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Unsupervised Neural networks A neural network is a system composed of many simple processing elements operating in parallel whose function is determined by network structure, connection strengths, and the processing performed at computing elements or nodes. Neural networks are commonly known as "artificial neural network" (ANN). An Artificial Neural Network (ANN) is an information-processing system that is evolved by the way biological nervous systems works, such as the human brain. Neural networks have broad applicability to real world business problems. In fact, they have already been successfully applied in many industries. Since neural networks are best at identifying patterns or trends in data, they are well suited for prediction or forecasting needs including: Sales forecasting Industrial process control Customer research Data validation Risk management Target marketing These neural networks are also used in the following specific paradigms: recognition of speaker s in communications; diagnosis of hepatitis; recovery of telecommunications from faulty software; inte...

Growth Monitoring Of Preterm Infants Health And Social Care Essay

Monitoring growing is of import in preterm babies as they are at a high hazard for postpartum growing limitation and impaired long term growing and neurodevelopment. In the absence of better charts, intrauterine growing charts recommended by taking professional pediatric administrations can be used for supervising the growing of preterm babies. The purpose when caring for preterm babies is to at least fit the growing speed from published best postpartum growing charts and strive towards making ideal growing speeds from intrauterine growing charts. The Fenton chart appears to be suited for supervising growing of preterm babies during their stay in the neonatal intensive attention unit ( NICU ) . Recently, Fenton charts have been updated utilizing the WHO 2006 charts for the 40-50 hebdomads ‘ station construct age group. Once a post-conception age of 40 hebdomads is reached, the WHO 2006 growing charts can be used for supervising on-going growing. The on-going â€Å" Intergrowth -21st survey † has the possible to get the better of the lacks of all current growing charts. It will enable the constitution of normative growing charts for supervising the growing of preterm babies during and beyond their NICU stay into early childhood. Care should be taken to avoid inordinate gimmick up growing which is associated with increased hazard of diabetes, high blood pressure, and fleshiness in ulterior life.Key pointsGrowth charts are indispensable for dei ¬?ning wellness and nutritionary position and early sensing and direction of growing upsets in babies and kids. Growth monitoring is particularly of import in preterm babies as they are at a high hazard for postpartum growing limitation and impaired long term growing and neurodevelopment. A ‘standard ‘ chart that represents the ideal healthy growing of a population is normative whereas a ‘reference ‘ chart that describes the population without doing claims about the wellness of its sample is descriptive in nature. In the absence of ideal growing charts, intrauterine growing charts are considered suited for supervising the growing of preterm babies until they reach term. In the absence of ideal charts, the WHO 2006 growing charts may be used for supervising the growing of ex-preterm babies. The International Fetal and Newborn Growth Consortium survey is designed to bring forth a set of international criterions ( normative charts for foetal growing, birth weight for gestational age and postpartum growing of preterm babies ) for clinical applications and supervising tendencies in populations. Perturbations in wellness and nutrition, irrespective of their aetiology, about ever affect growing ( 1 ) . Hence, growing appraisal utilizing growing charts is a utile tool for dei ¬?ning wellness and nutritionary position in kids ( 2 ) . Growth monitoring helps to better nutrition, educate the attention givers, and enables early sensing and referral for conditions manifested by growing upsets ( 3 ) . The most common measurings for measuring growing are weight, length/height, caput perimeter and organic structure mass index. Growth monitoring of preterm babies is even more of import because, as described below, many surveies have shown that ( a ) preterm babies suffer from postpartum growing limitation and ( B ) postnatal growing limitation is associated with long term inauspicious neurodevelopmental results.1. Preterm babies suffer from postpartum growing limitation:1.1 In a retrospective longitudinal cohort survey, Horemuzova et Al ( Sweden ) evaluated the physical growing of al l babies born before 26+0 hebdomads of gestation and lasting to full-term age ( n=162 ) , admitted to the NICU of Karolinska Hospital between January 1990 and December 2002 ( 4 ) . Body weight was recorded daily, caput perimeter ( HC ) hebdomadally and length twice a month. The bulk of the babies showed a marked postpartum growing limitation for all growing variables with increasing divergence from the mention with age. At discharge from NICU, 75 % of those initially appropriate for gestational age ( AGA ) babies were below -2 standard divergence tonss for at least one of the organic structure size variables ( 4 ) . 1.2 In a retrospective cohort survey ( 5 ) , 101 kids with a BW a†°Ã‚ ¤ 750g, born between 1996 and 2005 in the University Hospital Utrecht, The Netherlands, were followed until 5.5 old ages. Height, weight, occipital-frontal perimeter at birth, 15 months and 2 old ages corrected age and 3.5 and 5.5 old ages were measured. Between birth and 5.5 old ages catch-up growing in tallness, weight for tallness, weight and OFC was seen in 72.2 % , 55.2 % , 28.6 % and 68.9 % severally of the little for gestational age ( SGA ) babies. For AGA babies they found significant catch-down growing in tallness ( 15.4 % ) and weight ( 33.8 % ) .2. Physical growing and neurodevelopmental results in preterm babies:2.1. Association between postpartum growing during NICU stay and neurodevelopmental results:1. Ehrenkranz et Al. ( USA, 2006 ) ( 6 ) assessed the prognostic value of in-hospital growing speed on neurodevelopmental and growing results at 18-22 months post-conceptional age among highly low bi rth weight ( ELBW ) babies ( 501-1000 g ) . Of the 600 discharged babies, 495 ( 83 % ) were evaluated at a corrected age ( CA ) of 18-22 months. As the rate of weight addition increased from 12.0 to 21.2 g/kg per twenty-four hours, there was lessening in the incidence of intellectual paralysis, Mental Developmental Index ( MDI ) & lt ; 70 and Psychomotor Developmental Index ( PDI ) & lt ; 70 on Bayley Scale of Infant Development ( BSID ) , unnatural neurologic scrutiny, neurodevelopmental damage, and need for rehospitalisation. Similar i ¬?ndings were observed in relation to the rate of caput perimeter growing. They concluded that the growing speed during an ELBW baby ‘s NICU hospitalization exerts a signii ¬?cant and perchance independent consequence on neurodevelopmental and growing results at 18-22 months of CA. 2. Franz ( Germany, 2009 ) ( 7 ) et al evaluated the neurological results of a sum of 219 of 263 ( 83 % ) long-run subsisters at a average corrected age of 5.4 old ages. Increasing SD tonss for weight and caput perimeter from birth to dispatch were associated with a reduced hazard for an unnatural neurologic scrutiny. 