Animal Welfare Research Paper

Feeding a Pitbull It is suggested that pitbull owners feed their pets the foods that have what the breed requires in nutritional value. The dog food should contain nutrient sources that are similar to that found in their native lands that their ancestors ate. The requirements for a pitbull are a balance of protein, carbohydrates, fatty acids, vitamins and minerals. Many dogs are taken to the vet because of nutritional related problems. If the dog is not getting the proper nutrients that their diet requires they can suffer from dry/itchy/flaky skin, hot spots, yeast infections in the ears, or thyroid-liver-kidney problems.The best diet for the pitbull is one that the owner makes fresh, using quality ingredients, without preservatives. Preparing home cooked meals for a dog can be less expensive than buying the average all-breed or any-breed pet food. Native foods for this breed would have been yellow corn, soy meal, rice, venison and fish. Recommended foods for this breed would be food s that contain soy, corn, brown rice, beef and poultry. This breed needs a high fiber and low carbohydrate diet. Avoid feeding this breed foods with a high fat or high starch content.Do not feed this breed any supplemental vitamin C, such as ascorbic acid, sodium ascorbate, calcium ascorbate, or ascorbal Palmitate because these can cause kidney and liver damage to the breed. The best food for your dog is real food, not people food, but food like real chicken, turkey, beef, bison, venison, lamb, fish, some fruits and vegetables, occasionally yogurt and eggs. Vitamins and best sources Vitamin A Palmitate Vitamin B-1 Thiamine Hcl & Yeast Vitamin B-2 Riboflavin & Yeast Vitamin B-6 Pyridoxine Hcl & Yeast Vitamin B-12 Cyanocobalamin & YeastVitamin D D-activated Sterol Vitamin E dl-alpha tocopherol acetate Niacinamide Biotin Folic Acid D-Calcium Pantothenate Para Amino Benzoic Acid Minerals and best sources Calcium Bone Meal Copper Gluconate Iodine Sea Kelp Iron Ferrour Fumerate Magnesium Magnesium- Gluconate Manganese Manganese-Gluconate Phosphorus Bone Meal Potassium Potassium-Gluconate Zinc Zinc-Gluconate Habitat There is no such thing as a natural habitat for domesticated dogs such as the terrier breeds, and it would be easier to describe the places where they couldn’t and would have a hard time surviving.Extremely cold places and extremely warm places with no shade can really do some harm to this breed. The basic cage size for an American pitbull terrier would be 36 inches long, 23 inches wide, and 25 inches high. The metal cages are preferred because they can be folded down and stored away when they are not in use. The metal cages also give the dog a 360-degree visual of their surroundings. The plastic cages are more for the puppies and for transporting the dogs. Health Care Hip dysplasia is a serious problem in pitbulls.There were x-rays done of 480 pitbulls and 22% were found to have hip dysplasia. Elbow dysplasia is another serious problem in pitbulls . There were over 100 pitbulls that were x-rayed and 14% were found to have elbow dysplasia. This is the 15th worst rate in 82 breeds. Other orthopedic diseases in pitbulls are luxating patella and osteochondritis. American pitbull terriers have the 4th highest rate for hypothyroidism in 140 breeds. Vets are seeing heart disease in an increasing number of dogs in this breed. Skin problems are very common in this breed and can range from allergies to demodectic mange.Tumors and cancer are also a serious concern with this breed. Eye disease is also very common and can include progressive retinal atrophy, cataracts, and entropion. Inherited deafness can occur within pitbull puppies that have a lot of white on their heads. Depending on the gender of your dog there are many pro’s and con’s to getting these dogs spayed or neutered. Female Pro’s * Spaying prevents the nuisance of heat periods * Spaying prevents uterine infections * Spaying prevents false pregnancies * Spaying prevents real pregnancies Spaying offers partial protection against breast cancer * Spaying prevents cancer of the uterus and ovaries * Spaying may mean lower licensing fees Female Con’s * Spaying doubles the risk of obesity * Spaying increases the risk of the deadly cancer called hemangiosarcoma * Spaying triples the risk of hypothyroidism * Spaying is a major surgery and requires general anesthesia * If done at the wrong age, spaying increases the risk of hip dysplasia, ligament rupture, osteosarcoma (bone cancer), and urinary incontinence Male Pro’s Neutering may mean lower licensing fees * Neutering reduces leg-lifting * Neutering reduces dominance and aggression * Neutering reduces the risk of your dog being attacked by other male dogs * Neutering helps re-focus your dogs’ attention from other dogs to YOU * Neutering reduces sexual behaviors * Neutering calms you dog around unspayed females * Neutering reduces the risk of prostate disorders * Neuter ing prevents testicular cancer * Neutering reduces the risk of perianal fistula Neutering helps prevent your dog from breeding Male Con’s * Neutering triples the risk of obesity * Neutering increases the risk of a deadly cancer called hemangiosarcoma * Neutering triples the risk of hypothyroidism * Neutering increases the risk of geriatric cognitive impairment * If done at the wrong age, neutering increases the risk of hip dysplasia, ligament rupture, and osteosarcoma (bone cancer) Restricted Use: The American Pitbull Terrier breed is one of the most mistreated and misunderstood breed of dog there is.Because of this misinterpretation of the breed many counties, even states, have banned this breed. This is why there are so many of them euthanized or put in kennels. Many people are afraid of this breed because of stories on the news about a dog attack and they automatically assume that it was a pitbull that did it but in reality it was either a golden retriever or a german shep herd that caused the attack. Pitbulls were not bred to be attack dogs, they were bred to be work dogs and then got bred to be family dogs and they are terrific family dogs.

Old Fashion Technology Versus Modern Day Technology Essay

In today’s world everything is so much quicker, easier, and more convenient. When you have the technology right beneath your hands, why not take advantage of it? Even though the technology’s is much more expensive than the old fashion routine, not only is it worth it, but it’s also much more enjoyable. I prefer to take full advantage and use modern day technology rather then go back into time and try to accumulate what they did hundreds of years ago. Why shovel the snow in your driveway when you have the advantage to use a big, powerful snow blower. Dig inch by inch, by inch, and tossing the shoveled snow to new grounds instead of just walking your way through the snow and watching right in front of your eyes, the snow being thrown to the other side. Not only is it a lot quicker, more convenient, and easier, but it could also be much more effective in the long term. Such as, in today’s world many people suffer from bad backs when they get older because of the prior snow shoveling they’ve done in the past. It might not hurt when you’re a kid, but if you do it a lot, it could be very risky in the near future. So, why take the chance? The technology is right beneath your hands, the only thing may preventing you is the money. Another great explanation I would like to use and why I prefer to take full advantage of today’s modern day technology is the bread machine. Several years ago before my mother ever heard of the bread machine for your kitchen, she used to make bread the old fashion way. She didn’t mind making the bread, the only thing preventing her was time. Time was a big issue for her and she would rarely have any time to even dish out a piece of bread once a month on the dinner table for us. However, when she received a bread machine from my grandparents last Christmas, she’s now able to make bread every other day and although she misses making bread the old routine way, she claims she would never go back because the bread machine is much more convenient, quicker, easier, and time consuming for her. An excellent last explanation I would like to use and supporting using modern day technology rather than old fashion technology is the high powered boat and Jet Ski. Which is more convenient, quicker, and easier? The high powered  Jet Ski or this wooden canoe made in the 1970’s. Great question, but completely oblivious. Not only do you save many steps by using a high powered boat, you’re also accumulating great speeds which in result if your looking to get from Point A to Point B, becomes much more time consuming than the old fashion canoe. Preferably for me, the canoe isn’t very exciting. I find it very difficult to get everyone to paddle the boat at the same time, when one gets tried, another gets tired, then the last one or two people are dependant on getting that boat to Point B. I believe today’s modern day technology is amazing and I am very happy to be apart of it. Although the only thing preventing people from using modern day technology is the price, it’s definitely worth to have if you have the extra cash. Many elderly people prefer old fashion techniques because that was the way they were brought up, well I was brought up with this great technology beneath my hands so that brings me to take full advantage of it and I believe it’s time to move on. When something is much more time consuming to use, easier to equip, and saves you health risks in the near future, why not take advantage of it?

Case management Assignment Example | Topics and Well Written Essays - 1000 words

Case management - Assignment Example Creating such an institution requires massive financial resources to build the physical structure and procure equipments. The second step is to have a team of various professionals to run the program (Master and Taniguchi, 2006). Nurses should be available to coordinate the program as they are well versed with the care of patients and the skills to make clinical decisions. There are instances when the institution requires advanced medical expertise and the nurses` skills might be limited. In such cases, another team of specialized professionals are hired in order to cater for specific disabilities faced by the children. An example in this case is a child with autism. A medical expert who specializes in autism will have to be hired. The other group of workers central to the program is social workers. This team will have to be hired to coordinate the social needs of the family, specifically the patient when they are out of the program. A team of educational providers ought to be put in place in order to teach the family all things pertaining to child disability. Acquiring the needed funds to kick start the case management program is one of the key milestones which should be solved. The initiators of the project can convince the government to extend financial aid to the program as it is mainly a social welfare initiative. This can be achieved by writing proposals of detailed case management program to government officials such as the governor and the senators. The case manager can apply for coverage under the umbrella of Medicaid and Medicare (Master and Taniguchi, 2006). Another approach is to use lobbyists to present the case to the government. Several economists on the other hand have insisted that the government should be spared the burden of business in order to maintain the ideals of capitalism. In that case, the proprietors of the case management program should invite the private sector players to invest in the project. They can

Leading Cultural and Organizational Change at the Royal Conservatory Case Study - 18

Leading Cultural and Organizational Change at the Royal Conservatory of Music - Case Study Example The major issues raised in the study are incorporation of environmental changes within the broad goals and objectives of RCM and meeting the challenges of time with creative inputs. It was started in 1886 in Toronto as music school and had emerged as top school for piano. It had maintained its traditional approach to teaching. But by 1950s, University of Toronto gave it a stiff competition by its modern outlook and more professional way of working. The university gradually took over its traditional role of preparing concert stage musicians which led to the decline of RCM. These events were important issues that were raised in the text. Yes, Peter Simon was successful because he was able to turn around the declining status of RCM into successful institution with wide ranging activities in the field of music. He brought in corporate culture that used technology and innovation in the area of academics. A shift from academic to corporate culture broadly means that while academic is mainl y concerned with scholastic achievements, corporate culture is goal driven and strives to meet the challenges of time with new ideas and products. Higher performance outcome and financial gains become critical paradigms of success. I would advice Peter Simon to maintain high degree of ethics within RCM so that quality in music school is maintained. The online education must be accompanied by in-house training and practical tests. It would help to gain credibility amongst the various stakeholders like students, music teachers, donors etc. Knowledge sharing has increasingly become vital aspect of competitive advantage. I would therefore suggest Peter Flagstaff and Lindsay Gibson to create a learning environment that promotes knowledge share. Use of technology within the operations would greatly help to create a large database of new ideas and information that can be shared, as and when required. Effective management information system should also be developed so that management is abl e to monitor the projects and is able to give critical inputs to the accounts executives to save time.

