Gender Schema Theory Essay Example for Free

Gender Schema Theory Essay Martin and Halverson suggested an alternative to the cognitive-developmental approach proposed by Kohlberg and called it the gender schema theory. In Kohlberg’s theory, children must reach gender consistency before they are able to begin imitating the behaviour of same sex role models. In gender schema theory the early gender identity acquired at about the age of three is the starting point to which children will then begin to look for schemas, schemas are packages of organised clutters of information about gender-appropriate behaviour and children learn these schemas by interacting with people, such as learning which toys to play with, which clothes to wear etc. and these help children to make sense of the world around them and help children to organise their experiences and process new information and also to help self-evaluate themselves, this is to help them feel good about themselves. Support for the gender schema theory was conducted by Martin et al 1995 who showed toys to children aged four to five. Children were informed, before choosing a toy to play with that it was either a girls toy or a boys toy, they were then asked whether they and other boys or girls would like to play with the toys. They found that if a toy, such as a magnet, was given the label of being a boys toy then only boys would play with it. However if boys were told that it was a girl toy then they didn’t want to play with it. Similarly girls would not play with toys labelled for boys. The label given at the start consistently affected the children’s toy preference. It is an important finding in that it highlights the labelling and the categorisation of objects that children are subjected to from a young age, and how their toys can be labelled in the same way as appropriate gender behaviour. A limitation of this research is that an observation of the children and although it has high ecological validity as it is in a real life setting, the children may have shown demand characteristics as the toys were stereotyped for their gender it is questionable if they had guessed the aim of the research and the results may have been due to the children trying to please the researcher as they may have thought they would get punished for choosing the wrong gendered toy to play with and how much of the children’s choice was due to free-will. It was also done in a controlled environment which means that the findings cannot be generalised outside of the research setting. Bauer 1993 wanted to investigate this further and set out to study the way in which children call upon gender schemas when processing information. Pre-school-age and older children have been found to process gender consistent and gender inconsistent information differently so Bauer wanted to see if this was the case in very young children as well. Bauer devised a way to test girls and boys as young as twenty-five months of age. Children observed the experimenter carry out short sequences of stereotypically female, male or gender neutral activities, for example, changing a nappy, shaving a teddy bear or going on a treasure hunt. She tested children by ‘elicited imitation’ both immediately after and 24 hours later to see if they would copy what they had seen. Bauer found that girls showed equivalent quality of recall for all three types of sequence, boys on the other hand showed superior recall of male stereotyped activities, meaning they would not imitate any female behaviour and their recall for gender neutral activities was the same as for male stereotyped activities. These results indicate that boys more than girls tend to make use of gender schemas by the age of twenty-five months and boys appear to remember more accurately event sequences consistent with their own gender, whereas girls show no difference in recall of gender consistent and gender inconsistent information. A limitation of this research is that it could be due to boys being more likely to be penalised by their parents, especially their fathers for carrying out female stereotyped activities, so the children may have played with the male stereotyped toys even if they wanted to play with the other female stereotyped toys. The findings may also be down to that Bauer, who modelled the sequences, is female and the boys may have felt uncomfortable in copying her behaviour. Gender schema theory is parsimonious as it tries to explain gender through cognitive development and does not take into consideration biological gender differences, such as chromosomes, genes or hormones. It is also alpha-bias as it exaggerates the differences between men and women.

Obesity: History, BMI Classification, Determinants and Effects

Obesity: History, BMI Classification, Determinants and Effects OBESITY Obesity is fast becoming a serious epidemic in the United States due partly to eating habits and physical inactivity amongst Americans. According to the Centre for Disease Control, Seventy-three percent of adults and 43 percent of all children in the United States are overweight or obese. Among African-Americans 20 years and over, more than two-thirds are overweight or obese (Gaines, 2010). Generally, the rate of overweight and obesity are higher for African-American and Hispanic women than Caucasian women, higher in the south and Midwest and increases with age (Ogden et al., 2014; Gregg et al., 2009; Sherry et al., 2010). According to the World Health Organization, body mass index (BMI) of an obese person has a value greater than or equal to thirty. Type 2 diabetes and high blood pressure are two diseases that ultimately affect African Americans and this is predominantly caused by an increase in weight as those extra pounds predisposes a person to these diseases (Gaines, 2010). Obes ity is one of the primary risk factor for heart diseases, diabetes and a number of cancers and these are major causes of death in American today. The health implication of obesity and the complications associated with it is increasingly becoming more detrimental than cigarette smoking and has therefore become one of the major preventable causes of death worldwide. This investigation paper focuses on the brief history of obesity; this will take obesity from its discovery over 2000 years to this present day. An understanding of the BMI classification, aetiological determinants, pathophysiology and health effects is important if obesity prevalence will be curtailed. Furthermore, the socio economic impact of obesity management on the United States economy will be looked into. Finally, its treatment options, prevention and trends of the disease will be discussed. HISTORY OF OBESITY The Ancient Greeks were the first to acknowledge obesity as a health disorder and this was further recognized by the Ancient Egyptians in a similar way. According to Hippocrates, corpulence is not only a disease itself, but the harbinger of other diseases (Haslam & James, 2005). Hippocrates which was the Ancient Greek Father of Western medicine acknowledged obesity in his work and details of various diseases including diabetes was first given by him. Another Indian surgeon Sushruta, also discovered the association between obesity, diabetes and heart diseases and he was the first person to find out the significant signs, symptoms, causes and health implications. In the Ancient days, man always strived for food due to scarcity or famine and this resulted in obesity being regarded as a sign of wealth and good fortune in the middle age. However, all this changed when the scientific society of the 20th century revealed the medical implications of obesity (Caballero B., 2007) With the inception of the industrial revolution, body size and strength of soldiers and workers became pertinent as this was attributed to the military and economic power of Nations (Caballero, 2007). The increase in the average body mass index from underweight to the normal on the BMI charts played an important role in the development of industrialized societies (Caballero, 2007).   Therefore in the 19th century, there was an increase in weight and height generally. However, during the 20th century, the genetic potentials for height was reached and this resulted to weight increasing more than height in this century and thus resulted in the average increase in BMI (Caballero, 2007). In human evolution, for the first time, the number of adults with excess weight exceeded the number of those who were underweight which further led to obesity (Caballero, 2007). The perceptions of the public as regards healthy body weight varied from those regarded as normal in the western society, but this perception was changed in the beginning of the 20th century. There was a reduction in the weight seen as normal since 1920s and this was evident by the 2% increase in average height of the Miss America pageant winners and a 12% decrease in weight between year 1922 and 1999 (Rubinstein & Caballero, 2000). Also, the perception of most people as regards healthy weight has changed, for example in Britain the weight at which people regarded themselves to be overweight was considerably higher in 2007 than in 1999 (Johnson & Wardle, 2008). Obesity is still regarded as an indication of wealth and well-being in many parts of Africa and this has become more widespread since the HIV epidemic began (Haslam & James, 2005). BODY MASS INDEX (BMI) CLASSIFICATION According to the World Health Organization, Body Mass Index (BMI) is a simple index of weight-for-height that is commonly used to classify underweight, normal weight, overweight and obesity in adults. It is defined as the weight in kilograms divided by the square of the height in metres (kg/m2) (W.H.O. 2004). For example, an adult who weighs 60kg and whose height is 1.65m will have a BMI of 22.0. BMI = 60 kg / (1.65 m2) = 60 / 2.72 = 22.04 LEAN BODY MASS Lean Body Mass is a component of body composition, it is calculated by subtracting body fat weight from total body weight. Total body weight is lean plus fat. In equations: LBM = BW − BF Lean Body Mass equals Body Weight minus Body Fat LBM + BF = BW Lean Body Mass plus Body Fat equals Body Weight Lean Body Weight (men) = (1.10 x Weight(kg)) 128 ( Weight2/(100 x Height(m))2) Lean Body Weight (women) = (1.07 x Weight(kg)) 148 ( Weight2/(100 x Height(m))2) Ideal Body Weight (men) = 50 + 2.3 ( Height(in) 60 ) Ideal Body Weight (women) = 45.5 + 2.3 ( Height(in) 60 ) Body Mass Index = Weight(kg) / Height(m)2 The table below further explains the classification