3. Shah et Al ( 8 ) ( Canada, 2006 ) aimed to place step of postpartum growing failure associated with long-run result in preterm babies born at & lt ; 28 hebdomads ‘ gestation. Four steps of specifying postpartum growing failure at 36 hebdomads corrected gestational age: ( 1 ) weight & lt ; 10th centile, ( 2 ) weight & lt ; 3rd centile, ( 3 ) omega mark difference from birth & gt ; 1 and, ( 4 ) omega mark difference from birth & gt ; 2 ; were compared for their prognostic values and strength of association with inauspicious neurodevelopmental results at 18-24 months. Postnatal growing failure defined as a lessening in omega mark of & gt ; 2 between birth and 36 hebdomads corrected gestational age had the best prognostic values compared to other postpartum growing failure steps. However, it was significantly associated with PDI ( p=0.006 ) but non with MDI ( p=0.379 ) . Postnatal growing failure defined by omega mark alteration influenced psychomotor but non mental undertakings in this cohort.2.2. Association between post-discharge growing and neurodevelopmental results in preterm babies:1 ) Ramel et Al ( USA, 2012 ) ( 9 ) reported that pre- and post-discharge additive growing suppression in really low birth weight ( VLBW: Birth weight & lt ; 1500g ) babies was negatively associated with developmental results at 24 months CA. In their retrospective survey, weight, accumbent length and caput perimeter were recorded at birth, infirmary discharge and at 4, 12 and 24 months CA in 62 VLBW babies. Standardized Z-scores for weight ( WZ ) , length ( LZ ) and caput perimeter ( HCZ ) were calculated. Twenty-four-month neurodevelopmental map was analysed as a map of growing position. Controling for WZ and HCZ at each age, lower LZ at 4 and 12 months CA was associated with lower cognitive map tonss at 24 months CA ( p a†°Ã‚ ¤ 0.03 ) . 2 ) Ghods et Al ( 10 ) ( Austria, 2011 ) conducted a retrospective cohort survey to find whether caput perimeter ( HC ) catch-up is associated with improved neurocognitive development. 179 preterm really low birth weight ( VLBW ) ( Birth weight a†°Ã‚ ¤1500 g ) babies were followed to the age of 5.5 old ages. The association between HC catch-up and neurodevelopmental result was assessed and perinatal hazard factors, infant features and nutritionary patterns associated with HC catch-up were determined. HC catch-up occurred in 59 ( 34 % ) babies and was positively correlated with neurodevelopmental result. They concluded that among preterm VLBW babies, there is a close relation between HC growing and neurodevelopmental result. 3 ) Powers et Al ( 11 ) ( USA, 2008 ) assessed the post-discharge growing and developmental advancement of 135 VLBW preterm babies in a preponderantly Latino population and reported that failure to boom and microcephaly increased neurodevelopmental damage hazard at 3 old ages of age regardless of gestational age. 4 ) Kan et Al ( Australia, 2008 ) ( 12 ) aimed to find the associations between weight and caput perimeter, at birth and postnatally, with cognitive, academic and motor results at age 8 old ages for really preterm kids free of neurosensory damage. 179 really preterm babies ( gestational age & lt ; 28 hebdomads ) born in 1991 and 1992 who were free of neurosensory damage were included in the survey. At 8 old ages of age kids had cognitive, academic and motor appraisals. Weight and caput perimeter informations were collected at birth, at the clip of discharge ( weight merely ) , at 2 old ages of age and at 8 old ages of age, and growing limitation was calculated utilizing Z-scores ( standard divergence tonss ) relative to the expected mean for age utilizing the British 1990 growing mention charts ( 13 ) . Weight at any age was largely unrelated to any results. While caput perimeter at birth was non related to school-aged results, smaller caput perimeters at ages 2 and 8 old ages were a ssociated with poorer public presentation in most outcome steps. Catch-up growing in weight in early childhood was non associated with 8-year results. 5 ) Latal-Hajnal ( Switzerland, 2003 ) ( 14 ) studied the significance of growing position at birth and postpartum growing on neurodevelopmental result in VLBW babies. Growth and neurodevelopment were examined in 219 VLBW ( & lt ; 1250 g ) kids, 94 little for gestational age ( SGA ) ( & lt ; 10th percentile ) and 125 appropriate for gestational age ( AGA ) ( & gt ; 10th percentile ) . Result at age 2 was assessed with the Bayley Scales of Infant Development MDI, PDI and a standardised neurologic scrutiny. After accommodation for carbon monoxide variables including intellectual paralysis ( CP ) , SGA kids with weight & lt ; 10th percentile at age 2 had lower mean PDI than SGA kids with catch-up growing to burden & gt ; 10th percentile ( average [ SD ] , 89.9 [ 17.4 ] versus 101.8 [ 14.5 ] ; p & lt ; .001 ) . AGA kids with catch-down growing ( weight & lt ; 10th percentile at age 2 ) were, independent of CP, more likely to hold lower mean MDI ( 94.9 V 101.7, p=.05 ) and PDI ( 81.9 vs 9 5.1 ; P & lt ; .001 ) than AGA kids staying & gt ; 10th percentile at age 2. They besides more often had terrible CP ( 22.9 % vs 1.2 % ; p=.008 ) . They concluded that in VLBW kids, the class of postpartum growing instead than the rightness of weight for gestational age at birth determines later neurodevelopmental result. 6 ) Casey et Al ( USA, 2006 ) ( 15 ) assessed the 8-year growing, cognitive, behavioral position, wellness position, and academic accomplishment in low birth weight preterm babies who had failure to boom merely, were SGA merely, had failure to thrive plus were SGA, or had normal growing. A sum of 985 babies received standardised ratings to age 8 ; 180 babies met the standards for failure to boom between 4 and 36 months ‘ gestational corrected age. The undermentioned result variables were collected at age 8: growing, cognitive, behavioral position, wellness position, and academic accomplishment. Multivariate analyses were performed among the 4 growing groups on all 8-year result variables. Children who both were SGA and had failure to boom were the smallest in all growing variables at age 8, and they besides demonstrated the lowest cognitive and academic accomplishment tonss. The kids with failure to boom merely were significantly smaller than the kids with normal growing in all growing variables and had significantly lower IQ tonss. Those who were SGA merely did non differ from those with normal growing in any cognitive or academic accomplishment steps. There were no differences among the 4 groups in behavioral position or general wellness position. They concluded that low birth weight preterm babies who develop postpartum growing jobs, peculiarly when associated with antenatal growing jobs, show lower physical size, cognitive tonss, and academic accomplishment at age 8 old ages.3. Types of growing chartsA ‘standard ‘ chart represents the ideal healthy growing of a population and hence is of normative nature. To deduce such ideal healthy growing charts, the survey population should be from a cohort of babies born to healthy female parents with unsophisticated gestation and bringing. In add-on, the survey babies should be raised under optimum environmental conditions including breastfeeding, immunizations and follow recommended dietetic pattern s. The survey babies should be free from any disease that could impede growing. Longitudinal follow up and measuring of anthropometry of such babies will assist deduce the ‘standard ‘ growing charts which will be of normative nature. The WHO 2006 growing charts ( term babies ) are standard growing charts. In contrast, a ‘reference ‘ chart describes the population without doing claims about the wellness of its sample and hence is descriptive in nature ( 16-18 ) ( Table 1 ) . The ‘reference ‘ charts are derived by mensurating the anthropometry of a sample of babies and kids at assorted ages and plotting them on graph. The sample