News Story Assignment Example | Topics and Well Written Essays - 1250 words

News Story - Assignment Example Marisol Franken, an administration coordinator for community services targeting Australians over the age of 55 corroborated McKay’s statements. Speaking to the media at the same event, Mr Franken most people turned up for physical fitness in the evenings and over the weekend. He, however, urged people to take physical fitness seriously, especially the Australian elderly. â€Å"We need to have a nation that is physically fit,† he averred. The report also showed that most Australians were not physically active. 34.1% of the people interviewed did not participate in any sporting activity or physical fitness program while 6.3% only participated â€Å"occasionally†. Only 29% of the research sample engaged in sports more than twice a week. Noting that physical fitness was key to the general health of an individual, McKay termed the findings as â€Å"grim reality†. He, however, stated that the research identified various constraints that hindered people from participating in sports of physical fitness programs. Some participants cited age as a major constraint where they stated that they were too old to take part in sports. Others were afraid of the occasional injuries that people sustained in sports whereas others were simply not interested. There are some who cited heavy responsibility at home or at the work-place while others put the blame on financial challenges. In light of these findings, it is important that relevant authorities take up the challenge and work towards a better, healthier and physically fit Australia. There is need to put appropriate measures into place to encourage Australians to participate in sports and physical fitness programs. Moreover, every Australian has a responsibility of his or her health. It is a high time Australians came out of their cocoons and took sports and physical fitness seriously. The level of physical fitness in Australia is very low. A large number of Australians do not participate in sports

Reducing your Carbon Footprint Assignment Example | Topics and Well Written Essays - 500 words

Reducing your Carbon Footprint - Assignment Example 2) As indicated above, my CO2 emissions are above the average of Americans mainly in home energy where they stand at 66%. There are different measures that I can take in order to reduce CO2 emissions at home. For instance, I need to resort to methods such as using solar power for heating purposes of water. I also need to make sure that I switch off all electrical gadgets that are not in use at a particular moment. I also need to seriously take into consideration elements such as recycling of waste products. The other important step that I can take is to avoid using fossil fuels for energy at home for different purposes such as heating water. These fossil fuels emit large quantities of carbon dioxide and these emissions negatively impact on the environment and climate at large. Instead of resorting to artificial cooling systems is homes such as air conditioning, I can resort to open windows during the day for fresh air since this helps to reduce the quantity of CO2 emissions into the environment. There are CO2 gases that are emitted into the atmosphere during the air conditioning process. 3) The emissions of the average American are way above that of the world average mainly as a result of industrial activity. America is a heavily industrialized country and a lot of fossil fuels are used as energy in the industries. America also has a large population of automobiles that use fossil fuels as their major source of power. Combustible fuels such as oil, petrol kerosene among others produce large volumes of carbon dioxide when they are used for different industrial purposes. Excessive amount of carbon dioxide in the atmospheres is detrimental since it leads to global warming (Waugh, 196). This entails that excessive heat is trapped in the atmosphere and this condition can lead to climate change. Perennial droughts and floods are likely to be experienced in different parts of the globe and

Short Term Financing Essay Example | Topics and Well Written Essays - 750 words

Short Term Financing - Essay Example The intention of going for short term financing is essentially to raise funds for operational activities of the business, these essentially means that such kind of financing is required on a very sort-notice hence the high cost of servicing it in terms of interest. Short term operation money may be secured first, any encumbered physical assets of the business second, additional funds from shareholders, or personal guarantees fro principals. On occasion, inventories can be used as temporary security for operations loans. In essence short term borrowing should be used for working requirements for day to day operations of a business. Industries with seasonal peaks and troughs and those engaged in international trade will be heavy users of short term borrowing / Banks allow their customers for certain overdraft amount. They no longer need to work with a series of pr-signed drafts .They allow customers to withdrew more funds than what is the current account up to approved limits Some banks help their customers transform book debts into cash by advancing up to 80% of the credit term invoice value. To ease the company's workload further to banks collects the cash from creditors on behalf of a customer so that cash floe can be allowed, raise additional capital easily and quickly and save administrative time. Some businesses tend to confuse which source to go for but there must be a clearly idenfiable reason why a business has to source for funds before deciding on which source to go for. This can give a clear direction. There are no guarantees that the rule of determining the source of finance ca purely be followed, at some stage the firm may go for long funds when really they should have gone for short and vice versa. This can be influenced by the cost implications of going for one and not the other. If going for short term might cost the business a lot in terms of interest, then they may opt for long term. At one point, even the real consumer need also to be on he look out on which form of way o raise funds depending on what is the problem one wants to address. One can not go for a long term loan for a school fees for kids because this necessary need to take a lot of documentation to have it processed. The same considerations are equally to be viewed fro the same perspective whether consumer or business. Conclusion. There is no confusion at all between the sources which an establishment should adopt or an individual should go for. As long as one identifies the objective of the loan or finance, it is easily determinable on which one should be opted for. All the matters is the urgency with the funds are needed and the purpose for which the funds are needed. Bibliography: 1. P.A. Pandey: Financial management, 2nd edition, Central law agency,

World trade organization and how does it help poor countries Essay

World trade organization and how does it help poor countries - Essay Example es – one hundred and forty nine in number – and is a successor to the General Agreement on Tariffs and Trade, which was dissolved in the year 1995 to give birth to the World Trade Organization in its stead. All of the principles and agreements of the General Agreement on Tariffs and Trade were adopted by the new organization, which added approximately thirty more to them. The new organization stated that its mission is to increase international trade by promoting lower trade barriers. World Trade Organization is also a platform for the negotiation of trade (â€Å"World Trade Organization,† 2006). One of the fundamental principles of trading around which the World Trade Organization discussions revolve is that a trading system ought to be more accommodating for poor nations by giving them more time to adjust, greater flexibility, and more privileges. An open market system is advocated, while it is stressed that a trade system should be free of discrimination. The World Trade Organization is thus a powerful ally for the poor and less developed countries against exploitation from rich and developed nations as well as powerful companies. Some have argued that the World Trade Organization simply serves the interests of the United States and the European Union. Contrary to their opinion, the organization plays a crucial role in controlling a ravenous quest for profits on the part of rich nations and companies (Lipsey, 2006). Of course, the poor nations are in no condition to impose trade sanctions against developed countries. Disparities do exist. Rich nations are also known to engage in behind the scenes negotiations with the World Trade Organization. Yet, the organization gives a fair chance to the poor countries to voice opposition and form alliances through a major forum especially arranged for the less developed countries. The World Trade Organization is thus an indispensable tool for the poor nations’ access to and lawful participation in the

Jonathon Swift's A Modest Proposal Essay Example | Topics and Well Written Essays - 1000 words

Jonathon Swift's A Modest Proposal - Essay Example After 9/11 incidents US decided to take the war against terrorism to rouge states. With the help from the allies they bombed Afghanistan. They ended the Taliban era in Afghanistan. Now the allied forces and the US decided to take the war against terrorism in other parts of the world. Due to the past record of Iraq it became target for the allied forces. This war against terrorism helped in reducing the population of the world. The burden on mother earth became somewhat less. During and after the war many soldiers died. Both the allied forces and Iraq lost their soldiers Due to these deaths both the governments doesn't have to spend extra penny for their food, clothes and ammunition. They don't have to give monthly salaries to the dead. Thus they could use the money for other purposes. The allied forces include Australia, England etc. They send their sons and daughters to Iraq to die in the name of war against terrorism. They were willing to sacrifice their beloved ones to maintain a closer and friendly relationship with the US. By invading Iraq the US and the allied forces can get oil and other petroleum products cheaply. They fed their oil hungry industries by slowly making Iraq's only source for development perishable. This is just like taking from the needed and keeping it for themselves. The war on Iraq resulted in political instability in Iraq. ... It would work in favor of US, politically and economically. Iraq's position after the war is just like a blank paper on which the US and the allied forces could write anything i.e. they can mould Iraq's political and economic scenario as they wish. It is the best way of establishing a colonial rule. The ruling government in Iraq though has been declared elected democratically in under the US control. Thus the political decisions could be influenced by the US presence. It would help US in establishing temporary or permanent base for its troops in west Asia to expand their colonial rule.The war on Iraq provided other countries to have their own share for co-operating with US. It helped them to actively participate in different scandals. Scandal like oil-for-food program can easily surface. The war resulted in more employment. People from different countries work in Iraq and are awaiting their death to come which they don't know form which side it will come. Civil war is the result of US invasion of Iraq the civil war helped the Iraqis to become free from their filthy lives by becoming victims to it. Civil war is the best way for robbers, kidnappers and other anti-social elements to flourish their business. Thus they become richer and wealthier in a single night. Mafia gangs could emerge easily and can claim their position. Thus without much help from invading countries mafia can govern the society in Iraq. Children could take commando training at early age. Instead of spreading love they could spread hatred across the society. The war on Iraq helped US and the allied forces economically and politically. The industry that manufactures defense equipment was financially benefited. Due to the immediate requirement