of BMI in relation to the weight and height of an individual. Table 1: The International Classification of adult underweight, overweight and obesity according to BMI Source: Adapted from WHO, 1995, WHO, 2000 and WHO 2004. BMI values are age dependent and are the same for both males and females (WHO, 2000). The health risks associated with increasing BMI are many and the interpretation of BMI values in relation to risk may vary for different populations in different geographical locations (WHO, 2004). AETIOLOGY DETERMINANTS OF OBESITY Obesity is a heterogeneous group of conditions with numerous causes, it is not merely a single disorder and it is predominantly expressed phenotypically (Susan A.J, 1997). Obesity is hereditary, but the genetic component does not follow simple Mendelian principles and the effect of the genotype on the aetiology of obesity may be decreased or increased by factors that are non-genetic (Susan A.J, 1997). Several factors determine the body weight, and these are interactions of genetic, environmental and psychosocial factors which are in relation to the amount of energy consumed and the amount of energy expended and the resulting acting through the physiological mediators Table 1: The International Classification of adult underweight, overweight and obesity according to BMI of energy intake and energy expenditure and the resulting equilibrium between both (Susan A.J, 1997). ENDOCRINE AND HYPOTHALAMIC DISORDERS Certain endocrinological disorders may lead to obesity, but this applies to a very small percentage of the total number of cases (Susan A.J, 1997). The endocrinological determinants of obesity have been reviewed recently (Bouchard C., Perusse L., Leblanc C., Tremblay A, & Theriault, 1988). The single disorder that causes obesity in this group is hypothyroidism in which increased weight occurs largely as a result of reduced energy expenditure (Susan A.J, 1997). Other endocrinological factors contributing to obesity include Cushing’s syndrome and disorders of corticosteroid metabolism, where weight gain is typically accompanied by a distinctive prototype of fat deposition in the trunk, sex hormone disorders including hypogonadism in men and ovariectomy in women, insulinoma and growth hormone deficiency (Susan A.J, 1997). The key causes of weight gain in these cases are the amount of energy intake. Certain hypothalamic tumors or damage to the hypothalamic part of the brain as a result of excessive exposure to radiation, infectious agents or head trauma can also lead to obesity with defect in appetite control and hyperphagia (Susan A.J, 1997). A hypothalamic disorder is also believed to be the foundation of a number of congenital abnormalities which could also result in obesity, e.g. Prader-Willi syndrome, which is an abnormality that could be a primary cause of obesity (Susan A.J, 1997). GENETIC INFLUENCE At a population level, the genetic influence of obesity is expressed in terms of heritability (Susan A.J, 1997). This refers to the percentage of the total difference in a character which is attributable to genetic factors (Susan A.J, 1997). The heritability of obesity may be considered either in terms of the total fatness of an individual or the distribution of body fat in an individual (Susan A.J, 1997). Several discoveries have been made over the years regarding the influence of genetics on chronic diseases like cardiovascular disease and obesity (R. C. Whitaker, J.A. Wright, M.S. Pepe, K.D. Seidel, &W.H. Dietz., 1997). Recent reports indicate that at least 32 genes contribute to common forms of obesity. Many of these genes are thought to be related to the development of obesity through the deregulation metabolic hormones in the body (Susan A J, 1997).   The obesity related variant in the fat mass and obesity-associated protein also known as alpha-ketoglutarate-dependent dioxygenase FTO, has aroused interest in pediatrics due to its relationship with increased weight and ponderal index at 2 weeks of age (A. Lopez-Bermejo, C.J. Petry, M. Diaz, et al., 2008). FTO is located on the long arm of the chromosome 16 and is expressed in the brain, specifically the hypothalamic nuclei (Khung E. Rhee et al. 2012). Those who are homogenous for the at-risk allele have been found to be 3kg heavier than those who do not have the allele (T.M. Frayling, N. J. Timpson, M. N. Weedon et al. 2007). This weight gain is likely due to the gene’s involvement in the regulation of energy intake (Khung E. Rhee et al. 2012). According to recent studies, individuals carrying the at-risk allele prefer dense energy foods (J.E Cecil, R. Tavendale, P. Watt, M. M. Hetherington, & C.N.A Palmer, 2008), have reduced feeling of satiety (J. Wardle, S. Carnell, C.M.A. Haworth, I.S. Farooqi, S. O’Rahilly, & R. Plomin, 2008), display loss of control over eating (M. Tanofsky-Kraff, J.C. Han, K. Anandalingam et al. 2009), consume more fat and calories (even after adjusting for BMI) (N. J. Timpson, P.M. Emmett, T.M. Frayling, et al. 2008) and display a greater tendency towards consuming palatable foods after eating a meal (J. Wardle, C.Llewellyn, S. Sanderson, & R. Plomin, 2009). Therefore, FTO isn’t associated with energy expenditure, but it increases the susceptibility of individuals to higher calorie consumption and decreased satisfaction. A meta- analysis of 45 studies found that adults who were physically active attenuate the odds of obesity associated with FTO by almost 30% (T.O. Kilpelainen, L. Qi, S. Brage, et al. 2011). Thus carrying a gene for obesity does not necessarily predestine one to be obese (D. Meyre, K. Proulx, H. Kawagoe-Takaki et al. 2010), but rather increases the risk in the face of an obesogenic environment (Khung E. Rhee et al. 2012). Numerous studies in different ethnic groups suggest that the familial correlation in the total body fatness, expressed as body mass index, (BMI; kg/m2) from parent to offspring is about 0.2 and for sibling-sibling relationships about 0.25 (Bouchard C, Perusse L, Leblanc C, Tremblay A, Theriault G. 1988). As would be expected, studies of twins show a much higher concentration, particularly in monozygotic pairs (Susan A.J, 1997). However, these findings do not segregate the independent effects of genetic transmission and a shared environment (Susan A.J, 1997). Further studies of twins reared apart attribute 50-70% of the difference in BMI in later life to genetic factors (Stunkard A, Harris J, Pedersen N, McClearn G. 1990). Adoption studies, where an individual is compared both to their biological parent and their adopted parents, have also demonstrated the importance of genetic influences (Susan A.J, 1997). There is a strong relationship between the BMI of the adoptee and their biological parents across the entire range of fatness, but no relationship between the adoptee and their adoptive parents (Stunkard A, Sorensen T, Hanis C. et al. 1986). Studies of fat distribution have considered both the ratio of subcutaneous to total fat mass and the distribution of subcutaneous fat in the trunk relative to the limbs (Susan A.J, 1997). Data from the Quebec Family Study, suggest that the size of the internal fat stores are more strongly influenced by genetic factors than subcutaneous depots (Bouchard C., Perusse L., Leblanc C., Tremblay A, Theriault, 1988). Familial clustering suggests that genetic factors may account for 37% of the variance in the trunk to extremity skin fold thickness ratio (Rice T, Bouchard C, Perusse L, Rao D. 1995). These combined evidence from these genetic analysis suggests that obesity is a polygenic disorder and that a considerable proportion of the variance is non-additive (Susan A.J, 1997). This would explain the higher correlations between siblings than those between parent and offspring, and the 2-fold greater correlation between monozygotic than dizygotic twins (Susan A.J, 1997). These genetic influences seem to operate through susceptible genes; the occurrence of the gene increases the risk of developing a characteristic but not essential for its expression nor is it, in itself, sufficient to explain the development of the disease (Susan A.J, 1997). Unlike animal models, where a number of single genes can lead to obesity, no human obesity gene has yet been characterized, but the heterogeneous nature of human obesity does not preclude the identification of small number of individuals with a single defect which leads to obesity (Susan A.J, 1997). In man, a number of genetically determined conditions result in excess body weight or fatness (e.g Prader-Willi syndrome or Bardet-Biedl syndrome), but these account for only a very small proportion of the obese population (Susan A.J, 1997). PHYSIOLOGICAL MEDIATORS Energy expenditure Studies in animals have postulated that at the time of overfeeding, a remarkable increase in metabolic rate may deplete the excess energy thus reducing the rate of weight gain below theoretical values (Rothwell N., Stock M., 1983). Genetically obese animals tend to gain more weight than their lean controls even when they are pair-fed, thus implying a greater metabolic rate (Thurby P., Trayhurn P., 1979). One possible explanation for this effect is the decrease in diet-induced thermogenesis which is lessened in animal models of obesity due to a decrease in the sympathetic activation of brown adipose tissue (Rothwell N., Stock M., 1983). These unequivocal effects on energy expenditure in obese animals contrast with the paucity of evidence in humans (Susan A Jebb, 1997). Susan A.J (1997) stated that in obese humans, there have been constant reports of abnormally low energy intake which indirectly imply that there must be a defect in energy expenditure. There are three basic elements to energy expenditure which have each been the focus of extensive research. Basal Metabolic Rate In 1997, Susan A Jebb defined basal or resting metabolic rate as the energy expended by an individual at rest, following an overnight fast and at a comfortable environmental temperature in the thermo neutral range. Several studies of basal metabolic rate have concluded that obese subjects have a higher BMR compared to their lean counterparts. Researchers like Swinburn B. & Ravussin E, reported that approximately 80% of the inter- individual variance in BMR can be accounted for by age, fat-free mass, fat mass and gender. Nevertheless, this still gives room for some likelihood that inter-individual difference in BMR which may influence individuals with a relatively low BMR to become obese (Susan A. Jebb, 1997). Diet induced thermogenesis