is therefore cross-sectional instead than longitudinal. In add-on, wellness of the kids in the survey population is non taken into consideration. Majority of the presently available growing charts in full term babies and kids are mention ‘charts ‘ .4. Types of growing charts presently available for preterm babies during stay in the neonatal unit.4.1. Standard charts:At present, there are no normative criterion growing charts available for preterm babies. Theoretically talking, babies born prematurely should go on to turn at intrauterine rates until they reach term. The American Academy of Pediatrics ( 17 ) and Canadian Pediatr ic society ( 18 ) recommend intra uterine growing rates as the ideal growing of preterm babies.4.1.1. Considered being, but non truly â€Å" intra uterine growing † charts ( Table 2 )There are more than 25 surveies describing on ‘intrauterine growing charts ‘ . These have been best summarized by Karna et Al ( 19 ) . Until late, Lubchenko ( 1963 ) ( 20 ) and Babson/Benda ( 1976 ) ( 21 ) charts were normally used in many neonatal units around the universe. Fenton et Al ( 22 ) updated the Babson and Benda growing charts to develop modern-day ‘intrauterine growing charts ‘ . Using predetermined standards, three recent big population based studies of birth weight for gestational age were identified. The Canadian survey by Kramer ( 23 ) which had a sample size of 676,605 babies delivered between 22 to 43 hebdomads was used for updating the intrauterine weight subdivision. Two big surveies from Sweden ( 24 ) and Australia ( 25 ) were used to update the intrauterine caput perimeter and length subdivision. The informations were averaged together utilizing a leaden norm based on entire sample size to deduce the 3rd, 10th, 50th, 95th and 97th percentiles and make one growing chart. CDC 2000 growing charts were used to bring forth the growing charts from corrected gestation of 40 hebdomads ahead . The Fenton chart appears to be utile in supervising the growing of preterm babies during their NICU stay. It is used by many North American, European and Australian Centres. Recently Olsen et Als have published growing charts for New intrauterine growing charts based on United States informations ( 26 ) and it will be utile if Fenton charts are updated integrating this new information from USA. The latest updated Fenton charts have used WHO 2006 growing charts alternatively of CDC 2000 charts to bring forth growing charts from post-conceptional age of 40 hebdomads until 10 hebdomads post term ( personal communicating with Tanis Fenton ) . Built-in issues with intrauterine growing charts: Even though they are called â€Å" intrauterine † charts, they are in fact cross sectional informations derived from anthropometry measured at birth on preterm babies delivered at assorted gestations. It is good known that foetuss delivered prematurely may non hold reached full growing possible due assorted maternal/fetal morbidities and therefore make non reflect the â€Å" ideal † growing. Besides, these charts do non take into consideration, the normal 5-8 % weight loss that occurs in healthy preterm babies in the first hebdomad of life.4.1.2 ‘Fetal growing charts ‘ ( Table 2 )Strictly talking, merely charts derived from longitudinal surveies should be called growing charts, growing being a procedure extended over clip ( 27 ) . Hence it may look logical that ideal ‘intrauterine growing charts ‘ should be derived from consecutive and longitudinal appraisal of physical parametric quantities of we ight, length and caput perimeter utilizing foetal ultrasound technique ( 28 ) . However, the drawback of this method is that foetal ultrasound is non really accurate in foretelling the foetal weight. A systematic reappraisal which analysed informations from 58 articles over 28 old ages found broad variableness in diagnostic truth of ultrasound scrutiny in foretelling the foetal weight. Overall merely 62 % ( 8895/14,384 ) of the sonographic anticipations were within 10 % of the existent weight. The truth was affected significantly by the clip interval between scrutiny and bringing, individual making the echography ( registered diagnostic medical sonographers had better truth than doctors or occupants ) , and the gestation at appraisal ( assessment closer to term were more accurate compared to preterm patients ) ( 29 ) . Another systematic reappraisal came to similar decisions. The referees searched four of import databases ( MEDLINE, EMBASE, ZETOC, and The Cochrane Library ) . Studies including the appraisal of foetal weight by 11 different research groups utilizing different expressions were included in the reappraisal. No preferable method for the ultrasound appraisal of foetal weight emerged from their reappraisal. They found that the size of the random mistakes was rather broad, with 95 % assurance intervals transcending 14 % of birth weight in all surveies. They concluded that the truth of EFW utilizing foetal ultrasound is compromised by big intra- and inter-observer variableness and attempts must be made to understate this variableness if EFW is to be clinically utile ( 30 ) . In add-on, maternal morbidities can ensue in foetal growing limitation, which in bend can ensue in non- ideal growing charts. In position of such restrictions, foetal weight charts derived from the presently available u ltrasound engineering may non be appropriate for usage as ideal postpartum growing of preterm babies. In position of such restrictions, foetal weight curves derived from the presently available ultrasound engineering are non appropriate for usage as ideal postpartum growing of preterm babies. However, recent progresss in engineering have resulted in more frequent usage of 3-D ultrasound for foetal biometrics measurings. Chan et Al. ( 2009 ) in a prospective survey compared the inter- and intra-observer fluctuation of foetal biometric measurings using planar ( 2D ) and 3-dimensional ( 3D ) ultrasound imagination ( 31 ) . Three braces of physicians trained in echography evaluated singleton gestations in the mid-trimester. Measurements of the biparietal diameter ( BPD ) , head perimeter ( HC ) , abdominal perimeter ( AC ) , and femur length ( FL ) were taken in extra by each physician utilizing 2D imagination and so once more utilizing 3D volume informations sets. Each set of mated phy sicians evaluated 12 patients. Inter- and intra-observer fluctuations were calculated as the SD of the difference between paired measurings performed by the physician braces and by the single physicians, severally. Bland-Altman secret plans were used to visually compare measurement prejudice and understanding by 2D and 3D methods. The intra-observer fluctuation of HC, AC, and FL was significantly lower for 3D compared with 2D ultrasound. Inter-observer fluctuation was non significantly different when measured with 2D and 3D ultrasound, with the exclusion of FL, which was lower when measured with 3D ultrasound. They concluded that the usage of 3D ultrasound significantly reduces intra-observer fluctuation for HC, AC, and FL and reduces inter-observer fluctuation for FL ( 31 ) . Schild et Al. ( 2008 ) in a prospective cohort survey, obtained biometric informations of 150 singleton foetuss weighing a†°Ã‚ ¤1600 g at birth by sonographic scrutiny within 1 hebdomad before bringing ( 32 ) . Exclusion standards were multiple gestation, intrauterine decease every bit good as major structural or chromosomal anomalousnesss. Their new expression was compared with presently available equations for gauging weight in the preterm foetuss. They concluded that in foetuss weighing a†°Ã‚ ¤1600 g at birth, the new expression utilizing 3D ultrasound is superior to burden appraisal by traditional