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Research Papers on Artificial Sweeteners

Artificial Sweeteners: Aspartame Artificial sweetener is, basically, a replacement for sugar, the main difference being that the sweetener has fewer calories than its natural analogue. It is of white color, powdery and has no particular smell. Although it is said to be a sugar substitute, it is important to note that these substitutes can be subdivided into natural (for example, agave) and artificial sweeteners (e.g. aspartame). This report will expound on aspartame in particular. In 1965 chemist James M. Schlatter, working in G.D. Searle Company, discovered this sweetener albeit by accident, when he was working on an antiulcer drug candidate. Aspartame was first synthesized as an artificial non-saccharide sweetener used in some beverages and foods. It is a methyl ester of the phenylalanine dipeptide. This sweetener is approximately two hundred times sweeter than table sugar, because of which its calorific contribution is negligible. Aspartame and other artificial sweeteners have a distinctive difference from the normal sugars, especially regarding the onset of sweetness and how long it lasts, though aspartame is the closest in terms of taste to the table sugar. Since the sweetness of aspartame lasts longer than sucrose, it is mostly used together with other artificial sweeteners to produce a more natural sugary taste. Primarily, aspartame was derived from aspartic acid, phenylalanine, and methanol, which occur naturally in food through the processes of fermentation and synthesis. The direct fermentation process, which takes about three days, produces a contingent of bacteria enough to produce the required amino acids. These bacteria are destroyed at the end of the process to remain with the amino acids. The synthesis process involves a number of chemical pathways, but generally in order to form aspartame phenylalanine is combined with methanol, then with aspartic acid. The solid residue made after the metacatalyst has been taken away is filtered in an aqueous ethanol solution and then recrystallized to give the powder aspartame. The natural residue components of aspartame are aspartic acid, methanol and phenylalanine, which are realized when this sweetener is broken down once it has been digested. There occurs further digestion, the results being formaldehyde and formic acid, which is believed to be the cause of injury in methanol poisoning if it accumulates. However, for those who have the condition called Phenylketonuria (PKU), the sweetener is not advisable to use simply because phenylalanine is not properly metabolized in this case. Aspartame holds one significant advantage – it offers a perfect option for diabetics or those on a low calorie diet to enjoy a wide variety of desserts with low fat. Its introduction in diet is good for the reduction of blood sugar levels for people suffering from diabetes. Much has been said about the benefits of aspartame, but, as a naturopathic nutritionist, I would not use this sweetener chiefly because of its side effects, which include eye and ear complications, psychological imbalances, neurologic complications and allergies. Although aspartame is currently the best alternative to natural sugar, scientists are still