A number of studies have suggested that the post-prandial increase in energy expenditure is attenuated in obese subjects, perhaps due to decreased Sympathetic Nervous System activity (Astrup A. 1996). Similar effects have also been demonstrated in the post-obese. However this is not a consistent finding, even among studies from the same laboratory. A recent review by Ravussin E. & Swinburn B. (1993) identified 28 studies in favour of a defect in thermogenesis in humans and 17 against. However, since thermogenesis accounts for only a fraction of total energy expenditure (approximately 10%), the potential for a significant effect on total energy expenditure is insufficient (Susan A. Jebb 1997). Physical activity The most significant component of energy expenditure is physical activity which may represent 20-50% of total energy expenditure. Studies of fidgeting movements in Pima Indians within a whole-body calorimeter have shown significant inter-individual variations in the daily energy cost of these actions from 400-3000 kJ/day, with low levels predictive of subsequent weight gain at least in males but not females (Zurlo F., Ferraro R., Fontvielle A. et. al. 1988). However, in free-living conditions, the freedom to undertake conscious physical activity or exercise increases the inter-individual variability even further (Susan A Jebb). Research in this area has been hampered by imprecision in the methods to measure physical activities which have included various actometers, heart rate monitoring, activity diaries and direct observation (Susan A. Jebb, 1997). The energy requirements of an individual encompass the summation of basal expenditure, thermogenesis and physical activity. A whole-body calorimeter can be used to measure the total energy expenditure of an individual. The analysis of total energy expenditure in 319 obese subjects clearly demonstrates a significant increase in energy expenditure with increasing body weight such that individuals with a BMI in excess of 35 kg/m2 have energy expenditure approximately 30% higher than those with BMI less than 25 kg/m2 (Susan A Jebb, 1997). The outstanding difficulty with these studies , as stated by Susan A. Jebb in 1997 is that the increase in energy expenditure seen in obese subjects as a result of their increased body size may mask pre-existing metabolic defects in the pre-obese state which exposes the individual to excessive weight gain. However, in experimental overfeeding researches, there is no remarkable difference in the degree of weight gain between lean and obese subjects when matched for their excess energy intake (Diaz E. Prentice A. M et. al. 1992).   Studies of total energy expenditure in post-obese subjects have not arrived at a definite conclusion; some studies show no difference in energy expenditure in the post-obese relative to never-obese controls (Goldberg G.R., et. al. 1991), whilst others show a modest suppression of energy expenditure (Geissler C. Miller D., Shah M. 1987). In general, there is little evidence to support the hypothesis that human obesity may be due to a specific defect in energy expenditure in predisposed individuals (Susan A Jebb, 1997). Susan A Jebb further stated that advocates of a metabolic basis to obesity, argue that only very small differences in energy expenditure are neccessary to produce significant weight gain over many years, and this difference may be lower than the limits of precision of even the most advanced methodology. Energy Intake The failure to identify a defect in the metabolic control of energy expenditure and the contrary observation of high levels of energy expenditure, and the contrary observation of high levels of energy expenditure in obese subjects has led to a focus on food intake to explain the aetiology of obesity (Susan A Jebb, 1997). The increase in energy expenditure associated with the development of obesity should automatically help to prevent continued weight gain; hence the failure of this auto-regulatory system suggests that there must be a considerable error in the regulation of food intake (Susan A Jebb, 1997). Furthermore, habitually lean individuals are able to regulate intake to match energy requirements over a wide range of energy requirements yet those who become obese seem unable to achieve this balance (Susan A Jebb, 1997).   Breakthrough in discerning the role of energy intake in the aetiology of obesity has been critically disconcerted by under-reporting which is now largely recognized as a feature of obesity (Susan A Jebb, 1997). Comparisons of energy intake and energy expenditure indicate consistent shortfalls in self-reported intake, averaging approximately 30% of energy requirements in obese subjects (Prentice A.M., Black A.E., Coward W.A., 1986; Lichtman S., Pisarska K., Berman E., et al., 1993). This phenomenon also extends to post-obese subjects and to others who may be very weight conscious (Susan A Jebb, 1997). Under-reporting may be cause by several factors and it is natural for individuals to change their eating pattern when they are to record their food intake.   This is usually associated with a reduction in intake as subjects consciously or sub-consciously adopt a self-imposed ‘diet’. (Susan A Jebb, 1997). Therefore they might give accurate results about their intake for that duration, but it may not be a true representation of their habitual pattern. Forgetfulness, underestimation of meal size and lack of basic knowledge of food consumption can also lead to under-reporting. Although, it is possible to have falsification and fabrication of dietary records, there are also instances of self-deception or deliberate manipulation of dietary records. Recent research into the appetite control system by Blundell J.; Bouchard C., Bray G. (1996), has identified a network of synchronous interactions which govern eating behavior. These effects are mediated through the central nervous system particularly the hypothalamus, where a number of neuropeptides appear to regulate feeding behavior via effects on hunger and satiety (Susan A Jebb, 1997). Laboratory studies of feeding behavior by Spiegel T., et al., in 1989, proposed that, following a convert energy preload, obese subject may be less able to accurately compensate for the energy content of the preload at a subsequent meal than lean subjects. However, these studies are usually of short duration in laboratory settings and may not accurately reflect eating behavior in a naturalistic setting, where knowledge of foods consumed and conditioned learning may invoke other regulatory processes (Susan A Jebb, 1997). There is also significant evidence that the individual macronutrients (protein, fat, carbohydrate and alcohol) have different influences on eating behavior, majorly due to their effects on satiety (Stubbs R., 1995). Experimental studies of manipulated foods and retrospective analyses of dietary records suggest that protein is the most satiating (DeCastro J., 1987; Hill A., Blundell J., 1990). Carbohydrate is also an efficient inhibitor of later food consumption, at least in the short terms, meal-to-meal context (Rolls B., et al. 1994). Fat seems to have a satiating capacity (Lawton C., Burley V., 1993). Fat hyperphagia occurs during a single meal due to subjects overeating high fat foods and is also known as passive over consumption. In 1994, Poppitt S., stated that fat has two times the energy per gram of carbohydrate or protein which may be due to the level of energy density and not necessarily a characteristic of dietary fat. Appetite is said to be stimulated by alcohol and according to DeCastro J & Orozco (1990), in free living circumstances, alcohol consumption with meals is associated with higher energy intakes, but this may also reflect that alcohol is more likely to be consumed on special occasions which in themselves are associated with increased food intake. Basically, taste preference can have an effect on the amount of food consumed and the kind of food.   The individual preference for certain meals would make them more likely to consume more of that meal. Therefore, sensory preferences plays a role on energy balance since is it associated with energy intake. According to Witherley S, Pangborn R & Stern J (1980), several reports of sensory preferences for particular food groups in association with obesity, but inter-subject variability is so great as to obscure any underlying obese-lean differences. The relationship between sensory preference for fat versus sugar and BMI was pinpointed by Drewnowski in 1992. Obese women had preference for foods with high fat to sugar ratio while women with low BMI had preference for high sugar to fat ratio, therefore increase in weight is closely related to increase for fatty foods. Eating frequency has effect on weight gain, because people who eat several small meals at intervals have less weight than those that eat fewer meals in larger quantity and therefore large quantity of food consumed at a time may be a risk factor for obesity, however, studies as regards this, showed no remarkable relationship (Bellisle F, McDevitt R, Prentice A.M. 1997). Research in this area is contradicted by under-reporting of food consumption in obese subjects and by post-hoc variations in eating patterns as a result of obesity and efforts to control weight (Susan A Jebb, 1997). Eating frequency in obese subjects is however an unreliable blueprint to the eating patterns involved in the aetiology of obesity (Susan A Jebb, 1997). ENVIRONMENTAL INFLUENCE Obesogenic environment which was first coined in the 1990s, in a bid to explain the present obesity epidermic. According to King D (2007), obesogenic environment is the sum of the influences that the surroundings, opportunities or conditions of life have on promoting obesity in individuals and populations. This encompasses the cultural, social and infrastructural conditions that affect the ability of a person to embrace a healthy lifestyle. Individuals in a population respond to unhealthy environment and the more urbanized the environment, the more individuals are pressurized to adopt unhealthy habits. The pressure from the surrounding makes it difficult for individuals to change their lifestyle and practice healthy habits when the environment itself is unhealthy. Environmental factors may have a critical effect in the development of obesity by unmasking genetic or metabolic susceptibilities (Susan A.J, 1997). Environmental influences on diet involve a wide range of factors including accessibility to food and high