expression utilizing 2D measurings ( 32 ) . These informations indicate that 3D echography may hold the possible to be a more accurate step of foetal anthropometry than the traditional 2D ultrasounds. If these preliminary promising findings are proved correct in multiple big surveies, intrauterine growing curves derived from such method may hold the possible to be used as ideal growing curves for supervising preterm babies after birth.4.2 Postnatal ‘reference ‘ Growth charts ( Table 2 )Many mention charts that describe the existent longitudinal growing of preterm babie s during the class of their stay in the NICU have been published ( 33, 34 ) . If these mention charts are used to supervise the on-going growing of preterm babies, extra-uterine growing deceleration would be considered as normal. Hence they are non ideal for supervising the growing of preterm babies. However, these charts give an thought of what can be achieved with the available resources and bounds set by the morbidities of prematureness and can be used to compare the growing of preterm babies between different units.5. A note of cautiousness while taking to accomplish the perfect intrauterine growing ratesEven though the intra uterine growing charts may look idealistic ends, one needs to make up one's mind if it is truly executable and safe to achieve those parametric quantities. Any efforts to advance physical growing by aggressive enteric and parenteral nutrition may potentially harm the ill preterm baby. Rapid additions in enteric eating are known hazard factor for necrotising enterocolitis ( NEC ) ( 35 ) . In ELBW babies, higher fluid consumption and less weight loss during the first 10 yearss of life are associated with an increased hazard of decease and BPD ( 36, 37 ) . In add-on inordinate gimmick up growing in early neonatal period for may ensue in inauspicious cardiovascular results later in life. Finken et Al ( 38 ) and Euser et Al ( 39 ) found that in topics born really preterm, rapid babyhood weight addition until 3 months was associated with tendency towards higher insulin degrees at 19 old ages. They besides concluded that rapid weight addition in both babyhood and early childhood is a hazard factor for grownup adiposeness and fleshiness. Similar concerns have been raised by other research workers ( 40, 41 ) .6. Growth charts to supervise preterm babies from post-conception age of 40 hebdomads into early childhoodUntil late, many states used the growing charts released by Centers for Disease Control and Prevention ( CDC 2000 ) for supervising the growing of term babies and kids. The same charts are normally used for ongoing growing monitoring of preterm babies after making station ideational age of 40 hebdomads. The built-in job with the CDC 2000 and similar charts is that they are ‘reference ‘ charts, which merely describe the sample population without doing any claims about the wellness of the sample. Because of assorted environmental and lifestyle influences, the prevalence of corpulence in kids and striplings has increased markedly over the past few decennaries. Hence, any new mention charts, which are derived from such population of fleshy kids, would accept these abnormally high weights-for-age as normal ( 42, 43 ) . Use of such charts would besides ensue in more kids being wrongly and often diagnosed as scraggy ensuing in unneeded nutritionary supplementation and may lend to fleshiness and associated morbidities. To some extent, the CDC 2000 growing charts addressed this by excepting the informations derived from the National Health and Nutrition Examination Survey ( NHANES ) III for kids 6 old ages of age for weight-for-age and organic structure mass index ( BMI ) – for-age charts. This was carried out because they had identified that compared with the NHANES II ( 1976-1980 ) , the NHANES III ( 1988-1994 ) kids were of higher weight-for-age ( 44 ) . Despite this accommodation, the 97th and the 99.9th percentile charts ( +2 and +3 z-scores ) are located really high on the CDC weight-for-age and BMI-for-age charts, intending that fewer corpulence and corpulent kids and striplings are identified as such because the norms have been raised. The lower centiles have besides been shifted upwards, taking to overestimate of under nutrition, and therefore advice taking to overfeeding ( 45 ) ; besides, safeguards that were taken by the CDC can non be confidently expected from countless figure of ‘reference ‘ charts which are being published on a regular basis from different states all over the universe. To get the better of the jobs built-in with ‘reference ‘ charts, with a complete alteration in doctrine, the World Health Organization ( WHO ) conducted the Multicentre Growth Reference Study ( MGRS ) in order to set up the ‘standard ‘ growing charts for kids between 0 and 6 old ages ( 46 ) . The MGRS was conducted between 1997 and 2003 in 6 states from diverse geographical parts: Brazil, Ghana, India, Norway, Oman and the United States. The survey combined a longitudinal followup of 882 babies from birth to 24 months with a cross-sectional constituent of 6669 kids aged 18-71 months. The survey populations lived in socioeconomic conditions favorable to growing. The single inclusion standards for the longitudinal constituent were: no known wellness or environmental restraints to growing, female parents willing to follow MGRS feeding recommendations ( i.e. sole or prevailing breastfeeding for at least 4 months, debut of complementary nutrients by 6 months of age and continued suckling to at least 12 months of age ) , no maternal smoke before and after bringing, single-term birth and absence of important morbidity. The eligibility standard for the cross-sectional constituent were the same as those for the longitudinal constituent with the exclusion of infant eating patterns. A lower limit of 3 months of any breastfeeding was required for participants in the survey ‘s cross-sectional constituent. Weight-for-age, length/height-for-age, weight-for-length/height and body mass index-for-age percentile and Z-score values were generated for male childs and misss aged 0-60 months. The pooled sample from the 6 take parting states allowed the development of a truly international mention. The criterions explicitly identify suckling as the biological norm and set up the breastfed kid as the normative theoretical account for growing and development. They besides demonstrate that healthy kids from around the universe who are raised in healthy envir onments and follow recommended eating patterns have strikingly similar forms of growing. In add-on, to set up ‘standard ‘ normative charts for older kids and striplings, the WHO reconstructed the 1977 National Center for Health Statistics ( NCHS ) /WHO growing mention utilizing state-of-the-art statistical methods. The 1977 growing mentions were used because they were from a population prior to the happening of the current epidemic of childhood fleshiness. These new charts were released by the WHO in 2007 for general usage ( 47 ) . These charts are recommendations for how kids should turn. More than 125 states including UK, USA, Canada and New Zealand have started utilizing the WHO growing charts for full term babies ( 48 ) . The full set of tabular arraies and charts are available on the WHO website ( www.who.int/childgrowth/en ) together with tools such as package and preparation stuffs. Since their publication, many surveies have shown the utility of WHO growing charts in foretelling fleshiness and other cardiovascular morbidities. De Onis et Al ( 49 ) examined the association between cardiovascular hazard and childhood corpulence and fleshiness utilizing the BMI cut-offs recommended by the WHO. Children were