The Effects Of Sleep Deprivation On Teenagers - 939 Words

In a teenager’s daily they are consumed by the wonders of today’s technology and the social interactions during the day. This extended schedule for teenagers can cause many problems such as sleep deprivation. Sleep deprivation in teenagers can cause a lot of problems, in addition to that sleep deprivation is the leading cause of sleep disorders and depression. Sleep deprivation in teenager can have negative effects in their lives, especially academically and socially. There are different causes of sleep deprivation, two of the main causes are, Technology and Sleep Disorders. Teenagers in today’s society students are plague with the world of technology, this would include computers, cellphones, and T.V. Parents are not setting limits on technology, which means teenagers have access to technology whenever available. Social Media consumes more pressure upon technology now more than ever because of the rapid development being pushed by society. In contradiction, society wants teens to go to school within a time frame that is at odds with teenagers’ social and biological lives. (â€Å"Sleep and Teens†, 2006) Technology is not the only cause of sleep deprivation in teens, but sleep disorders. Teenagers are prone to high anxiety levels from school and social life that is leads to sleep disorders which cause sleep deprivation. The effects of sleep deprivation can vary from person to person, but it all boils down to the unhealthy conditions, disorders and diseases that we becomeShow MoreRelatedOn Some School Nights, I Have A Rough Time Trying To Fall1052 Words   |  5 Pagesfactors were resulted by the lack of sleep, or sleep deprivation. Many more harmful problems can result from sleep deprivation, such as sleep disorders, difficulty driving, and physical and mental effects on students. In which case, students wouldn’t want sleep deprivation affecting their academic grades and education in school. Therefore, students in high school should be allowed to sleep for a longer period of time on school nights or else sleep deprivation will affect the students’ education andRead MoreSleep Deprivation Essay684 Words   |  3 PagesSleep Deprivation It’s seven thirty in the morning, the time that most American high schools begin class. Instead of being chipper and ready to learn, most teenagers, at this time of the morning, can barely remain awake. These puffy eyed pupils are by no means ready to learn. Sixty percent children under 18 reported being sleepy during the day, with another fifteen percent reporting that they had fallen asleep during the school day within the past year (National Sleep Foundation, Dozing)Read MoreSleep Deprivation Essay901 Words   |  4 Pagesnot know what sleep deprivation is, it occurs when a person fails to receive enough sleep at night. A teen need nine hours of sleep to not feel sleep deprived also to be well alert and rested for the next day. Its more than important to manage enough sleep for the next day or experiences regarding the effects of sleep deprivation will occur. Many teens definitely have experienced sleep deprivation and may not have known how serious it is along with how bad it can affect them. Teenagers need to be awareRead MoreSleep Deprivation And Its Effects On Children Essay1249 Words   |  5 PagesRichard Simmons once said, â€Å"There is no such thing as sleep deprivation, there is only caffeine deficiency.† College students everywhere have claimed this as their motto. From art majors who stay up late practicing charcoal and shading, to nursing majors who are stressing all night studying for their exams and practicums, to engineering majors who think a good night’s sleep is three or four hours, sleep has rarely been prioritised in college. Psychology Professors at the University of Hong Kong,Read MoreEARLY SCHOOL HOURS DO NOT EQUAL SLEEP DEPRIVATION AND TEENS Essay893 Words   |  4 Pagesschool increases once leaving elementary school, students face the biological struggle of physiological changes due to puberty. According to â€Å"Adolescent Sleep Needs and School Performance†(1998), puberty demands more sleep, at least a total of 8 hours of sleep compared to an adult; they normally require 6 hours. Along with a greater requirement of sleep, the circadian rhythms of the adolescent change as well. The circadian cycle plays a biological part as to when people fall asleep and when people wakeRead MoreThe Dangers Of Lack Of Sleep Deprivation913 Words   |  4 Pagesof Lack of Sleep in Highschoolers Sleep deprivation in high school students is creating a long list of problems in their health and academic areas. Sleep deprivation has been linked to many different health effects, and a major cause of sleep deprivation in high schooler s is the start time of their first morning class. Many different studies have been conducted concerning start times in schools and the current time that schools begin classes, is wreaking havoc on student health. Sleep has been shownRead MoreThe Affects Sleep Loss Can Have On Your Body Essay1051 Words   |  5 Pages Sleep is the key to success in our world today. It there a certain amount of sleep needed? Can different methods help people get enough sleep? As simple as these two questions may seem there is an infinite amount of answers that could be given. People do not always get the proper amount of sleep their body needs to function properly. There are many ways it can affect a life and not in a positive way. Multiple people may think that there is a certain amount of sleep you need but really there is notRead MoreSleep Deprivation1096 Words   |  5 PagesHow Sleep Deprivation Leads to Cardiovascular Disease Sleep Deprivation is a condition where an individual do not meet the required hours of sleep most of the time. It is a common problem among teenagers and adults. Although lack of sleep does not lead to a serious health problem right away, but doing it repetitively can lead to physical and health problems gradually. Sleeping is one of the basic needs that our body makes in order to regenerate good health for both mental and physical aspect. SleepRead MoreThe Effects Of Sleep Deprivation710 Words   |  3 Pages Sleep Deprivation. How lack of sleep affects you? I bet everyone stayed awake for 24 hours at least once a life. Why has sleep deprivation become such a big issue? Firstly, the global human problem is that teenagers, especially high school or college students spend their nights on parties, in front of the computers playing games or some of them even doing their homework. As well, a lot of workers or workaholics spend their nighttime doing tasks and willing to skip sleep in order to impress theirRead MoreGetting The Right Amount Of Sleep Is Very Important Because1490 Words   |  6 Pagesamount of sleep is very important; because of sleep loss, many human and environmental health disasters have occurred. Looking back at the past one hundred years, the average amount of sleep that americans obtain, has decreased by twenty percent. There are certain amounts of sleep every age group needs to get through each night. Children six to thirteen years old need 9-11 hours; ages fourteen to seventeen need 8-10 hours; and eighteen to sixty-fou r year olds need to obtain 7-9 hours of sleep every night