calorie drinks. Eating habits are commonly influenced by the availability and accessibility of unhealthy food, which is an important consideration in the effect on obesity. Studies in the United States recommend that the availability of high quality, affordable ‘healthy’ food is limited for people who reside in low-income communities and such scarcity is associated with unhealthy diet and obesity (White 2007) .However despite several epidemiological studies that shows environmental influences play an important role in the aetiology of obesity, it is a fact that some people within the same ‘unhealthy environment’ still managed to maintain a healthy weight (Susan A.J, 1997). PSYCHO-SOCIAL INFLUENCES Food is sometimes used as a coping mechanism by individuals with weight issues, especially when they are unhappy, nervous, stressed, bored and depressed. In many obese individuals there seems to be a perpetual cycle of mood disturbance, overeating, and weight gain (Jennifer C. Collins & Jon E. Bentz 2009). When they feel frustrated, they rely on food for comfort, even though this coping mechanism may pacify their mood, the resultant weight gain that results may cause a dysphoric mood due to their inability to control their stress (Jennifer C. Collins & Jon E. Bentz, 2009). Eventually a guilty feeling may restart the cycle and might steer a habitual pattern of eating food to get comfort. This habitual pattern is specifically significant if there is a genetic risk factor for obesity or an ‘obesogenic’ environment where foods high in calorie & density are readily accessible and sedentary lifestyle is present. Regrettably, these situations are popular in America. In addition to depression and anxiety, other risk factors include problematic eating behaviors such as â€Å"mindless eating,† frequent snacking on high calories foods, overeating, and night eating (Glinski J., Wetzler S., Goodman E.2001). American Psychiatric Association has currently included Binge eating disorder (BED) in an appendix of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and is characterized by: recurrent episodes of eating during a discrete period of time (at least 2 days a week over a 6 month period); eating large quantity of food than majority of the people would eat at the same time; a feeling of loss of control during the episodes; and guilt or distress following the episodes (Jennifer C. Collins & Jon E. Bentz, 2009). According to Wadden T.A., Sarwer D. B., Fabricatore A. N., Jones L., Stack R., & Williams N.S (2007), BED is estimated to occur in approximately 2% of the general population and between 10% and 25% of the bariatric population. An important differentiation pointed out by the American Psychiatric Association, between BED and bulimia/anorexia is that BED is not associated with any regular compensatory behaviors, such as purging, fasting, or excessive exercise. It can therefore be implied that the majority of individuals with BED are overweight. Night eating, which was first identified in 1955 as another disorder that can lead to remarkable weight gain, though night eating syndrome (NES) is not currently recognized by the American Psychiatric Association as a distinct diagnosis in the DSM-IV-TR. Night eating syndrome is characterized by excessive late night consumption (> 35% of daily calories after the evening meal), unhealthy eating patterns, â€Å"morning anorexia,† insomnia, and distress (Stunkard A. J., Grace W. J. & Wolff H. G. 1955). NES occurs in approximately 1% of the general population and an estimated 5-20% of the bariatric population (Wadden T.A., Sarwer D. B., Fabricatore A. N., Jones L., Stack R., & Williams N.S. 2007). More recently, NES has been seen as a disorder of circadian rhythm that includes a delay of appetite in the mornings and the continuation of appetite and over consumption of food during the night (Jennifer C. Collins & Jon E. Bentz, 2009). PATHOPHYSIOLOGY OF OBESITY There are several possible pathophysiological mechanisms involved in the advancement and prolongation of obesity. This field of research had been almost unapproached until the leptin gene was discovered in 1994 by J. M. Friedman’s laboratory (Zhang, Y., Proenca, R., Maffei, M., Barone, M., Leopold, L., Friedman, J.M., 1994). These researchers proposed that leptin was a satiety element. However, soon after J. F. Caro’s laboratory could not ascertain any mutations in the leptin gene in humans with obesity. In 1995, Considine, RV; Considine, EL; Williams, CJ; Nyce, MR; Magosin, SA; Bauer, TL; Rosato, EL; Colberg, J., & Caro, J.F. proposed a contrary view that Leptin expression was increased, postulating the possibility of Leptin-resistance in human obesity. Since the discovery of leptin, insulin, ghrelin, orexin, cholecystokinin, adipokines, peptide tyrosine tyrosine, as well as many other mediators have been researched. The adipokines are intermediators produced by adipose tissue; their action is thought to revise many obesity-related diseases. Leptin and ghrelin are considered to be interrelated in their effect on appetite, with ghrelin produced by the stomach regulating short-term appetitive control (i.e. hunger pangs when the stomach is empty and satiety when the stomach is stretched). Leptin is created by adipose tissue to signal fat storage reservoirs in the body, and mediates long-term appetitive controls (i.e. to eat more when fat storages are low and less when fat storages are high). Although administration of leptin may be effective in a small subset of obese humans who have deficiency in leptin, most obese humans are considered to be leptin resistant and have been found to have high levels of leptin (Hamann A., & Matthaei S. 1996). This resistance is thought to explain in part why administration of leptin has not been shown to be effective in suppressing appetite in most obese people (Flier J.S. 2004). Leptin and ghrelin act on the hypothalamus and are produced peripherally. They control appetite through their actions on the central nervous system. They act on the hypothalamus, a region of the brain central to the coordination of food consumption and energy expenditure. There are several circuits within the hypothalamus that contribute to its performance in integrating appetite, the melanocortin pathway being the most well understood (Flier J.S. 2004). The circuit starts with an region of the hypothalamus, the arcuate nucleus, that has outputs to the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH), the brains feeding and satiety centers, respectively (Boulpaep, Emile L., Boron, & Walter F. 2003). According to Flier J.S. (2004), the arcuate nucleus contains two distinct groups of neurons; the first group co expresses neuropeptide Y (NPY) and agouti-related peptide (AgRP) and has stimulatory inputs to the LH and inhibitory inputs to the VMH and the second group coexpresses pro-opiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART) and has stimulatory inputs to the VMH and inhibitory inputs to the LH (Flier J.S. 2004). Consequently, NPY/AgRP neurons stimulate feeding and inhibit satiety, while POMC/CART neurons stimulate satiety and inhibit feeding (Flier J.S. 2004). Both groups of arcuate nucleus neurons are regulated in part by leptin. Leptin inhibits the NPY/AgRP group while stimulating the POMC/CART group (Flier J.S. 2004).   Researches done by Flier J.S., 2004, thus concluded that a deficiency in leptin signaling, either via leptin deficiency or leptin resistance, leads to overfeeding and may account for some genetic and acquired forms of obesity. EFFECT ON HEALTH Obesity is a severe medical condition and a chronic health issue worldwide. The association between body weight and mortality is a subject of concern, especially in regards to the optimal weight for longevity (JoAnn E. Manson, M.D., Walter C. Willett, M.D., et al, 1995). The significance of understanding the true relationship between weight and mortality is underlined by the increasing prevalence of obesity in the United States (Kuczmarski RJ, et al, 1994) especially women (Harlen WR, et al, 1988). Obesity is a major risk factor for cardiovascular diseases (e.g., heart disease, stroke and high blood pressure), diabetes (e.g. type 2 diabetes), musculoskeletal disorders (e.g., osteoarthritis), some cancers (e.g., endometrial, breast, and colon cancer), high total cholesterol or high levels of triglycerides, liver and gallbladder diseases, sleep apnea and respiratory problems, reproductive health complications such as infertility and mental health conditions (WHO, 2012). Obesity and Cancer Obese people are more vulnerable to cancer and their prognosis is extremely worse when diagnosed. Men that are obese are 33% more likely to die from cancer and obese women also have a 50% higher likelihood of dying from breast cancer (Weight Management Centre, 2010). Additional to obesity, cancer has recently been linked to diet and physical activity status (Bray 2004, Barnard 2004, Wiseman 2008). The cancers most significantly associated with obesity in women are cervical, uterine, kidney, breast and endometrial cancer and in men are colon, pancreatic and liver cancer (Calle, Rodriguez, Walker-Thurmond & Thun 2003). One study, using National Cancer Institute Surveillance, Epidemiology, and End Results data, estimated that in 2007 in the United States, about 34,000 new cases of cancer in men (4 percent) and 50,500 in women (7 percent) were due to obesity. The percentage of cases attributed to obesity varied widely for different cancer types but was as high as 40 percent for some cancers, particularly endometrial cancer and esophageal adenocarcinoma (National Cancer Institute, 2012). Obesity and cardiovascular disorders Cardiovascular disease (CVD) is one of the major cause of death in U.S. Obese people are more liable to die from CVD largely due to accelerated atherosclerosis, hyperlipidaemia, loss of glyceamic control and hypertension. Until recently the relationship between obesity and coronary heart disease was viewed as indirect, i.e., through covariates related to both obesity and coronary heart disease risk (Lew E.A., Garfinkel L., 1979) including hypertension; dyslipidemia, particularly reductions in HDL cholesterol; and impaired glucose tolerance or non–insulin-dependent diabetes mellitus. Insulin resistance and accompanying hyperinsulinemia are typically associated with these comorbidities (Reaven G.M., 1988). Although most of the comorbidities linking obesity to coronary artery disease increase as BMI increases, they also relate to the