Malnutrition Effects on Quality Of Life

Malnutrition Effects on Quality Of Life The focus of this assessment is quality of life and specifically this paper considers how malnutrition affects quality of life of community settings patients. According to the Scottish Governments publication Older people living in community Nutrition needs, barrier and interventions: a literature review, malnutrition is an umbrella term for undernutrition, overnutrition and imbalance diet intake (The Scottish Government, 2009). Malnutrition has previously been described in the various ways (The Scottish Government, 2009). However, for purpose of this assessment the following term will be used as defined by World Health Organisation (WHO) the cellular imbalance between the supply of nutrients and energy and the bodys demand for them to ensure growth, maintenance, and specific functions (see European Nutrition for Health Alliance, 2005). According to Saunders, Smith and Stroud (2010) 2 per cent of the UK population is underweight: Body Mass Index (BMI) is lower than 18.5 kg/m. However, they agreed that patients could be still at risk of malnutrition whatever their BMI is (Saunders, Smith and Stroud, 2010). Malnutrition, as well as other factors, has negative effect on the persons quality of life (The Scottish Government, 2009). In the UK, hospitals admission rate and mortality were greatest in patients with BMI below 20 (kg/m2) (Teo and Wynne, 2001). During nutrition screening survey in the UK various settings it was found that malnutrition doubles risk of mortality in the hospital patients and triples morality in elderly patients in hospitals following discharged (RCN and NPSA, 2009). Care Homes nutrition survey shown that 30 per cent of service users recently admitted to care homes were at risk of malnutrition (RCN and NPSA, 2009). According to Hickson (2006), malnutrition may be secondary to certain health conditions which is increasing risks for patients to become malnourished and those risk factors will be discuss later in this assessment (Hickson, 2006 and Teo and Wynne, 2001). However, European Nutrition for Health Alliance (2005) argued that malnutrition should be classified as independent disease (European Nutrition for Health Alliance, 2005), its due to undernutrition has a negative effect on all organs systems such as muscle-skeleton, cardiovascular, respiratory, gastrointestinal, endocrine systems and in addition, malnutrition has a psychosocial effect (Saunders, Smith and Stroud, 2010). It was found that undernutrition could cause following health conditions: in the healthy individuals and has advance exacerbation effects upon existent illnesses or injuries, reduced psychological wellbeing (increase anxiety, depression apathy, and loss of concentration and self-neglect) (Webb and Copeman, 1996 and Saunders, Smith and Stroud, 2010). According to Morley and Kraenzle (1995), balanced diet in general, is improving cognitive and memory performance in elderly (see Vetta et al, 1999). Chandra (1993) found that undernutrition is depressing organism immune function (see Webb and Copeman, 1996). It could be due to impaired cell-mediated immunity and cytokine, complement and phagocyte function this most commonly could lead to developing bacterial and parasitic infections and poor wounds healing (Saunders, Smith and Stroud, 2010). Malnourished patients have reduced muscle function, loss of cardiac muscle and reduce cardiac output, which results in impact on the renal function (Saunders, Smith and Stroud, 2010). The same individuals have reduced respiratory response to oxygen deficit by poor diaphragmatic and respiratory muscle function (Saunders, Smith and Stroud, 2010), increased risk of hypothermia, increase risk of falls and injuries (Webb and Copeman, 1996). In addition, redaction of fat and muscles mass are more obvious signs of malnutrition (Saunders, Smith and Stroud, 2010). According to Clayton (1991), malnourished elderly clients have a poor prognosis for recovery from following fractured femur, hypothermia, pressure ulceration and other conditions (Clayton, 1991). Fracture risk is high then calcium, magnesium and vitamin D intake is insufficient, during the weight loss bone mass is reducing as well (Saunders, Smith and Stroud, 2010). Early stage of malnutrition leads to loss of digestive enzymes that result in intolerance of lactose. The colon loses its ability to absorb liquid, electrolytes, and secretions of small and large bowels, which results in diarrhoea (Saunders, Smith and Stroud, 2010). According to Saunders, Smith and Stroud (2010), endocrine system is affected in malnourished patience. For example, chronic malnutrition will change the pancreatic exocrine function by reducing the insulin secretion (Saunders, Smith and Stroud, 2010). An author is currently working a nursing and residential care home for elderly patients as well as nursing and social recruitment agency, which is covering biggest part of the North West of England. Being allocated in hospitals and nursing homes the author noticed that patiences nutrition needs are being met well but where are still some areas for improvement. During the study carried out in the large the UK hospitals, it was found that 40 per cent patients admitted to hospitals were malnourished and two-thirds subsequently lost weight during their hospital stay (Teo and Wynne, 2001). During