Magnetic Tape Essay Example for Free

Magnetic Tape Essay Magnetic tape is a medium for magnetic recording, made of a thin magnetizable coating on a long, narrow strip of plastic film. It was developed in Germany, based on magnetic wire recording. Devices that record and play back audio and video using magnetic tape are tape recorders and video tape recorders. A device that stores computer data on magnetic tape is a tape drivOver years, magnetic tape can suffer from deterioration called sticky-shed syndrome. Caused by absorption of moisture into the binder of the tape, it can render the tape unusable. Merits: Capacity * One of the key advantages of magnetic tape is its capacity for holding data. Magnetic tape was the first medium able to hold a feature-length movie on a small, inexpensive device, thus enabling the home video market of the 1980s. In addition, compact cassettes can hold music on both sides, giving them a 90-minute total playing time, which is even greater than most CDs. Editing * Magnetic tape is also easy to edit using a traditional linear-editing system. This can involve duplicating a portion of a tape to a master reel, or physically cutting the tape and attaching the desired portions together with glue, splicing cement or adhesive tape. Editing in this manner requires no special computer equipment and may be less expensive and/or easier to learn than nonlinear digital editing. DEMERITS: Generation Loss * One of the disadvantages of magnetic tape is generation loss, which refers to the fact that each successive copy of a tape loses quality compared to the original. This can make it difficult to use magnetic tape for editing-intensive projects, or when extremely high fidelity is important. Digital media, on the other hand, can be copied and reproduced indefinitely with no visible or audible difference between the original and any of its copies. Durability * Another problem with magnetic tape is its tendency to stretch out over time, causing the quality of the data to deteriorate. On old video tapes, this generally appears in the form of poor audio, and picture data can eventually suffer as well. Over time magnetic tape acquires a layer of magnetic debris from recording and playback heads, which may need to be cleaned periodically to continue functioning. Mechanical Complexity * The mechanical complexity needed to use magnetic tape is another disadvantage of the medium. Items like cassette and VHS tapes include two separate reels, as well as a mechanism for exposing a small portion of the tape inside a player or recording device. Reel-to-reel tape players use multiple motors and moving parts, each of which is susceptible to mechanical failure. In the realm of digital media, flash-based memory uses no moving parts, thus eliminating this problem. Advantages and Disadvantages of a USB Flash Drive February 27, 2012 Advantages and disadvantages Advantages Compared to hard drives, flash drives use little power, have no fragile moving parts, and for most capacities are small and light. Data stored on flash drives is impervious to mechanical shock, magnetic fields, scratches and dust. These properties make them suitable for transporting data from place to place and keeping the data readily at hand. Flash drives also store data densely compared to many removable media. In mid-2009, 256 GB drives became available, with the ability to hold many times more data than a DVD or even a Blu-ray disc,[2] Most personal computers support USB as of 2010. Flash drives implement the USB mass storage device class so that most modern operating systems can read and write to them without installing device drivers. The flash drives present a simple block-structured logical unit to the host operating system, hiding the individual complex implementation details of the various underlying flash memory devices. The operating system can use any file system or block addressing scheme. Some computers can boot up from flash drives. Specially manufactured flash drives are available that have a tough rubber or metal casing designed to be waterproof and virtually â€Å"unbreakable†. These flash drives retain their memory after being submerged in water, and even through a machine wash. Leaving such a flash drive out to dry completely before allowing current to run through it has been known to result in a working drive with no future problems. Channel Five‘s Gadget Show cooked one of these flash drives with propane, froze it with dry ice, submerged it in various acidic liquids, ran over it with a jeep and fired it against a wall with a mortar. A company specializing in recovering lost data from computer drives managed to recover all the data on the drive.[42] All data on the other removable storage devices tested, using optical or magnetic technologies, were destroyed. Disadvantages Main article: Flash memory#Limitations Like all flash memory devices, flash drives can sustain only a limited number of write and erase cycles before the drive fails.[43][unreliable source?][44] This should be a consideration when using a flash drive to run application software or an operating system. To address this, as well as space limitations, some developers have produced special versions of operating systems (such as Linux in Live USB)[45] or commonplace applications (such as Mozilla Firefox) designed to run from flash drives. These are typically optimized for size and configured to place temporary or intermediate files in the computer’s main RAM rather than store them temporarily on the flash drive. Most USB flash drives no longer include a write-protect mechanism, although a small number have a switch on the housing of the drive itself to keep the host computer from writing or modifying data on the drive. Write-protection makes a device suitable for repairing virus-contaminated host computers without risk o f infecting the USB flash drive itself. A write-locked SD card in a USB flash card reader adapter is an effective way to avoid any writes on the flash medium. The SD card as a WORM device has an essentially unlimited life. A drawback to the small size is that they are easily misplaced, left behind, or otherwise lost. This is a particular problem if the data they contain are sensitive (see data security). As a consequence, some manufacturers have added encryption hardware to their drives—although software encryption systems which can be used in conjunction with any mass storage medium achieve the same thing. Most drives can be attached to keychains, necklaces and lanyards. The USB plug is usually fitted with a removable and easily lost protective cap, or is retractable. USB flash drives are more expensive per unit of storage than large hard drives, but are less expensive in capacities of a few tens of gigabytes as of 2011 Maximum available capacity is increasing with time, but is less than larger hard drives. This balance is changing, but the rate of change is slowing.. Most USB based flash technology integrates a printed circuit board with a metal tip which is simply soldered on. As a result the stress point is where the two pieces join. Some manufacturers quality control does not ensure a proper solder temp further weakening the stress point. Since many Flash Drives stick out from a users laptop or PC they are likely to be bumped repeatedly in their life time and may break at the stress point. Most of the time a break at the stress point results in permanent damage to the printed circuit board where the joint is torn from the circuit. However, some manufacturers produce discreet flash drives that do not stick out and others use a solid metal uni-body that has no easily discernible stress point.

Features Of An Effective Presentation

Features Of An Effective Presentation A presentation is a tool for communicating opinions and ideas of the speaker in front of the group of people. Presentation is very important for any profession like in a business to spread the information about any product launch etc., in teaching and training or so on. Being able to speak efficiently is an asset for any profession. The success of presentation depends on the confidence and capability of a speaker. Anybody can give good presentation just by practicing and preparing for presentation. A can be given in so many ways i.e. it can be oral, PowerPoint presentation, multimedia etc. Good presentations contain these elements: Content : it is the very important element because it contains the information which is needed for a presentation Structure: it is another main element of a presentation because a presentation should have the proper structure i.e. logical beginning, middle and proper end. FEATURE OF AN EFFECTIVE PRESENTATION PURPOSE OF PRESETATION: It is useful to make sure the exact purpose of the presentation. A presentation usually has 4 basic functions: To inform To encourage To persuade To entertain Audience research: Every communication must be in form and style which suits the audience. The tone and the matter of the speech depend upon the nature of the audience. In analysing the audience, age group is very important factor. Different age group respond differently to the presentation. High school children like to be treated as adults they can appreciate sincerity and are not very critical. Visual aids are effective Children love to listen to stories and they appreciate dramatic presentation emotions of joys and sorrows can be aroused through stories. Preparation of the text of the presentation: In any presentation the subject matter of the presentation is very primary concern because the subject and the matter is very important for any presentation without the matter of the presentation any presentation cant be successful. Structuring the subject matter : A presentation has 3 parts the introduction, the main body and the conclusion. Structuring of the text helps the presentation in following ways: Establishing the relationship among ideas Developing the complete arguments Tightening the text as per the time constraints Providing the audience a grip on the subject matter Emphasizing the significant ideas of the theme Stimulating the audience to learn what he or she thinks Registering the important concept with the audience Language and style : The style of the oral presentation is different from the written presentation in any language the difference must be kept in mind while drafting a presentation the style of the presentation must be simple and direct as the conversation. Timing for speech in an oral presentation: The efficient speaker arranges the text of his speech in such a way that till the end of the presentation the listener do not get restless. Also the time of day affects the audience. The afternoon hours hardly make any listener interested to listen to a presentation. But yet an efficient speaker may try to make that session interesting. For keeping to time an efficient speaker takes care of the concentration problem that the audience has with regards to time. Environment for speaking while making presentation: For effective speaking the venue or the place of delivering the speech plays a very important role. The speaker must be aware of the size of the room where he or she has to deliver the speech for an oral presentation. Sometimes the rooms are large and echoing. Speaking in such rooms require less resonating sound. The voice should be a little muffled showing the lower notes. However, it should have the required power. For the acoustically treated rooms the resonance of the speech in an oral presentation has absolutely different kinds of impression on the audience. The speaker should also check his or her voice in the rooms; find it out on his or her own, whether it reaches the last listener sitting at the back row. He or she should also find out how the delivery of the voice is. Has he or she practiced with the microphone? The room should be well-ventilated and well-illuminated. There should not be any distractions to both the speaker and the listeners. The distractions like noise and any other interruptions should not be entertained. The seating layout also determines the voice flow, voice reverberation. Every seating arrangement has its merits and demerits. There is various seating arrangement available. When the audience sits in rows like that in a theatre, there is difficulty in eye contact between the speaker and the listener. The environment is very formal. The horseshoe pattern of seating arrangement is more informal and it helps in increasing participation. The curved rows too hinder proper eye contact. People sitting around tables make it very informal unless the Audience is divided into groups for formal intercourse. INTRODUCTION OF STEVE JOBS STEVE JOBS full name was STEVEN PAUL STEVE JOBS, he was the American entrepreneur. He is known as the co-founder, chairmen and chief executive officer of Apple Inc. apart from that Steve jobs also co-founded the Pixar Animation Studios. He became the member of board of directors in The Walt Disney co. in 2006. Steve jobs founded next a computer platform development co. C:UsersparulDesktopsteve-jobs-quotes-4.jpg STEVE JOBS WAY OF PRESENTATION As everybody knows that the Steve jobs way of presentation is very unique because he not only conveys the information but he inspire the audience he sells the product and sizzles at the same time. Setting the theme of the presentation: Steve jobs always start his presentation by setting the theme like there is something in the air today by saying these words Steve jobs sets the theme of the presentation. Every presentation needs a theme but its not compulsory to give it in the start last year Steve jobs sets the theme about 20 min into his presentation once you set the theme make sure to deliver it several times in the presentation. Demonstrate enthusiasm: Every time when Steve jobs gives the presentation he shows his passion for the computer design. During his presentation he uses the words like cool extraordinary and amazing because always remember the wants to be wowed they dont want to get bored. In giving a presentation always remember to inject your personality into it if you think a particular feature for your product is the awesome because if you are not enthusiastic about your product then how a can a customer shows interest in that product. Provide an outline: Providing the outline to the presentation is again very important. Steve jobs outlined the presentation by saying there are 4 things I want to talk about today. So lets get started. Steve jobs followed his outlines by verbally opening or closing each of the section. Make the list and offer your audience the guide post along the way. Make numbers meaningful: When Steve jobs announced that the apple had sold the 4 million phones, he did not simply leave the number out of context. Instead he says that 20000 phones every day on an average. Numbers do not mean much unless they are placed in context. Try for an unforgettable moment: Unforgettable moment is the moment in your presentation that everyone will be talking about in every Steve jobs presentation the unforgettable moment is always their. Create the experience: Plan and create your ideas in analogy before you starting your presentation. Answer the one question that matters in the listeners mind. Have a clear sense of purpose of presentation. Develop- twitter like headlines. Use the rule of three to create a road map the listener can follow. Always identify your enemy who are against you. Always take intermission in every ten minutes. Deliver the experience: Make your visuals simple, highly visual and completely engaged. Bring statistics to life by providing a contextual framework people can use. Create interested and memorable words in your presentation. Share the stage with your partners. Use props and actual product demonstrations. Have one definitive moment in your presentation. Never forget your second intermission. Refine and rehearse: Never forget how you say something is just as important as what you say . Rehearse and then rehearse some more until you can make it worthless. Dress the convey the impression you are trying to make. Your speech become polished whatever you speak to the audience not your slides. Always have fun- even when things go wrong. Always end with a bang- have an encore which is legendary like one more thing! These all are the secrets of presentation of Steve jobs. The presentations of Steve Jobs are very much like a dramatic play- a finely crafted and rehearsed performance that informs, entertains and inspires. If you are passionate about your topic, you are 80% closer to developing the magnetism that Jobs has. Do not let your ideas die because you failed to present them in a way that sparked the imagination of your listeners. Use Jobs techniques to reach the hearts and minds of everyone you hope to influence.

