Managing Overtime Worked in the Workplace

In the following report, I will be give illustrations and possible solutions for an overburdening problem that exists in the U.S. Postal service Operations throughout the country. Overtime is an age-old problem that has gone long overdue without someone or a group paying serious attention to correcting this problem. The United States Postal Service is a large organization with many facets of operations; I will be concentrating on what we call the Field Operation or Area Office. This is where the public comes into personal contact with the Postal Service either by way of the individual letter carrier (mailman) or the window clerk who assists with business transacted at the post office. Every community across America has a Post Office. We are one of the most visible employers in the world. The U.S. Postal Service employs approximately 750 thousand diverse people. Many different cultures and nationalities come together to combine as an efficient workforce that gets the job done. The pay is moderate, so it would be pretty difficult to become independently wealthy working for the Postal Service. But, there are some employees that believe if they work, as much overtime as possible, maybe they can become rich. Unfortunately, this poses a daily obstacle to overcome for most managers in the U.S. Postal Service. The U.S. Postal Service is a production driven outfit therefore; everything is based on production verses cost ratio. The average workday for a postal employee is eight hours. It does not take a genius to figure out that the longer it takes to do the job, the more money is made. So, the employee that desires more money would be motivated to take longer to complete his or her assigned task(s). Historically, the Postal Service has been plagued with managers that were not diligent in doing their jobs with regard to overtime management. Because of this clusters of employees became accustomed to a Carte Blanche style of working. Employees were in effect managing the overtime and work production. During my career as a letter carrier, I completed my assigned tasks within my eight-hour shift working overtime only when deemed necessary by my manger. When I became a manager, I expected everyone who worked for me to have the same work ethics that I had. If this was not case, I attempted to force them to work as hard as I did. I later found out that this was not a good management approach. In fact, this was the easiest way to harvest disgruntle employees. Here was my dilemma; I was the new young manager who expected an honest day†s work, for an honest day's pay, paired with a staff that had been allowed to do whatever they wanted for the past ten years. The office of my first management assignment had 90 percent of the employees working an average of 10-16 hours of overtime per week. My performance as a manager as well as well as the production performance for our office was based on the amount of manpower hours used to deliver the total volume of mail. I will present information about the systems put in place that worked as a check and balance format. These systems enabled me to demonstrate to my employees that my requests were not unfair or unreasonable. I will discuss the areas that the employees were able to assist in helping to aleve the excessive use of overtime. I will also discuss in detail areas that contributed to the excessive use of overtime that did not involve my employees. With implementation of the new systems, my office has reduced its overtime to 14 percent.    While controlling overtime may seem as easy as just making an announcement â€Å"that no one is allowed to work overtime†; this is very far from true in the U.S. Postal Service area offices. There are many variables that come into play, the first of which is staffing. In order to do a good job; the office must be properly staffed. We have percentage breakdowns that factor in amounts of carrier routes; amounts of deliveries per zip code that derives to an employee complement. Each office has a number that satisfies their complement. If for any reason a particular office is operating under their complement that makes the task a more difficult. Any office can be fine one week and short the next, due to retirement, injuries, or details to name a few. If any of the aforementioned were to occur a manager could request replacement for these employees, whether they will be granted or not is another story. Then we have the day-in day-out mystery of who will call in on sick leave. Having any of these instances to take place in a given day can simply cripple an operation. If we take a carrier operation anywhere in the world that has 35 city carrier routes and 4 carriers call in sick on a Monday, that manager now has to scramble to get coverage for those four vacant routes. It is not like other organizations where your work can carry over by one day; the mail must be delivered daily without exception. This makes it difficult to get the work done in an eight–hour day for the remaining employees. The first thing the manager must do is to telephone four employees who would normally have the day off and ask them to come in and work their day off. Bare in mind that the U.S. Postal Service has something called an Overtime Desired List, a voluntary list of employees who wish to work overtime on assignments. When the manager telephones employees to come in on their day off, he must first call those on the Overtime Desired List. If the manager does not get four employees from the list, he may then exercise the option to call employees not on the Overtime Desired List. The only alternative to this situation is to have employees already present complete their assignments and pitch in to help deliver the vacant assignments. The advantage of this situation is that it allows you to minimize your overtime usage for the day. If the manager was able to get four employees from the Overtime Desired List to come he has automatically used 32 hours of overtime for that day. By having employees already present work additional hours, you are able to use far less overtime for that day. This is an area I feel managers need to stress to their bosses so that all efforts are exhausted in hiring more employees for offices to operate under their complement. The earlier mentioned example could have been avoided had that office been properly staffed. A fully complemented office would have unassigned employees who would have been given those assignments for the day avoiding the need for overtime. In order to be a successful office you must be fully complemented. When I was finally able to get my office fully complemented my overtime was reduced by 10% – 30% as shown in the graph below. The U.S. Postal Service has another formula that we use to gauge an employee†s production. There is a standard based on demonstrated ability. We can not hold Carrier A to Carrier B†s standards. This formula is for sorting letters and flats (magazines, newspapers, etc.). The formula allows 1 hour to sort 2 feet of letter mail. This is 2 linear feet, 2 linear feet equals 454 pieces of letter mail or 230 pieces of flat mail. So in order to standardize an employee the manager must count out 2 feet of mail, letters or flats, and calculate the amount of time it takes the employee to sort this mail. The average carrier has no problem at all meeting this quota, but there are those who attempt to outsmart their managers. If the manager is not focused on them during the sorting period there are those carriers who have the tendency to leave their areas to socialize among their coworkers, or â€Å"slow sort† their mail. The longer it takes a carrier to sort his mail, the longer it takes that carrier to get out of the office on the street to deliver this mail, making this same carrier late in returning from his assignment guaranteeing this carrier overtime for the day. You multiply this by several carriers in one office daily and you come up with an unaccountable amount of overtime usage as a manager. This affects your production numbers for the office as a whole. This where a manager has to jump in and approach the individual carriers immediately. As a manager I that this has happen to, I have approached the individual and asked some very basic questions to make certain that there are no health or personal issues going on with the carrier affecting their productivity. If nothing out of the ordinary exists, I point out that they are not meeting their productivity quota and make certain suggestions to assist them in meeting their quota. There are those times when you are challenged as a manager to verify your findings. When those situations arise, I go out and measure, with the carrier present, the actual number of feet of mail for them to sort and time them sorting this mail. Once you demonstrate to your employees that you are only expecting from them what is minimally required, and that you will hold them accountable for just that you run into this type of problem less and less. Another major contributor to overtime usage is the actual mail flow itself. Most days this is not a problem, but when it is a problem it is usually a big problem. In Northern Virginia we have two mail distribution centers, one in Merrifield and one in Dulles. For the Falls Church Post Offices, we receive our mail from Merrifield. Each morning we receive 3 dispatches of mail from 6:00 a.m. to 8:30 a.m. When these dispatches are on time everything runs smoothly, but when these dispatches are late an office goes from running smoothly to being hectic. One of the main reasons for a delayed dispatch is the mechanical failure of a mail-processing machine in Merrifield. In preparing itself for the new millenium, the U.S. Postal Service Distribution Centers are equipped with high-tech automated mail processing machines that do the job of ten employees sorting mail. In the event of a mechanical failure, one of our dispatches can be delayed by 1 – 2 hours. This 1 – 2 hour delay is passed along to my operation in 1 – 2 hours of down time for my carriers while they are waiting for their mail to deliver. That equals approximately 1 –2 hours of unforeseen overtime per employee that day. As demonstrated in the graph below this is a large usage of overtime for an entire office when calculated. The combination of mail volume and properly scheduled mail dispatches is critical in minimizing overtime. In closing, I would suggest that as we approach a new millenium the U.S. Postal Service would be better served by doing away with some of the older ways of thinking. The Overtime Desired List should be dismantled. This forces managers to go outside of the employees already present for work as a first solution to a vacant assignment list. To me this encourages overtime usage. I would also suggest for offices receiving mail dispatches late at least 3 times a week to move their scheduled time for mail receipt back and bring their carriers in a little later to accommodate for the dispatch schedules. For example if an office has consistently been receiving their dispatches an hour late, instead of having the carriers report to work at 6:30 a.m. they would move the carriers reporting times up to 7:30 a.m. instead eliminating that hour of downtime per person that they are losing.