Elements of Network Security - 1681 Words

Elements of Network Security Louis Kibby Network / Datacom I TCM 537 Mr. Stuart Sandler November 28, 2005 Elements of Network Security Introduction The primary objective of a network security system is to, in a cost effective manner, balance convenient access to legitimate users and inaccessibility to attackers. In a nutshell, the goal is to prevent connectivity to anyone intending to cause harm to the network. The harm to which this paper refers can come in the following forms: 1. Application-level security threats, such as e-mail viruses and attachments. 2. Threats to network infrastructure devices. 3. Theft of network connectivity services. 4. Unauthorized access from internal and external sources. 5. Denial of service attacks.†¦show more content†¦28, 2001). Because this is an automated system, it depends on a mechanical process of discerning what is good or bad. This at times can lead to false positives or negatives, or the blocking of a legitimate user and giving access to a system violator. This weakness in the Cisco IDS requires that an additional form of violation detection be used. In addition to the IDS, LADWP has a staff of technicians who provide continuous network monitoring. In addition to keeping track of the alarms detected by the IDS Director Platform, these technicians also use other tools to keep an eye on network traffic levels, as well as performing routine vulnerability probing. One key tool used is Lucents VitalSuite. This tool uses real-time event analysis, which helps to identify network resources that have exceeded acceptable levels. To properly use VitalSuite, the technicians establish what they believe to be normal network activity. This norm is then used as a baseline to help in the identification of any abnormal network traffic. Once the baseline is established, levels of severity are set. The levels are minor, major and critical, with critical meaning immediate action is required. The only time the system alarms is when a critical error is detected. During normal operations, the technicians monitor VitalSuites display, looking for unusual events. These events canShow MoreRelatedElements Of Network Security Essay1618 Words   |  7 PagesElements of Network Security Introduction The primary objective of a network security system is to, in a cost effective manner, balance convenient access to legitimate users and inaccessibility to attackers. In a nutshell, the goal is to prevent connectivity to anyone intending to cause harm to the network. The harm to which this paper refers can come in the following forms: 1. Application-level security threats, such as e-mail viruses and attachments. 2. Threats to network infrastructureRead MoreSecurity Is A Process Not Product1041 Words   |  5 PagesDr. Wang â€Å"Security is a process not product†. Security is a continuous process to ensure information, people and network have necessary protection for reliable and secure day to day operations. The Information Technology(I.T) and telecommunications firms need complete and low cost security solutions. It is required and essential to protect a secured network from dangerous and deliberate threats. Security should have the qualities that enhance the interweaving of capabilities of security in completeRead MoreDeveloping Mixed Environments Of 802.1x And Non 802.1x Endpoints1701 Words   |  7 Pageschallenging to configure different switches (particularly in multivendor networks) to handle a mix of both 802.1X and non- 802.1X endpoints. The combination of these factors in wired environments can outweigh the intended benefits of deploying 802.1X in the first place. [callout box]  »FACTORS LIMITING 802 .1X DEPLOYMENT IN WIRED LANS †¢ Legacy switches and unmanaged devices lack 802.1X support †¢ Configuration challenges in multi-vendor networks †¢ High proportion of non-802.1X endpoints †¢ Resource-intensiveRead MoreEffective Information Security Policy Elements864 Words   |  4 PagesEffective Information Security Policy Elements In the world today