Hurricanes Essay -- essays research papers fc

Hurricanes Hurricanes summer is over and fall has arrived but many people to the south of us are observing another season hurricane season. According to the Montshire Museum of Science, hurricanes usually occur in the North Atlantic from June to November, with most of them in September. On average, between six to eight hurricanes form in the North Atlantic or North Pacific each year (Montshire), however, as many as 15 have occurred in the Atlantic in a single year. Hurricanes are powerful, whirling storms that measure several hundred miles in diameter. The winds near the center of a hurricane blow at speeds of 74 miles per hour or more (World Book, 400). Many hurricanes leave a trail of widespread death and destruction. The definition of a hurricane, according to World Book Encyclopedia, is an area of low pressure that forms over oceans in tropical regions. Such a storm in the North Pacific Ocean is called a typhoon, and one in the South Pacific or Indian Ocean is called a cyclone. Most hurricanes originate within the doldrums, a narrow equatorial belt characterized by intermittent calms, light variable breezes, frequent squalls, and lying between the northeast and southeast trade winds (Encarta). Hurricanes consist of high-velocity winds blowing circularly around a low-pressure center, known as the eye of the storm. The low-pressure center develops when the warm, saturated air prevalent in the doldrums is under run and forced upward by denser, cooler air. From the edge of the storm toward its center, the atmospheric pressure drops sharply and the wind velocity rises. The winds attain maximum force close to the point of lowest pressure. Encarta Encyclopedia states that hurricanes generally move in a path resembling the curve of a parabola. Also, that in the Northern Hemisphere the storms usually travel first in a northwesterly direction and in the higher latitudes turn toward the northeast. In the Southern Hemisphere the usual path of the hurricane is initially to the southwest and subsequently to the southeast. Hurricanes travel at varying rates. Those areas in which the hurricane winds blow in the same direction as the general movement of the storm are subjected to the maximum destructive violence of the hurricane. According to the research team at Storm Central, hurricanes go through a set of stages from birth to dissipation. Tropical disturbance ... ... of friends and loved ones, etc. Much advancement has been made over the years to forewarn potential victims of these horrendous storms. Hurricanes are an act of nature that no one can ever control. As long as there are bodies of water, wind, and warm air, we will still be searching for the perfect warning system for those on the coast. We just have to be thankful that technological advancements have brought us thus far, now we have only the future and further experimentation to look forward to. Bibliography Works Cited Why hurricanes form over warm oceans USA Today Weather http://www.usatoday.com/weather/whur7.htm, 11/4/99 Montshire Minute: Hurricanes Montshire Museum of Science http://www.montshire.net/minute/mm99027.html, 11/6/99 How are Atlantic hurricanes ranked? Hurricanes 99 http://www.hurricanes99.com/huricanesSSS.html, 11/10/99 What are Hurricanes? Hurricanes 99 http://www.hurricanes99.com/FAQ.html, 11/10/99 Hurricane Stages of Development Storm Central http://www.stormsearch.com/stages, 11/11/99 Hurricanes Microsoft Encarta Encyclopedia 98 Microsoft, 1993-1997 Hurricanes World Book Encyclopedia World Book-Childcraft International Inc. Volume 9: 400-403.

Impact of the Film, Dr. Strangelove, on American Attitudes Towards the

Impact of the Film, Dr. Strangelove, on American Attitudes Towards the Atomic Bomb and Cold War "The truth is bad enough--but nowhere near as bad as you probably think. The truth will do away with a lot of silly ideas, a lot of completely wrong notions, which millions of people now believe about the atomic bomb. These ideas could easily cause great panic. And right now the possibility of panic is one of the best weapons any enemy could use against us." (Gerstell, How to Survive an Atomic Bomb 1) "Why should the bomb be approached with reverence? Reverence can be a paralyzing state of mind. For me the comic sense is the most eminently human reaction to the mysteries and the paradoxes of life. I just hope some of them are illuminated by the exaggerations and the style of the film. And I don't see why an artist has to do any more than produce an artistic experience that reflects his thinking." (Stanley Kubrick qtd in Wainright 15) In the third decade of the Cold War, less than two years after the United States population had been scared half-way to death by the Cuban Missile Crisis, Dr. Strangelove invaded the nation's movie theatres and showed the country the end of the world. Touted by critics then and now as the film of the decade, Dr. Strangelove savagely mocked the President, the entire military defense establishment, and the rhetoric of the Cold War. To a nation that was living through the stress of the nuclear arms race and had faced the real prospect of nuclear war, the satiric treatment of the nation's leaders was an orgasmic release from deep fears and tensions. Its detractors argued that the film was juvenile, offensive, and inaccurate. Viewed, however, in its context of the Cold War and nuclear proliferation, Dr.... ...7-38. Mordden, Ethan. Medium Cool. New York: Alfred A. Knopf, 1990. Mumford, Lewis. "Letter." New York Times 1 March 1964: 25. Prideaux, T. "Take Aim, Fire at the Agonies of War." Life 20 Dec. 1963: 115-118. Rabe, David. "Admiring the Unpredictable Mr. Kubrick." New York Times 21 June 1987: H34+ Starr, Michael. Peter Sellers: A Film History. Jefferson, North Carolina: McFarland and Company, Inc. Publishers, 1991. Suid, Lawrence. "The Pentagon and Hollywood: Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb (1964)." American History/ American Film: Interpreting the Hollywood Image. Eds. John E. O'Connor and Martin A. Jackson. Boston: Frederick Ungar Publishing Co., 1979. Taylor, Stephen . Review of Dr. Strangelove. Film Comment, 2. 1 (1964): 40-43. Wainright, Loudon. "The Strange Case of Strangelove." Life 13 March 1964: 15. Impact of the Film, Dr. Strangelove, on American Attitudes Towards the Impact of the Film, Dr. Strangelove, on American Attitudes Towards the Atomic Bomb and Cold War "The truth is bad enough--but nowhere near as bad as you probably think. The truth will do away with a lot of silly ideas, a lot of completely wrong notions, which millions of people now believe about the atomic bomb. These ideas could easily cause great panic. And right now the possibility of panic is one of the best weapons any enemy could use against us." (Gerstell, How to Survive an Atomic Bomb 1) "Why should the bomb be approached with reverence? Reverence can be a paralyzing state of mind. For me the comic sense is the most eminently human reaction to the mysteries and the paradoxes of life. I just hope some of them are illuminated by the exaggerations and the style of the film. And I don't see why an artist has to do any more than produce an artistic experience that reflects his thinking." (Stanley Kubrick qtd in Wainright 15) In the third decade of the Cold War, less than two years after the United States population had been scared half-way to death by the Cuban Missile Crisis, Dr. Strangelove invaded the nation's movie theatres and showed the country the end of the world. Touted by critics then and now as the film of the decade, Dr. Strangelove savagely mocked the President, the entire military defense establishment, and the rhetoric of the Cold War. To a nation that was living through the stress of the nuclear arms race and had faced the real prospect of nuclear war, the satiric treatment of the nation's leaders was an orgasmic release from deep fears and tensions. Its detractors argued that the film was juvenile, offensive, and inaccurate. Viewed, however, in its context of the Cold War and nuclear proliferation, Dr.... ...7-38. Mordden, Ethan. Medium Cool. New York: Alfred A. Knopf, 1990. Mumford, Lewis. "Letter." New York Times 1 March 1964: 25. Prideaux, T. "Take Aim, Fire at the Agonies of War." Life 20 Dec. 1963: 115-118. Rabe, David. "Admiring the Unpredictable Mr. Kubrick." New York Times 21 June 1987: H34+ Starr, Michael. Peter Sellers: A Film History. Jefferson, North Carolina: McFarland and Company, Inc. Publishers, 1991. Suid, Lawrence. "The Pentagon and Hollywood: Dr. Strangelove or: How I Learned to Stop Worrying and Love the Bomb (1964)." American History/ American Film: Interpreting the Hollywood Image. Eds. John E. O'Connor and Martin A. Jackson. Boston: Frederick Ungar Publishing Co., 1979. Taylor, Stephen . Review of Dr. Strangelove. Film Comment, 2. 1 (1964): 40-43. Wainright, Loudon. "The Strange Case of Strangelove." Life 13 March 1964: 15.