Modern Elements in Pinero’s “The Second Mrs. Tanqueray” Essay

The Modern Elements in Arthur Pinero’s â€Å"The Second Mrs. Tanqueray† As a modern writer, Arthur Pinero has presented a great amount of modern elements in his work. For instance, his tragedy â€Å"The Second Mrs. Tanqueray† has a marvelous collection of these elements. Stage direction, Defamiliarization, mystery, metatheatrical technique, Surrealism, impressionistic monologue, psycho patient concept, violating the unity of time, and cubism can all be found in this play, but one never knows the exact depth of words and the different worlds they hide. In fact, at the beginning of each act, a stage direction is found to guide the actors about where to stand and how to react. It, also, presents a description of their facial expressions and gestures , along with their tones of voice. Moreover, a stage direction gives some details about the characters’ social class. For instance, the stage direction at the beginning of Act I introduces Aubrey Tanqueray as a member of the upper-class, for his chambers have, â€Å"A richly and tastefully decorat ed room, elegantly and luxuriously furnished.† Furthermore, Pinero manipulates another modern element called Defamiliarization. In the 19th century, the Russian Formalist Critic Victor Shklovsky says that the modern writers should come up with something new as means of experimentation. In â€Å"The Second Mrs. Tanqueray,† Pinero inserts few French words in his English text for the sake of defamiliarization. For example, he says â€Å"Mesalliance† instead of â€Å"Unmatchable marriage,† â€Å"Vin ordinare† instead of â€Å"Ordinary wine† and â€Å"L’age critique† instead of â€Å"The critical age† in Act I. The modern audience is supposed to be cultured, so he/she is expected to understand the text. Since ambiguity and mystery are praised in modern drama, Pinero has employed these elements in his play as well. This matter is clearly seen in the first act, in which Aubrey tells his friends Jayne and Misquith that their friendship must come into an end, now, because he will rem arry. He insists that they will not remain friends when they know the second Mrs. Tanqueray. Aubrey, here, is ambiguous. He hides the identity of his new wife keeping his friends in suspense. Most importantly, at the end of Act III, Paula insists on telling Aubrey the truth about her previous relation with Hugh Ardale, who has come to marry  Ellean. This mystery has different interpretations, one of which is that, Hugh was the first man in her life who broke her virginity, betrayed her, and refused to marry her. Hence, this matter has led her to the path of prostitution. Another interpretation for the matter is that, Paula is trying to show herself as a good mother to Ellean. She does not want her daughter, as she thinks of Ellean, to marry such an indecent man like Hugh. Furthermore, according to Christianity, Ellean cannot marry a man who has slept with her stepmother; for if Hugh marries Ellean, it will be an incest. Lastly, this mysterious insist on telling Aubrey can be seen as Paula’s jealousy. She is jealous of Ellean, and how her relation with Hugh is better than her previous relation with him. Although she has lived with him, Hugh does not see Paula as his wife, for he, like everyone, is attracted to her physically not spiritually. Hence, he chooses Ellean as his wife describing her, † as good as my own mother.† In addition to the previous elements, Pinero, also, manipulates the Metatheatrical technique, which is found in Act I. Close to the end of that act, Aubrey converses with his friend Cayley Drummle after Jayne and Misquith has left, and reveals the identity of his new wife. Knowing that it is Paula, the prostitute, Drummle understands and admires Aubrey for being tolerant. He, then, tells him that, â€Å"I’m merely a spectator in life; nothing more than a man in a play†¦, I love to see certain characters happy and comfortable at the finish.† Drummle, here, is trying to remind the audience that he is actually an actor in a play, so what they watch is not reality. Using this method, Pinero has violated Aristotle’s Dramatic Illusion, which states that the audience must believe what they see as reality. Furthermore, Pinero employs another modern element called Surrealistic technique in the play. Surrealism is, in fact, an anti-realistic technique that was coined at the beginning of the 20th century. It is used in drama to make an oppressed character fight for her freedom against a totalitarian force. The fight is like a nightmare in the play. Andre Breton says that violence should be confined to the language only, and this is true as far as Paula’s quarrels are concerned. However, the other Surrealistic leader Antonin Artaud believes that violence should be shown in both language and action. It is worth mentioning, that the Surrealistic fight, though painful, is humorous, and includes grotesquery. A sample of this technique is seen in Act II, in which Paula quarrels with  Aubrey about Ellean’s trip with Mrs. Cortelyon. She becomes extremely angry at Aubrey, for she understands that he aims at isolating Ellean from her bad influence. She knows that Aubrey still sees her as a fallen woman like everyone, as she states, † I can’t be so useful to your daughter as such people as this; and so I’m to be given the go-by for any town friend of yours.† In order to annoy him, Paula decides to invite her friend Mabel, a prostitute who has married George Orreyed, as a revenge for her dignity. In fact, Pinero’s aim of using the Surrealistic technique is to incarnate Paula’s verbal fight with Aubrey and Ellean. In fact, Paula’s fight with Ellean, in Act II, presents two modern elements, the psycho patient concept and the impressionistic monologue. In that act, Paula inquires about the reason that makes Ellean behave coldly with her. Elle an tells her that her mother has appeared in her dream, before, telling her to love her father, but she has not told her to love Paula yet. Paula, then, tells Ellean, † Dreams are only a hash-up of one’s day-thoughts, I suppose you know. Think intently of anything, and it’s bound to come back to you at night.† Then, she plays the role of a Psychoanalyst by telling Ellean that she has got a complex after her mother’s death, which is the reason for seeing her in her dreams. Because Paula is vulgar, Ellean does not accept that. Here, Paula is echoing the Austrian Psychoanalyst Sigmund Freud’s theory of Psychoanalysis. According to Freud, a psychoanalyst treats a psycho patient by listening to him and allowing him to verbalize his thoughts, past conflicts, fantasies and dreams. In his book â€Å"The Interpretation of Dream†, Freud says that dreams are symbolic of what a person is unconsciously think of, similar to what Paula has stated. Freud says, that an analyst interprets to his patient his thoughts, fantasies and dreams, the, relates them to his present life; creating an insight for resolution of the problems. The analyst honestly clarifies the patient’s life wishes and guilt, then, confronts him with his complexes to undo them; and that what Paula has applied on Ellean. Since Ellean gets angry, Paula tries to justify her aggression. She tries to draw Ellean’s sympathy and love by telling her that she has been through several tragedies in her life that turn her to be like this. She tells her, â€Å"I’ve talked to you as I’ve never talked to a woman in my life.† Paula wants Ellean to love her and asks her, † Kiss me!† Instead of sympathizing with Paula, Ellean turns her back coldly, a matter that pushes Paula to become  extremely angry and start yelling at Ellean. This part presents an impressionistic monologue. This kind of monologue is along speech said by a char acter to another one who listens to her/him. This character expresses her/his inner conflicts. The impressionistic monologue reflects psychological realism and depth in characterization. What Paula has said previously represents her psychological depth and introduces her as a psycho patient, as well. Pinero, also, violates the unity of time at the same act. When Mrs. Cortelyon offers to take Ellean with her to Paris then London, she states, † I’m going to Paris tomorrow for a week or two before settling down in Chester Square.† She , also, asks Aubrey to let Ellean stays with her in town â€Å"during the season.† Here, Mrs. Cortelyon tends to take Ellean for about 2 months, a matter that reflects the modern sense of violating time. Last but not least, Pinero has , also, experimented with Cubism in his play. In fact, Cubist writers at the early 20th century used to hide some parts from the text. They believe that matters overlap one another in reality because no one can see an item from all sides at the same time. This idea of missing parts or incomplete text is attributed later to the postmodern writers who dismantle the text then reassemble it to look incomplete and ambiguous. Ambiguity, in fact, is praised in modern drama since it stimulates the audience to contemplate and think of what is missed in the text. Similarly, Pinero, in â€Å"The Second Mrs. Tanqueray,† skips some details expecting the cultured audience to think and guess of what has happened in the missing part. For instance, It can be imagined that after Paula has left Highercoombe in a rage at the end of Act II, Aubrey makes it up with her when she returns. Actually, Act III opens with the Orreyeds enjoying themselves at Highercoombe, a matter which indicates that Aubrey accepts the Orreyeds’ visit and welcomes them to please Paula. To conclude, despite the fact that he is described as a traditional writer, Pinero has presented himself as a real modern writer. He has experimented with several modern techniques that have not been coined yet as his time. Briefly, his new techniques have aided â€Å"The Second Mrs. Tanqueray† to survive until the 21st century.

Principles of Auditing

A company has not followed generally accepted accounting principles In the recording of its leases. 7 2. A company has not followed generally accepted accounting principles In the recording of its leases. The amounts involved are immaterial. 1 3. A company valued its inventory at current replacement cost. While the auditor believes that the inventory costs do approximate replacement costs, these costs do not approximate any GAAP inventory valuation method. 7 4.A client changed Its depreciation method for production equipment from the traight-line method to the units-of-production method based on hours of utilization. The auditor concurs with the change. 2 5. A client changed its depreciation method for production equipment from the straight-line to a units-of-production method based on hours of utilization. The auditor does not concur with the change. 7 6. A client changed the depreciable life of certain assets from 10 years to 12 years.The auditor concurs with the change. 3 7. A cli ent changed the depreciable life of certain assets from 10 years to 12 years. The auditor does not concur with the change. Confined to fixed assets and ccumulated depreciation, the misstatements involved are not considered pervasive. 3 8. A client changed from the method it uses to calculate postemployment benefits from one acceptable method to another one. The effect of the change Is Immaterial this year, but is expected to be material in the future. 1 9.A client changed the salvage value of certain assets from 5 percent to 10 percent of original cost. The auditor concurs with the change. 1 10, A client uses the specific identification method of accounting for valuable Items in inventory, and LIFO for less valuable items. The auditor concurs that this is a reasonable practice. 1 tOf3 has substantial doubt about an entity's ability to continue as a going concern for a reasonable period of time. The notes to the financial statements adequately disclose the situation. 12. Due to recur ring operating losses and working capital deficiencies, an auditor reasonable period of time. The notes to the financial statements do not adequately disclose the substantial doubt situation, and the auditor believes the omission fundamentally affects the users' understanding of the financial statements. 4 13. An auditor reporting on group financial statements decides to take responsibility for the work of a component auditor who audited a 70 percent owned subsidiary and issued an unmodified opinion.The total assets and revenues of the subsidiary are 5 percent and 8 percent, respectively, of the total assets and revenues of the entity being audited. 1 14. An auditor reporting on group financial statements decides not to take responsibility for the work of a component auditor who audited a 70 percent owned subsidiary and issued an unqualified opinion. The total assets and revenues of the ubsidiary are 5 percent and 8 percent, respectively, of the total assets and revenues of the enti ty being audited. 10 15.An auditor was hired after year-end and was unable to observe the counting of the year-end inventory. She is unable to apply other procedures to determine whether ending inventory and related information are properly stated. 8 16. An auditor was hired after year-end and was unable to observe the counting of the year-end inventory. However, she was able to apply other procedures and determined that ending inventory and related information are properly stated. 1 17. An auditor discovered that a client made illegal political payoffs toa candidate for president of the United States.The auditor was unable to determine that amounts associated with the payoffs because of the client's inadequate record- retention policies. The client has added a note to the financial statements to describe the illegal payments and has stated that the amounts of the payments are not determinable. 1 18. An auditor discovered that a client made illegal political payoffs toa candidate re tention policies, although there is no likelihood that the financial statements are ervasively misstated, they may be materially misstated.The client refuses to disclose the payoffs in a note to the financial statements. 3 19. In auditing the long-term investments account of a new client, an auditor finds that a large contingent liability exists that is material to the consolidated company. It is probable that this contingent liability will be resolved with a material loss in the future, but the amount is not estimable. Although no adjusting entry has been made, the client has provided a note to the financial statements that describes the matter in etail. 1 20.In auditing the long-term investments account ofa new client, an auditor finds future, and this amount is reasonably estimable as $2,000,000. Although no adjusting entry has been made, the client has provided a note to the financial statements that describes the matter in detail and includes the $2,000,000 estimate in that not e. 7 21. A client is issuing two years of comparative financial statements. The first year was audited by another auditor who is not being asked to reissue her audit report. (Reply as to the successor auditor's report.