total distribution of body fat. Long-term longitudinal studies, however, indicate that obesity as such not only relates to but independently predicts coronary atherosclerosis (Manson J.E., et al., 1995; Garrison R. J., et al. 1985; Rabkin S.W., 1977). Messerli F. H. (1982) stated that left ventricular hypertrophy is mostly seen in patients with obesity and is related to systemic hypertension and may be related to the severity of obesity. Hypertension is approximately three times more commonly found in obese individuals than normal-weight persons (Van Itallie T.B., 1985). This relationship may be directly related such that when weight increases, there is an increase in blood pressure (Kannel W.B., Brand N., et al., 1967) and when weight decreases, blood pressure also decreases (Reisin E., Frohlich E.D., et al., 1983). Obesity and mental health Individuals diagnosed with obesity tend to be less favorable on all levels of the psychological assessment and may exhibit several symptoms ranging from mere sadness to chronic depression. Evident are more episodes of mood swings, anxiety, personality and eating disorders, basically related to or associated with obesity experienced by individuals with obesity (Pickering, Grant, Chou, Compton 2007). Obesity may be an inception of psychiatric manifestations and vice versa and is related to psychosocial deterioration and bias based on weight. This comprises of loss of self-worth, and reduced self-esteem associated with stigmatization. Stigmatization can further lead to desolation and withdrawal and thus many obese individuals seek solace in binge eating, thereby gaining more weight. Based on reports from Roberts, Deleger, Strawbridge & Kaplan 2003; Herva, Laitinen, Miettunen, Veijola, Karvonen & Lasky 2006; Kasen, Cohen, Chen &Must 2008, concern, shame and guilt associated with low self-worth, which is finally related to excessive food consumption completes the obesity-mental disorder circle. There is bias and discrimination associated with obesity. They generally report reduced quality of life and functional wellbeing, collectively called Health-related quality of life (HRQOL) (Puhl & Brownell 2001; Wadden & Phelan 2002). This relationships is majorly expressed by women (Fontaine 2001) and for people with severe obesity (Hudson, Hiripi, Pope & Kessler 2007; Scott, Bruffaerts, Siomn, Alonso, Angermeyer, de Girolamo et al. 2008). Obesity and diabetes Diabetes is usually a terminal illness. i.e. it is a lifelong chronic disease characterized by high levels of sugar in the blood. One of the major risk factors for diabetes is obesity. Obesity is directly associated with Diabetes 2. The association between obesity and type 2 diabetes are firmly established and without the intervention of a healthy diet and proper exercise, obesity can lead to type 2 diabetes over a very short period of time.   In fact, obesity is believed to account for 80-85% of the risk of developing type 2 diabetes, while recent research suggests that obese people are up to 80 times more likely to develop type 2 diabetes than those with a BMI of less than 22 (National Health Service, 2014). It is a known fact that obesity carries a greater risk of developing type 2 diabetes, especially if you have excess weight around your abdomen. Studies postulates that abdominal fat causes fat cells to releases ‘pro-inflammatory’ chemicals, which can reduce the body’s sensitivity to the insulin, this can also disrupt the function of insulin responsive cells and their ability to react to insulin. This is known as insulin resistance   which is a primary activator for type 2 diabetes. Excess abdominal fat is a major high-risk form of obesity. SOCIO-ECOMOMIC/ FINANCIAL COST OF OBESITY In 1999-2000, nearly 65 percent of U.S. adults were either obese or overweight. Obesity accounts for $117 billion a year in direct and indirect economic costs. Obesity is associated with 300,000 deaths per year, and is fast becoming the leading cause of preventable deaths† (Mancino, Lin, and Ballenger, 2004). Certainly, obesity has become a large problem in America. Recent increase in meal portions and reduction in availability of natural food production may propose why people find it challenging to maintain a healthy diet. Although, certain People have been successful at maintaining a healthy nutritional status and avoiding this unhealthy situation. Gary Becker’s human capital theory is a groundwork that helps to clarify the effect of weight status on the economy in terms of the labor market outcomes for the individual. Human capital is the educational qualification, job experience/training, and the health condition that workers devote their time in to boost their capacity and skills to be â€Å"rented out† to employers (Ehrenberg and Smith, 2005). Healthy weight status in relation to labour is a type of human capital investment. According to Robert Pindyck and Daniel Rubinfeld (2004), â€Å"When an investment decision is made, the investor commits to a current outlay of expenses in return for a   stream of expected future benefits.† These stated costs for a healthy weight may include buying of food with high nutritional values and creating time for physical activities. As an investment, the individual sacrifices money, time and other resources to attain a healthy weight to become more productive in the future and, hence, earn higher income. Obese workers miss more days of work and inflict more cost on employers especially in medical and disability claims and also workers compensation claims. As a result, firms end up with extra costs associated with obesity, this is one of the economic effects of obesity. Obesity places significant burden on the society through health care expenditures and disability payments combined through group health insurance and public programs. The estimated annual medical cost of obesity in the U.S. was $147 billion in 2008 U.S. dollars; the medical costs for people who are obese were $1,429 higher than those of normal weight (CDC, 2011). Obesity there has direct and indirect effect on the Nation’s resources, as more money is spent on the obese due to the high risk of comorbidity with other life threatening diseases like type 2 diabetes, osteoarthritis and cardiovascular diseases. TREATMENT There are several weight-loss schemes available but many are ineffectual and short-term, especially for those who are morbidly obese. The strategies for weight loss with non-surgical programs usually involve a combination of diet modification, behavior modification therapy and appropriate exercise. Dietary Modification Dietary modifications for obesity are designed to create a negative energy intake-energy expenditure balance (i.e., calories consumed < calories expended) by reducing daily energy intake below the required level. The required energy varies by weight, sex and level of physical exercise such individuals with higher weights, more activity have greater energy needs, including men (Melanson K. & Dwyer J. 2002). Uniformly, higher energy deficits results in higher weight losses. Low calorie diet is recommended for obese individuals and they are advised to check calorie content of meals before consumption. Very low calorie diet is recommended for morbidly obese individuals with little or no success in low diet consumption. Behaviour Therapy The oldest report of the use of behavioral therapy in the management of obesity occurred in 1967. Since then, it has been widely used in the management of obesity (Gupta R. & Misra A. 2007). Behavior therapy involves setting out goals and principles to patients to aid their adherence to the diet modification and activity goals for weight loss. Conventional tactics include self-monitoring of food intake and exercise, reduced portion of meals and number of times of food intake, intellective restructuring, problem solving, and prevention of regression. The primary aim of behavior modification therapy is to change eating pattern and exercise practices to promote weight loss (CDC, 2011). Components of behavioral therapy Self-monitoring: This is one of the main elements of behavior therapy in obesity. Self-monitoring includes maintaining food dairies and activity logs (Guare J.C., et. Al., 1989).Stimulus Control: This is the second key element in behavior therapy. In this element, focus is placed on altering the environment that initiates eating and modifying it to help prevent overeating. Stimulus control includes proper purchase of food items, excluding energy-dense processed food and introducing more fruits and vegetables (Wing R.R., 2004) Slower eating: Reducing the speed of eating so as to allow signals for fullness come into play.Goal setting: Setting realistic goals for one’s self or setting goals for patients as appropriate (Bandura A. & Simon K.M., 1977). Behavioral contracting: Reinforcing of successful outcomes or rewarding good behaviors plays a key role (Volpp K. G., et. al., 2008).Education: Nutritional education is a necessary component of a successful behavior therapy for obesi ty. A structured meal plan in conjunction with consultation with a dietician will be helpful (Pedersen S. D., et. al., 2007).Social support: Behavioral modification is more sustainable in the long term when there is social support. Enhancing social support is essential for behavioral therapy (Avenell A. et. al., 2004). Physical activity Physical activity is the third component of non-surgical weight loss interventions and lifestyle modification. The advantages of physical activities include promoting negative energy balance by maximizing calorie expenditure, preserving fat-free part during weight loss, and improving cardiovascular fitness. Physical activity, however, is ineffective in weight loss in the absence of diet modification. The greatest benefit of physical activity is in facilitating the maintenance of weight loss (Pronk N.P & Wing R.R. 1992). Case studies have shown that people who exercise regularly are more successful in maintaining weight losses than are those who do not exercise. Kayman S., Bruvold W., Stern J.S. 1990; Klem M.L., Wing R.R., McGuire M.T., Seagle H.M., Hill J.O.1997). Additional evidence comes from randomized trials. Participants who receive diet plus exercise maintain greater weight losses 1 year after treatment than do those who receive diet alone, although the differences are not always statistically significant (Wing, R.R. 1999). PREVENTION Obesity is a long-lasting medical condition, which is linked with several debilitating and life-threatening