Comparing the Black Album and Rushdies The Satanic Verses Essays

The Black Album and Rushdie's The Satanic Verses      Ã‚  Ã‚   British writer C.C. Colton once claimed, "Men will wrangle for religion; write for it; fight for it; die for it; anything but--live for it" (Copeland 345). Indeed, if nothing else, Hanif Kureishi's The Black Album shows the depths to which people concern themselves with questions of religion, ethnicity, and the identity associated with them. Kureishi's themes and symbolism work within a larger context of the politics of identity, race, and nationality. Salman Rushdie's The Satanic Verses and the larger religious question associated with it, serve to polarize the British community between Muslims and non-Muslims, as well as to polarize people supporting liberation and those supporting containment. Combined with other cultural references, Kureishi uses the literary allusion to create his themes and symbolism.    The question of the racial, religious, and socioeconomic identity of Shahid becomes a central question posed as Shahid undergoes translation from his Pakistani ancestry to his desired identity as a Briton. Shahid's translation parallels the translations of the former Asian colonies of Britain into their new postcolonial identities. Unfortunately for Shahid, the struggle over The Satanic Verses catches him as he is translating himself, presenting him with a series of tough choices.    The quest for identity in Indo-English writing has emerged as a recurrent theme, as it is in much of modern literature (Pathak preface). Indeed, often the individual's identity and his quest for it becomes so bound up in the national quest for identity, that the individual's search for his identity becomes allegorical of the national search (Pathak pr... ...pular Quotations for All Uses. Garden City, New York: Garden City, 1942. Gorra, Michael. After Empire: Scott, Naipul, Rushdie. Chicago: U of Chicago P, 1997. Kureishi, Hanif. The Black Album. New York: Simon, 1995. Lings, Martin. Muhammad: His Life Based on the Earliest Sources. Revised edition. Bartlow, Cambridge, UK: Islamic Texts Society, 1991. Pathak, R.S., ed. Quest for Identity in Indian English Writing. New Delhi: Bahri, 1992. Rusdie, Salman. The Satanic Verses. First Owl Book edition. New York: Henry Holt, 1997. Saynor, James. Rev. of The Black Album, by Hanif Kureishi. The New Statesman & Society, March 3, 1995, p. 40(2). Wilkie, Brian, and James Hurt. Literature of the Western World. 2nd edition. In Galloway, Stan. "The House of Bernarda Alba." http://www.bridgewater.edu/~sgallowa/203/alba-notes.htm, April 26, 1999.    Comparing the Black Album and Rushdie's The Satanic Verses Essays The Black Album and Rushdie's The Satanic Verses      Ã‚  Ã‚   British writer C.C. Colton once claimed, "Men will wrangle for religion; write for it; fight for it; die for it; anything but--live for it" (Copeland 345). Indeed, if nothing else, Hanif Kureishi's The Black Album shows the depths to which people concern themselves with questions of religion, ethnicity, and the identity associated with them. Kureishi's themes and symbolism work within a larger context of the politics of identity, race, and nationality. Salman Rushdie's The Satanic Verses and the larger religious question associated with it, serve to polarize the British community between Muslims and non-Muslims, as well as to polarize people supporting liberation and those supporting containment. Combined with other cultural references, Kureishi uses the literary allusion to create his themes and symbolism.    The question of the racial, religious, and socioeconomic identity of Shahid becomes a central question posed as Shahid undergoes translation from his Pakistani ancestry to his desired identity as a Briton. Shahid's translation parallels the translations of the former Asian colonies of Britain into their new postcolonial identities. Unfortunately for Shahid, the struggle over The Satanic Verses catches him as he is translating himself, presenting him with a series of tough choices.    The quest for identity in Indo-English writing has emerged as a recurrent theme, as it is in much of modern literature (Pathak preface). Indeed, often the individual's identity and his quest for it becomes so bound up in the national quest for identity, that the individual's search for his identity becomes allegorical of the national search (Pathak pr... ...pular Quotations for All Uses. Garden City, New York: Garden City, 1942. Gorra, Michael. After Empire: Scott, Naipul, Rushdie. Chicago: U of Chicago P, 1997. Kureishi, Hanif. The Black Album. New York: Simon, 1995. Lings, Martin. Muhammad: His Life Based on the Earliest Sources. Revised edition. Bartlow, Cambridge, UK: Islamic Texts Society, 1991. Pathak, R.S., ed. Quest for Identity in Indian English Writing. New Delhi: Bahri, 1992. Rusdie, Salman. The Satanic Verses. First Owl Book edition. New York: Henry Holt, 1997. Saynor, James. Rev. of The Black Album, by Hanif Kureishi. The New Statesman & Society, March 3, 1995, p. 40(2). Wilkie, Brian, and James Hurt. Literature of the Western World. 2nd edition. In Galloway, Stan. "The House of Bernarda Alba." http://www.bridgewater.edu/~sgallowa/203/alba-notes.htm, April 26, 1999.   

Lord of the Flies, Quote Analysis

Chapter four of Lord of the Flies is an important chapter of the book. It contains some key turning points of the plot and shows various major developments of the characters. It this essay, three quotes concerning theme, symbolism and irony in chapter four will be analysed. In chapter four Golding visualises the theme of savagery in pages 79 and 80 by describing Jack’s ‘new face’. â€Å"He made one cheek and one eye-socket white, then he rubbed red over the other half of his face and slashed a black bar of charcoal across from right ear to left jaw.†Golding deliberately describes Jack’s face again, even though he had already described the changes concerning his face. By re-describing Jack’s savage like face, the author wants to emphasise the continuously more important getting theme of savagery at this point in the book. As the memory of an adult controlled civilisation fades away, the savage like behaviour increases. Jack’s unnaturally coloured face also resembles his will to hunt, to kill, to destruct.Jack’s character and his look are unifying as his face and character slowly transform into an uncontrollable, savage like monster. Moreover, his new face’s authority is immediately shown in the lines following the description of his face, in which the other are obeying his order to get him a coco-nut. Society as an illusion is nicely demonstrated on page 75 which states â€Å"They had built castles at the bar of the little river. These castles were about one foot high and were decorated with shells, withered flowers, and interesting stones.†This quote is explicitly clarifying the reader that society on the island is dead or an ancient memory at least. The withered flowers on the castle symbolise drained life, when one would see the castle as society, which was originally flourishing as it was beautifully decorated with flowers. However, at this point, the flowers more seem to resemble an overgr own layer of dead weeds, which indicate the lack of care and respect that has been shown to the maintenance of the castle and in this comparison, society.Not only does the castle look abandoned and not-taken-care-of, it is just a few lines away from total destruction as it is destroyed by Roger and Maurice on the next page. From that point onwards, society based on structure and rational thinking has completely crumbled down, burying the principals of their former world. The quote of Ralph on page 85 â€Å"They let the bloody fire out. † can be taken in by the reader in a very ironical way. This is due to various reasons. Firstly, one must ask himself the question: ‘Who is they?’After all, Ralph had quite a leading character in the book. If anyone should be held responsible for the dozing of the fire, one of the most likely would have been Ralph himself. Secondly, he was the first one to reach the top, indicating that if anyone could have been held responsible fo r letting the fire out it is, again, Ralph. The irony continues as Ralph went intensely red after the event had happened. The actual fire might have been let out but the fire like anger awoke inside Ralph because of the dozing of the fire.Ironically, even though at the start of the book the children cherished their fire, as if it was their only way of surviving, yet it is the fire that is neglected causing them to miss out on a potential rescue. Conclusionally, the quotes â€Å"He made one cheek and one eye-socket white, then he rubbed red over the other half of his face and slashed a black bar of charcoal across from right ear to left jaw. † (pages 79 and 80), â€Å"They had built castles at the bar of the little river.These castles were about one foot high and were decorated with shells, withered flowers, and interesting stones. † (page 75) and â€Å"They let the bloody fire out. † (page 85) depict the author’s intentions to express the omnipresence of the theme savagery and the way, which is regularly clarified by the use of symbolism and irony. The author has chosen to clarify this through symbolism and irony, to slowly make the reader more aware of the deeper thought of the book, war.