the service users meeting in the care home author working in, carried out in January this year, all 14 service users have stated that they are satisfied with food they are getting. However, two patients are still at risk of malnutrition. They have been referred to the GP for dietician support. The author strongly believes that nursing home is providing adequate food to the service users. Catering manager in the UK hospitals compare to chefs in nursing home have a small budge of  £11 to  £15 per patients a week (Teo and Wynne, 2001). The authors care home spends around  £30 per service user a week. However, in March 2007, Royal College of Nursing (RCN) carried out survey questioning nearly 2200 of their member relating nutrition issues. Survey has revealed that 42 per cent said the food provided for patients were below overage expectancy (RCN, 2011). In various reasons government and health profession organisations are now advising for routing screening of all patients admitted to any healthcare facilities (RCN and NPSA, 2009). In authors opinion, the main priority for addressing this issue is promoting patiences health and wellbeing and cutting financial cost. For example, annual financial cost of treatment malnutrition patience and any associated illnesses in the UK was estimated around 7.3 billion pounds. This figure includes treatment malnourished patience in the hospital setting, round 3.8 billion pounds and long-term care facility such as care home, round 2.6 billion (Elia M., et al., 2005). Causes of Malnutrition The author is currently looking after two service users who are scoring on the MUST. All two patients are elderly from 65 to 80 years old, with different background and health conditions. Patient No 1 is 87 years old female, was diagnosed with Alzheimers Disease, history of Transient Ischemic Attack (TIA), high blood pressure, right wrist fracture and Dysphasia. Current BMI is 19, which was stable after referral to dietician and commencing on oral supplements, than BMI was 17 back in the October 2010. Patient No 2 is 72 years old man, diagnosed with alcohol excess, CA oesophagus, Gout, Heart Failure. Current BMI is 23, which was stably increasing over past months following admission to nursing home, than his BMI was 17. Both patients have a poor appetite at present. Nursing homes staff cannot establish reasons for anorexia and BMI reduction in one patient. There are number of risk factors, which could cause malnutrition among elderly population. However, the most important factor leading to undernutrition is reducing of oral intake (Saunders, Smith and Stroud, 2010). Inadequate dietary intake is depending on various factors (Saunders, Smith and Stroud, 2010), which could be divided into three main categories: medical, social and psychological (Hickson, 2006). Firstly, age related changes such as changing in appetite or sensory (Teo and Wynne, 2001). Working in the care homes author noticed, an appetite is reducing with advanced age. Some people refused or preferred to omit meals, for example, one patient does not take breakfast, then the author asked her why she is not taken breakfast that patient replied that she is not a breakfast person. In addition, during the study carried out in USA it was discovered that elderly population are consumed less energy intake and follow more traditional eating pattern then younger population (Teo and Wynne, 2001). Poor appetite or anorexia is a most common factor leading to malnutrition in both young and old generation (Hickson, 2006). However, during the study commenced by Roberts et al (1994), it was found that ageing seemed to affect the ability to control food intake and weight lost will take longer to re-gains in elderly men compare to young (see Hickson, 2006). In addition, according to work of De Castro (1993), older people are less responsive to stomach contents than younger people, in term of hunger (see Hickson, 2006). Anorexia may occur as process of aging as well as during underlying illnesses (Teo and Wynne, 2001 and Hickson, 2006). Hetherington (1998) argued that changing in taste and smell could lead to loss of appetite through a perceived decline in the pleasantness of food. Loss of taste and smell could be associated with advance age and medications therapy mechanism of these changes are remains unknown (see Hickson, 2006). In authors care environment patients prefer to eat strong flavour and taste meals such as a roast meat with gravy, bacon, fish which are being served with traditional sauces or salt and vinegar to encourage patients to their food. According to Hickson (2006), a few works have been done to find out that improving the flavour of the food can improve diet intake and follow weight increase in hospitals and community healthcare patients (Hickson, 2006). A few patients do not like vegetables, intake of which have being recommended by NHS 5 a day complain based on the WHO (NHS, 2009). Patient No 1 and Patient No 2 do not have own teeth which is reducing ability to chew tender food. For both patients oral problems have not been reported. However, according to Finch et al (1998), National Diet and Nutrition survey, energy consumption was lower in edentate individuals compare to individuals with own teeth (see Hickson, 2006). Dysphasia or swallowing problem is leading concern in reducing dietary intake (Hickson 2006). The author has experienced