Stereotypes of gender and female employment

Stereotypes of gender and female employment Gender stereotypes are associated with the phenomenon of female employment in specific job types. This paper in general looks at the nature of stereotyping. Many researchers have documented this issue in their works and hence this paper goes a mile to look at this phenomenon of stereotyping in countries of Africa, Asia and South Africa. It surveys the relevant materials documented on this topic. This presentation will look at the reviews of existing measures on gender stereotyping. This presentation goes a mile further to detail the dynamic concept of gender stereotyping and tries to suggest measures brought in by developing countries can be accommodated. Lastly these presentation analyses the aspect of stereotyping of occupations in the developing countries. Documented evidence of gender stereotyping has been done with many writers and researchers all of them giving vital reasons as to why discussion of occupational segregation on labor market at large. This has been done by many including Hakim (1979), Elia (1988), Anker (1998) and Reskin Hartmann (1986) Occupational isolation occurs when different people participate in different kinds of occupations and there exists rigidity in the mobility of groups or people from one occupation to another. This presentation looks majorly at such occupational segregation which occurs along gender lines. We often find occupations which are termed male or female specific. Women and male workers have been divided and consideration for jobs in each gender group is segregated. Female candidates are not considered for male prioritized jobs and the same for the women. Less demanding and less paying jobs are left for women while men compete for the well paying through which the issue of gender isolation is widely brought out. This kind of segregation reduces efficiency and this is the point where gender stereotyping is evident. Women are concluded in thoughts to be house wife and many still have the generalization that women will still transfer the way they work in the house to the job place. This has lead to differential in wage payment forcing women to be paid in the lower rated jobs while men are paid heavily in the state of high income jobs. Thus, we view a subtle difference between segregation and stereotyping. Occupational segregation exists when men and women are differently distributed across occupations to a degree greater than is consistent with their overall shares of employment, irrespective of the nature of job allocation. Stereotyping is the phenomenon when the occupational segregation persists, maintains itself, and for a period of time continues to enrich itself fully between people. It is a concept that keeps on changing and full of life as compared to segregation which is static in a way. Stereotyping prohibits people to continue doing a job in the same group without changing a vice that has left female workers in a low class as compared to their counterparts. At this point the women remain in a poor state whereas men continue to prosper by advancing in other fields that require resources or opportunities that result out of occupation of such high cadre in the society. A consensus has been yielded that globalization policies in developing countries have devalued the traditional set up of female work which include agriculture in particular agro based and small scale production. This has displaced women form this form of occupation to certain newly created job types. Facts prove also that women specific income and development projects do not receive the same funding of resources and attention hence leading to the concentration of women in marginal economic sectors. For sure concentration of women laborers has risen in ill paid and low skilled jobs living their counterparts in much higher paying jobs. Experiences from East European transition economies also reveal the fact that there is preponderance of over-employment of female labor force in certain employments. These are the jobs with longer working hours, shorter retirement rates, and lower wages. International labor organization studies on women in the labor market disclose the occupational segre gation and the employment problem of the women in transition economies. Absorption of female workers is high in the informal sector activities in Asia, Africa and Latin America. Statistics from South American nations like Brazil, Jamaica and many others show that female laborers are strenuous in low-skilled job groups (Vickers, 1991). Displacement from original spheres of activities for both genders have combined with increasing concentration of female labor in marginal activities like being employed in minimal works at the tail end of the production process in companies. Through this globalization has brought in indirect form of occupational segregation into gender types The simplest measure of occupational segregation has been the sex ratio of the workers employed in the various occupations. If there exists q occupations indicated by x. Mx and Fx indicate respectively the number of male and female workers in the xth occupation, then Sx = Fx/ Mx indicate occupational segregation ratios. Higher Sx means that the particular occupation x has more concentration of females relative to males. Degrees of gender segregation has been defined in order of ascendance of the measure =Sx. Higher values and lower values of the indicator helps to categorize the occupations as exclusively men (EXM), mainly men (M), mixed (MF), mainly women (F) and exclusively women (EXF). This gauge has been used by many researchers successfully (Reskin Hartmann, 1986) to approximate the extent of segregation in different nations across occupations and also across jobs. Occupations are defined as aggregates over the cluster of jobs belonging to the occupation. Empirical data has sh own that occupational segregation can smoothen out the extent of segregation across job types. So sometimes segregation across job types reveal the segregation across occupations. Whatever may be the extent of desegregation, this measure of segregation suffers from the absence of relativity as this does not measure relative concentration of females compared to males in the occupations. Several other models are available but all with an objective to illustrate discrimination against gender. Occupational isolation is thus the main precondition for existence and generation of gender stereotyping. Since it is difficult to get together similar data of worldwide distribution of occupational gender distribution, the work of identifying the emerging stereotype work zones worldwide still remains. However, one can get a feel of the trouble from the data laid done in tables below. The practical figures regarding earnings differential of female and male workers can be taken to be an indication of occupational segregation. This problem is an unrelenting one and also a developing one mostly in the developing countries and the transition economies. The process of globalization has also brought in new occupations and job types in the third world countries. This vice itself as a reinforcing process to create gender stereotypes. There is need to identify areas of existing and emerging stereotypes so that necessary actions can be taken to prevent such labor market rigidity.