Family Medicines: a Strategic Weakness Essay

Recently the trends of urbanization and fast population increase expose several problems to healthcare system in Vietnam like shortage of healthcare manpower, low quality of care, unreasonable distribution of healthcare manpower in different geographic areas, particularly the serious shortage of physicians in Mekong Delta and North-west highland areas as specialists tend to locate their practices in urban medical centers where they could have access to advanced technology, supportive services and consultations from other specialists while rural areas are underserved and patient care becomes highly technocratic, fragmented and episodic. Furthermore, the shortage of physicians in major cities results in a seriously permanent overload at Central level and some specialty hospitals like Oncology, Pediatrics, Obstetrics and Gynecology .. etc.. In sustainable issues, deficit of Family medicine – a basic foundation of modern healthcare in the world, is identified as one of main causes of such problems in Vietnam healthcare system. The purpose of this Essay is to provide a theoretical discussion and analysis about the Family medicine weakness in Healthcare system and Family physician insufficiency in Vietnam to better understand about their impacts to the healthcare system at present and some proposed solutions and recommendations to improve these deficits. 2. Family Medicine and its roles in global healthcare system. In contemporary medicine, Family medicine remains the foundation stone of healthcare service in the community. As the most interesting and challenging of medical disciplines it is based on six fundamental principles: * primary care * family care * domiciliary care * continuing care All above principles are all designed to achieve: * preventive care * personal care (Pereira Gray, 1980). In the contemporary climate where medical services are fragmented and there are competing interests there is a greater need than ever for generalists. In those principles, primary care is the backbone of the health care system and encompasses the following functions: * It is first – contact care, serving as a point of entry for the patient into the healthcare system * It includes continuity by virtue of caring for patients in sickness and health over some period * It is comprehensive care, drawing from all the traditional major disciplines for its functional content. It serves a coordinative function for all the healthcare needs of the patient * It assumes continuing responsibility for individual patient follow-up and community health problems * It is a high personalized type of care (Rakel 2011) In the 2008 report, the World Health Organization (WHO) reaffirmed the importance of primary health care with its report â€Å"Primary health care now more than ever† and its emphasizes that primary care is the best way of coping with the illnesses of the 21st century, and that better use of existing preventive measures could reduce the global burden of disease by as much as 70%. The commentary emphasizes that ‘primary care brings promotion and prevention, cure and care together in a safe, effective and socially productive way at the interface between the population and the health system’. The key challenge is to â€Å"put people first since good care is about people† (WHO, 2008). Rather than drifting from one short-term priority to another, countries should make prevention equally important as cure and focus on the rise in chronic diseases that require long-term care and strong community support. Furthermore, at the 62nd World Health Assembly in 2009, WHO strongly reaffirmed the values and principles of primary health care as the basis for strengthening health care system worldwide. The essence of Family medicine is continuity of care and the evidence for its contribution to quality of care and better outcomes as follows: * Lower all cause morbidity * Better access to care * Less re-hospitalization * Fewer consultations with specialists * Less use of emergency service Better detective of adverse effects of medication interventions. Role definition of Family physician varies considerably both among family physicians and among people with whom they interact. Some individuals, particularly other medical specialists, see family medicine as merely another name of general practice. For others, family medicine is synonymous with primary care. A large proportion of family physicians further elaborate their role to include emphasis on personalized and humanized care. A smaller group adds a third component to their role: caring for families. The largest proportion who subscribes to this last notion refer to family physicians’ treating all members of a family (Cogswell, Sussman, 1982). In view of Family medicine, Family physicians are generalists who primarily draw their scientific medicine and technical expertise from five older specialties – internal medicines, pediatrics, surgery, obstetrics-gynecology and psychiatry-neurology. Compared to these specialties, family medicine is still a young field marked both by rapid expansion and by change, variety, ambiguity and conflict in the images and definition of the role of family physician. As the largest caring scope in healthcare services, the quality and quantity strengths of Family physician force play key roles to improve the health quality of national population. Globally the scope of Family medicine is extended with the recent view of global health care which is a field at the intersection of several disciplines: epidemiology, economics, demography and sociology. The term global health, as opposed to international health, implies consideration of the health needs of the people of the whole planet above the concerns of particular nations. That means global health has wide scope and reach to equity that the term of international health. The â€Å"global health† concept in Family medicine raises the changes in primary care nature as follows: * All population has to deal with the same risk of health due to the phenomena of traveling and immigration. Increase the gap between the poor & the rich globally. * The process of the urbanization/globalization. * Increase of the population in the world. * Decrease of the resources for health care. * Global warming phenomena. * Vaccination Era. * Evidence Based Medicine in daily practice. * Increase the bad behavior such as fast food, tobacco, stress, use alcohol†¦ * Primary health care change to Primary care concept  (Pham Le An, 2009). Such comprehensive changes upgrade the scale of Fami ly medicine in healthcare. In order to promote the global health support as well as strengthen the co-operation of national members, the World Organization of National colleges and Academies (WONCA), World Organization of Family physicians in WHO, was officially established and based in Singapore after the Fifth World Conference on General Practice in Melbourne in 1972. 3. Family medicine situation in Vietnam Although Family medicine basis had been established in the world for over 40 years, Family physicians, the most recently recognized specialists in Vietnam, are in the enigmatic situation of developing the occupational role which they simultaneously occupy. Family medicine had been only approved for establishment by Vietnam Ministry of Health since 2000. Until 2003, Family medicine specialty was established at 3 Medical Universities of Hanoi, HCMC City and Thai Nguyen province to train Family physicians and its specialists. However, its development was spontaneous with 7 Family medicine clinics (in both public and private sectors) nationwide and not strategically organized at all levels so far. There are only 59 post-graduated specialists and around 1,1 General practitioners who partly handle the roles of family physicians per 10,000 people averagely. The imbalance between Family medicine and other specialists can be seen by the ratio of 7,2 Medical doctors per 10,000 people in overall (Vietnam General Statistics Office – GSO – 2011) and the healthcare system only satisfies about 60- 70% of the demands and are lower than neighbor countries like Thailand, Singapore, Malaysia, Philippines.. tc. In 2011 report, Vietnam Ministry of Health forecasted the demand of 34,000 General practitioners more to obtain 10 Medical doctors/10,000 people in 2020 and this is a significant challenge to all 19 Medical educational Universities/Colleges to educate Medical doctors and post-graduate levels in medicine which capacities supply 4,800 graduated Medical doctors every year to add around 3,500 physicians more a year. Not only the quantity of family physicians is seriously insufficient, but also their quality to fulfill the roles of a family physician does not meet the needs of the patients and social development. The General practitioner training programs don’t orient student to the WHO’s critical requirements of â€Å"good doctors† in Family medicine, even though the criteria are more and more demanding by time, for example, the newer criteria of John Murtagh in 2001 â€Å"What makes a good General Practitioner? : * Develop rapport and good communication skills * Ask the right questions * Be astute and observant * Develop optimal ethical and professional standards * Have a fail-safe diagnostic strategy * Develop supportive networks * Know essential therapeutics * Develop basic procedural skills * Be well prepared for emergencies * Know yourself and your limitations including own general practitioners. The importance of certain specific competences and soft-skills in family physician force are emphasized in many studies. An interesting survey on patient care by representative health consumers conducted at St Vincent’s Hospital Melbourne revealed that the most important attributes of good doctors were (in some order of importance) caring, responsibility, empathy, interest, concern, competence, knowledge, confidence, sensitivity, perceptiveness, diligence, availability and manual skills. Additionally, there are neither comprehensive residency programs for Family physicians at Medical Universities/ Colleges in Vietnam nor supporting policy to them and general practitioners practicing at remote or rural areas so far. With effort to resolve the overload situation of Central hospitals in major cities, Project 1816 of Vietnam Ministry of Health deployed in 2008 with the purpose of â€Å"Fielding rotated professionals from upper level hospitals to lower levels to improve the quality of medical care† achieved some initial results such as transferring some technologies and conducting on-site training to improve skills and qualifications for lower level health care professionals; initially improving the quality of medical care at lower levels, especially in the mountainous, remote areas with staff shortage†¦etc, but its couldn’t obtain one of basic goals to reduce overcrowding for upper level hospitals, especially central level hospitals because it made the shortage of central level and specialty hospital more serious by the rotation. 4. Impacts of Family Medicine weakness in Healthcare system & Family physician insufficiency in Vietnam. Due to low reliability and poorly structured family physician network, patients tend to bypass to specialists/ central level hospitals (Vietnam Ministry of Health – 2011 Report), opposite with the trend in the world in which healthcare activities for chronic diseases such as diabetes, hypertension, asthma†¦are moved from in-patient to out-patient services with comprehensive treatment protocol at each level (Dang Van Phuoc, 2012) The irregular bypass causes the overload at Central level and specialty hospitals and the overloading condition becomes more serious, i. e, bed using capacity at Central hospitals increase from 116% (2009) to 120% (2010) and 118% (2011). It’s extremely high in some specialty hospitals such as K (Cancer) Hospital: 249%, Bach Mai Hospital: 168%; Cho Ray hospital: 154%; Central Obstetric and Gynaecological hospital: 124% .. etc. High capacity occurs in some specialties such as Oncology, Cardio-vascular, Orthopaedics (at 100% of hospitals), Obstetrics and Gynaecology, Paediatrics (at 70% of hospitals) while 36,8% of General hospitals are overloaded. The similar situation also happens in Consulting Departments with 80 exams/day/doctor while 60% – 80% of patients at Central level hospitals could be examined at local level and 40% of surgery cases at Central level hospital could be performed at local levels (Ministry of Health – Plan to decrease workload of Central level hospitals 2012- 2020) With the cost in health care, the deficit of Family medicine in Vietnam is one of reason making the medical expenses of patient higher. Total Expenditure on health as % of GDP (5. 1) is fairly high while General Government expenditure on health as % of total expenditure on health (28. 5) is so low to neighbor countries (Susan, 2005). The most cost-effective healthcare systems depend on a strong primary care base. This has been confirmed by a variety of studies comparing the care given by physicians in different specialties because primary care provided by physicians specifically trained to care for the problems presenting to personal physicians, who know their patients over time, is of higher quality than care provided by other physicians. When hospitalized patients with pneumonia are cared for by family physicians or full-time specialist hospitalists, the quality of care is comparable, but the hospitalist incur higher hospital charges, longer lengths of stay, and use more resources (Smith et al. , 2002). Similarly, the greater quantity of primary care physicians practicing in a nation, the lower is the cost of health care. The cost of healthcare is inversely proportional to the percentages of generalists practicing in that nation. According to OECD Health (Organization for Economic Cooperation and Development – OECD Health Data, June 2005), United Kingdom has twice the percentage of family physicians but half the cost to U. S.. Administrative overhead accounts for a major part of the high overhead cost (31%) of U. S. health care (Woolhandler et al. 2003). Countries with strong primary care have lower overall health care costs, improved health care outcomes, and healthier populations (Starfield, 2001; Phillips and Starfield, 2004). The shortage of Family physicians and Family medicine deficits also cause other problems in health care as follows: * Incomplete or unsuccessful Primary health care performance. * The gap between urban care and rural care in the health care network. * The competition among specialties: lack of cooperation in chronic disease care, increase the cost of management. * Barrier in teaching ambulatory care and doing out-patient’s research in academies (Pham Le An, 2009). In society, Family medicine meets some resistances of patients such as family hysicians are unfairly treated as â€Å"general consultants†, â€Å"home caring doctors† and even in medical community, they are considered as â€Å"incompetent doctor†, â€Å"poor specialist†, â€Å"unfair competitive doctor†.. e tc. Many other specialists and hospitals’ managements list Family physicians as one of financial losing causes to their hospitals. Such unfair treatments make many Family physicians feel uncomfortable with the specialty and their roles of Family physician. The reliability of patients and society to them is fairly low and this specialty does not attract the general practitioners to study. 