Harlem Renaissance Poets Essay Example | Topics and Well Written Essays - 750 words - 6

Harlem Renaissance Poets - Essay Example His experienced as Cuban refugee and a Cuban-American has influenced many people their daily lives. In addition, his work has been included in many anthologies, which include Paper Dance: 55 Latino poets (2002). It is not easy to imagine the composition of the Inferno, Canto I as having its beginning in such a mood of passionate exaltation and devotion to the memory of a dead person. And with the contrast with Virgil’s, it is clear that the final year of Dante life as the busy but contested one undisturbed by civil disputes. This could be a misleading picture, of course, and in any case it is not relevant to the fact that Dante left unfinished at his death plays on vitally the same poetic, emotional, and intellectual registers as its Italian precursor s. double consciousness is also expressed in Virgil Suà ¡rez poem. The double consciousness is more revealed in the closing section of Part II â€Å"by the mother-in-law tongue within a fiery circle of kerosene and watching as they stung themselves†. This contradicts some the whole nature and themes in which the poem is written about. To begin with, Dantes Hell is an indication of a threatening vestibule that is a home to the souls, which are undecided on whether to do good or evil. It is, thus, clear that the angels who did not take any side during the fight between Lucifer and Michael in the bible reside here. The entrance of Hell marks the beginning of darkness and unidentifiable shades, which do not bear any color in their symbolization of lifelessness (Molefi, 2004). These lifeless shades are what Dante uses in comparison to â€Å"‘dead leaves fluttering to the ground in autumn’, weightless and lifeless, as when falling leaves ‘detach themselves’ from the tree of life. All the souls descend ‘one-by-one’, like leaves falling ‘first one and then the other’† (Dante 112-117). In this instance, we find that the simile employed by

The Brit-Wear Fashion Company Essay Example | Topics and Well Written Essays - 1500 words

The Brit-Wear Fashion Company - Essay Example The unique aspect of the business will be the fact that designs will be developed from various themes or factors that demonstrate Britishness and instead of shipping finished clothing from the United Kingdom; the company will establish its own production plant in Hong Kong where labor is cheaper than in the UK. Research problem and objectives Collis and Hussey (2009) argued that before implementing a business idea it is always crucial to conduct a research about the market in order to establish the feasibility or the likelihood of the business idea becoming successful. Equally, before launching the Brit-Wear Fashion Company in Hong Kong it is of essence to conduct a market research focusing on the Hong Kong fashion/ clothing market. The main factors that the market research will be investigating are the market size that is available for the Brit-Wear Fashion Company in Hong Kong, the present trends that are prevailing in the Hong Kong fashion industry, the competitors present in the Hong Kong market and their unique advantage. Additionally, the demand that currently exist in the market for fashion clothes designed using British themes, and environmental factors affecting the Hong Kong fashion industry such as the economic, political, and technological issues. It is significant to note that these factors listed above are the objectives of conducting the market research. In order to attain these research objectives the researcher employed secondary research technique, which according to Collis and Hussey (2009), involves the collection of data from sources that already exists such as scholarly books, journal articles, and credible internet sites. The researcher opted to use three credible publications that contain pertinent information relating to the objectives listed above. In a scenario whereby it would be possible to conduct primary research, then the research would have seek to answers the research objectives/ question based on actual responses from particip ants who would have comprised of a random sample population of at least twenty men and women from Hong Kong and two prominent fashion designers based in Hong Kong. The primary research process would have been conducted using questionnaires and the two prominent fashion designers would have been further interviewed to provide further insights into the research questions. Secondary research findings In reference to the research publications that was written by Poon (2013), it is stated that clothing companies in Hong Kong have gain wide reputation for their quality production and reliability since they deliver quality clothing within a short lead-time. The Hong Kong clothing industry is a major sector within the region and it is the third top employer within the region based on the fact that there are 1,021 clothing companies that employee over ten thousand workers. According to Poon (2013), in the international arena of fashion, the Hong Kong fashion industry is a critical player sin ce it exports most of its products to international markets that includes even the United Kingdom and some of their products are stocked in leading fashion retail stores in both America and Europe such as JC Penney, Macy’s, Sears, and The Gap. Additionally, world-renowned fashion retailers such as Ralph Lauren, Calvin Klein, and Tommy Hilfiger, among others source some of their clothes from Hong Kong.  

Tylenol Recall Research Paper Example | Topics and Well Written Essays - 750 words

Tylenol Recall - Research Paper Example and Drug Administration regulator supervised the removal of five Tylenol products from the shelves after consumers complained that Tylenol bottles had a moldy like odor. Some of the consumers reported experiencing stomach pain, nausea, and vomiting after taking pills from those packages. (fda.gov). On that same year, the U.S Food and Drug Administration (FDA) regulator issued a press release statement expanding the recall that included all Tylenol arthritis pain drugs. According to the ABC news network, a further 54 million bottles and packages of pills were pulled from the shelves across the country that year. To the consumers, the Tylenol recall came as a relief especially since they had complained a year earlier about the products’ packaging (abcnews.go.com). On one of the news report aired on the ABC news network, the complaints are reported to have started back in the year 2008 but it is only after the FDA intervened that Johnson and Johnson reacted extensively. The following year, there was a massive voluntary recall by Johnson & Johnson Company under the FDA supervision. The recall saw McNeil consumer Healthcare, a child company of Johnson and Johnson, take actions to compensate its customers. According to the FDA press statement, a consumer who had purchased Tylenol arthritis pain medicine were requested to stop taking the pills and seek either refunds or replacement from the company. After pulling millions of bottles from the shelves , the government began a series of criminal investigations. In a federal court case in Philadelphia dated 10th march, 2015, McNeil settled for a criminal fine of 20 million dollars following an incidence that dates back to 1st May, 2009. A consumer had reported finding foreign materials in an infant Tylenol medication. Investigations later confirmed the materials to be harmful. Many of the widely products were pulled from the shelves affecting its millions of users. For example, Tylenol arthritis medicine was one the

Asperger's syndrome and how it affects the developing child Research Paper

Asperger's syndrome and how it affects the developing child - Research Paper Example Asperger’s Syndrome is one of a group of neurological disorders. This is a group of five closely –related disorders which also include Autistic Disorder, Pervasive developmental Disorder not otherwise specified, Childhood Disintegrative Disorder and Rett’s Disorder. All these disorders as Phetraswan, Miles and Mesibov (2009) explain have atypical patterns of development that affect multiple areas of functioning. These five disorders have some very similar symptoms that make it difficult sometimes to distinguish between them. This is especially so for Autism Disorder and Asperger’s Disorder which are sometimes confused for each other. Some describe Asperger’s Disorder as high functioning Autism Disorder. The terms are not always used with definite distinction made between Autism Disorder and Asperger’s Disorder and they are discussed together as Autism Spectrum Disorder where Asperger’s Disorder is included in the discussion. However it is important to distinguish between these two and know the subtle differences. Generally Asperger’s Disorder displays less severe autistic behavior. There is a more subtle impairment of language; there is not the delay in language development that is commonly seen in Autism Disorder. Also there may not be any cognitive delays; children with Asperger’s Disorder have normal IQs. The major characteristics of Asperger’s Disorder are social impairment and patterned, repetitive and focused behavior. Typically children with Asperger’s Disorder have underdeveloped social skills. This is manifested in their difficulty in forming friendships and relating to peers. Gibbons and Goins (2008) describe it as a â€Å"lack of understanding of social cues, which may lead to difficulty understanding the purpose of social interactions†. These authors go on to explain some of the other characteristics of Asperger’s Disorder or the difficulties

Business research week 5 individual assignment - 1

Business research week 5 individual - Assignment Example Samsung dealers will be requested to provide details of the customers who bought Samsung Android phones between January 2014 and March 2015 to the nearest Samsung customer care centers. From each center, a sampling frame of all the customers who purchased their phones between March 2014 and March 2015 will be prepared. From this list, a sample of 500 respondents from each center will be selected by random sampling. Customers will then be requested to come to the customer care centers on a chosen date to be administered with questionnaires. Those who will not be able to turn up will be indirectly interviewed on the phone by independent people. Collected data will be analyzed with the help of application software SPSS and result displayed on Graphs and Charts to simplify the analysis and interpretation process. ANOVA will be the preferred statistical test in the research. When the hypotheses test is negative, then the company will have to implement the recommendation of the research to strengthen their hold on the market. A positive test would mean there is no relationship between the variable there some other variable should be investigated not the ones discussed here. The qualitative methods that will be used are a little but mostly quantitative. A little of ethnographic or quasi-experiment maybe embraced to compare phenomenon. The insights developed from the report will be recommended to the board of directors through presentation to persuade them to implement the findings and even initiate more research on the related areas. Once the hypotheses test negative, then it will be so easy to convince them. This whole process of research will not take too long since most of the required information is in the database. It is only a matter or retrieving the information. However, it will be necessary to do a reconnaissance of the centers to make arrangements on how at least 250

Statistical and Quantitative Methods in Business Coursework

Statistical and Quantitative Methods in Business - Coursework Example However, for the purpose of bringing uniformity in the analysis, only 30 questionnaires were selected out of the correctly filled questionnaires for each company on random basis. The survey questionnaire comprised of two sections; the first section included demographic attributes of the respondents, whereas the second consisted of four statements relating to performance, innovativeness, service quality and relationship marketing of the company under consideration. Each statement in the survey questionnaire was required to be responded on the basis of a five point Likert scale, which is as follows: Upon reviewing the literature available on the subject of organizational performance and its determinants in retail sector, there are a number of variables identified. Most of the researchers and authors have regarded organizational performance as a dependent variable. Following is a review of relationships identified between organizational performance and various factors. It has been stated that organizations which are able to bring innovation in their business processes are able to improve their performance. In this regard, Hult and Ketchen (2001), Garg et al. (2003) and Wu et al. (2003), found that there is a positive relationship between innovativeness and organizational performance. The quality of services delivered by organizations to their customers is also regarded as an important factor in influencing the performance of those organizations. In their study of service organizations operating in Malaysia, Ramayah, Samat and Lo (2011) have found that performance of service organizations has a positive relationship with service quality. The concept of relationship marketing relates to the creation and improvement of relations by an organization with its the customers (Jobber & Fahy, 2006). Shaker and Basem (2010) in their study found that the relationship between relationship marketing and organizational performance. On the basis of conceptual model