Analysis of NFL Injuries

Analysis of NFL Injuries INTRODUCTION Achilles tendon (AT) ruptures are increasing in incidence across all populations[1-9]. Recent large-scale analyses put the incidence as high as 7-40 ruptures per 100,000 person-years[3-5, 10]. A 33-year study from Finland discovered from 1979 to 2011 the injury rate increased from 2.1 to 21.5 ruptures per 100 person-years in all age groups and activities[6]. Even in the athlete population, the number of athletes suffering AT ruptures is increasing which poses a potentially career-altering and even ending injury[1, 6, 11-13]. Nearly a third (27.5-32%) of all National Football League (NFL) players who suffer an AT rupture are unable to return to competition[13, 14]. In the NFL from 1980-2001, around 4 AT ruptures that required surgical intervention occurred each year[11]. From 2009 to 2014 in the NFL, there was an average of 14.67 (Standard deviation: 4.13) AT ruptures each season[15]. These ruptures are seen most frequently in running, jumping and cutting movements[6, 12, 16]. Achilles tendon ruptures typically occur from a non-contact mechanism during explosive acceleration or a sudden change of direction with an eccentrically loaded foot[14]. The AT has elastic properties that are required for locomotion and is the strongest tendon in the human body[12, 17, 18]. This elastic nature and strength allows it to transmit high forces, up to 12 times ones body weight[17, 19, 20]. Durability requirements of the AT create a unique set of challenges in proper treatment decisions. Current reconstruction concepts differ behind the ideal treatment strategy[9, 21]. The recovery process from all surgical techniques is an arduous challenge involving significant physical therapy and medical treatment. Unfortunately a majority of patients, especially those in the general population are able to return to a pre-injury level, with the current exception being elite athletes[22]. Although several studies evaluate AT ruptures in multiple populations, including professional athletics, studies that assess trends in professional football are scarce. NFL athletes provide an interesting patient population due to the intricate details and variables reported for every game where data is archived and widely available. A recent NFL Injury Surveillance System (ISS) analysis by Mai HT et al., discovered only a 72.5% return to play rate for athletes who suffered an AT rupture. If the athlete was able to return, the average return was 375.1 days, similar to the recovery period for ACL reconstruction (378.1 days)[13]. Athletes fortunate enough to return to competitive action frequently experience a significant decline in performance, and their competitive athletic longevity may be shortened[13, 14, 23]. The potential devastating effect on high-level athletes has required the development of ideas to optimize treatment management and improve return to play rates[23]. Previously, anterior cruciate ligament (ACL) injuries have been scrutinized due to their high incidence, long rehabilitative process and potential career-threatening nature of the injury[24]. A recent review by Balazs et al. identified four studies that found an increased risk of ACL injury on artificial playing surfaces in football cohorts, although these findings are not consistent across all studies[24]. Current research evaluates multiple variables in efforts to find potential contributing risk factors, including playing surface, that may increase the risk and rate of these devastating injuries[24, 25]. Identifying and understanding risk factors from prior research has been used to develop and improve protocols and outcomes after ACL injuries[24]. With the growing incidence of AT injuries, research is necessary to improve management and prevention of AT ruptures, especially in football players where the current literature is limited. This study performed an extensive review of reported NFL injuries from public injury records and injury reports during the 2009-10 to 2016-17 seasons. This data was compiled to monitor the incidence and injury rates of AT injuries that occurred during the regular season to evaluate the influence of playing surface on rupture rate. Additionally, further analysis to identify potential effects of position and frequency of injury at different periods of the season on AT ruptures was performed to guide future studies. Our hypothesis is that playing surface has no impact on the incidence and injury rate of AT ruptures in professional football players despite a recent overall increase in AT ruptures. METHODS A thorough online review was conducted by three co-authors to document AT ruptures sustained in the NFL between the 2009-10 and 2016-17 seasons. Online search criteria consisted of information acquired from Rotoworld.com, NFL.com, ESPN.com, SBNation.com, SI.com and from each teams local sports reports and blogs covering the team. Open searches through Google.com utilized combinations of the words Achilles and tendon along with the player, team and year of injury. Published weekly injury reports and team injury reserve lists were utilized to identify players who suffered injuries to their lower extremity or leg. Their names were added to the open internet search key words in attempts to improve accuracy of documenting all AT ruptures of NFL athletes. Only injuries with corresponding reports that confirmed the injury were included. Additional information gathered through the online search and acquired reports included player-specific details including team, position, approximate