For Improvement Essay716 Words   |  3 Pages(obesity) to promote health and reduce chronic disease risks are through eating healthy diets and achieve and maintain a healthy body weight. Reducing the proportion of adults who are obese in Twin Falls by 10% by being more active and eating healthy diet by promoting and active ad healthy lifestyle. In five years the rate of obesity will be reduced by 10% improvement. Also by educating the adults would be my primary in hopes that it will hopefully teach the younger generation about healthy eating and lifestyleRead MoreWellness in the Corporate Workplace1408 Words   |  6 Pageshelp many companies attract and keep their employees healthy at the same time, along with reduce the cost of healthcare within the company. When there is â€Å"healthier employees,† then lower healthcare plans for the company. â€Å"According to BusinessWeek, Scotts Miracle Grow instituted a corporate wellness program, after the company realized that 20 percent of its net profits were spent on providing healthcare. When companies reduce their health plan this not only helps them, but it also helps their employeesRead MoreA Better Health Association Plan988 Words   |  4 PagesBetter Health Association Plan Executive Director Introduction As Executive Director, I will provide staff leadership for Better Health Association. Our goal for the company is to improve the well-being of individuals. Audiences of all ages will be able to take part in learning about living a healthy lifestyle and developing the skills needed to make healthy choices to prevent diseases and ameliorate conditions for those already afflicted with illnesses. Over the course of the next year, It isRead MoreHow to Prevent Chronic Disease Essay757 Words   |  4 PagesA statistic from World Health Organization indicates that 60% of deaths are caused by chronic diseases. This is related to the increase of affluence and sedentary lifestyle. If we continue living this lifestyle, it will be easier for us to get the diseases. In this fast pace lifestyle, we are always on the go. We usually choose to eat food without thinking much about the food content but just thinking about filling our stomach. Apart from food consumption factor, family history and poll uted surroundingsRead MoreHealth Of Health And Health994 Words   |  4 Pages Today I see health and health education, as a big issue in society but not everyone else seems to have the same thought. Growing up with two parents who worked in the health department has given me a huge desire to live a healthy lifestyle. People need to have more opportunity to be health educated and have the resources to succeed in what they have learned. In society people should be able to be aware of their bodies and what they can do to improve their lifestyle. Social change is something thatRead MoreEffective Weight Loss Plan By Abdou Mssiah Essay807 Words   |  4 PagesEffective Weight Loss Plan By Abdou Mssiah | Submitted On May 21, 2015 Recommend Article Article Comments Print Article Share this article on Facebook Share this article on Twitter Share this article on Google+ Share this article on Linkedin Share this article on StumbleUpon Share this article on Delicious Share this article on Digg Share this article on Reddit Share this article on Pinterest Getting fit and healthy is not new to all of us. Information on how to achieve health and wellness areRead MoreEffective Weight Loss Plan. By Abdou Mssiah| Submitted807 Words   |  4 PagesEffective Weight Loss Plan By Abdou Mssiah | Submitted On May 21, 2015 Recommend Article Article Comments Print Article Share this article on Facebook Share this article on Twitter Share this article on Google+ Share this article on Linkedin Share this article on StumbleUpon Share this article on Delicious Share this article on Digg Share this article on Reddit Share this article on Pinterest Getting fit and healthy is not new to all of us. Information on how to achieve health and wellness areRead MoreObesity : Obesity And Obesity1699 Words   |  7 Pageslarge that two people could share them. Also, not having resources of healthy food, such as grocery stores in neighborhoods, causes problems for getting proper nutrition. (NIH, July 2012) Another interesting link to weight gain is sleep. Sleep is part of a healthy lifestyle and not getting enough increases the obesity risk. This is due to the fact that when people are not sleeping, they tend to eat. â€Å"Sleep helps maintain a healthy balance of the hormones that make you feel hungry (ghrelin) or fullRead MoreVegetarian Diets are the Healthiest Diets Vegetarians have a tendency to live a longer and1700 Words   |  7 Pagesleads to a healthier lifestyle all the while of promoting a healthy weight and diet. Some may worry about whether they are getting the right amount of nutrition or not, but with the right portions of each food group with moderations for the meat category, one can gain adequate nutrition. Vegetarians tend to eat organic over non-organic food due to the antibiotics and chemicals farmers put into their crops. Vegetarian diets are healthier and will help maintain a good lifestyle for many reasons: promotes

The Struggle For Freedom And Equality - 1621 Words

Throughout history, many trends have risen up and taken over the considered norm of the time. The need for political freedom was a trend that started in the early 1840s and has not diminished since. The 19th Amendment gave women the right to vote in all elections. This granted all American women political freedom and started a movement to end prejudice against females. Before the amendment was ratified women were prohibited from jury service, public speaking, holding office, and attending college (Nineteenth Amendment 1). The 19th Amendment was one of the most influential turning points in history; it has led women across the country to fight for freedom and equality. Countless women dedicated their lives to the fight for justice. Elizabeth Cady Stanton was just one of the most influential women of the time period. Elizabeth and her husband worked together as abolitionists and attended conventions to raise awareness. The conventions did not allow women to speak. This angered Elizabeth and spurred her to create the first Women’s Rights Convention with the aid of Lucretia Mott (â€Å"National Women’s History†¦Ã¢â‚¬  2). The two women began the fight to raise a woman’s status in America. Elizabeth wrote powerful speeches that were heard by many people and gathered audiences. Stanton not only preached about suffrage, but also divorce laws, temperance, and maternity (â€Å"National Women’s History†¦Ã¢â‚¬  5). Lucretia Mott worked with anti-slavery campaigns as well as women activists. MottShow MoreRelatedThe Black Freedom Struggle For Equality Essay1980 Words   |  8 PagesThe black freedom struggle has not yet come to an end – there are still prejudiced and racist radicals that try to negotiate white supremacy and dominance in order to prevent the blacks from their long wait for equality. Consequently, the movement has progressed very sluggishly in the past few centuries. Nevertheless, the campaign for equal rights has led to the triumph over slavery and has led to the accrual of suffrage rights. However, this is still not enough, not after centuries of enslavementRead MoreAnalysis Of Kurt Vonnegut s Harrison Bergeron 873 Words   |  4 Pages Equality they say is a state of being equal, especially in status, rights and opprtunites, But in Kurt Vonnegut story â€Å"Harrison Bergeron† equality is far from being equal. In this story, though it tries to paint an imaginary picture of a future in American society where everybody is finally equal before God and the Law, and where nobody is smatter, better, looking, stronger or quicker than anybody else, but that is a ctually not the case. Vonnegut, indirectly in this story re-echo’s the popular AnimalRead MoreEssay about Choosing Freedom over Equality553 Words   |  3 Pageswill mention, discuss and bring forward the irrationality of choosing either freedom over equality or visa versa, without having a harmonious counterbalance between the two factors, implemented by a regulatory body. It will also include examples of countries which total freedom or total equality is in practice, where the search for total freedom led to total anarchy, or the pursuit for total equality curtailed the freedom in all areas of life. This short writing will be concluded with a personalRead MoreJoseph Jackson Annual Address Rhetorical Analysis1209 Words   |  5 Pagesthe audience emotionally and establishes trust through his reputation as a black activist in order to argue to fight for equality and freedom; however the use of logos is not as strong as his appeals to emotions, making it less effective logic ally. The Annual Address begins by discussing the foundation of our nation, the United States. He later addresses the civil rights struggle and the reason behind it. About half of his speech addresses some advice and suggestions for the future of the black peopleRead MoreJoseph Jackson Annual Address Rhetorical Analysis1134 Words   |  5 Pagesused different modes of persuasion: logos, pathos, and ethos to convince his fellow Negroes to take action and fight for equality and freedom. We will be examining the context of this speech and Jackson’s perspective and claims. The Annual Address begins by discussing the foundation of our nation, the United States. Into a few paragraphs, he addresses the civil rights struggle and the reason behind it. About half of his speech addresses some advice and suggestions for the future of the black peopleRead MoreBattle Royal1553 Words   |  7 PagesA Battle Royal for Equality: An Analysis of Ralph Ellison’s â€Å"Battle Royal† â€Å"Battle Royal† provides a realistic portrait of the difficulty of being a black person in a Country dominated by white men. Ellison uses several symbols in â€Å"Battle Royal† to illustrate the black struggle for equality. These symbols include the stripper, the flag tattoo on the stripper’s stomach, the blindfold, and the battle itself. The stripper is symbolic of the connection between women and black people in the eyesRead MoreThe Rhetoric of LBJ: Speech Addressing Discrimination and Voting Right Legislation1076 Words   |  5 Pages rhetorical debut as president would have to be one that offered Americans the confidence to believe he was not simply a political figure, but instead a man of principle, with a value system that would advance the interests of peace, freedom, and social justice. There is no reason which can excuse the denial of that right.† Johnson reminded the nation that the Fifteenth Amendment, which was passed after the Civil War, gives all citizens the right to vote regardless of raceRead MoreBenjamin Banneker Letter To Thomas Jefferson Allusion707 Words   |  3 PagesJefferson that while he claims to follow American values of freedom and equality, he does not believe in allowing those same values to African Americans. Thomas Jefferson, the then secretary of state, is persuaded to put himself in the slaves’ shoes and have more compassion towards their oppression. Banneker uses allusions throughout his letter to persuade Jefferson to empathize with the slaves and have more compassion towards their struggle. This includes in lines 6 and 7, when Banneker points outRead MoreAyn Rands Anthem And The Soul Of An Anthem Individualism Analysis707 Words   |  3 PagesBoth Ayn Rand’s Anthem and The Soul of an Individualist display the struggles of living in a collective and oppressive society where new ideas and inventions are denied, and how the individual must break free towards an individual and creative spirit. The individual often encounters struggles along the way as they try to break free towards individualism. The struggles include guilt, a fear of punishment, and a fear of change. Although people win certain battles, it doesn’t mean guilt isn’t feltRead MoreMartin Luther King And King Remembered By Malcolm X Analysis804 Words   |  4 Pagesthese years civil and economic rights were being diligently fought for. The unity of all African Americans regardless of their religion, political views, or social was being encouraged. Speeches and rallies also took place to end racism and instill equality. There is no doubt any of this would have been accomplished without the help of notable activists Martin Luther King Jr and Malcolm X. Two bold and heroic men, one nonviolent and the other defiant. Yet, despite their different approaches to unjust