classified as normal weight, corpulence and corpulent harmonizing to the WHO BMI-for-age mention. Blood force per unit area, lipoids, glucose, insulin, homeostasis theoretical account assessment-insulin opposition ( HOMA-IR ) and uric acid degrees were compared across BMI groups. The topics were kids ( n 149 ) aged 8-18 old ages. About 37 % , 22 % and 41 % of kids were classified severally as normal weight, corpulence and corpulent. Corpulent kids were 10A ·6 times more likely than normal-weight kids to hold high blood pressure ; OR for other associations were 60A ·2 ( high insulin ) , 39A ·5 ( HOMA-IR ) , 27A ·9 ( TAG ) , 16A ·0 ( low HDL-cholesterol ) , 4A ·3 ( LDL-cholesterol ) and 3A ·6 ( uric acid ) . Fleshy kids were more likely than normal-weight kids to hold high blood pressure ( OR = 3A ·5 ) , high insulin ( OR = 28A ·2 ) , high HOMA-IR ( OR = 23A ·3 ) and high TAG ( OR = 16A ·1 ) . About 92 % and 57 % of the corpulent and fleshy kids, severally, had one or more hazard factor. They concluded that fleshiness and corpulence defined utilizing the WHO BMI-for-age cut-offs identified kids with higher metabolic and vascular hazard. Shields et Al ( 50 ) compared prevalence estimations of extra weight among Canadian kids and young person harmonizing to three sets of organic structure mass index ( BMI ) mention cut-points. The cut-points were based on growing curves generated by the WHO, the International Obesity Task Force ( IOTF ) , and the CDC ( USA ) . Prevalence estimations of corpulence and fleshiness were produced for 2- to 17-year-olds utilizing the three sets of BMI cut-points. Estimates were based on informations from 8661 respondents from the 2004 Canadian Community Health Survey and 1840 respondents from the 1978/79 Canada Health Survey. In both studies, the tallness and weight of kids were measured. They found that 2004 prevalence estimation for the combined overweight/obese class was higher ( 35 % ) when based on the WHO cut-points compared with the IOTF ( 26 % ) or CDC ( 28 % ) cut-points. Estimates of the prevalence of fleshiness were similar based on WHO and CDC cut-points ( 13 % ) , but lower whe n based on IOTF cut-points ( 8 % ) . In the absence of other ideal growing charts, it is appropriate to utilize the WHO growing charts to supervise the on-going growing of preterm babies after making post-conceptional age of 40 hebdomads.6.1 Evidence back uping the usage of WHO 2006 growing charts for supervising preterm babies after discharge ( Table 3 ) :Nash et Al ( 51 ) aimed to find whether the form of growing of really low birth weight ( VLBW ) babies during the first 2 old ages, assessed utilizing the WHO-GS or the traditional Centers for Disease Control and Prevention mention growing charts ( CDC-RGC ) , is associated with neurodevelopment ( 51 ) . Pattern of weight, length, and caput perimeter addition of appropriate-for-gestation VLBW preterm babies ( n = 289 ) from birth to 18-24 months corrected age was classified, utilizing the WHO-GS and CDC-RGC, as sustained ( alteration in Z-score a†°Ã‚ ¤1 SD ) , decelerated ( diminution & gt ; 1 SD ) , or accelerated ( incline & gt ; 1 SD ) . Development was assessed utilizing the Bayley Scales of Infant and Toddler Development ( BSID ) -III at 18-24 months corrected age. Using the WHO-GS, kids with a decelerated form of weight addition had lower cognitive ( 10 points ) , linguistic communication ( 6 points ) , and motor ( 4 points ) tonss than babies with sustained weight addition ( p & lt ; 0.05 ) , even after accommodation for morbidities. No association was found utilizing the CDC-RGC. They concluded that a decelerated form of weight addition, determined with the WHO-GS, but non the CDC-GRC, is associated with poorer neurodevelopment tonss on the BSID-III than a form of sustained growing ( 51 ) . Belfort et Al ( 52 ) aimed to place sensitive periods of postpartum growing for preterm babies relative to neurodevelopment at 18 months ‘ corrected age. They studied 613 babies born at & lt ; 33 hebdomads ‘ gestation who participated in the DHA for Improvement of Neurodevelopmental Outcome ( DINO ) test. They calculated additive inclines of growing in weight, length, BMI, and caput perimeter from 1 hebdomad of age to term ( 40 hebdomads ‘ postmenstrual age ) , term to 4 months, and 4 to 12 months utilizing the WHO growing charts, and estimated their associations with Bayley Scales of Infant Development, 2nd Edition, MDI and PDI in additive arrested development. The average gestational age was 30 hebdomads. Mean A ± SD MDI was 94 A ± 16, and PDI was 93 A ± 16. From 1 hebdomad to term, greater weight addition ( 2.4 MDI points per omega mark [ 95 % assurance interval ( CI ) : 0.8-3.9 ] ; 2.7 PDI points [ 95 % CI: 1.2-.2 ] ) , BMI addition ( 1.7 MDI points [ 95 % CI: 0.4-3.1 ] ; 2.5 PDI points [ 95 % CI: 1.2-3.9 ] ) , and caput growing ( 1.4 MDI points [ 95 % CI: -0.0-2.8 ] ; 2.5 PDI points [ 95 % CI: 1.2-3.9 ] ) were associated with higher tonss. From term to 4 months, greater weight addition ( 1.7 points [ 95 % CI: 0.2-3.1 ] ) and additive growing ( 2.0 points [ 95 % CI: 0.7-3.2 ] ) were associated with higher PDI. From 4 to 12 months, none of the growing steps was associated with MDI or PDI mark. They concluded that in preterm babies, greater weight and BMI addition to term were associated with better neurodevelopmental results. After term, greater weight addition was besides associated with better results, but increasing weight out of proportion to length did non confabulate extra benefit.7. Future researchAs discussed above, neither â€Å" intrauterine growing charts † nor â€Å" foetal growing charts † nor â€Å" postpartum growing charts † are suited for supervising the growing of preterm babies till they become term. Similarly, CDC 2000 and WHO 2006 growing charts are besides non ideal for supervising the growing of ex-preterm babies. In order to set up normative growing charts, the Inter Growth 21st survey has been commenced by the International Fetal and Newborn Growth Consortium ( 53, 54 ) . The end is to develop new â€Å" normative † criterions depicting normal foetal and preterm neonatal growing over clip and newborn nutritionary position, and to associate these to neonatal wellness hazard. The primary aim is to bring forth a set of international Fetal and Newborn Growth Standards ( foetal growing, birth weight for gestational age and postpartum growing of preterm babies ) for practical applications in clinical usage and for supervising tendencies in populations. The survey aims to enroll 4500 healthy adult females aged 18-35, who had regular catamenial rhythms and conceived spontaneously and do non hold major wellness issues and pattern healthy life styles. Study participant adult females are being recruited from 9 states across five continents. They undergo 6 scans in add-on to the initial dating scans. They are scheduled at 5 hebdomadal intervals: 14-18 hebdomads, 19-23 hebdomads, 24-28 hebdomads, 29-33weeks, 34-38 hebdomads and 39-42 hebdomads. Apart from the extra scans, they receive the standardised antenatal attention. Based on expected 9 % rate of prematureness, it is expected that around 360 babies would be born to these female parents ( 26-37 hebdomads gestation ) . Their longitudinal growing will be monitored for 8 months. This would include mensurating weight, length and caput perimeter every 2 hebdomads for the first eight hebdomads and so monthly until eight months after birth. Those enduring from decease or serious morbidities of prematureness such as NEC will be excluded. This will analyze will enable the derivation of normative intrauterine growing charts every bit good as postpartum growing charts from a diverse population across five continents.