date of injury, activity at time of injury and other injury specific details including mechanism and playing surface when available. Injury incidence was recorded for each season. A season was defined as the day after the prior Super Bowl until the day of the Super Bowl in each given season. Descriptive statistics characterizing the injuries by playing surface, time in the season (broken up in to four game segments specific to each team considering their bye week) and players participating on offense, defense or being a specialist (i.e. kicker, punter, long-snapper) were determined for analysis. As previously described by Lawrence et al., injury rates were calculated per 100 team-games (TG)[26]. A TG is defined as one team exposure to a game[26]. One regular season or post-season game is equal to two TG as there are two individual teams participating in each game[26]. Mid-P exact tests were calculated to evaluate differences in IRs with statistical significance established at p Team and schedule information was gathered through Pro Football Reference and official team websites. The yearly team schedules and location of games played was recorded to help determine the home team and playing surface for all injuries suffered in games. Adjustments were made when games did not take place at the stadium of the home team and corrected accordingly. An analysis of the number of AT injuries per game for each variable was calculated. An NFL game in this study included the participation of two teams. Injury rate ratios were used to compare the incidence of AT injuries on different playing surfaces (i.e. natural grass and artificial turf). RESULTS Between the 2009-10 and 2016-17 seasons, there were a total of 45 Achilles tendon ruptures reported in the NFL during games (Figure 1). There was a subtle increase in the number of ruptures suffered each year. The most Achilles tendon ruptures occurred during the 2013-14 and 2016-17 season (N = 9) and the incidence of ruptures on grass was 24 (IR: 1.00 per 100 TG) compared to 21 (IR: 1.13 per 100 TG) on artificial turf playing surfaces (Figure 2). The difference in rate was not statistically significant (p = .67). Of the 45 Achilles tendon ruptured over the eight years, 32 (71.1%) were suffered by defensive players.  Ãƒâ€šÃ‚   Offensive players only sustained 13 ruptures and specialists reported no ruptures over that time (Figure 3). Defensive players suffered the greatest number of Achilles tendon ruptures every season monitored except for 2015-16. Defensive players had a significantly increased IR (p = .005) compared to offensive players (Table 1). When factoring in the playing surface, offensive players suffered a higher percentage of their ruptures on turf (N = 8, 61.5%) compared to defensive players that sustained a great number of their ruptures on natural grass (N = 19, 59.4%). Achilles tendon ruptures were most likely to occur early in the season. The greatest incidence was reported in the 1st or 2nd 4 game segments of the regular season schedule (N = 17 and N = 14 respectively). These 31 ruptures in the first 8 games of the regular season made up 68.9% of all Achilles ruptures in games over eight seasons (Table 2). There was a significant rate difference between the first four games of the regular season with the last four games of the regular season (IRR: 3.40, p = .01). The second four games of the regular season also demonstrated a significant rate difference with the final four games of the regular season (IRR: 2.80, p = .04). DISCUSSION Previous studies have documented the increased incidence of acute Achilles tendon ruptures in the general population. After the NFL lockout, the increasing incidence of Achilles tendon ruptures in the NFL was noted and gained national attention[11]. The purpose of this study was to document the incidence and injury rates of Achilles tendon ruptures in games over eight NFL seasons. Using this data, we were able to evaluate the potential influence of playing surface on the rate of Achilles tendon ruptures between grass and artificial turf to improve our understanding of the growing injury. Game information provides playing surface details for each game for analysis. Since this injury compilation is from public records, the ability to accurately identify the playing surface for training and practice injuries is limited. Analysis of 4,272 regular season and playoff team-games reported 45 Achilles tendon ruptures. The overall game injury rate was 1.05 AT ruptures per 100 TG. As the current literature on AT rupture epidemiology in professional football is limited, this is one of the few studies in the past decade reporting IRs. The IR for artificial turf was 1.13 per 100 TG and 1.00 per 100 TG on natural grass. There was no demonstrated difference between rates on artificial turf and natural grass (p = .67). These early findings support that playing surface does not affect the rate of AT ruptures. Other studies evaluating injury patterns have confirmed that certain injuries are more likely during certain activities or periods of the season, like hamstring strains in the NFL preseason[27]. To further understand our findings, overall AT ruptures were broken down in to four game segments of the regular season and the post-season. The greatest IR was observed in the first and second four-game portions of the regular season (IR: 1.66 and 1.37 per 100 TG respectively). The only significant rate difference occurred between those two four-game segments with the final four games of the regular season (p = .01 