Interview Essay about Dance Essay Example for Free

Interview Essay about Dance Essay Joseph is 56 years old, and is the second to youngest of seven children, six of them being girls. Having only sisters, and six of them at that, Joseph found himself surrounded by more dancing than he may have wished for as a young boy. Growing up, the main musical Joseph remembers seeing in theaters was The Sound of Music, starring Julie Andrews that came out in 1965. Paying only a couple of dollars for a ticket, he remembers watching Andrews dance around in the mountains singing the title song, â€Å"The Sound of Music. † This song should ring a bell for it is ranked tenth in the American’s Film Institute’s list of 100 Greatest Songs in Movie History. Having many sisters much older than himself, meant that Joseph’s background in dance was a little before his time. While his generation was more Rock N’ Roll and informal dancing, he was more familiarized with the Jitterbug before he knew how to properly head-bang. One of his favorite memories revolving around dance is when his sisters all got together and taught each other the Jitterbug. The Strand, and other such dances. Innocently watching from the sidelines, his sisters insisted on him joining in. â€Å"My sisters practically raised me since my parents were older and working hard to make a living, so I believe dancing was a way for my sisters to just relax and let go from reality, and they always wanted me to experience that with them.† Growing up, dancing was never a huge aspect of Joseph’s life. He never had proper training, and he never really cared to. In his world, the only time one needed to showcase adequate dance skills was at school dances and family affairs such as weddings. Though, in high school, Joseph was always more focused on perfecting his footwork at the pitcher’s mound than his footwork on the dance floor. He grew up in a smaller more conservative town, where gender roles still hung high in influencing the social norms of their community. Joseph, however, was not completely brain-washed by these ideals, for he grew up as a child in the 60s, where he learned to have love and peace for all, despite what his parents and elders may have believed at the time. In fact, he was part of the stage crew for his high school production one year, which did give him an inside look at the world of the arts. Being from a large Irish-Catholic family, his relatives were always dancing when they all got together. As one of the younger kids and having a somewhat shy demeanor, Joseph always watched how much fun they were having and admired how free and joyous they appeared. Of course, his aunts and uncles had the help of alcohol to make them loose, but it was also the fact that everyone knew the same dances. It was the closes thing to a real-life choreographed scene that one could witness. â€Å"I could not tell what exact dances they were doing, but I just remember there were a lot. Although they are were very similar and seemed to be more like swing dancing than anything else. Over the years, I have learned some of them, but not all. It is a shame that my generation seems to be one of the last to value and perform and real dance style, and not just grinding and twerking like Miley Cyrus.† For Joseph, his dance style did not catch up to the times until he was out of the house and the disco craze began. In 1977, the movie Saturday Night Fever came out, starring John Travolta. This movie was a huge reason why disco became as big as it did in 1978-1980. Though disco had already been an underground phenomenon since 1970. The movie just made it more openly popular amongst white middle-class heterosexuals. â€Å"Now, for me personally, I was never into the music or went to disco clubs and danced like John Travolta. Though, it was hard not to know the main moves, and it was the first time in my life that I really noticed dance being so influential in society.† Not only did disco bring about new fashion and style trends, but also socially it accomplished amazing feats. For the first time, minorities such as Gays, Latinos, and African-Americans were able to be a part of the cultural movement. In fact, in many ways, they were part of it since the very beginning. The first New York City disco clubs were very gay-friendly, and they often became a safe place for gays to relax and enjoy themselves for who they are, free from worries. These clubs included David Manusco’s The Loft, The Gallery, and The Paradise Garage. The Latinos loved the new disco partner dancing, because in their culture two is better than one when it comes to dance. As for African-Americans, the single Soul Makossa by Manu Dibango starting playing in the city clubs in 1973 and that started the next generation of Motown soul. The blending of these three subcultures really allowed for disco to grow and expand, and take on different lives in different light, depending on w ho you were and where you went. As for Joseph and other white baby boomers, their generation was yearning for their own identity and a sense of freedom. Most baby boomers only missed the sixties and its long hair, Woodstock, peace-loving ways by merely a decade. Thus, envious of not being able to partake in such a revolution in society, the youth of the 70s needed their own way of fighting the man – whether that be large scale or simply rebelling against their elders. Disco became the perfect way to unite both the baby boomers and the hippies, due to the air of sophistication that defined disco. Disco was so different from the flower-child era, which was exactly was the baby boomers were looking for; their own identity. Everyone enjoyed this new age because dressing up and going to fancy clubs meant an escape from reality and the ability to go from being a nobody by day, to someone of importance by night. This idea is essentially the plot of Saturday Night Fever, where Travolta has a blue-collar day job, but also happens to be a disco king. Middle-class America was simply enchanted by this movement. It allowed for a sense of equality between both social classes and races, and an overall social movement. Disco became so big that it quickly spread to Europe and parts of Asia. At the time, Disco was futuristic and fun. Clubs were lit up colorfully, and were home to the latest and greatest technology available at the time. Even if you were not on dancing, simply being at these places was an experience on its own. The loud music, and strong dance beat can easily be compared to today’s raves and clubs. Growing up in the 2000s, it appears that like disco, dancing is less pertained to a certain culture, but rather internationally. With the media sources and technology today, nothing is within the boundaries of a nation. Cultures around the world look especially to America’s youth to define their own youth’s identity. In charge of the social movements are celebrities and musicians. Dances come and go such as the dougie, jerking, and now twerking. On a larger scale however, there is a huge international phenomenon taking place within the last couple of years especially, and that is with rave music festivals. My older brother has attended Ultra Music Festival in Miami Florida three times now, and recently went the campout-style Firefly Festival. These festivals can be compared to Woodstock in that they are outdoors in fields and the atmosphere there is a crowd of teenagers and young adults together for the love of music and a good time. Though, the music itself is much more related to that of the disco era, for it is house/techno music made for the sole purpose of making people dance and to make individuals have an outer body experience – mostly with the aid of drugs and alcohol. There is a reason why people spend hundreds of dollars to attend these festivals, though it is opposite of why Joseph and his generation spent so much money going to disco clubs. In today’s world, the younger generation finds they are growing up faster and faster, constantly surrounded by sophistication and the burdens of adulthood. A music festival provides a more primitive, relaxing, and raw experience. Instead of being part of society, festivals are meant to be a break from just that. They provide today’s youth with the ability to act childish and be outdoors with other people, instead of cooped up indoors with their technology. Personally, I have never attended one of these music festivals, and yet I still feel like I am part of that culture in a sense. Although, I did attend an indoor Tiesto Concert and the Liacourus Center and experienced on a smaller scale what such a performance is like live. Like Joseph who never really went to disco clubs, he still felt immersed in the era. For me, I believe it is due to how involved my generation is with social medias. There is Twitter, Facebook, Tumblr, and so much more that allows anyone anywhere to listen to the music and dress the fashions of one who attends these festivals. Often times, what young women of my generation wear out to college party is of the same style that you would see at these festivals, and the same techno house music is blasting through the walls. It is very possible to feel like a part of something even if you are not, simply due to its overwhelming influence on your world. Just like how Joseph may have dressed the part and new the music that would be played at discos such as â€Å"Stayin’ Alive† by the Bee Gees or â€Å"Dancing Queen† by ABBA. The closest experience I have ever had with knowing multiple dances is from attending Bar and Bat Mitzvahs and Sweet Sixteens. At these events we would do the Cotton Eye Joe, the Macarana, the Electric Slide, and more. It was one of the few times that everyone was on the dance floor, not matter the person’s age. There was definitely something special and unique about everyone knowing a certain dance and performing it together. It brought the room together and they were all dances that anyone of any age or dance level could accomplish easily. Often times, I saw these dances as ice breakers, because once those were over the only other dancing left to do for my generation was grinding. To call grinding a dance style is difficult, but none-the-less it is the dancing my generation is best at and most familiar with. No matter the time period or the style, dancing will always be a huge part of our culture. Dance being directly linked to music allows for genres to come and go with time. The first movies were a way to document dance, and even create new ones, such as â€Å"The Continental† in the film The Gay Divorcee. Then the musicals came and the song and dance numbers took on their own new life and told stories through the arts. And now Youtube and other social media outlets are broadcasting music videos and dancing of all types and genres. With each generation the styles change, sometimes more drastically than others, but as time goes on dance seems to become bigger and bigger with technology and a new sense of a worldwide culture. Joseph Donohue may be my father who grew in a suburb in New Jersey like myself, but our dance histories are completely different, and yet somewhat alike. I took classes, while he was taught through observation and his sisters. His generation’s dance legacy was disco, while mine is grinding and twerking. However, we both seemed to take to the sidelines when it came to partaking in these cultural evolutions. Both the 80s disco music and the house techno music of rave music festival that feature artists such as Avicii and Tiesto are meant for dancing and focus on a powerful beat to make people want to move. Works Cited â€Å"Disco Lifestyle.† Standford University. Richard Powers, 2010. Web. 6 Oct. 2013. . Disco Music. Bernard Lopez, 18 Dec. 2012. Web. 6 Oct. 2013. . †¨Early, Gerald. â€Å"Jazz and the African American Literary Tradition.† Freedom’s Story, TeacherServe ©. National Humanities Center. 6. Oct. 2013. Disco Now Disco Then. Greg Wilson. Greg Wilson, 1 May 2013. Web. 6 Oct. 2013. . Garofalo, Reebee. Disco. Britannica Academic Encyclopedia. N.p.: n.p., n.d. 1-2. Britannica Concise Encyclopedia. Web. 6 Oct. 2013. . View as multi-pages