technology is used everywhere, no matter if it is personal or business. Although technology has become important for so many reasons, there is also a measure of security that must be taken for protection. Policies are put into place for protection the organization from fall into a pitfall. It has also helped the organization to build better relations with personals, and build growth within the cooperate industry. There a several waysRead MoreSecurity Architecture Is Developed For Systems Providing End For End Communications1069 Words   |  5 PagesX.805 security architecture is developed for systems providing end to end communications. It was developed by ITU-T SG 17 and was published in October 2003. Issues which X.805 addresses are: 1. What type of protection is to be given against what kind of threats? 2. What are the various kinds of system gear and facility groupings that needs to be secured? 3. What are the different types of network exercises that needs to be secured? X.805 architecture incorporates three security layers which areRead MoreThreat Vectors For Cyber Security965 Words   |  4 Pagesthreat vectors for cyber security in relation to CIP: IT networks, insider threats, and equipment and software. Normally, ICS operate on an internal network, called OT (Operational Technology). Occasionally, this isolated network requires a connection to the organization’s corporate network (IT) for routine operation and management. As displayed in the Ukraine blackout, cyber threats infiltrate an organization’s IT systems in order to access ICS networks on the OT network. The methods used to achieveRead MoreSynopsis Of The Sdn Technology1156 Words   |  5 Pagesallows the controller to control data plane resources. SDN simplifies the configuration of the wide range of resources that are available. SDN must be applicable within systems that already exist which contain many organizations with the need for security of the information that is being shared. Limitations in the real world include the need to exist with the present support systems, administrative or technology fields. Functional subsets maybe summarized from the SDN architecture if the environmentRead MoreFailures in Design and Security Principles1347 Words   |  6 Pagescompanys employees. Hackers who do intentionally tamper with the companys network often do so because they are tempted by assets they know are poorly protected. Weak security policies present the image that a company does not truly value its assets, which in turn attracts the petty thief and curiosity seeker. Therefore, the preventive element of any network security system should include a strong and enforceable security policy for its employees to follow, re-enforced by a form of technical protectionRead MoreBuilding Adaptive Defense Against Cybercrimes Using Real Time Data Mining1648 Words   |  7 Pagessystems behind in the race, because of their inability to identify new patters of cybercrime and to ameliorate to the required levels of security. This paper visualizes the empowerment of security systems through real-time data mining by the virtue of which these systems will be able to dynamically identify patterns of cybercrimes. This will help those security systems stepping up their defense capabilities, while adapting to the required levels posed by newly germinating patterns. In order to confineRead MoreThe Cost Effective Enhancement Of Enterprise Network Security Via Openflow Controlled Switches And Specialized Sdn Applications Running On A1481 Words   |  6 Pagesproject focuses on the cost effective enhancement of enterprise network security via OpenFlow controlled switches and specialized SDN applications running on a controller. The project will investigate on securing the network from various attacks like ping attack, TCP SYN attack, Distributed Denial of Service (DDoS), DHCP attack. Different security measures will be discussed through which the us er can establish a secured network. These security measures will be implemented over SDN. 3. Objectives of Proposed