and .04 respectively). These findings support the significantly increased rate of injury early in the season. A further analysis of all AT ruptures in practice and games is important to help understand the significance of these early findings. Previously between the 1997 and 2002 seasons, a total AT analysis reported that Achilles tendon ruptures sustained were evenly distributed[ 14]. Our game findings do not support this earlier analysis; however, the overall incidence has increased substantially since the previous study[14]. Further evaluation may confirm these findings and help identify risk factors that lead to an increased risk of AT rupture early in the season. Additionally, further evaluation should identify if this increase is only during the beginning of the regular season or is also distributed throughout pre-season training camps. Immediately following the NFL lockout in the 2011 season, there were 10 reported Achilles tendon ruptures in the first 12 days of training camp[11]. That off-season was unique for at least the last decade due to the elimination of rookie mini-camps and off-season training sessions (OTAs), but potentially highlighted the importance of adequate preparation for current physical demands of professional football players[11]. Ultrasound evaluation found that subjects who are less active have a thinner Achilles tendon compared to athletes[18, 28]. A recent meta-analysis of 27 studies identified that differences in the loading conditions affected the adaptive responses (tendon stiffness, Youngs modulus, and tendon cross-sectional area)[29]. Additionally, although shorter high intensity programs may induce adaptive tendon responses, intervention programs of longer duration appears to be more efficient and clearly demonstrated increased adaptive responses (greater than or equal to 12 weeks)[29 ].   The combination of findings after an NFL Lockout off-season preventing team-affiliated practice and the meta-analysis findings stress the significance of adequate player preparation[29]. An adequate player preparation programs involves sufficient high level intensity training of significant length that prepares the athlete and allows for tendon adaptations to prepare them for training camp exposures. Continued efforts to identify the best training protocols to prepare athletes for the demands of football training camp is crucial for optimal injury prevention. Additional analyses identify specific positions or position groups most likely to sustain specific injuries[14, 27]. We were interested if the reactive nature of defensive players increased their likelihood for injury. Of the 45 AT ruptures identified, a majority (N = 32, 71.1%) were sustained by defensive players that demonstrated a significantly increased rate in games compared to offensive players (p = .005). Eccentric movements increase the tendon length[29, 30]. The Achilles tendon functions as both a spring and a shock absorber[18]. Previously, athletes have been found to have a thicker Achilles tendon than subjects who are less active[18, 28]. Currently, ruptures are believed to be caused due to the overloading of the taut tendon, but other studies have also discovered degenerative changes within the ruptured tendon[8, 29, 30]. Although research demonstrates a genetic influence on the predisposition of a person towards an Achilles tendon injury[31], these findings clearly demonstrate an additional risk experienced by defensive players.   We suspect one factor that increased the incidence of AT injuries for defensive players is the reactive nature of the position and movements required of defensive players compared to the movements utilized by offensive and specialist players. A further analysis may be able to confirm this hypothesis and if practice injuries are included may be able to provide an adequate sample size to identify specific positions more susceptible to injuries. CONCLUSION Utilizing game data, there is no apparent correlation between playing surface and rate of AT ruptures. Our findings identify significant rate differences in AT ruptures in the first and second four game segments of the regular season compared to the final four games. Additionally, our findings are some of the most recent published game IRs for AT ruptures. Defensive players suffered a majority of ruptures compared to offensive or specialist players. Further analysis to identify an overall IR including practices and additional analysis of player position and time of the season of injury will improve our understanding of AT ruptures in professional football. LIMITATIONS This analysis of the NFL relies on publicly available data. We are aided in our analysis as the NFL requires all teams to report and publish injury reports each week of the season in addition to every game of the season televised. This allows the accuracy of game data to be of increased accuracy compared to practice information that is not as widely publicly available. Even with the precautions, there are possibilities for AT ruptures to not be documented. With the current attention to long-term injuries, there is potential bias from an increased attention and publication of athletes who sustained AT ruptures compared to the beginning of our study. REFERENCES [1] Fox G, Gabbe BJ, Richardson M, et al. Twelve-month outcomes following surgical repair of the Achilles tendon. Injury 2016; 47: 2370-2374. [2] Ganestam A, Kallemose T, Troelsen A, et al. Increasing incidence of acute Achilles tendon rupture and a noticeable decline in surgical treatment from 1994 