Literature Review On Plantar Fasciitis Health And Social Care Essay

Literature Review On Plantar Fasciitis Health And Social Care Essay Well I would like to describe the prevalence and research about the topic in brief in this part as it is important to know why this topic has become an issue now and why do we need to make research on it. Plantar fasciitis is found to be the common foot complaint. It has been estimated that it affects approximately one in ten people at some time in their life (Crawford, Atkins, Edwards, 2003). However, it can occur at any age. It is twice as common in women as men and it is also common in athletes (NHS Clinical knowledge, 2009). The most common cause is infracalcaneal pain of plantar fasciitis and accounts for 11% to 15% of all foot complaints that require professional treatment (Buchbinder, 2004). A recent survey done by Riddle and Schappert in (2004) estimated that there are approximately one million patient visits per year to office-based physians and hospital departments in the United States by patients diagnosed as having plantar fasciitis. It occurs in approximately 10% of people who run regularly. Incidence of this condition peaks between the ages of 40 and 60 years (Buchbinder, 2004; Wearing , Smeathers , Urry et al., 2006). It is a bilateral complaint in about one third of pa tients (Buchbinder, 2004 ). Podiatric physicians, rheumatologists, general practitioners, physiotherapists and orthopaedic surgeons are the main healthcare providers involved in the treatment of plantar fasciitis (Riddle Schappert, 2004; Crawford and Thomson, 2003; Atkins et al., 1999). As I have been working as a musculoskeletal physiotherapist this topic quite influences me as most of the patient which i have been looking suffer from this injury. So in this systematic review i would be discussing about effectiveness of low-dye taping technique in plantar fasciitis. Plantar fasciitis is not gender specific and affects approximately 2 million of the American population per year (Irving , Cook and Menz, 2006). This disorder is expected to have many factors in origin such as obesity, excessive periods of weightbearing activity and decreased ankle range of motion commonly suggested to be involved (Riddle, Pulisic, Pidcoe, Johnson 2003). A wide diversity of treatment strategies have be en developed. Up to 90% of patients treated conservatively (eg taping and ultrasound), they experienced resolutions of symptoms (Thomas et al., 2001; Gill, 1997). There limited support of evidence showing specific treatment strategies for plantar fasciitis (Crawford and Thomson, 2003; Gill, 1997; McPoil et al., 2008). Atkins et al. (1999) identified 28 different conservative treatments and eight different surgical treatments, which confirms the vagueness of this condition. Foot orthoses are a common treatment for plantar heel pain, however due to the manufacturing process, they often require a time of a few weeks between the initial consultation and issuing the devices (Kosmahl, 1987; Lynch et al., 1998; Martin et al., 2001; Scherer, 1991). As such, short-term treatments such as supportive taping are used to improve symptoms during this temporary period (Martin JE, Hosch, Goforth, Murff, Lynch, Odom 2001) the low-Dye (Dye 1939) taping technique being one of the most frequently used . Foot taping, such as low-dye taping, alters the mechanical function of the foot, decreasing stress on the plantar fascia and subsequently producing symptom relief (Saxelby, Betts, Bygrave 1997). Low-Dye taping by Dye in (1939) is a common conservative treatment for plantar fasciitis. Most research (Ator et al., 1991; Childs et al., 1996; Del et al., 2004; Harradine, Jarrett, 2001; Holmes, Wilcox, Fletcher, 2002; Keenan, Tanner, 2001; Moss, Gorton, Deters, 1993; Russo, Chipchase, 2001; Scranton, Pedangana, Whitesal, 1982; Vicenzino et al., 1997; Whitaker, Augustus, Ishi, 2003) to date has examined the mechanical effects of the tape on the lower limb. One of the study done by Saxelby et al. in 1997 has evaluated the symptom relief offered by low-dye taping, but it had small numbers of participants and did not include a control group. But consequently there is need for larger studies that use a control group for comparison so we need to carry out this study. Those tapings which extended up the leg were known as High-Dye, while those in the foot were named Low-Dye. It has been used in the management of an array of foot pathologies, especially plantar fasciitis, and its effectiveness has been discussed by several workers (Newell1977, Miller 1977, Subotnick 1975, Van Pelt 1989). Taping as an intervention or as part of an intervention for the treatment of plantar fasciitis has been used for at least 70 years (Dye 1939). A systematic review assessing the efficacy of low-dye treatment strategy has not been found. Therefore, it was considered relevant to conduct the review. The discussion about the basic information regarding the topic in detail and why it is an issue now will be discussed in the following chapter. Well the basic aim of this review is asking whether low-dye taping is effective in the management of plantar fasciitis or not? The purpose of this study is to give low-dye taping treatment to people suffering from plantar fasciitis with respect to pain relief, gait improvement, impact on lifestyle and overall rate of success. The systematic review helps to identify the papers which relate to the question asked by the review and in turn will help to answer the review question. A organised SR protocol should be developed to carry the review in a easy way. The systematic review should be carried out in an organised manner as follows: Background: Intially i would like to discuss about plantar fascia, its situation and what structures it covers and how it causes injury. According to Haung 1993, the plantar fascia is the major arrangement that supports and maintains the arched position of the foot. This aponeurosis acts as a bowstring to grip up the longitudinal arch. It covers the major part of the foot. The planter fascia is a fat, fibrous group of connective tissue. Its starting point is the medial plantar tubercle of the calcaneum. It extends along the length of the sole of the foot like a fan, being attached at its other end to the bottom of each of the toes. It is a tough, flexible structure that has a number of significant functions during running and walking. It stabilizes the metatarsal joints during impact with the ground. It behaves as a shock absorber for the whole leg. It forms the longitudinal arch of the foot and helps to raise the arch to get ready for the take-off phase of the gait cycle. The plantar fascia helps to preserve the complex arch system of the foot and plays role in ones equilibrium and the various phases of gait. The pla ntar fascia consists of a multilayered fibrous aponeurosis (Kwong, Kay, Voner, White, 1988) that starts from the medial tubercle of the calcaneus .The plantar fascia is made of three major bands, the lateral, central, and medial. The central band is the strongest and thickest. The medial and lateral bands cover the undersurface of the abductor hallucis and abductor digiti minimi muscles, respectively. The fibers of the central band separate into 5 slips near the level of the metatarsal heads and then attach to the proximal phalanx via the plantar plate of each metatarsophalangeal joint (Schepsis, Leach, Gorzyca, 1991). Figure 1 Now we will discuss about plantar fasciitis. Here are some acceptable definitions of plantar fasciitis cited by experts which would be helpful in this study. Injury of this tissue, called as a plantar fasciitis, is very difficult to resolve. Plantar fasciitis is a localized inflammatory condition of the plantar aponeurosis of the foot and is reported to be the most common cause of inferior heel pain (Schepsis, Leach, Gorzyca, 1991). Plantar fasciitis represents the fourth most common injury to the lower limb and represent 8 10% of all presenting injuries to sports clinics. It can be caused by many factors. Plantar fasciitis develops when repetitive weight-bearing stress irritates and inflames the tough connective tissues along the base of the foot. It is difficult to treat. Rehabilitation can be long and frustrating process. The use of preventing exercise and early acknowledgment of danger signals are considerable in the avoidance of this injury. Plantar fasciitis refers to an inflammation of the plantar fascia. The inflammation in the tissue results in some type of injury to the plantar fascia. Typically plantar fasciitis ults from rep eated trauma to the tissue where it attaches to the calcaneus. According to souza, plantar fasciitis presents as a sharp heel pain that radiates next to the bottom of inside of the foot. In short the definition varies from person to person and it mainly depends upon the cause. The pain is found to be terrible when getting out of bed in the morning. Plantar fasciitis is a aching condition of the subcalcaneal aspect of the foot resulting from soreness or contracture of the deep fascia of the sole with or without calcaneal spur. Plantar fasciitis has been used synonymously with the following terms: Painful heel syndrome Subcalcaneal bursitis Subcalcaneal pain Runners heel Medial arch sprain According to Baxter, Plantar fasciitis can take place in runners or other athletes who repetitively land on the foot. Plantar fasciitis is an overuse damage whose occurrence accounts for 10% of all running injuries (Am J Sports Med 1991). Another vulnerable group is middle-aged people who use up much time on their feet. More infrequently, the fascia becomes irritated after a single traumatic episode, such as landing incorrectly after a jump or running a long hill. The massive majority of people will respond to conservative care and not require surgery. Appropriate treatment is necessary, however, to permit continuous participation in sports and daily activities, and to stay away from chronic damage. Risk factors: Plantar fasciitis is particularly prevalent in runners and people who are overweight (Hill and Cutting, 1989), however, it is also prevalent in people with systemic, inflammatory arthritis (Davis and Blair, 1950; Hassani et al., 2002; Furey, 1975; Gerster, 1980). Despite plantar fasciitis being a relatively common disorder, little is known about its etiology and pathogenesis (Wearing et al., 2006). Most anecdotally (Singh et al., 1997; Irving, Cook and Menz, 2006; Rome, 1997), intrinsic and extrinsic risk factors for plantar fasciitis have been reported. Participants in sports that engage some degree of running and jumping, e.g. basketball, tennis, step-aerobics, dancing may be at risk. Non-athletic people who spend much time on their feet. It may emerge in someone who suddenly becomes more active after a time of relative inactivity. Running on hard ground aggravates the risk, as does an increase in hill training. Worn out trainers boost risk as they lose their shock absorption prope rties. Obesity increases risk. There is increase in stress placed through the fascia. Other mechanical risk factors include flat feet (pes planus) and having a high arch (pes cavus). Studies done by (Riddle et al., 2003; Irving et al., 2007) identified that reduced talocrural dorsiflexion, high body mass index, pronated foot posture, and prolonged work related weightbearing are independent risk factors of plantar fasciitis. The most widely reported clinical sign of plantar fasciitis as said by Wearing et al., (2006) is pain localised to the medial tubercle of the calcaneus. Characteristically, the pain is exacerbated after periods of nonweightbearing. The pain decreases after few minutes of initial weightbearing but returns and get worst when time on feet increases (Singh et al., 1997; Thomas et al., 2001; Schepsis, Leach and Gorzyca, 1991). Various interventions used for plantar fasciitis: In general, plantar fasciitis is a self-limiting condition. Unfortunately, the period until resolution is frequently six to 18 months, which can direct to frustration for patients and physicians. Rest was cited by 25 percent of patients with plantar fasciitis in one study as the treatment that worked best (Wolgin, Cook, Mauldin, Graham 1994). It is equally important to correct the troubles that place individuals at risk for plantar fasciitis, such as increased amount of weight-bearing activity, increased intensity of movement, hard walking/running surfaces and worn shoes. Early recognition and treatment usually direct to a shorter course of treatment as well as improved probability of success with conservative treatment measures (Martin, Irrgang, Conti 1998, Reid 1992). Various treatment strategies, including orthoses (Kwong et al. 1988, Gross et al. 1984, Goulet et al. 2002, Lynch et al. 1988), stretching (Probe et al. 1999, Powell et al. 1998, DiGiovanni et al. 2003, Chandler et al. 1993, Barry et al. 2002), taping (Lynch et al. 1988, Scranton et al. 1982), extracorporeal shock wave therapy (Boddeker et al. 2001, Buchbinder et al. 2002), laser therapy (Basford et al. 1998) and drug therapy in the appearance of systemic medication (Probe et al. 1999), percutaneous injection (Cunnane et al. 1996, Kamel et al. 2000, Kane et al. 1998) and topical application (Gudeman et al. 1997, Japour et al. 1999) have been investigated and have revealed variable clinical benefit. In the recovery phase of rehabilitation, the objective is to decrease stress on the plantar fascia (J M.). Orthotic shoe inserts are thought to give stress relief and hold the plantar fascia, but a review of several studies found them to be unconvincing and contradictory due to methodology, small study size, or lack of long-term follow-up. There are many conservative treatments which can give better relief such as: Icing: Ice massage for over 15 minutes for three times a day can give better results and decrease the inflammation. Stretching Heel lifts Supportive shoes Weight loss Taping Orthotics: Devices such as rubber heel cups, elastic heel inserts can provide relief for plantar fasciitis. Night splints: Splints can provide relieve from plantar fasciitis, but it usually takes more than 12 weeks. Taping: The purpose of taping the foot is to change the mechanical load toward the fascial enthesis. Several studies done by Lange, Chipchase, Evans, (2004); Vicenzino et al., 2005; Radford et al., 2006) have reported that antipronation tape change the longitudinal arch height and decrease pressure in the heel which are clinically relevant in patients with plantar fasciitis. Taping can be done in many methods but i am more interested in low-dye taping as it is widely used and so i will be discussing about that technique in detail. LOW-DYE TAPING: Low-dye taping is an orthopaedic/sports adhesive strapping technique first described by Dye (1939) and later modified by a number of authors (Boergers, 2000; Del et al., 2004; Lange, Chipchase, Evans, 2004; Russo, Chipchase, 2001). Low-Dye taping is designed to off-load the plantar fascia. It is a short term treatment and its off-loading effects vary from patient to patient. However, as a general rule leave the tape on for a maximum of 3 days, but some might find it needs to be replaced more frequently in order remain effective. If at anytime the tape is uncomfortable, irritates, causes itching or pins and needles it should be removed immediately. The taping aims to limit foot pronation and is used in the short-term to reduce the symptoms of disorders thought to be related to excessive foot pronation which includes plantar fasciitis, tibialis posterior dysfunction, and patellofemoral syndrome (Schulthies, Draper, 1995; Whitesel, Newell, 1980). The taping required is a 1 inch zinc oxide (rigid strapping), most chemist should stock it. Another place to access it is from www.simplyfeet.co.uk, look under strapping and for Leukoplast (2.5cm), its costs approximately  £2.70p per roll (which should last for 3-4 applications) How to apply the taping 1. The first taping is applied down the outer and inner border of the foot, repeat 3-4 times. Apply enough tension to avoid the tape wrinkling, it needs to be no tighter. 