Course Notes on Principles of Management

The Global Environment In the past, managers have viewed the global sector as closed. Each country or market was assumed to be isolated from others. Firms did not consider global competition, exports. Today’s environment is very different. Managers need to view it as an open market. Organizations buy and sell around the world. Managers need to learn to compete globally. Tariff Barriers A tariff is a barriers to trade. Tariffs are taxes levied upon imports. These seek to protect jobs in the home country. Other countries usually retaliate.Free trade: in a free trade agreement, each country seeks to specialize in things they make most efficiently. If India is more efficient in making textiles, and the USA in making computer software, then each country should focus on these. Distance & Culture Barriers The second leading cause of trade barriers. Distance closed the markets as far as some managers were concerned. Communications could be difficult. Languages and cultures were differ ent. During the last 50 years, communications and transportation technology has dramatically improved.Jet aircraft, fiber optics, satellites have provided fast, secure communications and transportation. These have also reduced cultural differences. Effects on Managers Declining barriers have opened great opportunities for managers. Managers can not only sell goods and services but also buy resources and components globally. Managers now face a more dynamic and exciting job due to global competition. Free Trade NAFTA: North American Free Trade Agreement. Abolishes most tariffs on goods traded between Mexico, Canada and the U. S. Allows unrestricted cross-border flows of resources.Many U. S. firms have now invested in Mexico. This is a manufacturing opportunity. Wage costs are lower in Mexico. Can serve Mexico with a plant in Mexico and reduce freight. Managers face new opportunities and threats. Global Task Environment Suppliers & Distributors Managers buy products from global suppli ers or make items abroad and supply themselves. Key is to keep quality high and costs low. Global outsourcing: firms buy inputs from throughout the world. GM might build engines in Mexico, transmissions in Korea, and seats in the U. S. Finished goods become global products.Distributors: each country often has a unique system of distribution. Managers must identify all the issues. Customers & Competitors Formerly distinct national markets are merging into a huge global market. True for both consumer and business goods. Creates large opportunities. Still, managers often must customize products to fit the culture. McDonald's sells a local soft drink in Brazil. Global competitors present new threats. Increases competition abroad as well as at home. Forces in the Global General Environment Political-Legal ForcesResults from diverse and changing nature of each countries’ political system. Representative democracies: such as the U. S. , Britain, Canada. Citizens elect leaders who ma ke decisions for electorate. Usually has a number of safeguards such as freedom of expression, a fair court system, regular elections, and limited terms for officials. Well defined legal system and economic freedom. Totalitarian regimes: a single political party or person monopolize power in a country. Typically do not recognize or permit opposition. Most safeguards found in a democracy do not exist.Examples include Iran, Iraq, and China. These are difficult to do business with given the lack of economic freedom. Further, human rights issues also cause managers to avoid dealing with these countries. Economic Systems Free market economy: production of goods and services is in private ownership. Production is dictated by supply and demand. Command economy: decisions on what to produce, how much, done by the government. Most command economies are moving away from the command economy. Mixed economy: certain economic sectors controlled by private business, others are government controlle d.Many mixed countries are moving toward a free enterprise system. Recent Trends Current shift away from totalitarian dictators toward democratic regimes. Very dramatic example seen in the collapse of the former Soviet Republic. Also very pronounced in Latin America and Africa. With this shift, has come a strong movement toward free market systems. This provides great opportunities to business managers on a global level. Many businesses are investing millions in former totalitarian countries to seize these opportunities. Changing Political and Economic Forces Sociocultural ForcesNational culture: includes the values, norms, knowledge, beliefs, and other practices that unite a country. Values: abstract ideas about what a society believes to be good, desirable and beautiful. Provides attitudes for democracy, truth, appropriate roles for men, and women. Usually not static but very slow to change. Norms: social rules prescribing behavior in a given situation. Folkways: routine social co nventions including dress codes and manners. Mores: Norms that are central to functioning of society. much more significant that folkways. More examples include theft, adultery, and are often enacted into law.Norms vary from country to country. Hofstede’s Model of National Culture Individualism v. Collectivism Individualism: world view that values individual freedom and self-expression. Usually has a strong belief in personal rights and need to be judged by achievements. Collectivism: world view that values the group over the individual. Widespread in Communism. Prevalent in Japan as well. Managers must understand how their workers relate to this issue. Power Distance A society’s acceptance of differences in the well being of citizens due to differences in heritage, and physical and intellectual capabilities.In high power distance societies, the gap between rich and poor gets very wide. In low power distance societies, any gap between rich and poor is reduced by taxati on and welfare programs. Most western cultures (U. S. , Germany, United Kingdom) have relatively low power distance and high individualism. Many economically poor countries such as Panama, Malaysia have high power distance and low individualism. Achievement vs Nurture Achievement oriented societies value assertiveness, performance, success. The society is results-oriented. Nurturing-oriented value quality of life, personal relationships, service.The U. S. and Japan are achievement-oriented while Sweden, Denmark are more nurturing-oriented. Uncertainty Avoidance Societies and people differ on their willingness to take on risk. Low uncertainty avoidance (U. S. , Hong Kong), value diversity, and tolerate differences. Tolerate a wide range of opinions and beliefs. High uncertainty avoidance (Japan and France) are more rigid and do not tolerate people acting differently. High conformity to norms is expected. Long Term Outlook Long-term outlook is based on values of saving, and persistenc e.Taiwan and Hong Kong are cultures that are long -term in outlook. Short-term outlook seeks the maintenance of personal stability or happiness right now. France and the U. S. are examples of this approach. International Expansion Importing and Exporting: the least complex method of expansion. Exporting: firm makes products and sells abroad. Importing: firm sells products made abroad. Licensing: firm allows foreign organization to make and distribute goods for a fee. Helps the home firm since it does not have to set up a complete production and distribution network.Franchising: company sells a foreign organization the rights to use brand name and know-how in return for payment and profit percentage. International Options Strategic Alliances: managers pool resources with a foreign firm and both organizations share the rewards and risks. Allows firm to maintain control which is a problem with exporting, licensing, and franchising. Wholly-owned foreign subsidiary: firm invests in produ ction operations in a foreign country. Many Japanese auto firms have done this in the U. S. This is very expensive but can yield high returns. International Expansion

Are We More Free than We Were in the Past