Coaching for competence Essay Example For Students

Coaching for competence Essay Coaching for CompetenceIntroductionThe field of nursing is both a science and an art. New nurses graduate with, at least, acceptable basic competence. They are expected to have the ability to effectively communicate and make decisions in a complex environment with multiple demands on their practical comprehension. However, they usually lack the experience to apply this learned theory. This limited knowledge results in anxiety and difficulty in transitioning from the role of student to leader. How these students can best learn these skills is a topic that has come under considerable debate. We know that most become overwhelmed with multiple tasks and not able to prioritize with critical thinking in a fast pace acute hospital. This begs the questions: How do we make that transition phase easier for them and the staff around them? How do we get the doing and thinking to intertwine together? The article, Coaching for competence, gives one example of how to foster critical thinking skills in novice nurses as well as establish a culture that would help its entire staff to grow and excel together. Model concept and implementationThe nursing leadership of a 37-bed acute medical unit at the Mayo Clinic in Rochester, MN faced a challenge when they had significant numbers of new nurses hired during the year for a busy acute care general medical unit. The original policy for new nurses involved a six to eight week orientation with a preceptor who assisted new hires to assume complete care for an increasing number of patients. Once the new hire was handling a full patient case load independently, a resource nurse with her own full patient assignment remained available for direction and guidance for the next four weeks. While this orientation process was considered extensive, an extended learning period was needed due to the number of new hires. For this reason, the leadership team began to devise a plan to blend the acts of thinking with doing. This plan needed to encourage and stimulate the new nurses to develop self-directed, self-correcting, and innovative strategies in dealing with challenges. They were to develop competency and critical thinking in the novice nurses to a higher level of professional thinking. Thus, a coaching concept model was developed by the nurse manager, clinical nurse specialist, and nursing education specialist Preparing to initiate the programOnly staff members with solid work histories, who demonstrated sound clinical skills and a commitment to encouraging growth in novice nurses, were invited to become coaches. The goal of the unit coach was to build critical thinking skills and judgment in newer staff to allow them to become confident and competent more quickly. The coaches worked for three weeks along with the leadership staff to develop the program. A four hour training session was provided for each coach to build a general list of questions that would provoke critical thinking by the newer nurses. When the time came, they launched the new program with a sports theme lunch, posters and the coaches wore symbolic whistles. The coaches were there to witness all actual practice, prompt thinking and evaluate the outcome. They were to ask questions from the nurses instead of telling. They were not to be disciplinary. Nurse leadership designed lists of preferred activities for the coaches. The coaches who were assigned this role were not to give patient care or be extra staff. Rather, they would be assigned several new orientees after they were done with their initial orientation. They were to be available for the new nurses to ask questions; they prompted the nurses to think and reflect on the best course of action. The initial implementation of this program demonstrated the need for the newer nurses to have this guidance available. The new nurses asked multiple questions and needed help in prioritizing care. Their lack of knowledge included areas of patient discharge arrangements, administration of m edications, patient teaching resources and strategies. As the program continued, the charge nurses began to utilize the coaches for directions for prioritizing, classifying patients for acuity, determining staffing needs, workplace competencies, documentation and charting. The questions by the newer nurses and staff grew to more complex issues involving dealing with anxious patients and handling difficult situations like patient death. .ua1db8fde082224368b8bd55b6d215f61 , .ua1db8fde082224368b8bd55b6d215f61 .postImageUrl , .ua1db8fde082224368b8bd55b6d215f61 .centered-text-area { min-height: 80px; position: relative; } .ua1db8fde082224368b8bd55b6d215f61 , .ua1db8fde082224368b8bd55b6d215f61:hover , .ua1db8fde082224368b8bd55b6d215f61:visited , .ua1db8fde082224368b8bd55b6d215f61:active { border:0!important; } .ua1db8fde082224368b8bd55b6d215f61 .clearfix:after { content: ""; display: table; clear: both; } .ua1db8fde082224368b8bd55b6d215f61 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .ua1db8fde082224368b8bd55b6d215f61:active , .ua1db8fde082224368b8bd55b6d215f61:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .ua1db8fde082224368b8bd55b6d215f61 .centered-text-area { width: 100%; position: relative ; } .ua1db8fde082224368b8bd55b6d215f61 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .ua1db8fde082224368b8bd55b6d215f61 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .ua1db8fde082224368b8bd55b6d215f61 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .ua1db8fde082224368b8bd55b6d215f61:hover .ctaButton { background-color: #34495E!important; } .ua1db8fde082224368b8bd55b6d215f61 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .ua1db8fde082224368b8bd55b6d215f61 .ua1db8fde082224368b8bd55b6d215f61-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .ua1db8fde082224368b8bd55b6d215f61:after { content: ""; display: block; clear: both; } READ: The Importance of Voting Essay We will write a custom essay on Coaching for competence specifically for you for only $16.38 $13.9/page Order now Evaluation and evolutionThe overall impact of the program was positive; the staff members felt that new hires were more competent and the newer nurses reporting less anxiety. After a new clinical nurse specialist was hired, the coaches moved to the evening shift. Finally, once the need for the coaches diminished, they returned to their previous positions. When a large number of new nurses were hired again, the staff wanted the coaching positions to return. As money was not available in the budget, this was not possible. However, the principles and the methods used by the coaches were adopted by the preceptors. A subsequent program was developed from the coaching model that included training preceptors in coaching techniques, a preceptor handbook, a preceptor council with monthly meetings and a preceptor newsletter. Another outcome from this experience was a decrease in turnover in staff. While the innovative approach to the crisis faced at the Mayo Clinic may not be feasible as a reg ular program, a solid foundation for precepting new nurses was developed as a consequence. ConclusionHistorically, preceptors and coaches have served as liaisons between graduate nurses and the reality of the workplace. The function of coaches is to train new or transitioning nurses to function more efficiently in a short period of time. This concept has become increasingly more important in recent years. In order to accomplish this goal, leadership must promote positive attitudes in the expert nurses toward accepting and functioning in the roles of coaches and preceptors. Without the support of a coach, novice nurses would not develop the ability to be creative or think critically. The overall conclusion of the coaching concept model demonstrates that patient care and nursing job satisfaction are significantly enhanced where critical thinking skills are fostered and promoted.In todays environment of nursing staff shortages, budget constraints and a higher patient acuity, this is no small task to accomplish. However, it is still our primary responsibility in our profession to take the actions necessary to enhance our practice. Rather than being discouraged over the reality of our situation, we should become more creative in our solutions. This creativity was expressed in development of the coaching model. Finally; we found that nursing units that promote critical thinking, professionalism and cohesion will result in higher staff retention rate ReferencesGrealish, L. (2000) The skills of coach are an essential in clinical learning. Journal of Nursing Education, 39(5), 231-233. Nelson, J., Apenhorst, D., Carter, L., Mahlum, E., Schneider, J., (2004) Coaching for Competence. Medsurg Nursing, 13(1), 32-35. Publication Manual of the American Psychological Association. (5th ed.). (2003). Washington DC: American Psychological Association. Wright, A. (2002) Precepting in 2002. The Journal of Continuing Education in Nursing, 33(3),138-141.

Performance Appraisal and Review at the Zoological Society of San Diego free essay sample

The Zoological Society of San Diego (ZSSD) was founded in 1916. It was a non-profit organization that operated the Zoo and two more organizations in San Diego. ZSSD employed around 2500-3000 people during each year. The employees working in the ZSSD comprised a diverse group ranging from world-renowned scientists to teenage food-service workers. The HR function of the company was handled by an HR team headed by its Director. There were also other people who were responsible for organizational development, planning and training. It was actually very similar to any other mid-market enterprise. In January 2005, ZSSD implemented a new strategic plan in order to modernize its way of doing business. As a part of it, the organization wanted to improve employee accountability, recruitment and retention. In fact, ZSSD did not have a formal process for their employee performance appraisal, evaluation or development. They did not use any uniform metrics in order to evaluate subordinates, it was done in a very vague and subjective way and there was no seriousness regarding the whole process (there were even no consequences if the forms were not filled up) so multiple versions of the forms were handed in to the managers. We will write a custom essay sample on Performance Appraisal and Review at the Zoological Society of San Diego or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page As a matter of fact, there were employees who had not been evaluated for many years (there was one in particular who had not been reviewed in 27 years! ). With the purpose of facing this fact, a new Director of Human Resources, Tim Mulligan, was signed. Mulligan soon found all the problems related with the employees appraisal and evaluation and so decided to use an online employee performance management system. First of all, he identified the primary objectives for the new system which were to link unbiased employee goals to the organization ones and to include a midyear review to ensure there was continuous communication with the employees. Mulligan also realized they needed to identify the relevant metrics to measure performance and to ensure the software solution was easy to use so it was decided that performance appraisals would be based on two categories: †¢ Achievement of goals †¢ Leadership competencies At the beginning of each year, each manager would choose five goals, at least three of which had to be linked to overall organizational objectives. The other two goals could be related to the manager’s specific area of operation. By January 2007 more than 300 employees were using the new online system, which somehow enabled to track the progress of appraisals in less time and allow them to be completed in a much more fair and proper way. So setting goals and implementing the new performance management process helped employees get a clear understanding of their responsibilities and made them realize the organization had put special emphasis on accountability. Mulligan started to notice how the employee’s motivation and morale had been boosted and also how their satisfaction increased throughout higher benefits, improved training programs and rewarding performance. Of course now employees worked harder to get better personal financial rewards, which contributed to the overall objectives of the organization. Thus we are now able to see how important can be the role HR plays in a mid- market enterprise by helping achieve organizational objectives increasing the efficiency and horizontal communication following a previously established batch of simple rules. Now the appraisals were much faster and credible and even the whole organization was taking profit of it, supported by a much more self- conscious and effective work done by the employees, which also means it was easier to select those of them more talented and hard-workers. I see it like a huge improvement within the organization, like a win-win arrangement where both parts, employees and organization take advantage of it.

Story of An Hour †English Composition Essay

Story of An Hour – English Composition Essay Free Online Research Papers Story of An Hour English Composition Essay An unknown author once said, †Dont cry because it’s over, and smile because it happened†. This is how Mrs. Mallard looked upon the news of her husband’s death. She did not cry, but rejoiced at her newfound freedom. This was her chance to redo her life and move on. In the short story â€Å"The Story of an Hour† by Kate Chopin, Mrs. Mallard gets the news of her husband’s death in a train accident. There is a pattern in the story of Mrs. Mallards new freedom around her and coming out from the darkness. The imagery in the story describes the vivid picture of an open window and peaks of blue sky to help her realize the potential in this situation. She weeps at first, feeling alone and dark in her house but realizes that this occurrence has given her the freedom she strives for. She moves from the house that is holding her back to a new life. Mrs. Mallard lives in a dull, gray house, which has its comforts but does not satisfy her needs. After hearing of her husband’s death, â€Å"she went away to her room alone. She would have no one to follow her† (45). Her view of the world had changed; she now had a â€Å"dull stare in her eyes† (46). She was trapped in a room slowly encapsulating her. In the room there was only on thing to give her comfort was a â€Å"comfortable, roomy armchair† which faced an open window, a window that would be her escape. Everything seemed to be going wrong until something came to her. â€Å"She felt it, creeping out of the sky, reaching toward her through the sounds, the scents, the color that filled the air. This line, full of imagery, is extremely important because after this point Mrs. Mallard realizes her life has begun again. The symbols and images used by Kate Chopin to give the reader a sense of Mrs. Mallard’s new life appearing before her, come through her view of the open window. Mrs. Mallard could see â€Å"the tops of trees that were all aquiver with new spring life [and†¦] The delicious breath of rain was in the air† (45). She could hear â€Å"the notes of a distant song which someone was singing† (45). And â€Å"there were patches of blue sky showing here and there through the clouds† (45). The imagery of blossoming spring life in Chopin’s story is a sign of Mrs. Mallard’s new life as well. She was trapped in darkness all alone but an open window brought her her new sense of freedom. Mrs. Mallard felt overwhelmed by her day’s happenings until she felt a rush come upon her. â€Å"When she abandoned herself a little whispered word escaped through her slightly parted lips. She said it over and over under her breath: ‘free, free, free!’† (46). She felt overjoyed all of a sudden about the news of her husband’s death. â€Å"Her pulses beat fast, and the coursing blood warmed and relaxed every inch of her body† (46). She realizes that this event is her chances to get away and live her life the way she wants to. It is not that she did not love her husband it is that â€Å"she loved him – sometimes† (47). Kate Chopin uses these images to show Mrs. Mallard’s surroundings as one with her feelings. Mrs. Mallard feels trapped and alone in her room until she realizes the true potential of what has happened through the open window that showed her the world outside her dull, gray life. â€Å"She was drinking the very elixir of life through that open window† (47). Chopin, Kate. â€Å"The Story of an Hour†. The Seagull Reader: Stories. Ed. Joseph Kelly. New York: W. W. Norton Company, Inc, 2001. 45 – 47. â€Å"Quotes of the Heart: Life Quotes and Proverbs†. HeartMath. 10 Apr 2005. Research Papers on Story of An Hour - English Composition EssayThe Masque of the Red Death Room meaningsMind TravelTrailblazing by Eric AndersonThe Spring and AutumnBook Review on The Autobiography of Malcolm XHip-Hop is ArtHarry Potter and the Deathly Hallows Essay19 Century Society: A Deeply Divided EraCapital PunishmentAnalysis Of A Cosmetics Advertisement