5. Some proposed solutions & recommendations to improve Family medicine. In order to improve the Family medicine in Vietnam, it requires a comprehensive strategy with strong supports of government, educational institutes and society. Within the limit of this essay, I would like to propose some solutions and recommendations as follows: a. Increasing the quantity of Family physicians with additionally trained General practitioners and using the retired medical doctors: The greater the number of primary care physicians in a country, the lower is the mortality rate and the lower cost (Rakel, 2011). In the United States, a 20% increase in the number of primary care physicians is associated with a 5% decrease in mortality (40 fewer death per 100,000 population), but the benefit is even greater if the primary care physician is a family physician. Adding one more family physician per 10,000 people is associated with 70 fewer death per 100,000 population, which is a 9 reduction in mortality (Rakel 2011). A study of the major determinants of health outcomes in all 50 U. S. states found that when the number of specialty physicians increases, outcomes are worse, whereas mortality rates are lower where there are more primary care physicians (Starfield et al. , 2005). Starfield (2000) states, â€Å"the higher the primary care physician-to-population ratio, the better most health outcomes are† (p. 485). Researches in England reveal that with each Family doctor more in 10,000 people (about 20%), adjusted mortality will reduced about 5% in chronic diseases (Gulliford 2002). The increase of Family physicians obviously reduces the workload at Central level and specialty hospitals (49. 3% of out-patient and 59% of in-patient totally) because with many researches in the world, over 90% of patients are taken care with better service by Family physicians in developed medical or developed countries (Didier, 2011). They can help patients and their relatives in 80% health problems: acute or chronic diseases without complications or no need to transfer to Specialty hospitals (Dang Van Phuoc, 2012). To compensate the continuing decline of the number of students entering primary care as a common trend in the world (Bodenheimer et al. 2009) and insufficiency of graduated general practitioners, a policy to support general practitioners and retired medical doctors to practice as Family physicians such as additional training about Family medicine, financial supports, incentive†¦should be prepared and implemented. Rather than other countries where Family physicians usually work at home or their private clinics, Vietnam has a wide network of local level medical centers at wards/hamlets and popularly private clinics/medical units. This advantage allows Family physicians to practice and deploy the primary care programs easily and popularly. b. Family physician residency training programs: Quality of care and the inadequacy of medical training are two major concerns of Family physicians. Eventually, medical schools and residency programs graduated more specialists and fewer physicians trained for primary care. To improve their quality of care in accordance with global health principles, proposed solution is to build emerging curricula of family practice residency programs to envisioning family physicians as â€Å"horizontal specialists† who can deal with the large majority of patients’ needs on a continuing basis (Rakel, 2011) and envisioning this role as integrating humanized care with a high level of competence in scientific medicine. In contrast to the training of the general practitioner, the additional training that family physicians receive is intended to make them more proficient generalists in scientific medicine through formal training in appropriate interpersonal skills and in the behavioral and social sciences. Implementation of this role, however, requires reorganization within the medical system (Folsom, 1966) for continuing, comprehensive care by primary physician is difficult if not impossible within the normative organizational structures of highly specialized medical centers. As Family physicians play the important role in primary care, the Global health awareness program should be combined into General practitioner and Family physician’s training curriculum for being sure about the quality of â€Å"primary care† as follows: (i) Clerkship: adding knowledge of burden global disease in the world such as: tuberculosis, malaria, Preventive care: vaccination; improving skills such as clinical making decision, communication. ii) Orientation: Adding knowledge of new   emerging infectious disease like SARS, non communicable diseases, traumatism care, HIV/AIDS; (iii) Residents: adding knowledge of prenatal care,   neonatal care,   chronic care, mental health care, adolescen t care;   Emergency care in disaster; improving skills such as: doing research and practice Emergency care in disaster, Behavioral care after disaster, Kangoroo’s program, Obs-Gyn care program; building up the relationship center care with WIN- WIN theory for both developed and developing countries to increase of cooperation and Team work. In addition, the cooperation among experts in different medical fields should be strengthened for teaching, managing, doing research to promote the concept â€Å"relationship center care† through many activities: * Establish Continue Medical Education, Patient’s clubs. * Build the bridge or integrate the teaching contents   in Family medicine   with the other specialties like Pediatrics, Traditional Medicine ( Oriental nutrition, Shiatsu), Cancerology (Palliative care), Multidiscipline (Disaster care, EBM, chronic care). Communication through Internet/ Video conference and Electronic medical: The WHO 2008 report emphasiz es the appropriate ‘use of information and communication technologies to improve access, quality and efficiency in primary care. The writer has made a small contribution to basic patient education (also known as doctor education) by the production of common patient handouts which are available for print out from General practitioners’ computers or for one page photocopying from the book ‘Patient Education’ (Murtagh J; 2008). Besides the residency training programs, on-going training courses to improve the competences and skills of Family physicians should be set for attributes considered most important for patient satisfaction (Stock Keister et al. , 2004a). Overall, people want their primary care doctor to meet five basic criteria: â€Å"to be their insurance plan, to be in a location that is convenient, to be able to schedule an appointment within a reasonable period of time, to have good communication skills, and to have a reasonable amount of experience in practice†. They especially want â€Å"a physician who listens to them, who takes the time to explain things to them, and who is able to effectively integrate their care† (Stock Keister et al. , 2004b, p. 2312). c. Others solutions and recommendations (i) Building an incentive scheme and financial supporting policy to Family physicians, especially whom working in remote and rural areas: The effectiveness of this model had been proved in many countries, particularly in Thailand and Malaysia where healthcare conditions are fairly similar to Vietnam. Contrarily, the recent P4P (Pay for Performance) policy of Thailand’s of Ministry of Health to replace the incentive scheme to Family physicians creates several problems to healthcare force and patients and is considered as a main cause leading the Family physicians moving to major cities. With relation between income and satisfaction, in an analysis of 33 specialties in U. S. , Leigh and associates (2002) found that physicians in high-income â€Å"procedural† specialties, such as Obs – Gyn, ENT, ophthalmology and orthopedics, were the most dissatisfied. Physicians in these specialties and those in internal medicine were more likely than family physicians to be dissatisfied with their careers. Among the specialty areas most satisfying was geriatrics. Because the population older than 65 years old in U. S. has doubled since 1960 and will double again by 2030, it is important to have sufficient primary care physician to care for them. The need for and the rewards of this type of practice must be communicated to students before they decide how to spend the rest of their professional lives. Patient satisfaction correlates strongly with physician satisfaction, and physicians satisfied with their careers are more likely to provide better health care than dissatisfied ones. Physician satisfaction is associated with quality of care, particularly as measured by patient satisfaction. The strongest factors associated with physician satisfaction are not personal income, but rather the ability to provide high-quality care to patients. Physicians are most satisfied with their practice when they can have an ongoing relationship with their patients, the freedom to make clinical decisions without financial conflicts of interest adequate time with patient and sufficient communication with specialist (DeVoe et al. , 2002). Landon& colleagues (2003) found that rather than declining income, the strongest predictor of decreasing satisfaction in practice is the loss of clinical autonomy. This includes the inability to obtain services for their patients, control their time with patients, and the freedom to provide high-quality care. ii) Compulsorily assigning General practitioners/ Family physicians to practice at local level hospitals, the servicing term at local level hospitals must be reasonable and acceptable. (iii) Improving facilitates of local level hospitals/clinic s, enforcing the lower level hospitals to implement modern technologies and quality control. This allows Family physicians to better serve patients as some achievements of Project 1816 of Vietnam Ministry of Health. (iv) Involving patients for private and family health care and prevention, structured information supporting treatment. (v) Improving the reputation of Family medicine and physicians in society through public media channels like television, newspaper.. etc, medical education programs and medical community. Even after the specialty is formally acknowledged by institutionalized medicine, family physicians have experienced a variety of negative responses from medical colleagues in other specialties. Carmichael (1978) perceived 3 stages in the reactions of those in medicine to Family medicine: first, the field was ignored; second, it was actively opposed; and then, family medicine is entering a third stage of possible co-optation by medicine. 6. Conclusion The weakness of Family medicine and insufficiency of family physicians cause many strategic consequences to the healthcare system in Vietnam. Their correction requires a long-term strategy to increase the quantity of Family physicians, quality of care, revise the residency training programs, improve its reputation in the society .. etc. In conclusion it seems appropriate to paraphrase Dr Robert Rakel in his keynote presentation to the 14th WONCA World Conference to reaffirm the Family medicine era in the contemporary medicine: â€Å"Regardless of how computer literate we are or how high our technology or whether the setting is urban or rural, good medical care in the future will continue to depend on patient care provided by a concerned and compassionate family physician. The physician will be governed by ethics, not economics, by a partnership with the patient, not politics; and by compassion and communication, and not by capitation. Good medical care in the future will depend, as it does now and always has, on the quality of our interaction with the patient† Dr Robert Rakel – 14th WONCA World Conference) REFERENCES 1. Alain J. Montegut, The Power of Primary Care for the Future of health care: Is Family Medicine the Answer? 1st International PHC Conference Doha, Qatar 1 – 4 November 2008 2. Bod enheimer et al. , 2009. Bodenheimer  T. ,  Grumbach  K. ,  Berenson  R. A. :  A lifeline for primary care. N Engl J Med  Ã‚  2009;  360:2693-2696. 3. Cogswell BE, Sussman MB, Family Medicine: A new Approach to Healthcare (Marriage & Family review, ISSN 0149-4929; v. 4, no. 1/2), The Haworth Press Inc. 1982. 4. Dang Van Phuoc : Plan to decrease workload of Central level hospitals 2012- 2020 – Vietnam Ministry of Health, 2012. 5. Didier L. Roles of Family medicine, Texbook of Family medicine for the co-operation between Liege University – Brussel and Vietnam, Medicine Publisher, 2009. 6. DeVoe et al. , 2002. DeVoe  J. ,  Fryer  G. E. ,  Hargraves  L. ,  et al:  Does career dissatisfaction affect the ability of family physicians to deliver high-quality patient care?. J  Fam Pract  Ã‚  2002;  51:223-228. 7. Gulliford, J Public Health Med 2002; 24:252-4, and personal communication 9/04. 8. Landon et al. , 2003. Landon  B. E. ,  Re schovsky  J. ,  Blumenthal  D. :  Changes in career satisfaction among primary care and specialist physicians, 1997–2001. JAMA  Ã‚  2003;  289:442-449. 9. Leigh et al. , 2002. Leigh  J. P. ,  Kravitz  R. L. ,  Schembri  M. ,  et al:  Physician career satisfaction across specialties. Arch Intern Med  Ã‚  2002;  162:1577-1584. 10. Murtagh J: The road to excellence. Australian doctor 3 2008, 46-8. 11. Murtagh J: Paradigms of Family medicine: bringing traditions with new concepts; meeting the challenge of being the good doctor from 2011, Asia Pacific Family Medicine, 2011, 10:9 12. Murtagh J: Patient education. 5 edition. Sydney: McGraw-Hill; 2008. 13. Pereira Gray DJ: Just a GP. J R Coll Gen Pract 1980, 30:231-239 14. Pham Le An, Integrate the issue of global health in FM curriculum: promising solution for improving the quality f Primary care in Hochiminh city, Vietnam  , Introducion FM concept: global healh, texbook of Family medicine, Vietnamese version, Medicine Publisher, 2009. 15. Pham Le An, Global health perspective in Vietnam, A â€Å"Train the Trainer’s Workshop†   WONCA   ASIAN PACIFIC Vietnam Ho Chi Minh city, 2008 16. Phillips and Starfield, 2004. Phillips  R. L. ,  Starfield  B. :  Why does a U. S. primary care physician workforce crisis matter?. Am Fam Physician  Ã‚  2004;  70:440-446. 17. Rakel RE: Family medicine-meeting new challenges. Australian Family Physician 1996, 25(9 Suppl 2):S91-6. 18. Rakel RE: The Family Physician, Textbook of Family Medicine, Eight Edition, Elsevier Saunders, 2011, pp4-15 19. Rivo et al. , 1994. Rivo  M. L. ,  Saultz  J. W. ,  Wartman  S. A.   et al:  Defining the generalist physician’s training. JAMA  Ã‚  1994;  271:1499-1504. 20. Smith et al. , 2002. Smith  P. C. ,  Westfall  J. M. ,  Nicholas  R. A. :  Primary care family physicians and 2 hospitalist models: comparison of outcomes, processes, and costs. J Fam Pract  Ã‚  2002;  51:1021-1027. 21. Starfield, 1994. Starfield  B. :  Is primary care essential?. Lancet  Ã‚  1994;  344:1129-1133. 22. Starfield, 2000. Starfield  B. :  Is U. S. hea lth really the best in the world?. JAMA  Ã‚  2000;  284:483-485. 23. Starfield, 2001. Starfield  B. :  New paradigms for quality in primary care. Br J Gen Pract  Ã‚  2001;  51:303-309. 24. Starfield et al. , 2002. Starfield  B. ,  Forrest  C. B. ,  Nutting  P. A.   et al:  Variability in physician referral decisions. J Am Board Fam Pract  Ã‚  2002;  15:473-480. 25. Starfield et al. , 2005. Starfield  B. ,  Shi  L. ,  Grover  A. ,  et al:  The effects of specialist supply on populations’ health: assessing the evidence. Health Aff (Millwood)  Ã‚  2005;  24:W5-97-W5-107 26. Stock Keister et al. , 2004a. Stock Keister  M. C. ,  Green  L. A. ,  Kahn  N. B. ,  et al:  What people want from their family physician. Am Fam Physician  Ã‚  2004;  69:2310. 27. Stock Keister et al. , 2004b. Stock Keister  M. C. ,  Green  L. A. ,  Kahn  N. B. ,  et al:  Few people in the United States can identify primary care physicians. Am Fam Physician  Ã‚  2004;  69:2312. 28. Susan JA, Vietnam’s Healthcare system: A Macroeconomic Perspective, Paper Prepared for the International Symposium on Health Care Systems in Asia Hitotsubashi University, Tokyo, 2005. 29. Vietnam Ministry of Health: Plan to decrease workload of Central level hospitals 2012- 2020, 2012. 30. Woolhandler et al. , 2003. Woolhandler  S. ,  Campbell  T. ,  Himmelstein  D. U. :  Costs of health care administration in the United States and Canada. N Engl J Med  Ã‚  2003;  349:768-775. 31. World Health Organisation: The World Health Report 2008: Primary Health Care now more than ever Geneva; 2008. 32. World Health Organisation: World Health Report 2009: Promoting health and development-closing the implement gap Geneva; 2009. -oOo-