that often care and catering staff do not understand the different between soft and liquidised diet and which diet should be given to each patients with dysphasia. Moreover, care staff that is responsible for feeding patients, needed assistant, every often do not understand the sings for swallowing problem. This concern has been addressed in the care home that the author is working in by appointed care staff for appropriate training section provided by Liverpool Primary Care Trust (PCT). According to research carried out by Mowe et al (1994), swallowing problem is showing up in 64 per cent of in-patience elderly (see Hickson, 2006). In addition, Gariballa et al (1998) argued that post Cerebrovascular Accident (CVA) patients with Dysphasia had a worse nutrition status then those patients without swallowing problems (see Hickson, 2006). The author strongly believes that malnutrition caused by various factors combined together such as old age and health or mental health problem (Saunders, Smith and Stroud, 2010). In the UK, it was estimated that around 8 per cent of patients with chronic diseases living in the community are malnourished (Teo and Wynne, 2001). According to Hickson (2006), diseases-related malnutrition is usually associated with cancer, physical disabilities, endocrinology disorder and respiratory disease, gastrointestinal disorders, neurological disorders, sources of infection and other psychological factors such as depression and Dementia (Hickson, 2006 and Teo and Wynne, 2001). Medical factors increase the risk of patient to become malnourish through, for example, nausea or vomiting, diarrhoea or constipation, anorexia and malabsorption (Hickson, 2006). Cultural factors or social (Vetta et. al. 1999) and food habits are also playing an important role in developing malnutrition as independent illness (Hickson, 2006). As example, an individual who had a long-term hospital stay or had no nutrition support while in the community would not used to have full nutritional meals. Moreover, individual who has been admitted to the authors care home used to take fast food or sandwiches at all the time while at home, instead of cooked meals. According to Hickson (2006), there are lifestyles and social risk factors for malnutrition in elderly people are lack of knowledge about food, nutrition and cooking, isolation and loneliness, poverty, inability to shop or prepare food (Hickson, 2006). Dementia has a great effect on individuals relationship with food (Alzheimers Society, 2011). Dementia patients or patients with low mental status appeared to lost weight due to reducing self-feeding ability, acute sense of smell and taste that is depending on severalty and progression of disease (Teo and Wynne, 2001). Berkhout et al (1998) has confirmed that weight lost in demented patients is caused by patients ability to feed them rather than by dementia as illness (Hickson, 2006). According to Incalzi et al (1998), study carried out for in-hospitals patients found out that cognition is causing impairment to ability or desire to eat (see Hickson, 2006). Progressive dementia is usually associated with uncontrolled weight lost and changing eating habits (Claggett, 1989 see Hickson, 2006). Nutrition screening and risk assessment In 2007, RCN commenced Nutrition Now campaign, which has a wide response from members of public as well as members of multidisciplinary teams. The RCN Principles for Nutrition and Hydration were published in 2007. That principals aim to help of all health professionals grades to improve nutrition and hydration of patience. This paper is highlighting three principles of nursing care: accountability, responsibility and management to improve the patience nutrition and hydration (RCN 2011). Nutrition screening pathway, nutrition risk assessment are widely used which assist nursing staff to indentify the risk of malnutrition or/dehydration and appropriate actions to be taken. Risk of malnutrition screening should be a routine process in all healthcare settings (RCN and NPSA, 2009). In the authors care home as required all service users are being screened for malnutrition on the admission and once a month or more often if required, using Malnutrition Universal Screening Tool (MUST) as recommended by government bodies and Care Quality Commission (CQC) as registration body. Part of the admission documentation is to collect and record patiences food likes and dislikes. According to Saunders, Smith and Stroud (2010), MUST is reliable and valid screening tool in diagnostic or prediction of malnutrition (Saunders, Smith and Stroud, 2010). However, nutrition assessment was only done for patients who have been referral to their GPs following scoring, weight loss of 1 to 2 per cen t per week, 5 per cent per month or 10 per cent over period of six months (Mitchell, 2003). According to RCN and NPSA (2009), purpose of nutritional assessment is details identification of nutritional status and for special dietary plan to be formulated and implicated (RCN and NPSA, 2009). In the authors care home, dietician or dieticians assistant based on the information provided by staff nurse on duty normally carries out the nutritional assessment. As far as author concerns, nutrition assessment should be done by care home nurses as they are working in close contact with patients and their families on the daily basis, know better persons food