to 2013. A nationwide registry study of 33,160 patients. Knee Surg Sports Traumatol Arthrosc 2016; 24: 3730-3737. [3] Huttunen TT, Kannus P, Rolf C, et al. Acute Achilles Tendon Ruptures: Incidence of Injury and Surgery in Sweden Between 2001 and 2012. Am J Sports Med 2014; 42: 2419-2423. [4] Mattila VM, Huttunen TT, Haapasalo H, et al. Declining incidence of surgery for Achilles tendon rupture follows publication of major RCTs: evidence-influenced change evident using the Finnish registry study. Br J Sports Med 2015; 49: 1084-1086. [5] Jacobsson J, Timpka T, Kowalski J, et al. Prevalence of Musculoskeletal Injuries in Swedish Elite Track and Field Athletes. Am J Sports Med 2012; 40: 163-169. [6] Lantto I, Heikkinen J, Flinkkilà ¤ T, et al. Epidemiology of Achilles tendon ruptures: Increasing incidence over a 33-year period: Clinical relevance level IV. Scand J Med Sci Sports 2015; 25: e133-e138. [7] Sheth U, Wasserstein D, Jenkinson R, et al. The epidemiology and trends in management of acute Achilles tendon ruptures in Ontario, Canada: a population-based study of 27 607 patients. Bone Jt J 2017; 99-B: 78-86. [8] Wertz J, Galli M, Borchers JR. Achilles Tendon Rupture: Risk Assessment for Aerial and Ground Athletes. Sports Health 2013; 5: 407-409. [9] Ververidis AN, kalifis KG, Touzopoulos P, et al. Percutaneous repair of the Achilles tendon rupture in athletic population. J Orthop 2016; 13: 57-61. [10] Raikin SM, Garras DN, Krapchev PV. Achilles Tendon Injuries in a United States Population. Foot Ankle Int 2013; 34: 475-480. [11] Myer GD, Faigenbaum AD, Cherny CE, et al. Did the NFL Lockout Expose the Achilles Heel of Competitive Sports? J Orthop Sports Phys Ther 2011; 41: 702-705. [12] Gajhede-Knudsen M, Ekstrand J, Magnusson H, et al. Recurrence of Achilles tendon injuries in elite male football players is more common after early return to play: an 11-year follow-up of the UEFA Champions League injury study. Br J Sports Med 2013; 47: 763-768. [13] Mai HT, Alvarez AP, Freshman RD, et al. The NFL Orthopaedic Surgery Outcomes Database (NO-SOD): The Effect of Common Orthopaedic Procedures on Football Careers. Am J Sports Med 2016; 44: 2255-2262. [14] Parekh SG, Wray WH, Brimmo O, et al. Epidemiology and Outcomes of Achilles Tendon Ruptures in the National Football League. Foot Ankle Spec 2009; 2: 283-286. [15] Hoffman J, Krill M, Hewett T. Anterior Cruciate Ligament And Achilles Tendon Injuries In The Nfl From 2009-10 To 2014-15 Seasons: 3075 Board #140 June 3, 3:30 PM-5:00 PM. Med Sci Sports Exerc; 48: 873. [16] Hess GW. Achilles Tendon Rupture: A Review of Etiology, Population, Anatomy, Risk Factors, and Injury Prevention. Foot Ankle Spec 2010; 3: 29-32. [17] Joseph MF, Lillie KR, Bergeron DJ, et al. Achilles Tendon Biomechanics in Response to Acute Intense Exercise: J Strength Cond Res 2014; 28: 1181-1186. [18] Malvankar S, Khan WS. Evolution of the Achilles tendon: The athletes Achilles heel? Foot Edinb Scotl 2011; 21: 193-197. [19] Lorimer AV, Hume PA. Achilles Tendon Injury Risk Factors Associated with Running. Sports Med 2014; 44: 1459-1472. [20] Oda H, Sano K, Kunimasa Y, et al. Neuromechanical Modulation of the Achilles Tendon During Bilateral Hopping in Patients with Unilateral Achilles Tendon Rupture, Over 1 Year After Surgical Repair. Sports Med. Epub ahead of print 3 October 2016. DOI: 10.1007/s40279-016-0629-3. [21] Gulati V. Management of achilles tendon injury: A current concepts systematic review. World J Orthop 2015; 6: 380. [22] Egger AC, Berkowitz MJ. Achilles tendon injuries. Curr Rev Musculoskelet Med. Epub ahead of print 13 February 2017. DOI: 10.1007/s12178-017-9386-7. [23] McCullough KA, Shaw CM, Anderson RB. Mini-open repair of achilles rupture in the national football league. J Surg Orthop Adv 2014; 23: 179-183. [24] Balazs GC, Pavey GJ, Brelin AM, et al. Risk of Anterior Cruciate Ligament Injury in Athletes on Synthetic Playing Surfaces: A Systematic Review. Am J Sports Med 2015; 43: 1798-1804. [25] Hershman EB, Anderson R, Bergfeld JA, et al. An Analysis of Specific Lower Extremity Injury Rates on Grass and FieldTurf Playing Surfaces in National Football League Games: 2000-2009 Seasons. Am J Sports Med 2012; 40: 2200-2205. [26] Lawrence DW, Hutchison MG, Comper P. Descriptive Epidemiology of Musculoskeletal Injuries and Concussions in the National Football League, 2012-2014. Orthop J Sports Med 2015; 3: 232596711558365. [27] Elliott MCCW, Zarins B, Powell JW, et al. Hamstring Muscle Strains in Professional Football Players: A 10-Year Review. Am J Sports Med 2011; 39: 843-850. [28] Emerson C, Morrissey D, Perry M, et al. Ultrasonographically detected changes in Achilles tendons and self reported symptoms in elite gymnasts compared with controls An observational study. Man Ther 2010; 15: 37-42. [29] Bohm S, Mersmann F, Arampatzis A. Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Sports Med Open 2015; 1: 7. [30] Pedowitz D, Kirwan G. Achilles tendon ruptures. Curr Rev Musculoskelet Med 2013; 6: 285-293. [31] Maffulli N, Margiotti K, Longo UG, et al. The genetics of sports injuries and athletic performance. Muscles Ligaments Tendons J 2013; 3: 173-189. FIGURES Figure 1. Figure 2. Figure 3. Table 1. IncidenceIRaIRRbp-value Defense320.752.46 (1.31-4.85).005 Offense130.30 a Injury rate based on 4,272 TG (4,096 regular season and 176 post-season TG) bInjury rate ratios with 95% confidence limits Table 2. IncidenceIRaIRRbp-value 1st 4 games171.66 1.21 (0.59-2.51)c.60 2.13 (0.93-5.21)d.08 3.4 (1.30-10.31)e.01 2.92 (0.53-61.68)f.29 2nd 4 games141.37 1.75 (0.74-4.40)d.21 2.80 (1.04-8.67)e.04 2.41 (0.43-51.37)f.42 3rd 4 games80.78 1.6 (0.52-5.38)e.42 1.38 (0.22-30.76)f.85 4th 4 games50.49 0.86 (0.12-20.45)f.83 Post-season10.57 aInjury rate based on 4,096 regular season (1,024 each 4-game period) or 176 post-season TG bInjury rate ratios with 95% confidence limits Compared with c2nd 4 games of the regular season, d3rd 4 games of the regular season, e4th 4 games of the regular season, or fpost-season