Battle of Coochs Bridge in the American Revolution

Battle of Cooch's Bridge in the American Revolution Battle of Coochs Bridge - Conflict Date: The Battle of Coochs Bridge was fought September 3, 1777, during the American Revolution (1775-1783). Battle of Coochs Bridge - Armies Commanders: Americans General George WashingtonBrigadier General William Maxwell450 men British General Sir William HoweLieutenant General Lord Charles CornwallisLieutenant Colonel Ludwig von Wurmb293 men Battle of Coochs Bridge - Background: Having captured New York in 1776, British campaign plans for the following year called for Major General John Burgoynes army to advance south from Canada with the goal of capturing the Hudson Valley and severing New England from the rest of the American colonies.   In commencing his operations, Burgoyne hoped that General Sir William Howe, the overall British commander in North America, would march north from New York City to support the campaign.   Uninterested in advancing up the Hudson, Howe instead set his sights on taking the American capital at Philadelphia.   To do so, he planned to embark the bulk of his army and sail south. Working with his brother, Admiral Richard Howe, Howe initially hoped to ascend the Delaware River and land below Philadelphia.   An assessment of the river forts in the Delaware deterred the Howes from this line of approach and they instead decided to sail further south before moving up the Chesapeake Bay.   Putting to sea in late July, the British were hampered by poor weather.   Though aware of Howes departure from New York, the American commander, General George Washington, remained in the dark regarding the enemys intentions.   Receiving sighting reports from along the coast, he increasingly determined that the target was Philadelphia.   As a result, he began moving his army south in late August.   Battle of Coochs Bridge - Coming Ashore: Moving up the Chesapeake Bay, Howe started landing his army at Head of Elk on August 25.   Moving inland, the British began concentrating their forces before beginning the march northeast toward Philadelphia.   Having encamped at Wilmington, DE, Washington, along with Major General Nathanael Greene and the Marquis de Lafayette, rode southwest on August 26 and reconnoitered the British from atop Iron Hill.   Assessing the situation, Lafayette recommended employing a force of light infantry to disrupt the British advance and give Washington time to choose suitable ground for blocking Howes army.   This duty normally would have fallen to Colonel Daniel Morgans riflemen, but this force had been sent north to reinforce Major General Horatio Gates who was opposing Burgoyne.   As a result, a new command of 1,100 handpicked men was quickly assembled under the leadership of Brigadier General William Maxwell. Battle of Coochs Bridge - Moving to Contact: On the morning of September 2, Howe directed Hessian General Wilhelm von Knyphausen to depart Cecil County Court House with the right wing of the army and move east toward Aikens Tavern.   This march was slowed by poor roads and foul weather.   The next day, Lieutenant General Lord Charles Cornwallis was ordered to break camp at Head of Elk and join Knyphausen at the tavern.   Advancing east over different roads, Howe and Cornwallis reached Aikens Tavern ahead of the delayed Hessian general and elected to turn north without waiting for the planned rendezvous.   To the north, Maxwell had positioned his force south of Coochs Bridge which spanned the Christina River as well as sent a light infantry company south to set an ambush along the road. Battle of Coochs Bridge - A Sharp Fight: Riding north, Cornwallis advance guard, which was comprised of a company of Hessian dragoons led by Captain Johann Ewald, fell into Maxwells trap.   Springing the ambush, the American light infantry broke up the Hessian column and Ewald retreated to obtain aid from Hessian and Ansbach jgers in Cornwallis command.   Advancing,  jgers led by Lieutenant Colonel Ludwig von Wurmb engaged the Maxwells men in a running fight north.   Deploying in a line with artillery support, Wurmbs men attempted to pin the Americans in place with bayonet charge in the center while sending a force to turn Maxwells flank.   Recognizing the danger, Maxwell continued to slowly retreat north towards the bridge (Map). Reaching Coochs Bridge, the Americans formed to make a stand on the east bank of the river.   Increasingly pressed by Wurmbs men, Maxwell retreated across the span to a new position on the west bank.   Breaking off the fight, the  jgers occupied nearby Iron Hill.   In an effort to take the bridge, a battalion of British light infantry crossed the river downstream and began moving north.   This effort was badly slowed by swampy terrain.   When this force finally arrived, it, along with the threat posed by Wurmbs command, compelled Maxwell to depart the field and retreat back to Washingtons camp outside Wilmington, DE. Battle of Coochs Bridge - Aftermath: Casualties for the Battle of Coochs Bridge are not known with certainty but are estimated at 20 killed and 20 wounded for Maxwell and 3-30 killed and 20-30 wounded for Cornwallis.   As Maxwell moved north, Howes army continued to be harassed by American militia forces.   That evening, Delaware militia, led by Caesar Rodney, struck the British near Aikens Tavern in a hit-and-run attack.   Over the next week, Washington marched north with the intention of blocking Howes advance near Chadds Ford, PA.   Taking a position behind the Brandywine River, he was defeated at the Battle of Brandywine on September 11.   In the days after the battle, Howe succeeded in occupying Philadelphia.   An American counterattack on October 4 was turned back at the Battle of Germantown.   The campaign season ended later that fall with Washingtons army going into winter quarters at Valley Forge.            Selected Sources DAR: Battle of Coochs BridgePHAA: Battle of Coochs BridgeHMDB: Battle of Coochs Bridge

Medical Technology Assessment Research Paper Example | Topics and Well Written Essays - 1500 words

Medical Technology Assessment - Research Paper Example From this paper it is clear that technology assessment is the evaluation of emerging and existing technology trends to substantiate their existence in the world today. It seeks to identify the relevance of these technologies, and the role they play in the economic stability of organisations and the world at large. Furthermore, it is widely believed that scientists are not trained ethics as such whatever innovation they create should be assessed for any ethical concern. Technology assessment is viewed as interdisciplinary and capable of identifying and solving a wide range of technology based problems. An important concern, addressed by technology assessment is the collingridge dilemma. This is the situation where impacts of a new technology cannot be easily predicted unless the technology is fully developed and used. Yet on the other hand, it is absolutely difficult to change or control technology once it is widely used.This report stresses that  the Cleveland clinic is an academic medical centre that has seen a tremendous growth over the years since its inception. It has a designated research laboratory, the Cleveland Clinic Lerner Research institute that is characterised by high technological advancements.  A quick look at the operations within and without this medical facility reveals a heavy reliance on technology and information systems.  This is a specialised type of technology assessment that informs management and relevant medical policy makers of the efficacy of medical systems.   The main purpose of health technology assessment is to obtain ground for decision making with regards to application of technology within the healthcare system (Healthcare, 2009). These decisions should be made systematically with adequate and well documented information so as to leave little or no margin for error. Laboratory metal on metal hip resurfacing technology This medical procedure involves the replacement of the surface of the femoral head with an artificially made metal hemisphere that fits into a metal acetabula cup (Healthcare, 2009). This technology initially designed by an orthopaedic surgeon in Birmingham conserves and maintains most parts

The Co-operative Group (Food,Funeralcare,Banking group, Essay

The Co-operative Group (Food,Funeralcare,Banking group, Pharmacy,Travel) - Essay Example Marketers have started to make different market segments for ensuring an easy access to their target customers. It ensures proper delivering of the products as demanded by the target customers (Wedel & et. al., 2000). Source: (Gelb Consulting Group, n.d.) In relation to the study of market segmentation, The Co-operative Group Ltd has been chosen to demonstrate the features, failures and overcoming of the failures in different market segmentation in terms of this company. The Co-operative Group Ltd is a consumer cooperative based company headquartered in the United Kingdom with having its diverse retain chains including business relating to food, funeral care, banking group, pharmacy and travel. There are many cooperative businesses in the world. Among them The Co-operative Group is one of the largest. It is the biggest mutual business of the United Kingdom. It has been operating with more than 4800 retail outlets and it also employs above 100,000 individuals in its chain organisation . Its annual turnover in over 13billion Pounds a year. It is a kind of consumer cooperative (Co-operative Group Limited, n.d.). ... The reason behind this is that marketing strategies made for a group completely differ by its accessibility to another group. Target markets are actually quantifiable through factors related to their income, age bracket and population. Characteristics should be recognisable in a well defined manner and in measurable format. Substantial indicates that the segment should be large enough to stand as a group and also large enough to become profitable (Gelb Consulting Group, n.d.). 2.0 Features of Segmentation Market segmentation plays a very crucial role for formulating marketing strategy of a majority of successful organisations. Contextually, all markets embrace a different kind of groups of people with different needs along with preferences (Lamb & et. al., 2008). It helps the marketer to define the marketing objectives more accurately. In addition to this, better allocation of resources also should be there. On the other side, performance of the market can be evaluated more preciousl y when the marketers have the precise objectives for the specific segment of markets. Each and every firm cannot serve its potential customers in the same way as it does not have abundant resources (Blyth & Zimmerman, 2005). 2.1 Defining the Target Market Market is a very complex phenomenon from the viewpoint of a company. It constitutes different sets of consumers, leads to different tastes and demands for different products. Thus, from a company perspective, it is quite tough to position products to a specific market as the demand for that particular is distinct with reference to a varied set of consumers. Market segmentation techniques help an organisation to differentiate a market into different target

September 11 Terrorist Attacks and Americans’ Preparedness for Disaster Essay Example for Free