2. The second taping is applied across the underside of the foot-starting level with the ankle, apply the tape across the foot from the outside to the inside. Over lap the each strap slightly and keep going until just before reaching the ball of the foot. 3. The final taping is a securing tape-apply a piece of tape across the midfoot, at about where the second taping ends, apply across the top of the foot, but do not encircle the whole foot, as this will be too tight. 4. Initially the tape will feel slightly tight, but this should ease, if it feels uncomfortable at all-remove immediately. Effects of Low-Dye taping: Offers support for the medial longitudinal arch and reduces pronation (inward rolling of the foot). Can be used for any condition affected by excessive pronation Plantar fasciitis, Tibialis Posterior Tendonopathy/Dysfunction, Sinus tarsi syndrome. Limitation of taping: One restriction of long term taping is that there is danger for skin breakdown. So therefore it may be considered only as a short term management option. Literature review: For writing the literature review, the following databases and books were searched. There was a detailed search on internet which gave a lot of information about plantar fasciitis. Some information was gathered from books and journals as well. Some of the journals were available online while rest of them had to be purchased from library. Some of the books were available online as well. The following databases had been searched for writing this literature review: Medline AMED CINAHL ClinPSYC EMBASE PsycINFO PEDRO. The following information was gathered from all the sources taking account of the review question. The proximal insertional disorder of the plantar fascia is best known as plantar fasciitis and as per Lemont, Ammirati and Usen in (2003), histopathologic research has found no signs of inflammation but has reported degenerative changes in the plantar fascia. The prevalence of plantar fasciitis has not been studied (Riddle Scappert 2004), but it is estimated that it affects 10 percent of the general population at some time during life (Demaio et al., 1993). PF is considered a self-limiting condition, however, the typical resolution time is anywhere from 6-18 months, sometimes longer (Young, Rutherford, Niedfeldt 2001) which can lead to frustration on both that is the physician and patient. Most experts agree that early recognition and treatment of PF leads to a shorter course of treatment and greater probability of success with conservative therapies (Singh, Angel, Bcntk, Trevino 1997). Of the many treatment options available for PF, one of the most effective is also the most fundamental rest and avoidance of aggravating activity provides significant relief. One study cited rest as the treatment that worked best for 25percent of PF patients (Wolgin, Cook, Graham, Mauldin, 1994). Martin et al. 2001 compared custom orthoses, over-the-counter arch supports, and tension night splints in the management of plantar fasciitis. Lynch et al. compared anti-inflammatory therapy, accommodative therapy and mechanical therapy in the management of pla ntar fasciitis. There are several conservative treatments that are employed to manage this condition. Scientists at the University of Bridgeport Chiropractic College in Calgary, Alberta, conducted an comprehensive review of the literature from 1980 to March 2005 on the management of plantar fasciitis. They concluded that due to numerous methodological flaws, none of the 15 randomised controlled trials showed finally which conservative treatment modality was best for plantar fasciitis (JCCA, 2006). Contrast baths, in which the application of cold and heat to a wounded area is alternated, are widely believed to reduce oedema (tissue swelling) and relieve uneasiness following an injury (Sullivan and Anderson 2000). A hunt of the scientific literature on this topic using Medline uncovered just two articles in this area, and one of the articles was unreliable in nature, with no rigorous, controlled testing of the efficacy of contrast baths. The other journal article listed research carri ed out at the University of North Carolina in which 30 subjects with post-acute sprained ankles were assigned to either a cold (n = 10), heat (n = 10), or contrast-bath (n = 10) treatment group (Comparison of Three Treatment Procedures for Minimizing Ankle Sprain Swelling, Physical Therapy, Vol 68 (7), pp1072-1076, 1988). Volumetric measurements of the subjects ankles were completed in a specially constructed tank, prior to and after treatment. An increase in the measure of oedema was actually observed with all three treatments, but cold application was connected with the least measure of swelling; contrast baths were no better than the direct application of heat when it came to controlling swelling. This study is somewhat faulty, since there were no control individuals with whom the persons utilizing a variety of treatments could be compared. Nonetheless, the research suggests that there is nothing particularly beneficial about contrast baths (especially when compared with the appl ication of nothing but cold) in the management of sprained ankles or oedema in common. Interestingly enough, there also does not show to be a single study in the scientific literature involving contrast baths with quicker recovery from injury or with a considerable decrease in pain associated with an injury. Compression is thought to be valuable in this phase through taping of the foot (Anderson 2000). Scherer and the Biomechanics Graduate Research Group in 1998 performed a prospective study in which they treated 73 patients with 118 painful heels with taping, nonsteriodal anti-inflammatory drugs, injections, and rigid orthoses (98% received these orthoses). The study showed that, within 6 weeks, approximately 84% of the patients had at least 80% relief of symptoms. This study also identified a subgroup of 43 heels (27patients) that received only mechanical therapy with taping or orthoses. Of this group, 90% had more than 80% relief of symptoms. The author concluded that mechanical control of midtarsal joint was the most successful treatment modality for plantar fasciitis. In an attempt to measure the effects of Low-Dye taping on the foot, eight patients (nine feet) with plantar fasciitis were studied using the pedobarograph to investigate changes in gait patterns. In addition, patients completed a questionnaire to assess symptom improvement. Significant changes between the untaped and taped foot were found in respect of pressure levels, areas under the pressure time curves and temporal parameters. The questionnaire revealed subjective improvements in symptoms in eight out of the nine feet studied (Saxelby, Betts and Bygrave 2004). The results from this nonrandomised trial indicate that this technique may be helpful for pain associated with plantar fasciitis. This article reveals that taping technique can improve gait to some extent. The best method to avoid plantar fasciitis is to minimise your risk factors. Follow the guidelines outlined above for selecting suitable and well-constructed shoes. Progress training schedules properly and works in new environments gradually. Keep your calf muscles physically powerful. Although plantar fasciitis is a prevalent problem, little scientific evidence exists concerning the most appropriate intervention (Crawford, Atkins, Edwards 2002 ). In the book by Rose Macdonald (2009), named Pocketbook of Taping Techniques By Rose Macdonald, Functional taping is now acknowledged as a skill which is essential for those concerned in the treatment and rehabilitation of sports injuries and many other conditions such as muscle imbalances, unstable joints and neural control. It incorporates all the basic techniques essential to the practice of good taping but also includes chapters on new evidence-based procedures written by experts from around the world. To assist in the development of these techniques, this pocketbook demonstrates many new methods which may be used as indicated or customized to suit the clinical situation. The Key Features in the book are Structured by body region with highly-illustrated descriptions of significant taping techniques Covers all aspects of functional taping New techniques to modify muscle activity and proprioception based on scientific evidence. Handy, portable size for simple reference in the field. Well there are few papers (Saxelby et al., 1997; Radford et al., 2006; Osborne and Allison, 2006; Landorf et al., 2005) published in the journals which say that low-dye taping has been effective in the management of plantar fasciitis. We will discuss about the papers in detail in the later part of the review. A systematic review conducted by Radford et al., in (2006) of randomised controlled trials examined the result of low-dye taping on biomechanical variables. According to Kogler et al. (1999), the supportive tape reduces the symptoms of plantar heel pain by reducing strain in the plantar fascia during standing and ambulation. A study conducted by Nolan and Kennedy in 2009 aimed to determine the special effects of Low-Dye taping on peak plantar pressure immediately post-application and found that Low-Dye tapes initially reduced lateral forefoot peak plantar pressure after a 10-minute walk. However, the tape continued to have an effect on the medial forefoot after 20 minutes of exercise. Chapter 2: Now we will be discussing about the systematic review methodology in this chapter The basis for a systematic review: According to Altmann (1999), Systematic reviews, in healthcare, have been described as providing objective overviews of all the evidence currently available on a particular topic of interest. Such overviews cover clinical trials in order to establish where effects of healthcare are consistent and where they may vary. This is achieved through the use of explicit, systematic methods aimed at limiting systematic error (bias) and reducing the chance of effect (Higgins and Green 2006). So systematic review are useful to decide which treatment in health care is more effective. Methodology: Systematic literature reviews are a method of making sense of large bodies of information, and a means of contributing to the answers to questions about what works and what does not- and many other types of question too (Petticrew and Roberts 2006). They are a method of mapping out areas of uncertainty, and identifying where little or no relevant research has been done, but where new studies are needed. Systematic reviews are literature reviews that remain closely to a set of scientific methods that explicitly aim to limit systematic error (bias), mainly by attempting to identify, appraise and synthesize all relevant studies in order to answer a particular question. Definition of systematic review: A review that strives to comprehensive identify, appraise, and synthesize all the significant studies on a specified topic. Systematic reviews are often used to test just a single hypothesis, or a series of related hypotheses (Petticrew and Roberts 2006). Systematic reviews provide information about the effectiveness of interventions by identifying, appraising, and summarising the results of otherwise unmanageable quantities of research (Light and Pillemer 1984, Mulrow 1994). A review of the evidence on a obviously formulated question that uses systematic and explicit methods to identify, select and critically appraise relevant primary research, and to remove and analyse data from the studies that are incorporated in the review. Statistical methods (meta-analysis) may or may not be used. Systematic reviews are defined, according to the Cochrane collaboration, as scientific literature reviews aimed at answering clearly formulated questions by use of systematic and explicit methods for identifying, selecting, and critically appraising relevant research, and for collecting and analysing data from the literature included in the review (The Cochrane collaboration. During a systematic review, meta-analysis may be used as a statistical tool for analysing and summarising the results of the included studies (Green and Higgins 2005). In order to fulfil this function, a systematic review should: (i) present a synthesis of the acquired knowledge regarding one particular clinical question derived from all relevant studies that are identifiable at one point in time, (ii) identify the level of internal validity and the subsequent potential systematic error risk associated with the acquired knowledge and (iii) provide recommendations for improving any identified shortcoming related to internal validity, for further research. Owing to continued further research, systematic reviews should also provide continued updates of their synthesis. Why do a systematic review? A rationale: Single studies can usefully be seen as similar to single respondents in a survey. The results from one respondent may say something, and sometimes something very important, but one might well get the opposite answer from the next respondent. It is more likely that one will learn more by examining data from other respondents, by looking at the range of answers and examining why those answers vary, and by attempting to summarize them (Petticrew and Roberts 2006). Literature reviews are also, in essence surveys, and it is worth remembering that they share very similar biases with other forms of social surveys. History of systematic review: From the 1930s onwards, and possibly even before, the specific term systematic review was being used to refer to literature reviews (Petticrew and Roberts 2006). In short, contrary to what is commonly supposed, neither the term systematic review nor the general approach of systematic literature reviewing is particularly new, nor particularly biomedical. Many systematic reviews involve a statistical pooling of the findings of the primary studies. This approach, meta-analysis, probably derives in its current form from Glass and Smiths work, which began in the late 1970s (Glass and Smith 1978). Systematic Review Process: Scoping review: A scoping review involves a search of the literature to determine what sorts of studies addressing the systematic review question have been carried out, where they are published, in which databases they have been indexed, what sorts of outcomes they have assessed, and in which populations (Petticrew and Roberts 2006). It may include restricted searches across a limited number of key databases, limited to a certain time period, and perhaps restricted by language. This can help cost a review for the purpose of drawing up a funding proposal, and can help with estimating how long it is likely to take, and what mix of skills might be needed to carry it out. From the below systematic review on effectiveness of low dye taping in the management of plantar fasciitis we can see that one relevant study has been found which involves effectiveness of taping in the management of plantar fasciitis but that differs from the current systematic review as it did not involve low dye taping which is the key factor of the undergoing review and this review is based on only effectiveness of low dye taping and not taping in broader context. Chapter 3: Role of the protocol: The protocol will specifies the plan which the review will follow to identify, appraise and collate evidence (Cook, Sackett and Spitzer 1995). The first milestone of any review is the development and approval of the protocol before proceeding