Are We More Free than We Were in the Past Centuries ago, production was limited to long hours of manual labour, which yielded low output. Simple goods required a lot of man-hours to produce. The 18th century was accompanied by revolutions that changed man’s way of life. Machines were invented and production started growing. The labour intensive model that was used before the invention of the machines was replaced by the factory system.Advertising We will write a custom essay sample on Are We More Free than We Were in the Past? specifically for you for only $16.05 $11/page Learn More The use of machines replaced hand tools and most of the human labour was replaced by the power of the steam engine. This is what characterized the industrial revolution. Over a short time span, rural towns grew as more factories came up. There was increased movement from the rural areas to the fast growing urban centers (Amin, 1995). This further promoted the establishment of social classes; employers on one side and workers on the other. Britain was the first to enjoy the benefits of machine production; its economy grew and was the envy of the neighbouring European countries and the, the US Included. The inventions like the spinning jenny and the flying shuttle boosted the textile industry a great deal. Steam power was used in the manufacture of automobiles, leading to ease of transportation. It is important to note that the effects of the industrial revolution not only shaped the lives of people in the 18th century; but still develop the 21st century as newer technologies are applied. The growth of industries prompted competition amongst countries all over the world. Similar concepts started emerging in different countries. As production grew, there was a need to find new markets and places to establish industries. The US became a new ground for development and soon caught up with the competition. The concept of factory production became the primary focus of all businesses. The second indu strial revolution came with an increased production and an improvement on machines used in production. Machines that had been using steam power were replaced by those using electrical power; which proved more economical and easy to manage. Electricity could power huge mechanical plants in the factories, making arrangement of machines more flexible. As more machines were introduced into the factories, the need for human labour became less valuable. Factories made mass production a priority and in 1913 Henry Ford introduced a more effective way of production; using the assembly line to produce goods. This concept ensured the production of identical goods in huge numbers and within a short time (Gartman, 2009).Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More The assembly line used a conveyor belt which held components that would be put together to form the final product; as the conveyor belt moved from one work station to another. Henry Ford used this model of production to manufacture his Model-T Ford automobiles, which made him a market leader in the automobile industry (William, 1978). The assembly lines became popular and were adapted by other industries; and that process of production was referred to as fordism. Fordism introduced a system of mass production that was efficient and cost effective. Economies of scale were achieved by investing more on production plants thereby increasing output and reducing unit costs. With mass production came division of labour, workers specialized on specific tasks in different work stations. The remaining staff did the overhead work, which included procurement, marketing, accounting, repairs and stocking. Working on an assembly line had it merits and demerits. Workers routinely worked on the same stations for a long time, after a while those kinds of jobs became boring and saw a high number of staff quit their jobs. On the o ther hand skilled labour became highly paid. Management policies further ensured job securities and safety measures for workers. Though fordism grew economies, improved lifestyles and provided opportunities for highly paid jobs; it also led to the loss of numerous jobs that were previously held by the unskilled labourers. Rise of industries also made critical changes to the environment, in terms of pollution and exploitation of resources. As cities grew, the rural regions remained poor. It is about time we moved from mass production of goods to a system that advocated for transformation of institutions, which promote a flow of information (Giddens, 1990). Post-fordism is movement from the system of mass production to a just-in-time production model coupled with the flow of information and transportation to enable economic development. Markets became more liberalized and were not restricted by national borders. Trade agreements were signed to enable free movement of goods and service s to consumers wherever they were.Advertising We will write a custom essay sample on Are We More Free than We Were in the Past? specifically for you for only $16.05 $11/page Learn More Organizations targeted countries with competitive demand for their products; they also considered production costs in those new countries. Lower taxes also promoted migration of those corporations to their new destinations. While Fordism focused on mass production, Post-Fordism used a model that customized production to the customers’ needs. Relocations focused on areas with lower wage payouts, while exploiting a highly professional staff. The automation process and the use of information technology saw an increase in quality of production, as experts were hired to manage tasks at different levels of manufacture. Post-Fordism promoted a production process that constantly required the input of skilled labour and rotational work schedules. Although this model of producti on sought to maximize efficiency; corporations had to take advantage of short term contracts hence increasing the rate of job insecurity. Outsourcing became a popular concept, used by companies to deliver services at reduced wages. All these factors made Post-Fordism successful in delivering goods and services on time. It created disparities in incomes for its workers, in that different countries paid different wages for the same level of expertise. Profit margins were also high considering the low production costs. The major difference between the two systems is that, while Fordism produced a particular good in huge quantities for an undifferentiated market, Post-Fordism had an assortment of goods produced to satisfy diverse consumer bases that had different tastes and cultures (Harvey, 1989). Post-Fordism can be seen as a promoter of globalization, through liberalization of trade and division of labour across the entire globe. It also spreads modern cultures and technologies to di fferent countries (Koch, 2006). As the western countries grow their economies, part of their wealth also remains in the poorer countries; especially those in the developing world.Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More Post-Fordism can be viewed as a modern way of life, as people exchange ideas, cultures, traditions and do business with each other. Institutions that do not move with change, and those that do not consider customer satisfaction are bound to fail; in this consumer based system of production. (Becks, 2001) Although each system worked best during its era, both of them have had an adverse effect on the global society. So are we safe than we were in the past? This will depend on an individual’s view, as both systems had both advantages and disadvantages. Jobs were created and lost, there was economic and social growth across the board. If we compare the two systems carefully, Post-fordism seems to encompass the global demands of the employers, workers and the consumers. Development might be on different levels, but there is evidence that it is distributed to the most remote places on the globe. References Amin, A., 1995. Post-Fordism: A reader (studies in urban and social change). Oxford: Blackwell Publishers Ltd. Becks, U., 2001. Individualization: institutionalized individualism and its social and political consequences. London: Sage Publications Limited. Gartman, D., 2009. From autos to architecture: Fordism and architectural aesthetics in the twentieth century. New York: Princeton Architectural Press. Giddens, A., 1990. The consequences of modernity. Palo Alto: Stanford University Press. Harvey, D., 1989. The condition of postmodernity: An enquiry in to the origins of cultural change. London: Basil Blackwell. Koch, M., 2006. Roads to Post-Fordism: Labour markets and social structures in Europe. Hampshire: Ashgate Publishing Ltd. William, A., 1978. The productivity Dilemma: Roadblock to innovation in the automobile industry. Baltimore: Johns Hopkins University Press.