conditions. The increasing rate of obesity globally is a public health concern (Srinivas N., et. al., 2004). Hence an effective way to control obesity requires strategies that would tackle the major issues relating to prevention (Srinivas N., et. al., 2004). The treatment and prevention of obesity are interrelated. The prevention of obesity involves several levels i) Primary ii) Secondary iii) Tertiary (Timothy P.G., 1997). Primary prevention: The goal of primary prevention is to reduce the number of new cases. Diet modification/ healthy diet habits is a primary way of preventing obesity. Sedentary life style which is one of the causes of obesity can be prevented by appropriate exercises and activities that help burn out excess calories in the body and also prevent accumulation of fat. Simple habits ranging from 30 minutes walk in a day to weekly work out at the gymnasium can go a long way in maintaining a healthy weight. Health education is also very important in this aspect because some individuals in the community are unaware of the health implications of their habits. Appropriate health education programs should be organized to increase awareness. Accessibility to healthy food is also an important factor in the prevention of obesity. Formulations of policies that would facilitate healthy eating habit should be adopted by the Government; this would go a long way in reducing the economic effects of ob esity and the burden on the Nation’s resources. Policy and environmental approaches that make healthy choices available, affordable and easy can be used to extend the propagation of strategies designed to raise awareness and support people who would like to make healthy lifestyle changes (CDC, 2011).Secondary prevention: Secondary prevention is to lower the rate of established cases in the community (Srinivas N., et. al., 2004). Secondary prevention includes strategies to diagnose and treat an existing medical condition in its early stage to avoid complications. (Jeffery G.K., 2014). Tertiary prevention: Tertiary prevention is to stabilize or reduce the amount of disability related to obesity ((Srinivas N., et. al., 2004). For those who are already obese and showing signs and symptoms of complications, there are clinical preventive maintenance and treatment regimes (Srinivas N., et. al., 2004). These treatment includes medications and increase in fruit and vegetable consumpti on. Some extreme cases may include surgery and this is used usually when BMI exceeds 30kg/m2 or 40 kg/m2 and when other treatment options have failed. Examples of surgical procedures to treat obesity and its complications includes gastric partitioning and gastric by-pass (Srinivas N., et. al., 2004). REFERENCES Allison, B. D., Fontaine, R. K., Manson, E. J., & VanItallie, B. T. (1999). Annual deaths attributable to obesity in the United States. Journal of American Medical Association , 282 (16), 1530-8. Barness, A. L., Opitz, M. J., & Gilbert, E. (2007). Obesity: Genetic, molecular and environmental aspects. American Journal of Medical Genetics , 143 A (24), 3016-3034. Calle, E. E., Thun, J. M., Petrelli, M. J., Rodriguez, C., & Heath, W. C. (1999). Body mass index and mortality in a prospective cohort of U. S. adults. New England Journal of Medicine , 341 (15), 1097-105. Cawley, J., & Meyerhoefer, C. (2012). The medical care costs of obesity: An instrumental variables approach. Journal of Health Economics , 31 (1), 219-230. CDC.gov. (2011). National Diabetes Fact Sheet. Retrieved November 29, 2014, from Center for Disease Control and prevention http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf Flegal, M. K., Ogden, L. C., Wei, R., Kuczmarski, L. R., & Johnson, L. C. (2001). Prevalence of overweight in US children: Comparison of growth charts from the centre for disease control and prevention with other reference values for body mass index. American Journal of Clinical Nutrition , 73 (6), 1086-93. Glenny, A., & et, a. (1997). A systematic review of the interventions for the treatment of obesity and the maintenance of weight loss. International Journal of Obesity and Related Disorders . Gray, S. D., & Fujioka, K. (1991). Use of relative weight and body mass index for the determination of adiposity. Journal of Clinical Epidermiology , 44 (6), 545-550. Haslam, W. D., & James, P. W. (2005). Obesity. Lancet , 366 (9492), 1197-1209. Healthy weight: Assessing your weight; BMI: About BMI for children and teens. (2009, April). Retrieved April 2009, from Centre for Disease Control and Prevention. Miech, A. R., Kumanyika, K. S., & Stettler, N. (2004). Trends in the association of poverty with overweight among US adolescents. Journal of American Medical Association , 2385-2393. Mokdad, H. A., Marks, S. J., Stroup, F. D., & Gerberding, L. J. (2004). Actual causes of death in the United States, 2000. Journal of American Medical Association , 291 (10), 1238-45. Ogden, L. C., Flegal, M. K., Carroll, D. M., & Johnson, L. C. (2002). Prevalence and trends in overweight among US children and adolescents, 1999-2000. Journal of the American Medical Association , 288 (14), 1728-1732. Popkin, M. B., Adair, S. L., & Ng, W. S. (2012). Global nutrition transition and the pandemic of obesity in developing countries. Nutrition Reviews , 70 (1), 3-21. Sturm, R. (2007). Increases in morbid obesity in the USA: 2000-2005. Journal of Public Health , 121 (7), 492-6. Sweeting, N. H. (2007). Measurement and definitions of obesity in childhood and adolescence: Afield guide for the uninitiated. Nutritional Journal , 6 (1), 32.

Character Study in Manual Puigs Kiss of the Spider Woman Essay

Character Study in Manual Puig's Kiss of the Spider Woman On the surface, Manual Puig's Kiss of the Spider Woman is about politics and oppression. Caged literally and figuratively in an existential cell, both Molina and Valentin are wards of a police state and are therefore powerless to change their circumstances. But the novel is really about how spiritual freedom is cultivated and made manifest by Molina's retelling of his favorite movies. Because the substance of the films is first filtered through Molina's perspective, his perversion of the characters and plots reflect his own progression from an oppressed prisoner to a heroine who freely chooses the path to her own death. That Molina identifies himself with the heroines in the films is unmistakable by the end of the novel. In the first movie he tells to Valentin, a woman who involuntarily changes into a panther whenever she kisses a man is parallel to Molina's life as a homosexual man in a society that condemns him. The panther woman's love is dangerous, and so is Molina's. His fatalistic view of his place ...

Affirmative Action Essay -- Affirmative Action Essays

What can be done about the majority of higher paying jobs going to the white males, and the issue of racial/sexual discrimination in both the workplace and in education? To this, the government already has its so-called solution†¦ affirmative action. Affirmative action forces businesses and colleges to hire a certain number of minorities including women, so as to fill a government assessed quota. The solution is not to get even with the white males by disregarding either their hard work through high school to achieve the grade to get into their desired college or their superiority over a competitor for a job position just because the competitor happens to belong to a minority group. Affirmative Action was created to make up for past prejudices in an effort to create more equality between majorities and minorities. It requires businesses to hire a certain number of blacks, Asian, Latin-American, and women so that it will create more opportunities for people of minorities. Colleges also require a less severe requirement for those of a minority party because the number of the people that did fit the requirement would not fit the quota. Thus, many more deserving majority Americans were denied jobs and acceptance to college because the quota had to be met. Firstly, Affirmative Action promotes the hiring of less skilled workers, thus creating reverse discrimination. It upsets employers, forcing them to choose the best employee from a limited pool of minorities, not just si...

Sir Gawain and the Green Knight :: Sir Gawain Green Knight Essays

Sir Gawain and the Green Knight Sir Gawain and the Green Knight is a Middle English romance poem written by an anonymous West Midlands poet also credited with a lot of other poems written during that time. The protagonist, Sir Gawain, survives two tests: a challenge, which he alone without the assistance of King Arthur's knights accepts, to behead the fearsome Green Knight and to let him retaliate a year later at the distant Green Chapel; and the temptation to commit adultery with the wife of Lord Bercilak--in reality the Green Knight--in whose castle he stays in en route to the chapel. This story is emblematic of life; how it issues tests and challenges and the consequences rendered as a result of failing or succeeding these challenges. Sir Gawain is a very symbolic character; symbolic in the sense that he represents innocence in life. He was not afraid to accept a challenge because it meant saving the kingdom from the affects of anarchy as a result of not having a king. Sir Gawain accepting the challenge from the Green Knight instantly represented one of the things that knighthood represented, fearlessness. People accept those kind of challenges everyday. This could possibly be where the term "sticking your neck out" could have come from. When people accept challenges, most do not want to accept the consequences as a result of being unsuccessful. Gawain was not like this. When the year passed he gallantly mounted his horse and set off for the Green Chapel. This showed that Gawain was brave. This was preceded by the warning "Beware, Gawain, that you not end a betrayer of your bargain through fear." Along this journey Gawain faces peril and self-reluctance in the form of the elements and the never-ending search for the chapel respectively. These feeling can be characterized as the inner turmoil suffered as a result of dealing with one's conscience. The journey also tested his faith in the sense that he was constantly in prayer during his journey, and not once did he curse or renounce the name of God. It seems as if the prayers were what kept Gawain sane and focused on the purpose of his journey. Gawain's prayers were answered when he rode along and finally came upon a place that he could petition for possible rest.