September 11 Terrorist Attacks and Americans’ Preparedness for Disaster Essay The September 11, 2001 terrorist strikes on the Pentagon and the World Trade Center were arguably the heaviest attacks on the U.S. soil since the Pearl Harbor attack by the Japanese in 1941. The attacks, masterminded from one of the poorest countries in the world, shook the core of the world richest and most powerful nation. Many Americans still believe that the colossal intelligence machinery failed to intercept the hits, even when it had sufficient evidence that an attack was looming (Betts, 2008). The U. S. intelligence community missed or chose to overlook some of the strongest indicators of the imminent attack. Some of the pilots who launched the attacks trained in the U.S. In June, 2001, a detective observed that flight schools in Arizona were populated by an â€Å"inordinate number of individuals of investigative interest† (Betts, 2008). Having learnt earlier that the Al-Qaeda was planning to launch â€Å"plane operations,† the FBI missed to connect the imminent operations and the suspect flying students (National Commission on Terrorists Attacks Upon the United States, 2004). The former students were part of the 9/11 strike team (Marquise, 2008). One of the plotters of the 9/11 strikes, Ramzi Yousef (a Pakistani) had been arrested in the Philippines where he planned to down 11 airliners in 1995. He escaped and fled to Pakistan. His partner told the police that he planned to ram a plane into the CIA headquarters. Yousef was nephew to Khalid Sheikh Mohammed who plotted the plane attacks in the Philippines and later masterminded the 9/11 attacks. The U.S. intelligence was aware of an Al Qaeda operation in the offing after surveilling a meeting of Al-Qaeda bigwigs in Malaysia in January 2000. According to Marquise (2008), the intelligence did not share the information with the law enforcement agencies to tighten surveillance within the US and at the entry points. The US would have pre-empted the attack if it had acted promptly and conclusively on the â€Å"Phoenix memo† which was written by the agent who noted the suspicious persons attending flying lessons in Arizona (Betts, 2008). In the memo, the agent raised concern that Osama bin Laden was likely to be planning an attack. He recommended that the FBI investigate the flight students. Investigators only paid attention to the memo after the attack. The attackers who trained in the US entered the country legally, and were granted tourist visas. Even as they entered the country however, custom officers noted anomalies with their applications but went ahead to allow them in. In June 2001, Saeed al Ghamdi entered the US with only $500, a one-way ticket and no address on the I-94 form. Investigations showed that six of the hijackers had contravened immigration laws during their months of stay yet none had been arrested. The Immigration Department could therefore have averted the attacks had its agents detected the overstays and violations of student status (National Commission on Terrorists Attacks Upon the United States, n.d). There is no evidence of either Washington D.C. or New York having employed a hazard or vulnerability analysis to plan for a disaster of the kind and magnitude of the 9/11 terrorist attacks. While the authorities of both cities were not in a strong position to avert the attacks, their reaction in the time following the strikes was catastrophic. Besides the people who were killed by the crashes, hundreds of responders succumbed to illness as a result of exposure to the atmospheric conditions occasioned by the explosions. The responders worked in an asbestos-contaminated environment yet they worked without respirators (Levin, S. et al., 2004). Residents of Lower Manhattan were assured that the â€Å"air was safe† yet tens of thousands perished after contact with the toxic fumes later (Mason, 2007). New York and Washington D.C authorities were unwilling to admit their unpreparedness and were quick to declare the air and water safe while it was not. References Betts, R. (2008). Two Faces of Intelligence Failure: September 11 and Iraq’s Missing WMD. Political Science Quarterly, Vol. 122, No. 4. Levin, S., Herbert, R., Moline, J., Todd, A., Stevenson, L., Landsbergis, P., Jiang, W., Skloot, G., Baron, S. Enright, P. (2004). Physical Health Status of World Trade Center Rescue and Recovery Workers and Volunteers- New York City, July 2002 – August 2004. Journal of the American Medical Association, Vol. 292 Issue 15. Marquise, R. (2004). Terrorism Threat Indicators. The Counter Terrorist. Mason, M. (2007). The 9/11 Cover-Up. Discover, Vol. 28, Issue 10. National Commission on Terrorist Attacks Upon the United States (2004). The 9/11 Commission Report. New York.

Enrich Maria Remarque: A Militant Pacifist :: essays research papers

Enrich Maria Remarque: A Militant Pacifist   Ã‚  Ã‚  Ã‚  Ã‚  The First World War was a horrible experience for all sides involved, no one was immune to the effects of this global conflict, and each country was changed in many ways. Erich Maria Remarque was drafted into World War I at age 18. In 1929 Remarque’s first book All Quiet on the Western Front was published. Throughout the book, the death and destruction caused by battle is clearly shown. Remarque's novel is a statement against war, focusing dramatically on the extreme effects of war on the humanity of soldiers. Biography   Ã‚  Ã‚  Ã‚  Ã‚  Erich Paul Remark was born on June 22, 1898 In Western Germany. In 1913 Remark began to attend a teachers college called Osnabruck’s Lehrerseminar. During his third year when he was eighteen he was drafted into the war. After finishing basic training in the war he was assigned to a reserve battalion. His mother became very ill, so he was often allowed to visit her. In June 1917 he was reassigned to a trench unit. Remark was soon injured by grenade splinters and rushed to St. Vincenz hospital in Duisburg during 1917-1918. His mother died while he was in the hospital. After a year in the hospital he returned to Osnabruck for further training. The war had ended before Witt 2 he returned to active duty. After the war he changed his middle name to Maria after his mother.   Ã‚  Ã‚  Ã‚  Ã‚  Remark went back to college after the war. He graduated and started his two-year substitute training in 1919. Finally he got bored teaching, and did different odd jobs such as, playing organ on Sundays at an insane asylum, working for a tombstone firm, working as a small town drama critic, and racing sports cars. In 1920 he published a novel that was so bad he changed the spelling of his last name to Remarque. His book All Quiet on the Western Front was published in 1929 and Remarque â€Å"became a spokesman of a generation that was destroyed by war†-Kirjas. Many people loved the book, and according to New York Times, All Quiet was â€Å"one of the best-known anti-war novels ever, which decepted the horrors of war from the point of view of the ordinary soldiers†. In 1930 the Nazis banned his books and burned them at the famous book burning in 1933; Remarque later stated, â€Å"I was only misunderstood where people went out of their way to misunderst and me†.