Be a Ruthless Editor

Be a Ruthless Editor Be a Ruthless Editor Be a Ruthless Editor By Michael Hard rules are a good thing for writers sometimes. The sonnet is one of the strictest forms of poetry, but some of the worlds greatest poems are sonnets. A haiku form is even stricter, seventeen syllables in three lines. Hard word counts force a writer to overcome his or her natural laziness by editing ruthlessly. Because writers have no choice but to keep on ruthlessly editing and shortening until the piece is short enough, their job becomes easier, paradoxically. With fewer choices, decision-making becomes faster. There is only room to make one main point, and once you decide what it is, theres no need to struggle to fit any others in. Tighten Your Writing Ruthless editing becomes a necessary skill because some short writing opportunities have very hard word count limits. For example, each of my monthly allotment of academic journal abstracts could never exceed 150 words, After I completed them, they were loaded into a searchable database your local library may have a subscription to it. The database included fields for the author, title and publication, each with limited lengths, but the abstract field in the database could only hold 150 words. So I had to keep editing and reediting until my abstract was less than 150 words. It was a hard rule that could not be broken. Builders talk about load-bearing walls. When youre remodeling your house, if you want to open up the floor plan or provide more space, maybe you decide to remove a wall. Thats fine, unless the wall is a load-bearing wall. If you remove a load-bearing wall, part of the building will fall down. As you remove sentences or words, parts of the sentence or paragraph that used to be cosmetic become load-bearing. This is a good thing: it makes you pay more attention to what youre writing. It requires your writing to be more efficient. And that makes your writing easier to read, because there is less fluff to read through, and it makes your writing more powerful. Ruthless editing can lead to honest evaluation. Summarizing your work in a shorter form, as in a pitch letter or synopsis, provides you a reality check on what you wrote. If you cant briefly present your work without sounding ridiculous, maybe (I gently suggest) maybe it is ridiculous. Help the Reader Besides the invigorating, astringent benefits to the writer learning to edit ruthlessly, brief writing benefits the reader too. The human mind can only hold so many thoughts and words at once, just as a computer screen or the page of a book can only hold so many words. So for example, academic researchers need abstracts to be brief so that several can be compared on a single page or computer screen. Short summaries let readers get a taste of the writers ideas or many writers ideas in a small space and time. By limiting the number of ideas in the summary, the writer also limits the number of ideas that need to fit into the readers head at one time. With fewer ideas to focus on, the reader has more room to think about them. With fewer words to move around in your head, words can be moved around more easily, compared, pondered and felt. Which is more effective: a single powerful, precise word or a string of twenty words that mean exactly the same thing and add nothing more? Here are some tips for editing ruthlessly: Cut Riskily Set a goal for yourself, if your editor hasnt already, to cut 10% from your draft. But why stop there? Choose a paragraph and cut out one-fourth. Or take a risk, let the adrenaline flow and cut it down one-half. Youll be surprised at how often the passage still works. (Often it wont thats why its called a risk.) If it doesnt work, simply restore the cut passage from your recently saved draft. Some reasons why such ruthless cutting often works: You may find you had more fluff than you thought. The passage still works because the cut part never did. You may find that the cut part wasnt as necessary as you thought. Only when its gone do you realize you can live without it. It was pulling some weight, but not so much. If you want, take the best words from it, use them elsewhere, and move on. You may find that your reader doesnt need the cut part to figure out whats happening. When a character leaves the room, your reader will assume the character went through a door without being explicitly told. Make Less More Even if I increase it to 1,000 or 100,000 words, I still cant improve on the classic six-word-novel: For sale: baby shoes, never worn No one is saying that War and Peace would be improved if it were edited down from 587,287 words to 1,000 words. If you want to deal with five families and the Napoleonic War, you will need a lot of words. But a key to ruthless editing and having the heart to do it in the first place is being able to see when you have gained more than youve lost by cutting words. Maximize Your Space If you have a limited number of words to work with, make each word carry its weight. For example: The river flowed through the river bed, making a sound like thunder. We can cut some of those words without losing any meaning. Rivers always flow, usually through river beds, and thunder is always a sound. Changing it to The river thundered or The thundering river says as much in three words as the original sentence did in eleven really, it says more. Now I have to find a new, sleek sentence to put them into. It will take a little work to make the most of them, just as it takes a little work to make the most of the garlic chives I just harvested from my garden. But should I give up a good thing because it takes work? Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Writing Basics category, check our popular posts, or choose a related post below:60 Synonyms for â€Å"Walk†That vs. WhichTypes of Ignorance

Public transportation affects on the economy in terms of employment, Essay

Public transportation affects on the economy in terms of employment, wages, and business income in the usa - Essay Example This paper discusses the effects of public transportation services on the economy in terms of employment, wages, and business income in the US. Public transportation generates numerous jobs in US. First, jobs are created through capital investments that take place in the sector, or to support the sector (Economic development Research, 2). This includes the purchase of vehicles and equipments, development of infrastructure, and other supporting facilities. An analysis conducted by Weisbrod and Reno (1) observed that per every billion dollars spent in investment activities in the US public transportation, approximately 24,000 jobs are supported annually. Public transportation operations are in addition significant sources of employment. These employment opportunities include management, operations, and maintenance of vehicles and facilities. The analysis conducted by Weisbrod and Reno (1) elaborate that for every billion dollars spent on public transportation operations in the US, around 41,000 jobs are supported annually. Moreover, the US public transportation sector helps to create jobs for individuals, or in industries inv olved in providing services such as repairs and car wash. On average, Weisbrod and Reno (1) observed that per every $ billion invested in public transportation sector in US, approximately 36,000 jobs are supported directly or indirectly annually. Investments in public transportation generate wages for employees working in the sector, in addition to individuals working in related sectors. An increase in investment in the sector results in an increase in public transportation spending, leading to employment of persons to fill the new created jobs (United States Department of Transportation, 2). This creates an opportunity for unemployed persons to earn income. The analysis conducted by Weisbrod and Reno (1) indicate that $1 billion investments in the public transportation sector in US results to $1.6 billion increase

Gun control Research Paper Example | Topics and Well Written Essays - 750 words

Gun control - Research Paper Example Many also contend that the right to own handguns, specifically, has turned out to be a detriment to public safety which is opposed to the intentions of the Founding Fathers. According to The Second Amendment â€Å"A well regulated militia, being necessary to the security of a free state, the right of the people to keep and bear arms, shall not be infringed† (â€Å"The Constitution†, 2006). Those who are against limited forms of gun control refuse to consider the important word â€Å"militia† within this Amendment. â€Å"The Second Amendment was intended solely to guard against suppression of state militias by the central government and therefore restricted in scope by that intent; or does not guarantee a right that is absolute, but one that can be limited by reasonable requirements† (Krouse, 2011). Advocates of gun control, by and large, desire the weapon that harms the most people, handguns, to not be legal anymore but are agreeable with compromising on s hotguns and rifles. In this way, the constitutionally guaranteed right to keep and bear arms is protected but so are the many thousands of people that are killed by handguns each year. When reading the actual wording of the Second Amendment it is clear that armed militias alone have the right to bear arms. However, given the present passionate emotions tied to this topic and the allure of guns for citizens of the country, a compromise can be the only solution. Philosophies are formed by a people’s innermost values, refined by many years of thought and fashioned by life’s many experiences. Therefore a philosophical debate causes people to be more emotional than any other type. Political philosophies are tightly and vigorously held and in politically tumultuous times, such as today in a post 9-11 world, are especially apparent. The war in Afghanistan, gay marriage, the Occupy Movement, global warming, health care, abortion, health care, stem cell research, the loss of ci vil liberties and numerous other politically inspiring subjects have provoked emotional philosophical battles. The right to own firearms ranks highly among these political philosophies and any attempt to outlaw any type of gun always make this point of view even stronger. To make the argument for upholding the largely voiced ‘right’ to keep and bear arms by permitting shotguns and rifles of a particular length while prohibiting assault rifles and handguns seems the rational answer and a battle that may possibly be won. This approach has proven effectual in other countries such as Japan and many European countries. Those nations that have ban handguns experience a much lower murder rate than America. The idea that ready access to handguns has a major impact on the murder rates in the U.S. is supported by overwhelming evidence. Approximately two thirds of all murders that occur in the U.S. involve a handgun. Yet, restricting handgun use by legal methods has proven to have little impact on homicide rates. This is not a surprising revelation given that most criminals do not get their guns from licensed sources (Cramer/Kopel, 2011). Each year, at least 3000 American children are killed by the use of handguns. America’s children are much more likely to die via handgun use than the children of all other developed countries combined. Compare the number of American children killed with England where fewer than two dozen minors are killed by handguns in a given year. In Japan, the number is