Introduction to Internet Addiction

Introduction to Internet Addiction Ten years ago, the only people who spent a majority of their leisure time on the computer were paid members of the technology industry. Today, however, surfing the Web has become a pastime as social and marketable as bar hopping or going to the movies. As the web has become a part of mainstream life, some mental health professionals have noted that a percentage of people using the web do so in a compulsive and out-of-control manner.In one extreme (1997)  Cincinnati case, unemployed mother Sandra Hacker allegedly spent over 12 hours a day secluded from her three young and neglected children while she surfed the Web. For better or for worse, this phenomena of compulsive Internet use has been termed ‘Internet Addiction' based on its superficial similarity to common addictions such as smoking, drinking, and gambling. Internet Addiction has even been championed as an actual disorder, notably by psychologists Kimberly Young, Ph. D and David Greenf ield, Ph. D.. However, at this time the true nature of Internet Addiction is not yet determined.In a true addiction, a person becomes compulsively dependent upon a particular kind of stimulation to the point where obtaining a steady supply of that stimulation becomes the sole and central focus of their lives. The addict increasingly neglects his work duties, relationships and ultimately even his health in his drive to remain stimulated. In some cases of addiction (such as addiction to alcohol or to heroin), a phenomenon known as tolerance occurs, wherein more and more stimulation is required to produce the same pleasurable effect.A related phenomena, withdrawal, can also occur, wherein the addicted person comes to be dependent upon their source of stimulation and experiences dramatically unpleasant (and even potentially lethal — as can be the case with alcohol) reactions when he goes without it. Sources of addictive stimulation can be chemical (as is the case with addictive d rugs such as alcohol, cocaine, nicotine and heroin), sensual (as in sex) or even informational (as in gambling or workaholism).What all sources of addictive stimulation have in common is that they provoke a strong, usually positive (at first) reaction in the potential addict, who then seeks out the source of that stimulation so as to obtain that feeling on a regular basis. While many people like to engage in sexual relations, or gamble, or have the occasionally drink because of the pleasure to be had, clearly not all people who do so are addicts. Rather, the term ddiction only applies when someone's stimulation seeking gets to the point where it starts interfering with their ability to function normally and non-neglectfully at work and in relationships. Mental health professionals are split as to whether or not Internet addiction is real. No one disputes that some people use the Internet in a compulsive manner even to a point where it interferes with their their ability to function at work and in social relationships. What is disputed is whether people can become addicted to the Internet itself, or rather to the stimulation and information that the web provides.The controversy surrounding Internet Addiction is precisely whether people become addicted to the net itself, or to the stimulation to be had via the net (such as online gambling, pornography or even simple communication with others via chat and bulletin boards). Some psychologists do not believe in addiction to the Internet itself, but rather in addiction to stimulation that the Internet provides. They suggests that new Internet users often show an initial infatuation with the novelty of the Web, but eventually lose interest and decrease their time spent online back to a normal, healthy amount.Those users who do go on to show compulsive Internet utilization, for the most part become compulsive only with regard to particular types of information to be had online, most often gambling, pornography, chat r oom or shopping sites. This is not an addiction to the Internet itself, but rather to risk-taking, sex, socializing or shopping. In essence then, the chief addictive characteristic of the Internet is its ability to enable instant and relatively anonymous social stimulation. Addicted† Internet users are addicted to a favored kind of social stimulation and not to the Internet itself, although it is also true that the Internet has made it vastly easier and more convenient for someone to develop such a compulsion. Because the Internet is used by many people as a normal part of their career or education, knowing how to separate excessive from normal use becomes difficult and cannot be accomplished using simple measures such as amount of time spent online in a given period. Most fundamental in differentiating normal from problem Internet use is the experience of compulsion to use the net.Normal users, no matter how heavy their usage, do not  need  to get online and do not neglec t their occupational duties or their relationships with family and friends to get online. Help for Internet related addiction is available from multiple sources. Anyone concerned about serious problem Internet usage should consider consulting with a local licensed psychologist, social worker or counselor, specifically one with experience treating addictions. Cognitive therapy based approaches are recommendable due to their systematic and direct focus on reducing problem use and preventing relapse, and the strong scientific support for the approach.Marital and or family therapy approaches may be useful as well when an individual's Internet Addiction is affecting their larger family system (such as might be the case when a husband uses Internet-based pornography as his sole sexual outlet, leaving his wife frozen out). More than a few books and self-help resources (such as audio tape sets) are also available for those who want to educate themselves on the problem. Our Internet Addictio n Treatment article provides further detail.