likes and dislikes. However, special nutrition trainings are not always available to the nursing home staff. This could lead to complicated nutrition issues not to be addressed as quickly as they should be due to community dieticians waiting time is usually 6 weeks. In the authors nursing home all necessary equipments are available such as weight scales and height measures. However, weight scales calibration has not been done which could lead to poor nutrition screening assessment (NPSA). After completing the MUST, the author and colleagues will formulate the personalised care plan for each patient in order to meet nutritional requirements. Nutrition care plan could be based on the information or guidance provided by dietician or other health professions. Treatment According to Hark and Morrison (2003), the nutrition needs of healthy older adults are mainly the same as for middle age adults (Hark and Morrison, 2003). The intake of food containing Calcium, Vitamin D, Folate, Vitamin B12 and B6 should be increased for the elderly population (Hark and Morrison, 2003). Protein intake recommendation is variable from 0.8 g/kg per day in the USA (Mitchell, 2003) to 0.75 g/kg in the UK (McKevith, 2009). However, according to Mitchell (2003), one established nutrition needs recommendation cannot be used for all ages population (Mitchell, 2003). In addition, patients lifestyle, height and weight should be taken in account (Mitchell, 2003). There are number of fundamental support of nutrition available at present such as enteral and parenteral nutrition support (Hark and Morrison, 2003). At this assessment only oral nutrition support (ONS) will be discussed. The aim of the nutrition support is to ensure an individual gets enough energy, proteins, macronutrients and micronutrients to meet patients nutrition requirements (Saunders, Smith and Stroud, 2010). Saunders, Smith and Stroud (2010) argued that provision of regular meals with better nutrition content, wide menu choice and assistant with feeding should be enough to meet nutrition requirement and reduce nutrition risk (Saunders, Smith and Stroud, 2010). Numerous studies show that nutrition support could reverse weight loss, only if underlying health conditions under control (Saunders, Smith and Stroud, 2010). However, not all patients react at the same way (Hickson, 2006). At what reasons care and treatment should take an account of individual needs and preferences (RCN and NPSA, 2009). In practice, knowledge of food preferences and past medical history, following personalised nutrition care plan, serving patients with small meals (Teo and Wynne, 2001) or using a small plate could encourage service user to finish all meal. Currently some of the UKs hospitals commenced to use red tray scheme for serving the meals to patients. A purpose of using red trays is to alert hospital staff that patience with red tray is at nutrition risk and need assistance or supervision with diet intake (Bradley and Rees, 2003 see Davis, 2007). Protection of mealtime scheme is also widely spread across the UK. The purpose of this scheme is to create an environment for hospital patients free from hospital activities and unnecessary disturbance during a mealtime. In addition, this scheme is to assist nursing staff with concentration on the meeting nutrition need of hospital patients (NS, 2007). People with Dementia could loss an ability to use cutlery that could lead to weight loss and malnutrition. Providing those patients with available finger food could improve nutrition status (Alzheimers society, 2011). Teo and Wynne (2001) argued that the possible benefits from using energy supplements in elderly patients have received little or no evaluation in clinical practice (Teo and Wynne, 2001). However, during the study carried out by Volkert et al (1996), it was found that patients consuming food supplement while in-patience and 6 months in community have develop positive nutritional status compare to group of patients without food supplements (see Teo and Wynne, 2001). The author has come across the situation then GP has refused to prescribe food supplement to one of the patience and recommended full fat milk instead. In addition, during controlled trial for six months in patients who have been discharged from hospital and prescribed ONS has no economic benefit. To compare, using ONS in community is costing more than using ONS in hospitals (Elia et al., 2005). However, malnourished patients using could be at risk of re-feeding syndrome, which could results in death (Saunders, Smith and Stroud, 2010). Re-feeding syndrome is associated with water retention leading to fluid overload due to decay of potassium, magnesium, phosphorus and sodium in blood plasma (Mallet, 2002). Saunders, Smith and Stroud (2010) recommended that during re-feeding saviour malnourished patients potassium, phosphate and magnesium should be prescribed and thiamine (for patients with history of alcohol excess) (Saunders, Smith and Stroud, 2010). Conclusion The UK elderly population is rising, currently about 16 per cent of the population is above 65 (Hickson, 2006) and by 2050 over 30 per cent European population will be over 60 which will result in prevalence of malnutrition to rise (European Nutrition for Health Alliance, 2005). Many changing associated with aging have been documented, however, how senescence leads to the health