Communication Problems Between Teenagers And Adults Essay

From the beginning of time teenagers and adults have always had conflicts with each other. These conflicts occur most of the time because of the lack of communication between the teenager and the adult. The generation gap between the teenager and the adult can play a role in the problems they have communicating. The superior adult has the instinct that whatever the inferior teenager does can lead to bad things, and lectures the teenager about it. Most of the time teenagers have many other sources of advice they can listen to, and it seems that the adult can become the last resort or not a resort at all. The generation gap, the feeling of being inferior and superior, and the other sources of advice can play a big part in the problems teenagers and adults have communicating. Both parties have an equal role in communicating with each other. But the choice comes down to the two willing to take that particular role. The generation gap between teenagers and adults plays a huge part in why they have problems communicating with each other. The adult who had a very different lifestyle and childhood then that of a teenager may have a different view on life. Things unheard of years ago to the adults can now have rational reasoning through the advance of technology. For a teenager to talk to an adult, on a subject that the adult has no idea on can almost become impossible. Still living in the last decade, adults may not correspond with the thinking of today’s youthful teenagers. The age difference between the teenager and the adult plays a huge role in the game of communicating between the two. The superior adult has always had the impulse to contradict the ideas of the inferior teenager, and lecture the teenager on the teenager’s wrongful ways. The more mature adult thinks that he or she has more knowledge than the younger teenager and sees that the teenager may benefit from the lecture. This gives a feeling of uneasiness in the teenager and makes them very irritable. Many verbal conflicts have aroused after the adult has given his or her point of view in the lecture. The adult often times makes the teenager feel inferior to him or her in the lectures. The teenager feeling inferior, who has a lot on his mind, may not express what he or she really  feels to the adult. This state of feeling inferior and superior between the teenager and adult does not help solve the problems they have communicating. Teenagers talk to so many friends about things they have in common with, it makes talking to an adult like taking to a person on the other side of the planet. Teenagers have so many other options on expressing what they think, that it seems very difficult talking to an adult. The teenager could always first go to a close friend of theirs if they had something on their mind. Teenagers going to adults for help can lead to more problems because the two may not agree on the same thing. This example goes the same way with an adult. If an adult has something on his or her mind and has to express it some way, he or she will go to another adult who would have the same ideas on it. The lack of respect they have for one another can explain the problems they have in communication. Problems and conflicts occur all the time among teenagers and adults. The hurdle of communication can sometimes become the hardest obstacle teenagers and adults have to overcome. The trouble of the two communicating can lead to a very tough relationship or lead to no relationship at all between the two. The two must try to have better communication with one another if they want to improve the relationship between them. The leading responsibility for this problem can have something to do with the generation gap of the two, the feeling of inferior and superior, and the abundant sources of advice. One person cannot fight the communication battle alone. With the help of both sides this war on communication can lead to a victory for both teenagers and adults.

Enterprise Rent-A-Car Strategy Essay

Enterprise Rent-A-Car is one of the largest car rental companies in North America. It specializes in providing customers temporary or a replacement vehicle. Jack Taylor founded the company in 1957 where he started Enterprise Rent-A-Car as an Executive Leasing Company with only seven cars. The company began leasing cars for longer periods. Later on executive leasing launched itself as a short-term rental operation with 17 cars plus a car sales division. That’s when the company changed its name from Executive Leasing to Enterprise Leasing. Established in St. Louis, Missouri, their number of rental units began rising and by the mid 70’s the number of rentals hit 5,000. Enterprise also started offering fuel, maintenance and insurance products. In the 90’s, Enterprise expanded its operations into the UK and Canada. In 2004, Enterprise started its Month or More service to both business and retail consumers with rental vehicles. Then in 2007, Enterprise expanded into Puerto Rico and the Caribbean. In addition, Enterprise purchased Vanguard Car Rental; National Car Rental and Alamo Rent a Car businesses from Cereberus Capital Management. In 2008, Enterprise and the St. Louis Car Sharing Cooperative launched WeCar which is an environmentally friendly car sharing program. Enterprise now operates more than 713,000 vehicles including more than 120 different makes and models. It also has more than 8,000 rental offices and operates 230 on-site airport locations throughout the United States, Canada, UK, Germany and Ireland. http://aboutus.enterprise.com/ 1. The strategy Enterprise is using and its components Business Strategy Enterprise’s strategy is to achieve and fulfill its mission by Jack Taylor’s  philosophy: â€Å"Take care of your customers and employees first, and profits will follow† Key elements of Enterprise’s strategy involve long-term loyalty, motivation & promotion. Enterprise employees try to build long-term relationships with customers by over delivering on their promise. Motivation acts as a key component of Enterprise’s strategy. Enterprise motivates its employees to provide exceptional customer service by developing, providing opportunities for growth and giving incentives for their achievements. Enterprise promotes managers from within, which creates a hardworking & motivated work force. Their business motto is to hire smart, motivated individuals and give them the tools to run a business by delivering customer service. Delivering exceptional customer service results in repeat customers, which results in growth at each of the local branches. Followi ng business growth, Enterprise’s strategy is to open more branches and create new opportunities for its current employees. Overall, Enterprise’s strategy is to satisfy its customers and motivate its employees to achieve long-term profitability Product and Market Strategies Enterprise has a management plan that separates them from others providing them with a significant competitive advantage. Enterprise made a decision to sustain a decentralized, professional, and entrepreneurial approach to management. Decision powers are given at the branch level where the employees are also offered unique training programs. Management trainees and interns start at the bottom learning the different aspects of the business and also experiencing different management styles. After working as a management trainee or intern, an individual has the opportunity to be promoted. Promotions are based off of performance and not on seniority. Process is Management Assistant > Assistant Manager (Begin to train, supervise and mentor employees) >Branch mangers >Area manager International Involvement Enterprise international operations are located in: Canada, UK, Ireland,  Germany and Puerto Rico. In addition, the company has more than 900 international car rental branches. The Canadian operation of the company operates a fleet of more than 55,000 vehicles in 500 locations (80 airport locations). European operations for the company are located in the UK, Germany and Ireland. Analyzing the above strategies, Enterprise appears to be adopting a growth strategy. Their strategy entails introducing new locations, adding new features to existing products. Analyzing the Industry Porters Competitive Forces There are many factors that drive competition within the car rental industry. Price competition may not be the only factor; as companies are focused on implementing a value system and long term profitability. In addition, most companies are gradually lessening their focus on their airline operations and focusing on leisure rentals. Threat of potential entrants is low since the established car rental companies have continued to increase their market share. Plus, their competition is fierce within the car rental industry. Alternatives to Business Car Rental include video conferencing, virtual teams, collaborative software, personal cars and public transport. Supplier power within the rental car industry is low. Suppliers do not have a significant influence in supplying cars as there are many. SWOT Analysis STRENGTHS Industry Recognition leading to a strong brand image Large fleet of vehicles Large scale of operations Robust financial performance within the company Top performer in Customer Service WEAKNESSES Concentration of assets Maintenance and cost of repairs No one-way rentals Very capital intensive operations OPPORTUNITIES Recent initiatives Growing global car rental market Increasing use of the internet Bigger presence at airports THREATS Intense competition High labor costs Rising Interest rates Increasing fuel prices Factor Analysis Assessment Political Legislation Environment Company Cars Competition Taxes & Duty Subsidies Keen competition, political issues with specific corporations and high taxes due to the state Economic Excess Capacity Economies of Scale Diversification Mergers and strategic alliances Environmentally safe cars Diversification between competitors Social Car Culture Fashions and Taste Redundancies Consumer taste differentiation Technology E-Commerce Safety Plant Efficiency Online Car Rental Reservation Systems Overall Market Attractiveness The overall market attractiveness for the car rental industry is fairly attractive Consumers will continue to travel and need rental vehicles for insurance replacement rentals and car sharing With low air travel numbers in recent years, the car rental industry has had a slight decline. Consumers will start to travel as the economy begins to recover from recession. On the flip side, non-airport locations are continuing to grow in revenue from people taking local vacations and insurance customers (Appendix 1 indicates revenue for Enterprise went up during recession). Small car rental companies would need to focus on niche markets or risk bankruptcy. As shown in the analysis above, there are multiple political issues including legislation, taxes and duty and company cars. Some consumers would get frustrated with the high taxes E.g. Fuel Tax, Environment Tax and Airport Tax. Economic factors shown above include: Excess capacity, economies of scale, diversification and mergers and strategic alliances. Social factors are when consumers tend to have different tastes on vehicles which will cause them to prefer different makes and models. Technological factors such as E-Commerce, safety and plant efficiency plan is an important part as well. The overall market attractiveness is high as consumers will continue to travel in out of the country and would need to rent vehicles. Consumer Analysis There are four main types of consumers: leisure, business, sharing and leasing. These consumers all have a different perspective on the business and what they went to purchase. Leisure consumers may be interested in purchasing an affordable, economical car whereas a business traveler would opt for the luxury model. 