Promote and implement health and safety Essay

Promote and implement health and safety in health and social care (HSC 037) Outcome 1 : Understand own responsibilities, and the responsibilities of others, relating to health and safety 1. identify legislation relating to health and safety in a health or social care work setting The settings in which we are likely to provide support are generally covered by the Health and Safety at Work Act 1974 ( HASAWA ). This Act is like the overall â€Å"umbrella† that has been updated and supplemented by all the regulations and guidelines which extent it, support it or explain it. Health and Safety at Work Act: Manual Handling Operations Regulations 1992 ( as amended 2002 ); Control of Substances Hazardous to Health Regulations 2002 ( COSHH ); Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 1995 ( RIDDOR ) ( amended 2008); Health and Safety First Aid Regulations 1981; Management of Health and Safety at Work Regulations 1999. Read more: Analyse factors that tend to trigger own stress essay 2. explain the main points of health and safety policies and procedures agreed with the employer The Health and Safety at Work Act 1974 is the main piece of legislation that covers related health and safety in England. It is everyone, no matter what their job role is, within the organisation has a responsibility to ensuring the health and safety of each other while at work. It is also the employee’s duty to take care for themselfves and of other persons who may be affected and time to read the risk assessment reports and follow any changes that have been made. All staff should follow the changes that have been made. Things such as manual handling, be sure that we move and handle object and inviduals safely; fire/evacuation policy, be sure that we know our organisation fire /evacuation policy and procedure and the location of fire exits and fire equipment and how to call for help; risk assessment, understand the risk to each activity that we undertake and assess the risk regulary if there is any improvement or not; waste disposal policy, understand the colour of the general waste and clinical, the type of sharp boxes with differrent colour; infection control, we need to know the policies that are designed to prevent the spresd of infection, such as washing your hands between each patient and side rooms, where can have an infection with mrsa, cddif so we have to wash before entrering the room and after, aswell hearing a yellow appron. 3. Analyse the main health and safety responsibilities of: †¢ self, to take care of our own health and safety; if possible, avoid wearing jewellery, such as necklace, that can be stuck in some equipment; if you have long hair or wear a headscarf, to make sure it is tied up; making sure that we get proper training and that we understand and follow the company ´s health and safety policies; to report any injuries, strains or illnesses we suffer as a result of doing our job; tell our employer if something happens that might affect our ability to work. †¢ the employer or manager, have to make the workplace safe; prevent risks to health; ensure that equipment is safe to use, and that safe working practices are set up and followed; make sure that all materials are handled, stored and used safety; provide adequate first aid facilities; tell us about any potential hazards from the work we do, chemicals and other substances used by the organisation, and give us information, instructions, training and supervision as needed; set up emergenc y plans; make sure that temperature, lighting and tolitel, washing facilities all are adequate in health and safety; check if the right work equipment is provided and properly used and regulary maintained; avoid potentially dangerous work involving manual handling and, if it cannot be avoided, take precautions to reduce the risk of injury; report certain accidents, injuries, diseases and dangerous occurances to eitheir the Health and Safety Executive (HSE). †¢ others in the work setting, other employees in the work place have the same role as us. They should use all PPE made available to them. They should be responsible for their own health and safety, in accordance to the policies, as well the patients and other employees around them and they should report any concernes to reduce the risk to the patients. 4. identify specific tasks in the work setting that should not be carried out without special training. Manual handling equipment, such as sliding sheets, hoists,mobility aids, need to be carried out by people who have had a training to do it. Employers are obliged to provide training in manual handling. Traning it is important to be up to date, for new techniques and equipment. Moving patients without proper training is dangerous for both of us. We will also need training for specific equipment, for example, arjo hoist and oxford hoist is to be used in workplace, no one will be able to operate it without training. When we have to move a patient out of bed and get him in the armchair, so we have a look on the risk assessment manual & handling form how to mobile, it is  written need to use a arjo hoist. To use a hoist we have to have a training how to use it and how to know which sling we should use. A patient weigh 60 kg, so we check the different colors of the slings and we should use the yellow sling, so now we can hoist the patient on the armchair. So for that we need a manual handling training update. Outcome 2: Be able to carry out own responsibilities for health and safety 1. use policies and procedures or other agreed ways of working that relate to health and safety Health and Safety policies set out the arrangements thta a workplace has for complying with legislation. Health and Safety procedures decribes the activities that need to be carried out our work in line with the policies and procedures laid down by your employer. There is no point having policies and procedures if they are not followed. We must be clear about the areas thatt are our responsibility. 2. support others to understand and follow safe practices Supporting people to take steps about their own safety. It is important that we recognise that people you are supporting need to be able to ensure their own health and well-being as far as possible. To support this, we should encourage and assist people to: talk about the stepd they would prefer to take in relation to health and safety; understand and take responsibility for promoting their own health and care; assess and manage risks to their health and well-being; identify and report any factors that may put themselves or others at risk. It is very difficult if we are the only person in your worplace following good practice. We may able to encourage others by: always showing a good example; explaining why we are following procedures; getting some health and safety leaflets from our trade union or environmental health office and leaving them in the staffroom for people to see; bringing in any imformation about training; asking our manager if they can arrange a talk on health and safety. 3. monitor and report potential health and safety risks We are have a responsability with our employer for the safety of all the peolple who use our service. This means that we need to be alert alll the time- risks and hazards are constantly changing and we need to make sute that we are aware of these canges. Juat because we checked something six  months ago, do not assume that it is still working well; a hoist that worked few days ago may not work today. We need to be aware of and monitor the following types of hazards regulary. Reporting risks to our manager or 6000 is important , even after a risk assessment and control measures. We should report hazards that are beyond our role and competence, such as: faulty equipment; loose or damaged fittings; damage or faulty aids-for exemplo, bed brakes, bed controlers, hoists. As well as our responsibility to report risks and hazards to our employer, all employers have to report certain events to the Health and Safety Executive or environmental health department. 4. use risk assessment in rela tion to health and safety Risk assessment in health and social care is important for everyone whether they are employers, self-employed or employees, who are required by law to identify and assess risks in the workplace. This includes any situations where potential harm may be caused. There are many regulations that require risks to be assessed and some are covered by European Community directives. These include: Management of Health and Safety at Work Regulations 1999; Manual Handling Operations Regulations 1992; Personal Protective Equipment at Work Regulations 1992; Health and Safety ( Display Screen Equipment ) Regulation 1992; Noise at Work Regulation 1989; Control of Substances Hazardous to Health Regulations 2002 (COSHH); Control of Asbestos at Work Regulations 2002; Control of Lead at Work Regulations 2002. The Management of Health and Safety at Work Regulations 1999 state that employers have to assess any risks which are associated with the workplace and work activities. Risk assessments are vitally important in order to protect the health and safety of both of us and the people we support. We should always check that a risk assessment has been carried out before we undertake any task, and then follow the steps identified in the assessment in order to reduce the risk. 5. demonstrate ways to minimise potential risks and hazards Done. assess at work. 6. access additional support or information relating to health and safety. Outcome 3: Understand procedures for responding to accidents and sudden illness 1. describe different types of accidents and sudden illness that may occur in own work setting We may be involved with any of different types  of accidents and sudden illness at the hospital, we can occur with patients wandering around the ward, who has dementia, they can trip over with their clothes, getting tired to walk around and can have a fall, they can have aggressive behaviours towards to the staff who trying to help them. Patient walking with mobility aids, frame, to the toilet with assistance from a member of staff and carried a oxygen bottle(small). Can occur a sudden illness of strength using a toilet and having a loss of consciousness. Can occur loose stool with offensive smell and type 5/6/7 when a patient been treated with antibiotics due to any infection they had such a UTI or a chest infection. 2. explain procedu res to be followed if an accident or sudden illness should occur. When accidents or sudden illness happen we call for help, cases of a fall, if the patient follow commands, they can stand using a chair or a bed, bending their knee and stand with our help, in case of a patients can ´t stand, we use the hoist, after that we check their skin, asking if they have any pain and do a set of observation and bleep the doctor. Loss of consciousness happen from a strength, call for help, pulling the emergency alarm, quick and bring him back to bed, increase the oxygen, set of observations and bleep the doctor. If we have a patients with C. Difficile infection is a type of bacterial infection that can affect the digestive system. It most commonly affects people who have been treated with antibiotics, they should be in the side room. The procedure to be followed when a patient has loose stool type 5/6/7, a stool speciment should be sent for c.diff and mrsa check, when we know the result of the speciment and it is c.diff, isolate the patient if a side room is available or barrier nurse in the bay with a trolley with gloves, yellow apron and a sign with a date of commence of the diarrhea and tick the boxes what the visitors should do and give to the patient a leaflet of information regarding the infection they have. C. difficile bacteria spread very easily can usually be prevented by practising good hygiene such as washing hands regularly and cleaning surfaces using products containing bleach. Visitors/staff can reduce the risk of spreading infection by washing your hands before and after entering the bed space. Alcohol hand gel is not effective against C. difficile spores, so the use of soap and water is essential. Outcome 4: Be able to reduce the spread of infection 1. explain own role in supporting others to follow practices that reduce the spread of infection My role in supporting others is to follow practices that reduce the spread of infection by always ensuring I wear the correct ppe, wash my hands frequently, and dispose of contaminated waste in the yellow bins provided. Make sure all the equipment is clean before use and after use. My role in supporting others to preventing C. difficile infections is advising visitors, if they are visiting a patient in hospital who has diarrhea or a stomach upset, to try to avoid taking any children under the age of 12 with them. They should also, wash their hands with soap and water when entering and leaving ward areas, side rooms. Avoid coming to hospital if they are feeling unwell or have recently had diarrhoea. Observe visiting hours and all visiting guidelines. Healthcare workers should wear disposable gloves and aprons when caring for anyone who has a C. difficile infection. Whenever possible, people who are infected with C. difficile should have their own room and toilet facilities to avoid passing the infection on to others. Staff, patients and visitors should be encouraged to wash their hands regularly and thoroughly. Alcohol hand gel is not effective against C. difficile spores, so the use of soap and water is essential. Surfaces that may have come into contact with the bacteria or spores, such as toilets, the floor around toilets, bedpans and beds, should also be cleaned thoroughly with water and a cleaning product that contains bleach. 2. demonstrate the recommended method for hand washing Face to face done 3. demonstrate ways to ensure that own health and hygiene do not pose a risk to an individual or to others at work. Face to face done Outcome 5: Be able to move and handle equipment and other objects safely 1. explain the main points of legislation that relates to moving and handling There are 2 main pieces of legislation that are relevant to moving and handling. They are the Health and Safety at Work Act 1974 and the Manual Handling Operations Regulations 1992 (amended 2002). Health and Safety at Work Act 1974: This refers to all health and safety issues, not just moving and handling. It states that employers have an obligation to provide equipment, information, instruction, training and supervision to ensure as  far as is reasonably practicable, the health and safety at work of their employees. It also states that every employee must safeguard themselves and others and must co-operate with the employer. Manual Handling Operations Regulations 1992: This states that manual handling should be avoided whenever possible; If it is not possible to avoid manual handling, the task should be risk assessed; Any risks that have been identified should be reduce as much as possible; Assessments should be reviewed on a regular basics; Employees must comply with policies and procedures regarding manual handling. 2. explain principles for safe moving and handling Wear appropriate footwear and clothing which allows freedom of movement. Always assess the load, task, capabilities of staff and environment (TILE) before manual handling. Always select the correct equipment or technique for the movement. Avoid manual lifting wherever possible. Remove all potentially dangerous objects. If moving a patient, teach them to participate and encourage independent movement. Stand as close to the patient as possible, and spread your feet to shoulder width. Bend your knees ( use thigh not back muscles ) and try and keep the back upright posture. Keep head up to avoid stooping, look straight ahead. Use the legs to lift the patient in a smooth motion as this offers more leverage reducing the strain on your back. Avoid twisting the body as much as possible by turning your feet to position yourself with the patient. Brace your abdominal muscles when moving and handling to help support the lumbar spine. Use the commands READY BRACE MOVE. 3. move and handle equipment and other objects safely. Outcome 6: Be able to handle hazardous substances and materials 1. describe types of hazardous substances that may be found in the work setting The Control of Substances Hazardous to Health ( COSHH ) Regulations apply to substances that have been identified as Toxic: chemicals which in very low quantities cause death or acute or chronic damage to health whn inhaled, swallowed or absorbed through the skin; Corrosive: chemicals which on  contact withh living tissues may destroy them; Harmful: chemicals which may cause death or accute or chronic damage to health; Irritant: non-corrosive chemical which through immediate, prolonged or repeated contact with the skin or mucous membranes, may cause inflammation; Explosive; chemicals that may react producing heat without atmospheric oxygen, quickly producing gases and which can detonate and explode; Oxidising: chimicals which give rise to heat producing reactions when in contact with other substances, particularly flammable substances; Flammable: Extremely ( F+ ) liquids that have an extremely low flash point below 0 ºC and low boiling point equal to or below 35 ºC. Or gaseous substnces which are flammable in contact with air at ambient temperature and pressure. Highly ( F ) chemicals which may become hot and catch fire in contact with air at ambient temperature without any application of energy. A solid which readily catches fire with minimal contact with a source of ignition and which continue to burn after the source is removed. Liquids with a very low flashpoint ( equal to or less than 21 ºC ) and not classified as extremely flammable. 2. demonstrate safe practices for: †¢ storing hazardous substances †¢ using hazardous substances †¢ disposing of hazardous substances and materials. Outcome 7: Be able to promote fire safety in the work setting 1. describe practices that prevent fires from: a. starting Practices that prevent fires from starting include: the use of smoke alarms, ensuring all cigarettes have been extinguished, ensuring all unused electrical equipment is unplugged and ensuring electrical and gas appliances have been checked. b. spreading Practices that prevent fires from spreading include: Keeping fire doors closed to prevent the spread of fire, not opening windows that might make the fire spread suddenly. 2. demonstrate measures that prevent fires from starting 3. explain emergency procedures to be followed in the event of a fire in the  work setting Fire emergency procedures: Sound the alarm, then call the fire brigade, follow the evacuation plan, report to the assembly point. Help others only if safe to do so otherwise close doors behind to avoid the fire spreading, it is also important not to use the lift in a fire. All routes of evacuation, fire exits, doors, corridors and passage ways must be kept clear at all times because if a fire occurs, all means of quick escape are available. This also complies with legislation requirements. 4. ensure that clear evacuation routes are maintained at all time. Outcome 8: Be able to implement security measures in the work setting 1. demonstrate use of a greed procedures for checking the identity of anyone requesting access to: †¢ premises †¢ information 2. demonstrate use of measures to protect own security and the security of others in the work setting 3. explain the importance of ensuring that others are aware of own whereabouts. The importance of ensuring that others are aware of own whereabouts when in a care setting is that to avoid being caught in the situation or emergency cases where you don’t even know where to escape to save yourself. Also, If you know your whereabout, then you will avoid accidents that may happen since you know the place where you are, most of all, you will avoid being lost. For example, there was fire in the building and you have already left without telling anyone and you are not accounted for on the register they might assume you are still in the building, that’s why it is very important to tell about your whereabouts. Outcome 9: Know how to manage stress 1. describe common signs and indicators of stress Stress is the way that you feel when too much pressure is placed on you.   A little bit of pressure can be positive, productive and motivating, but too much pressure can lead to negative stress. When we talk about stress we are usually referring to negative stress. It is unhealthy for the mind and body. Everyone reacts differently to stress and different people can cope with different levels of stress. In many cases, too much stress often leads to physical, mental and emotional problems.