A Hierarchical Regression Analysis Psychology Essay

A Hierarchical Regression Analysis Psychology Essay This study was conducted to determine what the predictors of Body Mass Index are. There were two research questions of this study. First research question was How well the type of chocolate and frequency of chocolate consumption predict body mass index, after controlling for gender physical activity? Second research question was How well do fat percentage and cacao percentage in chocolate explain body mass index, after controlling the results of the first research question? In order to reveal the predictors hierarchical regression analysis was used. In this study BMI was outcome variable; gender, type of chocolate, fat rate in chocolate, cocoa rate in chocolate, frequency of chocolate consumption and frequency of physical activity in a week were predictor variables. The study was conducted with 600 university students. Method Participants and the Variables The sample of the study was consisted of 600 Middle East Technical University students; 46.3% (n=278) were male and 53.7% (n=322) were female. Convenience sampling method was used to determine the participants. The most crowded places of the university, such as library, market area, dormitory area, were selected as data collection areas. Requisite sample size for multiple regression could be calculated with the formula of number of predictors * 8 + 50. According to formula required sample size is 106 (7*8+50). While there are 600 students, sample size is quite enough to conduct multiple regression. The questionnaire used in this study was consisted of seven items which are presented in Table 1. Moreover, there is an id number for each participant. Totally, there were six continuous and two categorical variables on data file. Table 1 List of variables and brief descriptions in the data file Variable Name Description of the variable Id Identity number of each participant BMI Body Mass Index Gender Gender (1: Male; 2: Female) Type Type of chocolate ( 1: Milk; 2: Berry; 3: Peanut) Fat Fat rate (%) in chocolate Cacao Cacao rate (%)in chocolate Frequency Frequency of chocolate consumption (number of chocolates eaten in the last week) Activity Frequency of physical activity in a week Data Analysis Plan In this study hierarchical regression will be held to find out how much the predictors can explain the dependent variable, BMI. In hierarchical regression different models are tested sequentially. In contrast to stepwise regression, researcher decides the sequence of the predictors that included the model. Three different models will be used to determine how much these independent variables predict the dependent variable. In the first model gender and frequency of physical activity in a week will be included into analysis. In the second model, gender and frequency of physical activity in a week will be controlled; type of chocolate and frequency of chocolate consumption will be included into analysis. In the third model, gender, frequency of physical activity in a week, type of chocolate and frequency of chocolate consumption will be controlled, fat percentage and cacao percentage in chocolate will be included into analysis. To conduct the regression analysis, categorical data should be recoded. There are three different ways to do this; dummy coding, effects coding and contrast coding. In this study, dummy coding will be used to recode categorical data. In dummy coding, one categorical variable recode into different variables that the number of new variables are one less than the number of categories. Nevertheless, a categorical variable should have at least three levels to be recoded. A categorical variable with two levels such as gender neednt to be recoded. In this study there were two categorical data; gender and type of chocolate. As it mentioned before, gender neednt to be recoded. The other categorical variable, type of chocolate, should be recoded. Milk chocolate will be selected as reference variable; and, two other variables will be coded as milkvsberry and milkvspeanut. Likewise all other multivariate statistical methods, Multiple Regression has various assumptions; and, all these assumptions should be checked before conducting the analysis. First assumption of multiple regression is normality. Unlike other multivariate analysis, regression analysis checks whether the error distributes normally or not. Secondly, multicollinearity, which is high level of intercorrelation among predictor variables, should be checked. Thirdly, assumption of homoscedasticity should be checked. Homoscedasticity assumes that the variance of the error term is constant across each value of the predictor. This means that there should not be seen a pattern on scatter plot. Fourth assumption is independence, that the error term is independent of the predictors in the model and of the values of the error term for other cases. The fifth assumption of multiple regression is linearity. Lastly, outliers should be check whether they affect the results or not. Partial plots, leverage statistics, Cooks D, DFBeta and Mahalonobis distance could be used to determine outliers. Results Descriptive Statistics Table 2 shows the descriptive statistics of the study. Table 2 shows that there is no missing data; mean of dependent variable, BMI, is 24.65 and the standard deviation is 4.48. Table 2 Descriptive Statistics Mean Std. Deviation N body mass index 24.65 4.48 600 Gender 1.54 .50 600 physical activity in a week 2.62 .74 600 milk chocolate vs berry chocolate .25 .44 600 milk chocolate vs peanut chocolate .27 .45 600 frequency of chocolate consumption 4.66 .73 600 fat rate (%) in chocolate 51.70 9.69 600 cacao rate (%) in chocolate 51.95 9.96 600 Table 3 shows the correlations between the variables. If the table is examine it is seen that the best predictor of BMI is fat rate in chocolate. There is a positive and high correlation between the BMI and fat rate in chocolate. On the other hand, there is no correlation between BMI and gender, physical activity in a week, milk chocolate vs berry chocolate. Moreover, there is no correlation higher than .90 between the independent variables. Table 3 Correlation Matrix 1 2 3 4 5 6 7 8 Pearson Correlation body mass index (1) 1.00 Gender (2) -.03 1.00 physical activity in a week (3) .04 -.13 1.00 milk chocolate vs berry chocolate (4) -.03 .03 -.11 1.00 milk chocolate vs peanut chocolate (5) .23 -.02 .12 -.36 1.00 frequency of chocolate (6) consumption .31 .12 .15 -.05 .19 1.00 fat rate (%) in chocolate (7) .64 -.12 .08 .02 .21 .30 1.00 cacao rate (%) in chocolate (8) .52 .08 .03 -.04 .22 .28 .51 1.00 Assumptions The first assumption of multiple regression to be checked is normality. Unlike other analysis, normality of residuals is checked whether errors normally distributed or not. Normality of residuals could be checked via two different ways; histogram and P-P plot. Figure 1 shows the histogram of regression standardized residuals. The histogram shows that there is a normal distribution of residuals. The frequency distribution of residuals is close to normal distribution line. Moreover, figure 2 shows the P-P plot of regression standardized residuals and it shows that distribution of errors is normal. It can be said that first assumption of multiple regression, normality, is not violated. Figure 1 Histogram of Regression Standardized Residual Figure 2 P-P Plot of Regression Standardized Residual The second assumption of multiple regression to be checked is multicollinearity. Multicollinearity could be checked with correlation matrix, VIF or tolerance values. There should not be any correlation that is higher than .90 between two independent variables. When the correlation matrix (Table 3) is examined there is no correlation higher than .90 between two independent variables. Table 4 shows the collinearity statistics of all three models. VIF values more than four or tolerance values higher than .20 are indicators of multicollinearity. Table 4 shows that there is no VIF value higher than four or tolerance value higher than .20. So, assumption of multicollinearity is not violated. Table 4 Collinearity Statistics Model Collinearity Statistics Tolerance VIF 1 (Constant) Gender .98 1.02 physical activity in a week .98 1.02 2 (Constant) Gender .96 1.04 physical activity in a week .94 1.06 milk chocolate vs berry chocolate .87 1.15 milk chocolate vs peanut chocolate .84 1.19 frequency of chocolate consumption .93 1.08 3 (Constant) Gender .92 1.08 physical activity in a week .94 1.06 milk chocolate vs berry chocolate .86 1.17 milk chocolate vs peanut chocolate .80 1.24 frequency of chocolate consumption .84 1.19 fat rate (%) in chocolate .67 1.49 cacao rate (%) in chocolate .70 1.43 The third assumption of multiple regression to be checked is homoscedasticity. Scatter plot of predicted value and residual is used to control homoscedasticity. Any pattern should not be seen on the scatter plot. Figure 4 shows that there is no pattern on the scatter plot; so, there is not homoscedasticity. Figure 4 Scatter plot of predicted value and residual The fourth assumption of multiple regression to be checked is independence. Independence