conditions, related to aging, is still unknown (Mitchell, 2003). It was found that ageing is leading to slow reduction of weight and modification in body composition. It is due to declines in bone, muscle mass and body cell mass. Bone mass reduced due to inadequate intake of Calcium and inadequate exposure skin to the sunlight to encourage production of Vitamin D (Sahyoun, 2002). In general, people are gaining weight until they 60th birthday and after gradually reducing weight, usually 10 per cent between 70 and 80 (Mitchell, 2003). Weight loss related to aging and malnutrition should be indentified during initial nutrition assessment. In addition, community healthcare is facing many concerns. Firstly, malnutrition remains under-recognized problem facing patients, their families and health professions (Saunders, Smith and Stroud, 2010). Secondly, according to, Hark and Morrison (2003) argued that there are no single physical or biochemical screening tools could accurate predict the nutrition status in elderly (Hark and Morrison, 2003). Food prices are constantly rising and ONS are costing too much to the local PCT. In the authors opinion, providing service users with good quality food, offer choice of menu and snacks between meals are solution to fight malnutrition. The significant role in education medical students and junior doctors in nutrition has widely recommended (Saunders, Smith and Stroud, 2010). However, inadequate knowledge in nutrition of nursing and care staff could increase risk of malnutrition (Saunders, Smith and Stroud, 2010). In the authors care home nutrition in elderly is not mandatory training for the care staff. Following this assessment, the author will provide relevant care staff with information on the nutrition in elderly service users. This could be achieved through supervision sections and face-to-face talks. Moreover, there it is possible, elderly population and their families should be informed about the latest nutrition recommendations related to their age, lifestyle and health conditions and should encouraged to apply those recommendations to individuals lives (Sahyoun, 2002).

Myths and Facts About Bullying

A topic of great concern among American society, and parents in particular, is that of youth violence. The media often makes the situation appear as though youth violence is on the increase in the United States. However, scientific research shows that youth violence is not truly increasing, but that certain environmental factors make the statistics read as though the violence is increasing. Statistics can be influenced by a number of factors besides actual increases in violence, such as the introduction of ‘zero tolerance’ policies in schools or the reduction of police discretion on police forces.These environmental factors lead to more incidents of youth violence being detected by those who measure youth violence, but dose not actually represent an actual concrete increase in the violence. However, there is one area of youth violence that has increased somewhat over the past three decades. Although the increase is not drastic, bullying is a form of youth violence that i s highly prevalent in all schools in North America, and abroad. Bullying is a lesser form of violence in which one or more students pick on, verbally or physically abuse another student who is viewed as a weaker child.This often takes the form of physical and/or psychological harm (Bastche & Knoff et al. , 1994). Although bullying is a major problem within the school system, the topic is not fully understood and there are many circulated myths related to the subject. This paper attempts to highlight some of these myths and clarify the actual facts that do exist within the documented literature. Myths about the topic of bullying are widespread and are commonly believed by the majority of individuals.One of the most common myths can even be seen in the above definition of bullying, in that the victims of bullying are not always weaker children than are the bullies. One of the myths about bullying relates to the fact that some schools say their do not have bullying. Sometimes schools w ith ‘zero tolerance’ policies in place believe that they have successfully managed to end bullying as a problem for their students, but it is highly unlikely that this is true (Byrne, 1994).There are many different ways bullying can occur beyond the sight of teachers and authority figures, as bullying is often a very subtle form of violence or harassment, and can be as simple as a glance from one student to another. The only difference between schools with the subject of bullying is whether or not they choose to deal with it in an effective manner. Schools that take a proactive approach to the problem of bullying, by educating their students and dealing with it promptly and firmly, are the most likely to have success in combating the issue, but no school will ever fully remove the problem of bullying (Byrne, 1994).Another common myth about bullying relates to how children are encouraged to deal with the issue. Nearly everyone can relate to a parent or teacher telling th e victim of bullying to simply ‘ignore it. ’ Nearly all victims of bullying are told that they should ignore their bully, not give in to them or respond, as all the bully wants is to get a reaction. But bullying should not be ignored. Every student and child has the right to