Effect of Red Bull Energy Drink

International Journal of Sport Nutrition and Exercise Metabolism,? 2007,? 17,? 433-444?  ©? 2007? Human? Kinetics,? Inc. Effect of Red Bull Energy Drink on Repeated Wingate Cycle Performance and Bench-Press Muscle Endurance Scott C. Forbes, Darren G. Candow, Jonathan P. Little, Charlene Magnus, and Philip D. Chilibeck The purpose of this study was to determine the effects of Red Bull energy drink on Wingate cycle performance and muscle endurance.Healthy young adults (N = 15, 11 men, 4 women, 21  ± 5 y old) participated in a crossover study in which they were randomized to supplement with Red Bull (2 mg/kg body mass of caffeine) or isoenergetic, isovolumetric, noncaffeinated placebo, separated by 7 d. Muscle endurance (bench press) was assessed by the maximum number of repetitions over 3 sets (separated by 1-min rest intervals) at an intensity corresponding to 70% of baseline 1-repetition maximum. Three 30-s Wingate cycling tests (load = 0. 075 kp/kg body mass), with 2 min recover y between tests, were used to assess peak and average power output.Red Bull energy drink significantly increased total bench-press repetitions over 3 sets (Red Bull = 34  ± 9 vs. placebo = 32  ± 8, P < 0. 05) but had no effect on Wingate peak or average power (Red Bull = 701  ± 124 W vs. placebo = 700  ± 132 W, Red Bull = 479  ± 74 W vs. placebo = 471  ± 74 W, respectively). Red Bull energy drink significantly increased upper body muscle endurance but had no effect on anaerobic peak or average power during repeated Wingate cycling tests in young healthy adults. Key Words: anaerobic power, caffeine, exercise Red Bull energy drink is purported to improve some aspects of performance (i. . , reaction time, concentration, and alertness) in exercising individuals (1). The primary ergogenic ingredient in Red Bull is caffeine. Acute caffeine ingestion of 2–9 mg/kg body weight during aerobic exercise increases endurance and reduces fatigue (11, 12, 25, 37, 46). Most resear ch on caffeine ingestion has focused primarily on its effects during short-term or extended aerobic exercise (23), with numerous studies supporting an ergogenic effect from caffeine on exercise time to exhaustion (17, 22, 29, 46, 48), maximal power output (32, 37), and performance time (9, 41).The effects of caffeine ingestion on anaerobic performance (i. e. , Wingate cycle power) and muscle endurance Forbes, Little, Magnus, and Chilibeck are with the College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada S7N 5B2. Candow is with the Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada S4S 0A2. ? ? 433 434 Forbes? et? al. (i. e. , total repetitions for lifting a given resistance over multiple sets) are less evident, however. Regarding anaerobic performance, Collump et al. 16) showed that caffeine ingestion (250 mg) 1 h before 100-m freestyle swimming significantly improved performance time. In addition, caffeine ingestion (250 mg) 30 min before exercise resulted in significant improvements during a maximum-power 6-s cycle sprint against various loads (2). Greer et al. (28), however, observed no improvement in maximum force output or reduced fatigue during repeated Wingate anaerobic tests with 6 mg/kg of caffeine 1 h before exercise; Collomp et al. (15) found no improvement during a single 30-s Wingate test with 5 mg/kg of caffeine 60 min before exercise; and Crowe et al. 18) found that 6 mg/kg of caffeine given 90 min before two 60-s cycling bouts had no effect on peak power or work output. Regarding muscle endurance, Kalmar and Cafarelli (35) reported that 6 mg/kg of caffeine given 1 h before exercise significantly increased submaximal isometric-contraction time. In contrast, Beck et al. (7) and Jacobs et al. (34) found no improvement in bench-press or leg-press muscle endurance (i. e. , total repetitions of lifting a weight corresponding to 70–80% one-repetition maximum [1-RM]) 60–90 min after su bjects consumed ~2. 5–4 mg/kg of caffeine.Although it is difficult to compare results across studies, possible explanations for these inconsistent findings might include the dose of caffeine used, subject training status, timing of caffeine ingestion, habitual caffeine consumption, and exercise modality. Although the mechanisms explaining the possible ergogenic effects of caffeine remain to be elucidated, plausible theories include caffeine’s ability to act as an adenosine-receptor antagonist (18, 19, 23), increase plasma epinephrine concentrations (33, 45), enhance calcium release and reuptake from the arcoplasmic reticulum (40), and alter plasma potassium concentrations (18). These mechanisms most likely occur with larger caffeine doses, and it is unclear whether smaller doses would be as effective. Recently it was found that larger doses of caffeine might have negative health consequences such as impaired glucose tolerance (6). We therefore decided to study the effe cts of a smaller dose of caffeine (2 mg/kg) in the form of Red Bull energy drink. To date, only 1 study has examined the effects of Red Bull energy drink on anaerobic exercise performance in young adults.Alford et al. (1) found a significant increase in maximum speed during an all-out cycling test after Red Bull supplementation (80 mg caffeine). Our purpose was to determine the effects of Red Bull energy drink on a more standardized test of anaerobic performance (i. e. , Wingate cycle test) and on muscle endurance (i. e. , maximal repetitions during bench-press lifting). These tests were used to simulate the demands of sports such as ice hockey that involve repeated bursts of activity or muscle endurance of both the lower and upper body.Energy-drink consumption and caffeine supplementation are very common in this type of sport (38). We hypothesized that Red Bull supplementation would increase Wingate anaerobic peak and average power and bench-press muscle endurance. Methods Particip ants Sixteen healthy physically active participants (12 men, 4 women, 24  ± 6 y old) volunteered for the study. They participated in moderate physical activity 2 or 3 Effect? of? Red? Bull? on? Athletic? Performance? ? 435 times per week and were instructed not to change their diets or physical activity patterns before or during the study.All subjects were required to fill out a Physical Activity Readiness Questionnaire, which screens for health problems that might present a risk with performance of physical activity (52). The study was approved by the University of Saskatchewan Biomedical Research Ethics Board for research in human subjects. Participants were informed of the risks and purposes of the study before they gave their written consent. Experimental Design The study used a double-blind repeated-measures crossover counterbalanced design in which participants were randomized to supplement with Red Bull or placebo and receive the opposite treatment 7 d later.All participant s were required to come to the laboratory on 2 occasions before the start of the study, once to determine their bench-press 1-RM strength and again 3 d later for familiarization with the experimental design by performing 3 sets of bench-press repetitions to fatigue (separated by 1-min rest intervals) at an intensity corresponding to 70% 1-RM, followed by three 30-s Wingate cycle tests (separated by 2-min rest intervals) at a load corresponding to 0. 075 kp/kg body mass (4). There was a 10-min rest period between the bench-press endurance tests and Wingate cycle tests.Three days after the familiarization trial, subjects were randomly assigned to supplement with Red Bull (2. 0 mg/kg caffeine) or placebo (noncaffeinated Mountain Dew, lemon juice, water) 60 min before performing repeated-bench-press endurance tests and Wingate cycle tests. Seven days after this initial supplementation and testing session, subjects returned to the laboratory and ingested the opposite supplement drink and performed the same exercises in the same order. They were instructed to refrain from caffeine for 48 h, physical activity for 24 h, and food and drink for 3 h before testing.The 7-d counterbalance was chosen to allow subjects adequate recovery between exercise tests. The 48 h of caffeine withdrawal before testing would be adequate because the half-life of caffeine is about 4–6 h (24). The dependent variables measured were bench-press endurance, peak power during repeated Wingate tests, and average power over 3 Wingate tests. Physical activity level and habitual caffeine consumption were recorded before the study through the questionnaire. The exercise tests were chosen to simulate sports that involve repeated bursts of high-intensity activity, such as ice hockey.For example, the 30-s Wingate tests with 2 min rest between tests simulate the work-to-rest ratio of typical hockey shifts. Time–motion analyses indicate skating times of 30–40 s between rest intervals of either whistle stops or time on the bench. Whistle stops last about 27 s, whereas time on the bench is about 227 s, for an average rest interval of about 2 min (27, 47). The bench-press test simulates upper body work during ice hockey, such as occurs during corner play and occasionally fighting (26).A caffeine-containing supplement is ideal to evaluate for this type of sport because caffeine-containing supplements are the most popular type of supplement ingested by ice hockey players (38). 436 Forbes? et? al. Supplementation Red Bull and the placebo were identical in caloric content, volume, and taste. Supplements were provided to each participant 60 min before exercise in an opaque water bottle and consumed in the presence of a researcher. Sixty minutes was chosen because this is the approximate time it takes for caffeine concentration to reach its peak after oral ingestion (23). The caffeine dose of 2. mg/kg was chosen because it is an approximate amount shown to increase muscl e performance (7) and reduce fatigue in young healthy adults, higher doses might be associated with impaired glucose tolerance (6), it is the maximal daily dose of commercial energy drinks considered safe by Health Canada (30), and this dose allowed our heaviest subjects to consume approximately 2 cans of Red Bull, which is the maximal amount recommended on the Red Bull label. Ingredients in the Red Bull energy drink are shown in Table 1. Muscle Strength and Endurance The procedures for determining bench-press 1-RM have previously been described (13).All bench-press testing was done on a bench-press machine (Lever chest-press machine, Winnipeg, MB, Canada). Reproducibility of our 1-RM test, expressed as a coefficient of variation, was 1. 9% (14). For bench-press muscle endurance, participants performed 3 sets of bench-press repetitions to volitional fatigue, separated by 1-min rest intervals, at an intensity corresponding to 70% 1-RM. Reproducibility of the bench-press endurance tes t was assessed by testing 15 subjects 3 d apart. The coefficient of variation was 1. 5%. Anaerobic Power Peak power and average power were assessed using repeated Wingate cycleergometer tests.Blood lactate concentration was measured at rest, immediately after each Wingate cycle test, and 2 min postexercise using an automated lactate analyzer (Accutrend Lactate, Roche Diagnostics, Mannheim, Germany) according to the manufacturer’s instructions. Ten minutes after the bench-press endurance test, each subject was positioned on the Wingate cycle ergometer, and seat height, handlebar Table 1 Red Bull Energy-Drink Ingredients Ingredient Sugar Caffeine Taurine Glucuronolactone Niacin Pantothenic acid Vitamin B6 Riboflavin Vitamin B12 Amount (per kg body mass) 0. 