is affected by the order of the independent variables and can be ignored if the order of independent variables is not important. Order of the independent variables is important in this study; so, independence should be checked in this study. Independence is checked with Durbin-Watson value that should be between 1.5 and 2.5. Durbin-Watson value of the model is 1.88; so, independence assumption is not violated. The last assumption of multiple regression is linearity. We assume that linearity is not violated in this study. Influential Observations Data should be checked whether there are outliers or not. Outliers could cause misleading results. There are different ways of checking outliers in multiple regression such as Partial plots, leverage statistics, Cooks D, DFBeta and Mahalonobis distance. Each method uses a different calculation method; so, multiple methods should be used and then make a decision whether a data is outlier or not. At first, partial plots of the dependent variable with each of the independent variable is examined (see on figure 5,6,7,8 and 9). Some cases that could be outliers are seen on each partial plot; but, this should not be forgotten, making decision over partial plots is a subjective way and other ways of controlling outliers should be used. A decision could be made even after all methods were conducted. Figure 5 Partial Plot of BMI and physical activity in a week Figure 6 Partial Plot of BMI and milk chocolate vs peanut chocolate Figure 7 Partial Plot of BMI and frequency of chocolate consumption Figure 8 Partial Plot of BMI and fat rate in chocolate Figure 9 Partial Plot of BMI and cacao rate in chocolate After controlling partial plots, leverage value could be controlled to identify the outliers. It is seen that there is no case, leverage value of which is higher than .50. According to leverage test results there is no outlier. Table 5 Extreme Values of Leverage Test Case Number Value Centered Leverage Value Highest 1 448 .04 2 384 .04 3 141 .03 4 324 .03 5 592 .03 Lowest 1 196 .00 2 103 .00 3 535 .05 4 160 .05 5 8 .05 After controlling leverage values, Cooks distance could be controlled. In Cooks Distance, a value greater than the value, calculated with the formula of mean + 2 * standard deviation, can be admitted as outlier. In this study critical value is .008 (.002+2*(.003)). Maximum value of Cooks distance is .03; so, it is expected that there will be outliers. Boxplot of Cooks distance (figure 10) shows that the cases 499, 438, 449, 236, 284, 484, 37, 354, 137, 97, 324 and 165 could be outliers. On the other hand, according to Cook and Weisberg (1982) values greater than 1 could be admitted as outlier. So, it can be assumed that there is no outlier. Figure 10 Boxplot of Cooks distance After controlling Cooks Distance, DF Beta values of each independent variable could be checked. DF Beta value shows the change in regression coefficient due to deletion of that row with outlier. According to Field (2009) a case can be outlier if absolute value of DF Beta is higher than one. According to Stevens (2002) a case can be outlier if absolute value of DF Beta is higher than two. In this study there is no case that has DF Beta value higher than one (see figure 11). According to DF Beta test values there is no outlier in this study. Figure 11 Boxplots of DF Beta values of Independent Variables Lastly, Mahalanobis Distance could be controlled to identify the outliers. If there is any case that is greater than the value of chi square at ÃŽÂ ±=.001 that could be admitted as outlier. The critical value at ÃŽÂ ±=.001 with seven predictors is 24.32. Table 6 shows the extreme values for this study and there is no value greater than 24.32. According to Mahalanobis distance test there is no outlier. Table 6 Extreme Values of Mahalanobis Distance Case Number Value Mahalanobis Distance Highest 1 448 23.72 2 384 20.90 3 141 20.50 4 324 19.15 5 592 17.99 Lowest 1 196 2.62 2 103 2.62 3 535 2.78 4 160 2.78 5 8 2.78 If the results of each test is summarized; Partial plots shows that there could be outliers, Leverage values show that there is no outliers, Cooks distance values show that there is no outlier, DF Beta values show that there is no outlier. According to results of the tests, it could be assumed that there is no outlier. Regression Results A hierarchical regression analysis was conducted to identify the predictors of BMI. Three different models were examined to understand which predictor explains has how much variance. Table 7 shows the summary of three models. Among three models, the first model is not statistically significant; the second and third models are significant. In the first model; gender and physical activity in a week were the predictors. This model explains the .2% of total variance, but insignificant; F (2, 597) = .67; p > .05. In the second model, milk chocolate vs berry chocolate, milk chocolate vs peanut chocolate and frequency of chocolate consumption are the predictors after controlling for the effect of gender and physical activity in a week. This model explains 13% of total variance explained significantly, F (3, 594) = 28.901; p In the third model, cacao rate (%) in chocolate, fat rate (%) in chocolate are the predictors of BMI after controlling for the effect of gender, physical activity in a week, milk chocolate vs berry chocolate, milk chocolate vs peanut chocolate and frequency of chocolate consumption. This model explains 34% of total variance explained significantly, F (2, 592) = 189.154, p Table 7 Regression Analysis Model Summary Model R R2 Change Statistics Durbin-Watson ΆR2 ΆF df1 df2 Ά Sig. F 1 .05a .00 .00 .69 2 597 .50 2 .36b .13 .13 28.90 3 594 .00 3 .69c .47 .34 189.15 2 592 .00 1.879 a. Predictors: (Constant), physical activity in a week, gender b. Predictors: (Constant), physical activity in a week, gender, milk chocolate vs berry chocolate, frequency of chocolate consumption, milk chocolate vs peanut chocolate c. Predictors: (Constant), physical activity in a week, gender, milk chocolate vs berry chocolate, frequency of chocolate consumption, milk chocolate vs peanut chocolate, cacao rate (%) in chocolate, fat rate (%) in chocolate d. Dependent Variable: body mass index Table 8 shows the Coefficients of Hierarchical Regression Analysis that shows the significance and total variance explained by each predictor. In the first model any of the predictors significantly predicts the dependent variable, BMI. It can be said that neither the model, nor the predictors are statistically significant and do not predict the outcome variable, F (2, 597) = .67; p > .05. In the second model, overall model is significant, F (3, 594) = 28.901; p In the third model, overall model is significant, F (2, 592) = 189.154, p Table 8 Coefficients of Hierarchical Regression Analysis Model Unstandardized Coefficients Standardized Coefficients t p Correlations B Std. Error Beta Part 1 (Constant) 24.419 .941 25.938 .000 Gender -.232 .370 -.026 -.628 .530 -.026 physical activity in a week .226 .251 .037 .900 .369 .037 2 (Constant) 17.165 1.309 13.110 .000 milk chocolate vs berry chocolate .539 .423 .052 1.273 .204 .049 milk chocolate vs peanut chocolate 1.943 .420 .193 4.629 .000 .177 frequency of chocolate consumption 1.751 .245 .283 7.135 .000 .273 3 (Constant) 5.426 1.191 4.557 .000 fat rate (%) in chocolate .221 .017 .477 13.033 .000 .390 cacao rate (%) in chocolate .109 .016 .242 6.766 .000 .203 a. Dependent Variable: body mass index Discussion Two different research questions were tried to be answered in this study. First research question was How well the type of chocolate and frequency of chocolate consumption predict body mass index, after controlling for gender physical activity?. Second research question was How well do fat percentage and cacao percentage in chocolate explain body mass index, after controlling the results of the first research question?. A hierarchical regression analysis was conducted to answer the research questions. Three models were examined to find the predictors and their contribution to these models. The first model that examines that how well gender and physical activity in a week predict the dependent variable. Result of the first model shows that neither model nor predictors significantly predict the BMI. The second model examined to answer the first research question. This model predicts 13% of total variance explained. Milk chocolate vs berry chocolate does not significantly explain the BMI. Milk chocolate vs peanut chocolate explains 3%, frequency of chocolate consumption explains 7% of total variance explained. The third model examined to answer the second research question. This model predicts 47% of total variance explained and 34% of total variance explained uniquely. Fat rate in chocolate explains 15% and cacao rate in chocolate explains 4% of total variance uniquely. When all models were examined it is seen that fat rate in chocolate is the best predictor of BMI by explaining 15% of total variance explained. Frequency of chocolate consumption is the second by explaining 7% of total variance explained. Cacao rate is the third predictor by explaining 4% of total variance explained.