2. The actions management has taken to implement strategy, including key policies and procedures, support systems and management approaches The management of Enterprise Rent-a-Car has taken many actions to implement  their strategy. From hiring educated, competitive, social employees, giving them sense of ownership, encouraging them to be entrepreneurial, and giving its managers autonomy in operating their locations. To supporting corporate innovation in order to identify best practices and apply this knowledge throughout the company, as they did with their world famous slogan†We’ll pick you up†. Development of things such as the Enterprise Rent-a-Car Cultural Compass, to help guide their service oriented employees in interacting with the customer, each other, and the local community. Employees who followed the values of the cultural compass were recognized for their work and encouraged with the Jack Taylor Founding Values Award and a grant for a local non-profit cause. Enterprise Rent-a-Car developed the Enterprise Service Quality Index (ESQi), which provides a score for each branch based on their customer service satisfaction, in order to increase customer satisfaction, and managers were held publicly accountable for their scores. Enterprise used compensation and career advancement incentives along with the ESQi to encourage and promote employees, only if their location’s ESQi score was at or above the corporate average would they be eligible for promotion. Enterprise Rent-a-Car, also used the Automated Rental Management System (ARMS), a system which linked all of Enterprises locations together in order to automatically update and also send vehicle status reports to insurance companies, and in 2006 partnered with FIX AUTO Network to provide more efficient ways of sending collision repair and rental status reports to be monitored by insurance companies. Although Enterprise Rent-a-Car encouraged autonomy amongst its manager, and its employees to be entrepreneurial, it still administered some corporate control over individual locations to ensure consistency and to implement and accomplish its goals. Enterprises actions in all 6 of its market segments: 1. Off-Airport Market- Provided great customer service with great prices, which appealed to leisure travelers and value minded business travelers. 2. On-Airport Market- Offered prices at airports that were on average 20% below the industry average. 3. After-Market/ Used Auto Sales- Established a haggle free buying policy, selling cars below the Kelley Blue Book listed retail value. Also all of Enterprise’s used cars passed a 109-point inspection by an ASE-certified technician and had a 7-day repurchase agreement. 4.  California Vanpool Services- Prices varied according to van size, round-trip distance, and equipment included. 5. Rent-a-Truck- Provided great customer service, customized billing, and 24-hour roadside assistance. 6. International Operations-Enterprise hired locally, bought cars locally, and focused on off airport markets such as providing corporate travel cars, replacement cars, and fleet management. Our assessment of culture and the role it plays in the success of Enterprise Enterprise Rent-a-car culture is based on their core values and what the company lives by. Jack Taylor did not talk about founding values when he started up his business back in 1957 — he and his team just lived by them. They set the example through a personal commitment to the company and its customers. Those values have served as the foundation for their growth and success for more than five decades. And today, this simple, yet powerful set of beliefs is more critical than ever to their continued success; its how they hold themselves accountable everyday. When Jack Taylor founded Enterprise, he clearly articulated his business philosophy. â€Å"Take care of your customers and your employees, and profit will take care of itself.† â€Å"Treat customers the way you would want to be treated as a customer.† â€Å"Repeat customers are the quickest way to build a solid base of business.† â€Å"Never promise what you can’t deliver; deliver more than you promise.† â€Å"After dealing with us, we want customers to say, ‘This is the best place I’ve ever done business.’† Enterprise has remained true to these basic principles. Taylor’s philosophy is also reflected in a tool called the Enterprise Cultural Compass, shown below: The company developed the compass to guide service-oriented employees in conducting business and in interactions with each customer, each other, and their local communities. The compass was also intended to aid employees in focusing on key areas through the organization. To help promote the values depicted in the compass, Enterprise developed an award named the Jack Taylor Founding Values Award, which provided winners with a grant from the  Enterprise Rent-a-car Foundation that could be used for qualified non-profit causes in the winners’ local communities. Employees were expected to adhere to these principles in all of their business dealings. A failure to do so could result in disciplinary action or dismissal. Enterprise Rent-a-car’s Cultural Compass Priorities Operations – Enterprise evaluate the performance of their operating groups based in large part on how their operations maintain a balance between customer satisfaction, employee development, fleet growth and profitability. They know that keeping a healthy equilibrium among these critical factors is essential to steady, long-term growth. Diversity – Enterprise takes pride in understanding and embracing their differences in ways that drive innovation, connect them completely to their communities and make their company a place that is welcoming to all. A diverse supply chain allows their company to foster growth and opportunities for historically underutilized suppliers, while also mirroring the communities in which they operate. Work/Life Balance – Enterprise is providing an atmosphere that challenges all employees to do their best work helps them achieve successful careers and supports them in their efforts to maintain a healthy work-life balance. Sustaining their strong workplace reputation is critical to their ability to attract and retain the best people. Helping their employees achieve higher satisfaction and engagement can drive lower absenteeism, higher productivity, better retention and other outcomes that contribute to their overall success. Business Practices – Enterprise takes pride in exemplifying the highest moral standards. They know that they are held accountable by their actions and their reputation, they adhere to the strictest accounting rules and the highest ethical standards, and those standards apply to every single individual. Enterprise takes pride in holding themselves accountable for such high standards because they know that they are only as strong as their reputation that each of them maintains in the minds of customers, potential customers and employees. Community Relations and Philanthropy – Enterprise is a local company that just happens to have a presence in thousands of neighbourhoods across five countries. They actively support thousands of organizations and donate millions of dollars each year to a variety of causes. They know that business can’t be a one-way street; good  will makes good sense. Government Relations – Enterprise acknowledges that it is only with the support of key community stakeholders that they can continue to grow their business and strengthen their reputation as a responsible corporate citizen and valued member of the community. They must build and strengthen these invaluable strategic partnerships on a national, regional, and local scale. Enterprise values high standards and regard for customers and employees, one can clearly see why they have been winning so many awards for customer satisfaction as well as setting themselves as one of the best employers to work for in Canada. Their culture is based on the their mission, values and high standards for customer satisfaction and employee relations. They base their company on how their founder lived by and they believe their actions are what set them apart from other companies. All of these combined are what play a key role in the success of their company. Having such immaculate standards for themselves is what is helping them be this successful with so much competition. Their customers know that they â€Å"will not promise more than they can deliver and they will always deliver more than they promise.† 4. Our recommendations for the management 1. Enterprise can potentially decide to analyze the need of a strategic alliance or potential merge with one of its competitors. A potential alliance will allow Enterprise to continue to conduct business as usual but will allow them to have a bigger competitive advantage among its main competitors. A merge between Enterprise, a medium to large company in the industry will allow Enterprise to meet its current challenges. This will allow them to match up with its current competition which has recently acquired companies in the auto rental industry and has become the second and third largest auto rental company in the industry. Such a merge will stop the recent increase of the Dollar Thrifty Automotive Group and Budget Rental Group. As well, a merge will allow enterprise to increase its market share with its main competitor in the airport segment of the industry, Hertz. The previously discussed merge will allow Enterprise to grow substantially as a company, it has huge market shares in the off-airport market, however,  lately they have focused on developing their on-airport market, which has lead Enterprise to gain some market share in that segment, Hertz has begun to take notice and challenged Enterprise in the off-airport market. Since Enterprise already has a huge lead in the off-airport market it might be hard for Hertz to catch up to Enterprise but they can surely bother Enterprise. By merging with a company it will allow Enterprise to meet those challenges head on, they can have enough off-airport outlets to crush the potential growth of Hertz as well gain on-airport outlets, which can lead to gaining and taking away market share from Hertz. 2. Enterprise should strengthen relationship with insurance companies it deals with. They can strengthen that relationship by offering those companies special deals for their customers. They can offer cheaper pricing for the rental of their cars in case of an accident. By cutting down their profit margin, Enterprise can increase the loyalty of the current insurance company they have partnered with. As well such attractive pricing can pursued with current insurance companies that have decided to go with Hertz to reconsider and analyze the potential of Enterprise as a c ompany who they will use for their customers that are in need of a car. By doing this they will defeat the potential growth of Hertz in the insurance segment of the markets. 3. Enterprise should invest some money in their technology department. Investing money in the development of technology, Enterprise can have a head start in the need for their customers and develop an app to make it easier for them to either rent a car, find a retail location or book an appointment for an Enterprise employee to pick them up for a car rental delivery or a rental return. By developing an app they will be getting ahead of its main competitors and will increase their customer service. Customer satisfaction will increase since it is the company’s core culture and business model. Entering the app market will increase the positive perception currently and new customers have of the customer service that is offered by Enterprise. Enterprise will have entered a market, which had not yet been tapped into. They will increase their presence in the hospitality part of the market by delivering an easier way for its consumers to gain access to their services. 4. Enterprise should develop or adopt a rewards system that other companies  are using in order to stay competitive. Their competitors, such as National and Budget are currently using rewards program like air miles. Enterprise should adopt this reward system as well; it will be beneficial for the company to do so. First of all, as previously discussed, it will allow them to stay competitive, it will allow Enterprise to tape into a specific niche in the market where it targets customers who are in that air miles program already or are attracted by the fact that they want to be part of a reward program, where they receive things in return for using a product. By taping into this specific niche there could be substantial profit growth since not many companies are offering such programs. Enterprise already has a huge off-airport market share. A program, such as air miles will only strengthen their position in the off-airport market; as well it can increase their growth in the on-airpor t market. Enterprise should also continue emphasizing growth within the company and focus on implementing one of the following strategies: Market Penetration Although Enterprise already has advertisements on television they could focus on a different approach instead of just using the motto, â€Å"We’ll pick you up† such as focusing the commercials on the weekend special deals. Product Development Enterprise could introduce newer models and expand on their luxury car selection. Market Development- Enterprise could continue their global expansion and increase airport locations. Diversification Enterprise could establish a service called â€Å"Rent-A-Bike† We think that Enterprise should step outside of their comfort zone and implement a diversification strategy. We believe creating â€Å"Enterprise Rent-A-Bike† will gain interest in consumers and also expand on annual revenue for the company.