65 g/kg 2. 0 mg/kg 25 mg/kg 15 mg/kg 0. 45 mg/kg 0. 15 mg/kg 0. 5 mg/kg 0. 04 mg/kg 0. 025  µg/kg Effect? of? Red? Bull? on? Athletic? Performance? ? 437 height and position, and toe straps were adjusted based on the settin gs determined during the familiarization trial. Subjects were instructed to cycle at a slow pace against zero resistance for 5 min. Five seconds before data collection, they were instructed to pedal at maximal rate to ensure optimal power and force production at the beginning of the test and to continue cycling at a maximal speed for the duration of the 30-s test at a load corresponding to 7. 5% of their body mass (4). Subjects were verbally encouraged throughout the test.This procedure was repeated for 3 tests, with 2 min of active rest against zero load between tests. Reproducibility of peak and average power was determined by testing 10 subjects 3 d apart. The coefficients of variation were 4. 1% for peak power and 3. 6% for average power. Statistical Analyses A 2 (caffeine-consuming subjects vs. caffeine-naive subjects) ? 2 (supplement: Red Bull vs. placebo) ? 3 (exercise sets) ANOVA with repeated measures on the last 2 factors was used to assess differences between conditions f or benchpress repetitions and for peak and average power during the Wingate tests. A 2 (caffeine-consuming subjects vs. affeine naive subjects) ? 2 (supplement: Red Bull vs. placebo) ? 5 (blood lactate at 5 time points) ANOVA with repeated measures on the last 2 factors was used to assess changes in blood lactate concentration. To determine whether 1 familiarization trial was adequate to eliminate any effects of learning over time, we ran a 3 (set) ? 2 (time) repeatedmeasures ANOVA to determine whether there were differences across sets for Wingate tests and bench-press tests between the familiarization and placebo trials. Tukey’s post hoc tests were used to determine differences between means. Statistical significance was set at P ? 0. 05.All results are expressed as mean  ± standard deviation. Statistical analyses were carried out using Statistica, version 5. 0 (StatsSoft Inc. , Chicago). Results Of the original 16 subjects who volunteered, 15 completed the study. One mal e subject withdrew because of time constraints. Seven subjects were correct in perceiving that they were ingesting Red Bull or placebo, with the remaining subjects unsure. Before testing, 8 subjects were caffeine naive, 4 reported consuming 200 mg/d. There were no side effects reported from the exercise testing, Red Bull energy drink, or placebo.There were no time main effects or set ? time interactions between the familiarization trial and the placebo trial, indicating that the familiarization trial was adequate to eliminate any learning effects. Subjects who regularly consumed caffeine did not differ from caffeine-naive subjects for any of the tests or for their responses to Red Bull versus placebo (i. e. , there were no group ? supplement interactions). There was a supplement main effect for bench-press endurance, whereby the number of repetitions over the 3 sets was greater in the Red Bull condition than with placebo (Red Bull = 34  ± 9 vs. lacebo = 32  ± 8 repetitions over the 3 sets, P = 0. 031; Figure 1). There was a set main effect for bench-press endurance, Wingate peak power (Figure 2), and Wingate average power (Figure 3); that is, performance dropped across sets as 438 Forbes? et? al. would be expected (P < 0. 05). There were no differences between Red Bull and placebo for performance across sets during the Wingate tests (peak and average power: Red Bull = 701  ± 124 W vs. placebo = 700  ± 132 W and Red Bull = 479  ± 74 W vs. placebo = 471  ± 74 W), and there were no supplement ? et interactions for any of the exercise tests (Figures 2 and 3). There was a time main effect for blood lactate (mmol/L) during repeated Wingate tests (P < 0. 01; baseline: Red Bull: 4. 2  ± 1. 3 vs. placebo 3. 6  ± 1. 0; after test 1: Red Bull 7. 4  ± 2. 4 vs. placebo 6. 6  ± 1. 8; after Test 2: Red Bull 9. 0  ± 2. 9 vs. placebo 8. 9  ± 3. 4; after Test 3: Red Bull 9. 3  ± 4. 2 vs. placebo 8. 1  ± 4. 7; and 2 min postexercise: Red Bull 9. 2  ± 3. 0 vs. placebo 7. 9  ± 2. 4), with no differences between Red Bull and placebo (Figure 4). Post hoc analyses indicated that blood Total repetitions over 3 sets of bench press 5 40 35 30 25 20 15 10 5 0 Red Bull placebo * Figure 1 — Bench-press repetitions across sets, mean  ± standard deviation. Units are repetition number. Repetition number was determined as the total number of repetitions over 3 sets of bench-press exercise at 70% of 1-repetition maximum, 1 min of rest between sets. *Number of repetitions performed during the Red Bull condition was greater than the number of repetitions performed during the placebo condition (P = 0. 031). 850 Red Bull placebo Wingate peak power (W) 800 750 700 650 600 550 500 450 400 Set 1 Set 2Set 3 Figure 2 — Wingate peak power across sets, mean  ± standard deviation. Peak power was determined by the highest power output during each of 3 sets of 30-s Wingate tests, with 2 min of rest between tests. There were no differenc es between Red Bull and placebo conditions. There was a main effect for set, with Set 1 higher than Set 2 (P = 0. 021) and Set 2 higher than Set 3 (P < 0. 01). Effect? of? Red? Bull? on? Athletic? Performance? ? 439 700 Wingate average power (W) 650 600 550 500 450 400 350 300 250 200 Set 1 Set 2 Red Bull placebo Set 3Figure 3 — Wingate average power across sets, mean  ± standard deviation. Average power was determined during each of 3 sets of 30-s Wingate tests, with 2 min of rest between tests. There was a set main effect, with Set 1 higher than Set 2 (P < 0. 01) and Set 2 higher than Set 3 (P < 0. 01). 14 12 Red Bull placebo Lactate (mMol/L) 10 8 6 4 2 0 baseline after Set 1 after Set 2 after Set 3 2 min post Figure 4 — Blood lactate concentration before and after each set of 30-s Wingate tests (separated by 2 min of recovery) and 2 min postexercise, mean  ± standard deviation.Blood lactate values were determined from fingertip blood samples. There was a set mai n effect for lactate (P < 0. 01). Blood lactate concentration increased from baseline to after Set 1 (P < 0. 01) and from after Set 1 to after Set 2 (P = 0. 016). Lactate values after Set 2 were similar to lactate values after Set 3 and 2 min after Set 3. lactate concentration was elevated above baseline after each Wingate test and at 2 min after the last Wingate test (all P < 0. 01). Blood lactate concentration increased from baseline to after Test 1 (P < 0. 01) and from after Test 1 to after Test 2 (P = 0. 16). Lactate values after Test 2 were similar those after Test 3 and 2 min after Test 3. Discussion This is the first study to investigate the effects of Red Bull energy drink on upper body muscle endurance and anaerobic cycle performance in young adults. Results 440 Forbes? et? al. showed that Red Bull energy drink significantly increased total bench-press repetitions over 3 sets compared with placebo but had no significant effect on peak or average power or blood lactate conce ntration during repeated Wingate cycling tests. The main active ingredient in Red Bull energy drink is caffeine.Although the mechanisms explaining the ergogenic effects of caffeine are not fully known, plausible theories include the antagonism of adenosine receptors (18, 23, 42) leading to an increase in central-nervous-system activation (54) and plasma epinephrine concentrations (45), enhanced calcium release and reuptake from the sarcoplasmic reticulum (40) affecting skeletal-muscle excitation–contraction coupling (42), and the alteration of plasma potassium concentrations (18, 39). Caffeine has been shown to reduce plasma potassium levels compared with placebo during exercise (39).The increased intracellular potassium concentration coupled with lower extracellular potassium might help maintain membrane contractility during exercise (39). Our results of a greater increase in bench-press repetitions over 3 sets from Red Bull ingestion (2. 0 mg/kg), but no single set effect, expand the findings of Beck et al. (7), who found no effect of a caffeine-containing supplement (2. 4 mg/kg) on single-set bench-press repetitions. For the present study, bench-press muscle endurance was assessed by the total number of repetitions over 3 sets at 70% 1-RM separated by 1-min rest intervals.In contrast, participants in the Beck et al. (7) study performed a single set of bench-press repetitions at 80% 1-RM. Differences in supplement composition, study design (crossover vs. cross-sectional), and gender might also explain these different results. In addition, we cannot conclude with certainty that the greater increase in bench-press repetitions from Red Bull energy drink is a result solely of caffeine, because Red Bull contains other ingredients (see Table 1) such as carnitine, B vitamins, and taurine.The effectiveness of carnitine is controversial, with most studies showing no benefit but some showing a benefit for increased fat metabolism and enhanced recovery from exer cise stress (for reviews, see 10 and 36). These ergogenic effects might help during aerobic endurance exercise; however, it is doubtful that a benefit would be provided by acute supplementation before high-intensity exercise. Carnitine supplementation has no effect on high-intensity exercise performance (i. e. five 90-m swims separated by 2-min rest intervals) (53) or metabolic response to high-intensity exercise (i. e. , five 1-min cycle sprints separated by 2-min rest intervals) (5). The B vitamins are important for chronic adaptation to exercise training but most likely would have minimal influence when taken before an acute exercise session (55). Although carnitine and the B vitamins might not be ergogenic for the exercise tests used in the current study, taurine might exhibit beneficial effects.Taurine, a sulfonic amino acid found primarily in skeletal muscle (31, 44), has been shown to increase force production in skinned muscle fibers in a rodent model (3), possibly through i ncreased calcium release from the sarcoplasmic reticulum and increased calcium sensitivity for excitation–contraction coupling. Others have suggested that taurine might exhibit protective effects against cellular stress such as exercise by acting as a free-radical scavenger (49).In humans, taurine supplementation (6 g/d) significantly increased exercise time to exhaustion, VO2max, and maximal workload during cycle-ergometer exercise (56). Nonetheless, the amount of taurine administered before exercise in the current study was relatively low, ranging from 1 to 2 g. Therefore, it is doubtful that it would have significantly affected performance. Effect? of? Red? Bull? on? Athletic? Performance? ? 441 Red Bull energy drink had no effect on anaerobic power measures. These findings support those of Beck et al. 7), who found no effect from a caffeine-containing supplement on peak or average power output in young adults. Although it is unclear why these caffeine-containing supplemen ts had no greater effect on anaerobic power output compared with the findings of others (2, 16), possible explanations might include the caffeine dose used, caffeine habituation, and individual training status. The caffeine dose used in the current study (2. 0 mg/kg) and that of Beck et al. (7) of 2. 