Catcher In The Rye And Huck Finn :: essays research papers

All novels contain common elements and qualities. In most cases the plot, conflict, and a narrative voice forms the style of writing. Frequently the incidents told are direct experiences from the narrator himself. The Catcher in the Rye by J.D. Salinger and Huckleberry Finn by Samuel Clemens employ these characteristics, particularly using a constructive voice, symbolism, and a complex connected sequence of events, dealing with human experiences.   Ã‚  Ã‚  Ã‚  Ã‚  There are many instances in The Catcher in the Rye which deal with such characteristics. The novel is told in first person through the eyes of the narrator, Holden. He recalls the events as a series of flashbacks placing the setting of the story in his mind. Next, there is the repeated use of symbolism throughout the novel. Three major symbols were the ducks, the Museum of Natural History, and Jane Gallagher. While Holden is wandering around New York City, he asks many people about what happens to the ducks in the pond when it freezes. In actuality, the ducks represent Holden wondering about himself. Jane Gallagher and the Museum of Natural History, both represent the theme of the past in two different aspects. Jane Gallagher was an old friend of the past, and he mentions calling her repeatedly throughout the story. She is a significant part of his past that he misses a lot, which makes him want to reminisce those times once again. The Museum of Natural History, o n the other hand, makes Holden realize he will never be the same as he used to be, and this changes his mind on wanting to return to the past. All of these hidden messages represent Holden, revealing the way he thinks and acts. Throughout the novel there’s continuance of events that deal with human experiences. The novel is based on the story of his nervous breakdown lead by being expelled from Pencey Prep, increasing feelings of loneliness and desperation brought on by the insincerity and ugliness of the adult world, and the tormenting memories of the death of his younger brother Allie.   Ã‚  Ã‚  Ã‚  Ã‚  Huckleberry Finn was also written in first person but through the eyes of the Huck Finn. Huck tells about a series of adventures, making many observations on human nature and the South as he does. The use of symbolism is again portrayed throughout this novel. It is often said that the story of Huck Finn is about Mark Twain himself.

Violence, Terrorism, and the Interactions between Cultures Essay

Violence, Terrorism, and the Interactions between Cultures When humans from different cultures interact, the result is often bloodshed, domination and disease. Also, without exception, the exchange of ideas gradually occurs. All of these factors have shaped the course of history. While much of the spread of disease has been reduced since the Black Death, much bloodshed still comes from the interaction of cultures, possibly from physical contact without intellectual or rational interaction and understanding. Interaction itself is necessary and does result in good as well, especially in terms of technological advancements. The spread of disease is possibly one of the most dramatic results of interactions between cultures. The different ways of living in Europe and other parts of the world caused very different illnesses to develop in each. Europeans lived in close quarters in densely populated cities, which allowed crowd diseases, such as measles, to develop. These diseases quickly result in death, or recovery and immunity. Thus, they do not remain relevant in smaller communities; by the time victims have recovered fully, the disease is not around to be spread. In larger communities, the disease can shift from area to area, remaining in existence until there are babies to be infected in the original area. (Diamond) A leading theory maintains that these diseases developed from animal diseases that adapted to the environment of the human body when humans and animals were in close contact. In particular measles and smallpox came from cattle, and the flu came from pigs and ducks. (Diamond) Because this con tact with animals, the close contact with thousands of other humans in cities, and the connection of populations by trade, a... ...p. 1-35. Cipolla, Carlo M., Epilog from "Guns, Sails, and Empires: Technological Innovation and the Early Phases of European Expansion, 1400-1700" Sunflower Univ. Press, 1996, pp. 132-148. Diamond, Jared, "Ch. 11: Lethal gift of livestock," in "Guns, Germs, and Steel" W.W. Norton & Co, 1997, ISBN 0-393-03891-2, pp. 195-214 Ponting, Clive. Ch.11 from "A Green History of the World," St. Martins Press, NYC, 1991, pp. 224-239. Pursell, Carroll W. Jr., Ch. 1 and 2 in "Early Stationary Steam Engines in America: a study in the migration of a technology" Smithsonian Inst. Press, 1969, pp. 1-27. Schneider, Jane. Rumpelstilskin's Bargain: Folklore and the Merchant Capitalist Intensification of Linen Manufacture in Early Modern Europe. In Cloth and Human Experience, edited by Annette B. Weiner and Jane Schneider. Washington: Smithsonian Institution Press, 1993.