attend school without being harassed or bullied by other students (Hoover et al, 1992).To tell the student to simply ignore the problem is telling them that the problem does not matter, and the other student is within his or her own right to bully. This is not true. Victims of bullies should maintain records of the events and insist that the school deal with the problem effectively by punishing the bully (Hoover et al, 1992). Many adults believe that bullying really has no damaging effects on children. It is often believed that bullying is a part of life, or a part of growing up and that all children are teased over one topic or another. Thus, the lesson to be learned is how to brush it off and cont inue on with life.Some adults will say that â€Å"it builds character,† but this is not true. Bullying does have immediate and long term detrimental effects on victims. It certainly will build character, but not the positive time. Victims of bullies often carry the damage with them for the remainder of their life, and may become weary of social situations or develop a habit of being submissive to any other person who appears to be somewhat dominant (Craig, 1998). Victims of bullying have even been found to suffer from forms of post traumatic stress disorder, in that they often spend the majority of their school years in fear.The fear of bullying victims can also have negative impacts on their school performance. Thus, the effects of bullying are far from being fleeting or unimportant. Victims of bullying have their psychological injuries reinforced by such myths and untrue so called facts, as they never witness anyone telling them that it is not their fault, that they should not have to put up with bullying, or that the bully is the individual in the wrong. Another related myth is that bullying serves to toughen kids up and make them resistant to future problems as adults, but this is not true at all (Craig, 1998).Myths abound concerning who the targets and victims of bullying are. Many believe that the bully-victim dichotomy is one that is analogous to the strong-weak dichotomy. This, however is not true. Victims of bullies are often sensitive, caring individuals. While their kindness, intelligence, honesty or creativity may be taken as a form of weakness, in reality they are strong individuals who endure years of abuse at the hands of bullies (Olweus, 1997). The typical victim of a bully is not inclined towards violence in the least, making them an easy target, but hardly a wimp or weakling.Often this low inclination towards violence is a result of high levels of personal integrity and values, not a result of being a wimp. If society were made up sole ly of these so called ‘wimps’ and ‘weaklings’ society would be a much better and safer place to live. Many have viewed bullying as something at attacks individuals who are in essence, the best individuals society has created (Craig, 1998). They are smart, respectful, honest, creative, have high values, morals and integrity, and often have a very strong internal sense of fairness or justice.Bullies target these individuals because often they will not fight back due to their own values, but this does not make bullying acceptable or explainable. Other myths concern the relationship between bullying and social skills. Many people believe that it is the popular kids with good social skills that become bullies and pick on the children who do not have good social skills or who are psychologically weak. On the contrary, it is bullies who lack the social skills and who are themselves psychologically weak. Many bullies are in fact afraid of social situations or of re jection (Olweus, 1997).They set themselves up into social situations where they cannot be rejected because other children are afraid of them. Bullies often also suffer from low self esteem which is one of the reasons they derive a better sense concerning their own abilities through the harassment of other students. Bullies will often also target individuals whom they envy, either due to their increased social skills or higher intelligence. Unable to articulate the fact that they are envious, or in some cases actually wish to be the victim’s friend, bullies react with negativity towards these individuals (Rigby & Slee, 1991).Thus it is clear that there are quite a few myths concerning the topic of bullying. Bullying is a very serious problem that causes long lasting, and sometimes life long damage to victims (Craig, 1998). Bullying cannot be completely removed from any school system, but effective policies can be put in place for dealing with bullying. Such policies should tak e the side of the victims and assert to students that bullying, in any form, is not acceptable. Both bullies and victims should be taught effective social skills and skills of communication that allow them to sort through difficulties using words that are not harmful and a lack of violence.Bullies should be dealt with harshly in a manner that informs them that their behaviour is unacceptable, yet at the same time it should not be ignored that bullies themselves are often victims of lowered self esteem or may be victims of violence in another part of their life. Above all, the feelings of victims and their experiences should not be discounted by adults as ‘parts of life,’ ‘rites of passage,’ or ‘wimpy and sensitive. ’ The feelings of victims of bullying