4 mg/kg might have been too low to observe an ergogenic effect on anaerobic-power measures.Regarding caffeine habituation, most subjects in the current study were caffeine naive; however, 7 of 15 subjects were caffeine users, with 4 consuming 200 mg caffeine per day. The Red Bull energy drink provided approximately an additional 150 mg caffeine. One previous study suggested that caffeine might not be ergogenic in habitual caffeine consumers as a result of caffeine saturation (50). Several studies have shown, however, that habitual caffeine intake does not affect the ergogenic benefits of caffeine (8, 20, 21, 43, 51).In agreement with these studies, we did not find any differences in res ponse to the Red Bull energy drink between caffeineconsuming subjects and caffeine-naive subjects. Finally, in examining the effects of caffeine ingestion on anaerobic performance in trained and untrained swimmers, Collump et al. (16) observed a decrease in 100-m swim time in the trained swimmers but no effect in the untrained swimmers. We suggest that the variations in subject training status might explain the lack of consistency across studies. Most studies that report positive effects from caffeine on naerobic exercise have used well-trained subjects (16, 20). The results of the current study suggest that moderately active individuals experience no anaerobic benefit from caffeine through Red Bull energy-drink ingestion. In summary, the results of the present study indicate that Red Bull energy drink increases upper body muscle endurance but has no effect on Wingate anaerobic power. Red Bull energy drink is commonly ingested in the hope that it will increase exercise performance. These findings suggest that it might be effective for individuals who perform repeated upper body exercise.Future research is needed to determine whether this increase in upper body muscle endurance will translate into improved performance in sports involving upper body muscle work. References 1. Alford, C. , H. Cox, and R. Wescott. The effects of Red Bull energy drink on human performance and mood. Amino Acids. 21:139-150, 2000. 2. Anselme, F. , K. Collump, B. Mercier, S. Ahmaidi, and C. Prefaut. Caffeine increases maxim anaerobic power and blood lactate concentration. Eur. J. Appl. Physiol. 65:188191, 1992. 3. Bakker, A. J. , and H. M. Berg.The effects of taurine on sarcoplasmic reticulum function and contractile properties in skinned skeletal muscle fibers of the rat. J. Physiol. 538:185-194, 2002. 4. Bar-Or, O. The Wingate anaerobic test: an update on methodology, reliability and validity. Sports Med. 4:381-394, 1987. 5. Barnett, C. , D. L. Costill, M. D. Vukovich, et al. Effect of L-carnitine supplementation on muscle and blood carnitine content and lactate accumulation during high-intensity sprint cycling. Int. J. Sport Nutr. 4:280-288, 1994. 442 Forbes? et? al. 6. Battram, D. S. , R. Arthur, A. Weekes, and T.E. Graham. The glucose intolerance induced by caffeinated coffee ingestion is less pronounced than that due to alkaloid caffeine in men. J. Nutr. 136:1276-1280, 2006. 7. Beck, T. W. , T. J. Housh, R. J. Schmidt, et al. The acute effects of a caffeine-containing supplement on strength, muscular endurance, and anaerobic capabilities. J. Strength Cond. Res. 20:506-510, 2006. 8. Bell, D. G. , I. Jacobs, and K. Ellerington. Effect of caffeine and ephedrine ingestion on anaerobic exercise performance. Med. Sci. Sports Exerc. 33:1399-1403, 2001. 9. Berglund, B. , and P. Hemmingsson.Effects of caffeine ingestion on exercise performance at low and high altitudes in cross-country skiing. Int. J. Sports Med. 3:234-236, 1982. 10. Brass, E. P. Carnitine and spor ts medicine: use or abuse? Ann. N. Y. Acad. Sci. 1033:6778, 2004. 11. Bruce, C. R. , M. E. Anderson, S. F. Fraser, et al. Enhancement of 2000-m rowing performance after caffeine ingestion. Med. Sci. Sports Exerc. 32:1958-1963, 2000. 12. Cadarette, B. S. , L. Levine, and C. L. Berube. Effects of varied dosages of caffeine on endurance exercise to fatigue. In: Biochemistry of Exercise (13th ed. International series of sport sciences), H. G. Knuttgen, J. A. Vogel, and J. Poortmans (Eds). Champaign, IL: Human Kinetics, 1982, pp. 871-876. 13. Candow, D. G. , N. C. Burke, T. Smith-Palmer, and D. G Burke. Effect of whey and soy protein supplementation combined with resistance training in young adults. Int. J. Sport. Nutr. Exerc. Metab. 16:233-244, 2006. 14. Candow, D. G. , P. D. Chilibeck, D. G. Burke, K. S. Davison, and T. S. Palmer. Effect of glutamine supplementation combined with resistance training in young men. Eur. J. Appl. Physiol. 86:142-149, 2001. 15. Collomp, K. , S. Ahmaidi, M. Audran, J. L. Chanal, and C. Prefaut. Effects of caffeine ingestion on performance and anaerobic metabolism during the Wingate test. Int. J. Sports Med. 12:439-443, 1991. 16. Collump, K. , S. Ahmaidi, J. C. Chatard, M. Audran, and C. Prefaut. Benefits of caffeine ingestion on sprint performance in trained and untrained swimmers. Eur. J. Appl. Physiol. Occup. Physiol. 64:377-380, 1992. 17. Costill, D. L. , G. P. Dalsky, and W. J. Fink. Effects of caffeine ingestion on metabolism and exercise performance. Med. Sci. Sports. 10:155-158, 1978. 18. Crowe, M. J. , A. S. Leicht, and W. L. Spinks.Physiological and cognitive responses to caffeine during repeated, high intensity exercise. Int. J. Sport Nutr. Exerc. Metab. 16:528-544, 2006. 19. Cureton, K. J. , G. L. Warren, M. L. Millard-Stafford, J. E. Wingo, J. Trilk, and M. Buyckx. Caffeinated sports drink: ergogenic effects and possible mechanisms. Int. J. Sport Nutr. Exerc. Metab. 17:35-55, 2007. 20. Doherty, M. The effects of caffeine on the maximal accumulated oxygen deficit and short-term running performance. Int. J. Sport Nutr. 8:95-104, 1998. 21. Doherty, M. , P. M. Smith, M. G. Hughes, and R. C. Davison. Caffeine lowers erceptual response and increases power output in high-intensity cycling. J. Sports Sci. 22:637643, 2004. 22. Flinn, S. , J. Gregory, L. R. McNaughton, S. Tristram, and P. Davies. Caffeine ingestion prior to incremental cycling to exhaustion in recreational cyclists. Int. J. Sports Med. 11:188-193, 1990. 23. Graham, T. E. Caffeine and exercise: metabolism, endurance and performance. Sports Med. 31:785-807, 2001. 24. Graham, T. E. Caffeine, coffee and ephedrine: impact on exercise performance and metabolism. Can. J. Appl. Physiol. 26(Suppl. ):S103-S119, 2001. 25. Graham, T. E. , and L. L. Spriet.Metabolic, catecholamine, and exercise performance responses to various doses of caffeine. J. Appl. Physiol. 78:867-874, 1995. Effect? of? Red? Bull? on? Athletic? Performance? ? 443 26. Green, H. J. Meta bolic aspects of intermittent work with specific regard to ice hockey. Can. J. Appl. Sport Sci. 4:29-34, 1979. 27. Green, H. J. , P. Bishop, M. Houston, R. McKillop, R. Norman, and P. Stothart. Timemotion and physiological assessments of ice hockey performance. J. Appl. Physiol. 40:159-163, 1976. 28. Greer, F. , C. McLean, and T. E. Graham. Caffeine, performance, and metabolism during repeated Wingate exercise tests.J. Appl. Physiol. 85:1502-1508, 1998. 29. Greer, F. , D. Friars, and T. E. Graham. Comparison of caffeine and theophylline ingestion: exercise metabolism and endurance. J. Appl. Physiol. 89:1837-1844, 2000. 30. Health Canada. It’s Your Health. Available at: http://www. hc-sc. gc. ca/iyh-vsv/alt_ formats/cmcd-dcmc/pdf/caffeine_e. pdf. Accessed December 17, 2006. 31. Huxtable, R. J. Physiological actions of taurine. Physiol. Rev. 72:101-163, 1992. 32. Ivy, J. L. , D. L. Costill, W. J. Fink, and R. W. Lower. Influence of caffeine and carbohydrate feedings on enduranc e performance. Med. Sci. Sports Exerc. 1:6-11, 1979. 33. Jackman, M. , P. Wendling, D. Friars, and T. E. Graham. Metabolic catecholamine, and endurance responses to caffeine during intense exercise. J. Appl. Physiol. 81:1658-1663, 1996. 34. Jacobs, I. , H. Pasternak, and D. G. Bell. Effects of ephedrine, caffeine, and their combination on muscular endurance. Med. Sci. Sports Exerc. 35:987-994, 2003. 35. Kalmar, J. M. , and E. Cafarelli. Effects of caffeine on neuromuscular function. J. Appl. Physiol. 87:801-808, 1999. 36. Karlic, H. , and A. Lohninger. Supplementation of L-carnitine in athletes: does it make sense? Nutrition. 0:709-715, 2004. 37. Kovacs, E. M. R. , J. H. C. H. Stegen, and F. Brouns. Effect of caffeinated drinks on substrate metabolism, caffeine excretion, and performance. J. Appl. Physiol. 85:709-715, 1998. 38. Kristiansen, M. , R. Levy-Milne, S. Barr, and A. Flint. Dietary supplement use by varsity athletes at a Canadian university. Int. J. Sport Nutr. Exerc. Metab . 15:195-210. 39. Lindinger, M. I. , T. E. Graham, and L. L. Spriet. Caffeine attenuates the exercise-induced increase in plasma [K+] in humans. J. Appl. Physiol. 74:1149-1155, 1993. 40. Lopes, J. M. , M. Aubier, J. Jardim, J. V. Aranda, and P.T. Macklem. Effect of caffeine on skeletal muscle function before and after fatigue. J. Appl. Physiol. 54:1303-1305, 1983. 41. MacIntosh, B. R. , and B. M. Wright. Caffeine ingestion and performance of a 1500 meter swim. Can. J. Appl. Physiol. 20:168-177, 1995. 42. Maridakis, V. , P. J. O’Connor, G. A. Dudley, and K. McCully. Caffeine attenuates delayed-onset muscle pain and force loss following eccentric exercise. Pain. 8:237-243, 2007. 43. McLellan, T. M. , and D. G. Bell. The impact of prior coffee consumption on the subsequent ergogenic effect of anhydrous caffeine. Int. J. Sport Nutr. Exerc.Metab. 14:698708, 2004. 44. Nieminen, M. L. , L. Tuomisto, E. Solatunturi, L. Eriksson, and M. K. Paasonen. Taurine in the osmoregulation of th e Brattleboro diabetes insipidus rat. Life Sci. 42:2137-2143, 1988. 45. Norager, C. B. , M. B. Jensent, A. Weimann, and M. R. Madsen. Metabolic effects of caffeine ingestion and physical work in 75-year old citizens. a randomized, double blind, placebo-controlled, cross-over study. Clin. Endocrinol. 65:223-228, 2006. 46. Pasman W. J. , M. A. van Baak, A. E. Jeukendrup, and A. de Haan. The effect of different dosages of caffeine on endurance performance time.Int. J. Sports Med. 16:225-230, 1995. 47. Paterson, D. H. Respiratory and cardiovascular aspects of intermittent exercise with regard to ice hockey. Can. J. Appl. Sport Sci. 4:22-28, 1979. 444 Forbes? et? al. 48. Powers, S. K. , R. J. Byrd, R. Tulley, and T. Callender. Effects of caffeine ingestion on metabolism and performance during graded exercise. Eur. J. Appl. Physiol. 50:301-307, 1983. 49. Redmond, H. P. , P. P. Stapleton, P. Neary, and D. Bouchier-Hayes. Immuno-nutrition: the role of taurine. Nutrition. 14:599-604, 1998. 5 0. Tarnopolsky, M. A. , S. A. Atkinson, J. D.MacDougall, D. G. Sale, and J. R. Sutton. Physiological responses to caffeine during endurance running in habitual caffeine users. Med. Sci. Sports Exerc. 21:418-424, 1989. 51. Tarnopolsky, M. A. , and C. Cupido. Caffeine potentiates low frequency skeletal muscle force in habitual and nonhabitual caffeine consumers. J. Appl. Physiol. 89:1719-1724, 2000. 52. Thomas, S. , I. Reading, and R. J. Shephard. Revision of the Physical Activity Readiness Questionnaire (PAR-Q). Can. J. Sport Sci. 17:338-345, 1992. 53. Trappe, S. W. , D. L. Costill, B. Goodpaster, M. D. Vukovich, and W. J. Fink.The effects of L-carnitine supplementation on performance during interval swimming. Int. J. Sports Med. 15:181-185, 1994. 54. Williams, J. H. Caffeine, neuromuscular function and high-intensity exercise performance. J. Sports Med. Phys. Fitness. 31:481-489, 1991. 55. Woolf, K. , and M. M. Manore. B-vitamins and exercise: does exercise alter requirements? Int. J. Sport Nutr. Exerc. Metab. 16:453-484, 2006. 56. Zhang, M. , I. Izumi, S. Kagamimori, et al. Role of taurine supplementation to prevent exercise-induced oxidative stress in healthy young men. Amino Acids. 26:203-207, 2004.