Justice Essay -- essays research papers

Justice Every action or decision we make is either justifiable or unjustifiable. Justice is usually decided by society or the "norm." The "norm" changes from one society to another. However, there are always laws that can be broken, consequences that must follow, and punishment that must be imparted. Justice can be seen in two different ways, social and criminal. Justice is in the eye of the beholder because we all have different attitudes about right and wrong. Criminal justice is a term that refers to the area of social laws which a group of people deem valuable in order for the day-to-day mechanics of society to function. When these laws are broken, the infrastructure of a society breaks down, and this deviance from the "norm" must be corrected. Personal feelings, morality, religious beliefs, and inflammatory, biased feelings towards certain laws cannot supersede the concrete social laws. This type of high emotion was apparent when dealing with the facts in the murder of a Topeka police officer. In the recent trial Steven Shively was prosecuted for shooting a police officer. The prosecutor was caught up in the media and emotional hype of this case. She apparently thought that she could win simply because a police officer was shot and the public was behind her. It was a case of public revenge where the mind- set was "We're going to get the guy that did this horrible crime. It d...

Clinical Decision Support

A state of irritability, exhaustion, or bewilderment triggered in clinicians who have been exposed to too many alerts which cause the user to ignore some or all the alerts. American National Standards Institute (ANSI) ; coordinates for the development of Health bevel Seven's Arden Syntax Standard. Bar Code Medication Administration (ABACA) ; An inpatient CADS to assist nurses with the five rights of medication administration. ; Provides warnings if any of the five rights are violated. ; It also requires the nurses to enter an override reason if he/she chooses to proceed.Bar Code Medication Administration Health Level Seven (HAL) ; A standards development organization for health information technology (HIT) Look-Alike, Sound-Alike (ALAS) ; Drugs with similar spelling or pronunciation. ; Refers to providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented to appropriate times, to enhance patient care. ; Integrate patie nt-specific data with an available knowledge base in order to assist the clinician in selecting and delivering the safest and most effective therapies.Clinical Decision Support System A system intended to provide CDC to clinicians, caregivers and health care consumers. ; An Automated CADS includes: 1. A Knowledge base 2. An Event monitor 3. A Communication system Take Note: ; CADS may be a stand alone system ; CADS may be integrated into other technology solutions (ex. Bar code scanning technology and e-Prescribing) General Attributes of CADS 1. Designed for three purposes: Improve the quality of clinical decisions Notify of potential change in patient status ;. Prevent errant action at the point of care a.Error of commission b. Error of omission 2. Patient specificity 3. Context sensitive- relates directly to the work at hand 4. Integrated into workflow- convenient to use. 5. Timely- executes in real time 6. Pushes information to the clinician, care-giver or health care consumer 7. Intelligently filtered clinical information ; Information, advice or warning is relevant and meaningful ; CADS uses patient data to infer that the message is actually needed. ; CADS is customizable to clinical preferences. Types of Clinical Decision Support A. Patient-specific CADS B.Non-patient specific CADS ; This type of CADS consist of three types f alerts 1 . Commercial drug-interaction alerting system 2. Commercial dose and dose-range checking alerts 3. Commercial clinical rules engine Commercial drug-interaction alerting system ; Most common in COPE and Pharmacy Information systems. ; Provides alerts for drug-allergy, drug-drug, drug-pregnancy and other interactions. ; Limitation is that severity levels Of drug interaction is pre-assigned by the vendor based on the anticipated adverse reaction and cannot be customized.Four Possible Results from deterioration alerting system Alert Result Produces alert? Relevant? Clinician deeds to see? True Positive Yes True Negative NO No P ositive False Yes but never gets the chance Commercial dose and dose-range checking alerts ; Currently, this is rudimentary using few patient data, usually only age. Therefore this systems only loosely fit paternalistic category. Commercial clinical rules engine ; These allow local development or customization of clinical content and programming logic. 2. 3. 4.Data mining Informational notice Order sets Knowledge retrieval systems ; Provides population specific relationships and information. ; Encompasses numerous methods used to identify patterns and relationships in data. ; Usually just-in-time, product specific information. ; Examples: 1 . Provides alert for possible ALAS 2. In COPE, it might be order specific information such as the cost off lab test, or formula status of a drug. ; An organized set of patient care orders that are usually population, procedure or disease specific. It may be evidence-based such as clinical guideline. ; The KIRKS ; It could be: 1. Primary KIRKS ex. Google and 2. Secondary KIRKS (Harridan's online) 3. Tertiary KIRKS (ASAP, Thomson Health care and How to maximize the benefits Of CADS? Maximizing the benefits 1. Ensure that the data available for decision-making is as comprehensive as possible. Data should be current and urge Larry updated. 