The Asian Education System versus the U.S. System

According to the World Rank Research Team, Japan is at the top of industrial advances that lead to a very high amount of patents in the country (211). Japan is overtaking America in producing new inventions and conducting scientific research (World Rank Research Team 211). Producing and creating new inventions are the results of very productive, smart individuals, who had a great education throughout their school careers. The Asian education system is known world-wide for having many advantages compared to others like the United States. But they also share their own disadvantages. The United States education system is great to a certain extent, but not very efficient. According to William S. Robinson in â€Å"New Math-Science Study Rates U.S.†¦show more content†¦Japanese parents do not like seeing their children fall behind in school, and they go to an extreme level of parenting which is a main key point of stress onto their children. Fallows uses a quote â€Å"Pass with four, fail with five† referring to the amount of hours their children should sleep (204). Four hours of sleep lets the student have more time to study than five hours of sleep. Extreme levels of parenting lead to excessive pressure on their children, and many teachers and parents â€Å"complain bitterly† about their education system, but little is done to change it (Fallows 204). Pressure on students may lead to stress and depression that can change their lives forever. It can affect teenagers, and young adults by encouraging them to do illegal things such as drinking, smoking, and doing drugs because pressure would change their behaviors, attitudes, and even their morals. Besides all the negativity, the United States and Asia have advantages that make them different from one another. The United States education system may not be efficient enough, but there are also advantages of having the system we have now. The main advantage America has in its education system is freedom. Having the freedom in class to speak and express our opinion is very important in the American culture. Such as, speaking out loud and being free to give an opinion in class. For example, children in kindergarten can It promotes a free flow of ideas thatShow MoreRelatedAmerican Education System Versus Asian Education System Essay772 Words   |  4 PagesAmerican Education System versus Asian Education System Today the American education system is no longer the best in the world. With declining test scores and poor academic achievement, people have questioned whether our current educational system is working for us? On the other side of the Pacific, the situation is totally different. Students of Asian countries achieve higher academic achievements, and they rank at the top on math and science tests. If their educational system is better thanRead More The Importance of Globalization Essay830 Words   |  4 Pagesdon’t see the growing Hispanic and Asian populations in our midst, viewing them—if we acknowledge them at all—as invaders in our world. According to Census 2000, 35,305,818 people of Hispanic or Latino origin inhabited the United States in the year 2000, nearly 13 million more than in 1990. The census revealed the growth rate among the Hispanic population of the U.S. to be the greatest out of any of the minorities at a surprising 57.9%, and the growth of America’s Asian population to be the second fastestRead MoreOrange County, California Demographic Report1604 Words   |  7 PagesSouthern California (U.S. Census Bureau, 2014). Primarily known as â€Å"The OC,† Orange County is famous for its tourist attractions and beaches that stretch along more than 40 miles of coastline. The OC is a comprehensive metropolitan to it s 34 cities, with the four largest cities each exceeding a population of 200,000 (Orange County, 2016). It ranked as the sixth most populous county in the United States showing a combination range of statistic data based off race and ethnicity, education, household andRead MoreChinas Emergence As A Superpower Essay1586 Words   |  7 Pagesprestige, but its confidence has soared as it continues to be the worlds fastest growing economy for the past three decades. Chinas rise as a manufacturing base is going to have the same kind of impact on the world that the industrialization of the U.S. had, perhaps even bigger, stated Andy Xie, a Hong-Kong based economist with Morgan Stanley. It is particularly important to note both the causes and the impact of the emergence of China as a superpower. Although, in order for the impact to beRead MoreChinas Emergence as a Superpower1552 Words   |  7 Pagesprestige, but its confidence has soared as it continues to be the worlds fastest growing economy for the past three decades. Chinas rise as a manufacturing base is going to have the same kind of impact on the world that the industrialization of the U.S. had, perhaps even bigger, stated Andy Xie, a Hong-Kong based economist with Morgan Stanley. It is particularly important to note both the causes and the impact of the emergence of China as a superpower. Although, in order for the impact to beRead MoreHigh Stakes Testing And The Turn Is Not Well Received1152 Words   |  5 Pageschanges over years. The current trend in education is mainly focused on accountability through assessment, such as standardized tests. There are many defining factors and elements that are articulated in the realm of standardized testing. Some of these factors are academic shift from learning to accountability in learning, test data, the problems that plague education and schools related to standardized tests, and the possible solutions for them. Education has gone from standardized testing to highRead MoreCongressional District : 41 Riverside1404 Words   |  6 Pagescommunity. For example, he states that the best person to represent the African American community would be another African American who can empathize with what the community experiences on a daily basis. He explains the two theories black majority versus black-influence districts. For example, the term white-majority has lost its emphasis over the year. Within California, you can travel to the city and see how diverse and socially accepting our society is slowly becoming. With communities such asRead MoreCultural Differences Of Math Performance : L inguistic Influence On Development1276 Words   |  6 Pagesconsistently, that Asian students continue to perform better than Western students in mathematics (Mark Dowker, 2015; Paik, Gelderen, Gonzales, Jong, Hayes, 2011). Studies have also indicated that this distinct gap in performance begins to show even before children have had any kind of formal schooling (Mark Dowker, 2015). This has only served to further reinforce the stereotype that Asian people are naturally good at math; there is some kind of inherent advantage for Asian students (Mark DowkerRead MoreThe Issue Of Medical School Tuition972 Words   |  4 PagesBlacks and Whites have higher rates of medical school debt, in contrast to Asians and Hispanics. Some proclaim that these results are due to an individual’s socio-economic status. On the other hand, others present the idea that it could be a result of attempts to diversify the medical field, encouraging more financial aid and preference for underreprese nted minorities.Within recent years, the price of a medical education has significantly increased. Despite the standard beliefs, researchers discoveredRead MoreRacial Inequality And The And Out Of The Classroom1519 Words   |  7 Pages Racial Inequality’s Influence in and out of the Classroom Race functions as a determining factor in a student’s ability to access quality education. In The United States of America, race directly affects school factors such as policy, funding, and curriculum. Schools affected by location, such as the inner city, and high poverty rates are usually connected to a community that is populated with minority groups. In contrast, studies have shown that public schools in residential areas, where the