are very legitimate and should be dealt with immediately to prevent long term psychological effects (Craig, 1998).References Batsche, G. M & Knoff, H. M. (1994). Bullies and their victims: Unders tanding a pervasive problem in the schools. School Psychology Review, 23,165-174. Byrne, B. J. (1994). Bullies and victims in a school setting with reference to some Dublin schools. The Irish Journal of Psychology, 15, 574-586. Craig, W. M. (1998). The relationship among bullying, victimization, depression, anxiety and aggression in elementary school children. Personality and Individual Differences, 24,123-130. Hoover, J. H. , Oliver, R. & Hazler, R. J. (1992). Bullying: Perceptions of adolescent victims in the Midwestern U. S. A. School Psychology International, 13, 5-16. Olweus, D. (1997). Bully/Victim problems at school: Knowledge base and an effective intervention program. The Irish Journal of Psychology, 18, 170-190. Rigby, K. & Slee, p>T. (1991). Dimensions of interpersonal relation among Australian children and implications for psychological well-being. The Journal of Social Psychology, 133, 33-42. Online Sources: Bullying by Mobile Phone and Abusive Text Messaging  œ Child Bullying, http://bullyonline. org/schoolbully/mobile. htm Terrorism Starts in the Playground – http://www. bullyonline. org/schoolbully/terror. htm

The Success Of A Successful Entrepreneur Essay - 1528 Words

â€Å"Success is not a key to happiness; happiness is a key to success. If you love what are you doing, you will be successful,† said by Albert Schweitzer (Brainy Quote, 2016) This quote shows that everyone can be successful in their own life, human will be happy when they love or enjoy what they are doing and it is the first step to become successful. Nowadays there are pretty of businessperson, therefore being businessperson are completely different from successful businessman and businesswoman because not everyone can be successful business man or women. Many entrepreneurs may had failed to build their own business but some of them are never giving up, that is why most of the successful entrepreneurs have failed their business before and they know how to settle or solve with lot of problems and it makes their business become successful. The researcher has chosen Anna Wintour, she is an editor in chief of Vogue magazine US. 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List of some of the successful women entrepreneurs Ekta KapoorRead MoreEducation And Study At Universities1414 Words   |  6 PagesHowever, what about for entrepreneurs? People who don’t want to work in a steady paid job, but who wants to be their own boss. Do entrepreneurs need to study for a University degree? Would, in the course of studying a degree, increase the chance of becoming a successful entrepreneur? Does higher education teach the necessary skills to help people be successful in running a business? Thus, lead to my research topic. I would like to investigate whether successful entrepreneurs obtained their necessaryRead MoreSkills, Traits, And Characteristics Of A Successful Entrepreneur1210 Words   |  5 PagesCharacteristics of a Successful Entrepreneur Anonymous Author University of the People Entrepreneurship 1 3303 â€Æ' Abstract Skills, traits or characteristics are essential ingredients in being a successful entrepreneur. Although these ingredients are numerous, an entrepreneur should develop the ones that are relevant to becoming successful. This paper will first examine skills, traits, and characteristics that are more important to have as an entrepreneur. Then, we researched and explored entrepreneurs who co-foundedRead MoreThe Practice Of Entrepreneurship Through Time And The Global Enterprise1642 Words   |  7 Pagesvision with the overarching goal of holistic success and autonomy (Arthur Hisrich, 2011). The entrepreneur exudes behaviors which foster initiative, orchestrate options, and accept responsibility for the success or failure (Arthur Hisrich, 2011). Entrepreneurship has transformed the global marketplace and imprinted all disciplines. Therefore, a balanced discussion on identifying features, characteristics, and venues of consequence for an entrepreneur will drive the direction of this ana lysis.

Excited State Definition in Chemistry

The excited state describes an atom, ion or molecule with an electron in a higher than normal energy level than its ground state. The length of time a particle spends in the excited state before falling to a lower energy state varies. Short duration excitation usually results in release of a quantum of energy, in the form of a photon or phonon. The return to a lower energy state is called decay. Fluorescence is a fast decay process, while phosphorescence occurs over a much longer time frame. Decay is the inverse process of excitation. An excited state that lasts a long time is called a metastable state. Examples of metastable states are single oxygen and nuclear isomers. Sometimes the transition to an excited state enables an atom to participate in a chemical reaction. This is the basis for the field of photochemistry. Non-Electron Excited States Although excited states in chemistry and physics almost always refer to the behavior of electrons, other types of particles also experience energy level transitions. For example, the particles in the atomic nucleus may be excited from the ground state, forming nuclear isomers.