2. Optimize the method by which the decision support information is delivered to the health care provider values of CADS ; Application of CADS in different current medical technologies available: 1.COPE 2. OMAR(Getronics Medication Administration 3. Smart Pumps 4. Automated distribution cabinets CADS in COPE CADS integrated in COPE can: ; Reduce medication errors (any preventable event that may lead to inappropriate medication use or cause harm to he patient while the medication is in the control of a health care professional, patient or consumer) ; Improve compliance with recommended monitoring or adjunctive therapies. ; Improve efficiency by reducing the time spent clarifying incomplete ord ers. Screen for a variety or risks on the point of entry (ex. Duplicate therapy, drug-drug, allergic cross sensitivities) ; can reduced mathematical errors by automating weight-based and similar dosing calculations. ; can identify possible ALAS medications. Computerized Provider Order Entry CADS in Omar ; OMAR (Electronic Medication Administration Record) CADS integrated in Omar can: ; Can provide real time confirmation of the 5 rights of medication administration: 1. Right medication 2. Right dose 3. Right route 4. Right patient 5.Right time ; Can screen for recent changes in laboratory parameters, vital signs, or allergy status which may interact with a scheduled medication and alert the nurse prior to administration. ; Ex: laboratory shows critical level of potassium thereby alerting the nurse before administering dioxin to patient. CADS in Smart Pumps ; Smart pump- a computerized infusion device that can be programmed to include specific set of data. CADS integrated in Smart Pum ps can: ; Provide real time confirmation of the volume, rate and concentration of the solution being administered.Smart Pumps CADS in Automated Dispensing Cabinets ; ADS- secure storage cabinets typically located decennially on patient care units capable of handling most unit-dose and multiple dose medications. ; CADS integrated in ADS can: ; Notify nurses of potential hypersensitivity or ADAIR when certain trigger medications are withdrawn for a patient. ; In pharmacy, can provide alerts when medication is withdrawn too early or too ate based on scheduled administration time. Automated Dispensing Cabinets Unintended consequences in CADS ; A. Alert fatigue ; 8. Delay in care ; C. System performance A.Alert fatigue ; Tendency users to become overwhelmed and begin to ignore CDC messages due to a high quantity of alerts or a perception that the alerts have little perceived value. B. Delay in care ; The risk that interruptions in the workflow caused by clinical decision support alerts o r system limitations may lead to a delay in delivery of patient care. C. System Performance ; The risk that the processor resources seed by the CADS will cause the hospital information system software to perform slowly. Arden syntax standard ; A programming language designed for clinicians to build clinical rules. Streamlined computer language based on Pascal. ; Developed in Columbia University Arden Homestead in 1989. ; This standard provides a method to construct clinical rules, such as alerts, reminders and recommendations, known as Ml. ; Provides a flexible and clinically way to develop Ml. What is Ml? Ml ; Means Medical Logical Modules ; Offers a suggestion or warning (alert, recommendation or reminder) regarding a alnico decision or action, or an informational notice to report a change in a patient's clinical status.

Critical Evaluation: Frankenstein Essay

Frankenstein Mary Shelley creates strong meaning through her interpretation a monster by the main concept. Bringing something back from the dead is what created the mystery and curiosity for this lost soul. The idea of this impossibility is what has made it recognised today. Mary Shelley had conceived the idea for Frankenstein in a time of wonder. She uses imagery and strategic repetition of key descriptive words to create an atmosphere of horror and gloom in the first part of the chapter, when the monster comes to life. Shelley invites readers to believe Victor’s story through an objective person. Shelley also uses an important literary device known as the epistolary form — where letters tell the story — using letters between Walton and his sister to frame both Victor’s and the creature’s narrative. She uses imagery and strategic repetition of key descriptive words to create an atmosphere of horror and gloom in the first part of the chapter, when the monster comes to life. She uses variations of words such as â€Å"dreary†, â€Å"horrid†, â€Å"disgust†, â€Å"miserable†, and â€Å"wretched† liberally, and paints vivid images of ugliness and decay. Frankenstein was deeply described as a monster that should not deserve the advantage of having a female companion through his life. The experiences which led Frankenstein understand the way the world perceives those who are different were unfortunately not the way they thought they would be. Within the book Frankenstein has a section where he speaks in first person narrative so that he can present his won perspective of the situation. Harmony was the soul of our companionship,† is an example of personification to the concept. Shelley uses the issues of being different to influence the way the audience feels towards the monster and his brutal murders. Meaning is exposed to the way Frankenstein really feels. His vulnerability is shown when he reveals that â€Å"it tort ured my heart† when he killed these innocent people. An understanding can also be gathered and influenced by the personalities and wishes of both Frankenstein and Victor. At first Victor’s mistake was to create this being of horror. It portrayed Frankenstein as the monster when actually Victor is refusing him of the only thing he wants and needs to live through this life which was not his choice to live. Mary Shelley guides you through the life of the creator and the creator’s created. Shelley gives the audience the change to make up their own mind of who caused the wrong doings by giving using different language techniques to give you an explanation on both sides. Why is it Valued? Mary Shelley’s Frankenstein is so very valued because of the imagination which is depicted through the concept of life after death. Frankenstein is recognised worldwide because of his kind heart in such a sad life. Even though he is seen as positively repulsive Frankenstein still finds joy in seeing others act like a family and learning from their experiences in life. Frankenstein is cherished because of its shocking concept. Frankenstein was brought into the world without a second’s thought to what the consequences would be. It has captured audiences in our generation and generations to come for its passionate personalities and imaginary themes.