Whar Do You Know About Linda Wishkob free essay sample

The Wishkobs took Linda in, gave her their name and raised her as their own on the Indian reservation for a better life. â€Å"Every morning until I was eleven, they woke me up before everybody, Albert said put your feet out Tuffy† which was a nickname given to her by one of her sibling. â€Å"He pulled me one way while Betty pulled the other way’’ (p65) The Wishkob used this method to untwist Linda legs in order for them to grow in a way that will make her look normal. This left Linda abnormality free. Betty and Albert did their best to give Linda the best possible life. In this adopted family Linda grew up with love and patience. Tuffy grew up and turned into a wonderful, strong, loving woman. She was no longer that four year old girl who would not stop crying until she was in her mommy’s arm. We will write a custom essay sample on Whar Do You Know About Linda Wishkob or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Years had passed, she had a job in the local post office, when her adoptive parents passed she stepped up to take care of the family home and the dogs and was living independently. She was strong and could stand on her on. One day her biological mother contacts her. â€Å"I took a deep breath said nothing and set the phone back in the cradle. (pg 66) In that moment, Tuffy had taken the power, and rejected the women who abandoned her. Linda eventually agrees to meet her biological mother for dinner. During the meal her mother offers to pay for meal , Linda said â€Å"no thank you, we will split the check† (p67). In this moment, Lindas actions demonstrates her strong attitude, that she is now her own person and that it is too late for her mother to act like she cares about her. At the restaurant Nancy took one look at Linda and she said â€Å"you aren’t† (p67) and Linda finished the sentence by saying â€Å"Retarded? Lame? † (pg67). Nancy Lasher realizes that the weak, deformed, unwanted girl she abandoned in the hospital was no more. In spite of her lapse as  real mother Linda survived. Linda had  lead a more normal life than everyone had expected including the people who brought her unto this earth. Yes, Linda was now strong, independent and had changed for the best. Later during the dinner her mother reveals her true intention for seeking her out. Mrs. Lasher was seeking to save the life of Linden, Lindas twin. In spite of this callous request for her kidney to save her brother’s life, Linda demonstrate her strength of character and compassion when she agrees to give her twin the kidney he needs to save his life. Linda was far from perfect. However her life journey had taken her from an abandoned, left for dead, weak, and unwanted, into a strong, loved, independent, compassionate, and needed young women.

Multi-Skilling “Jack of All Trades Master of None” free essay sample

Multi-skilling â€Å"Jack of all trades master of none? † Gerald R. Snider June 14, 2010 Wayland Baptist University David Gomez Abstract In today’s Health Care arena where economics is failing and healthcare workers are looking for a reason to stay in the business, it is important to look at every tool available to make that happen. Multi-skilling is a unique tool available that if used correctly could combine technical and administrative duties normally held by several different employees into one job. This paper explores the multi-skill lifecycle model used, associated elements, stages and criteria needed to properly implement this process. It also explores recent challenges that are specific to the medical field when this model is used and how the healthcare industry can implement this process to help it with downsizing and reorganization issues. My research found few studies that explicitly or specifically considered the affects of multi-skilling on the healthcare industry and its affects on patient care. Consequently, general management literature was reviewed with the aim of identifying the model used; generic issues and lessons learned that can be applied across the field of resource management. The literature considers issues relating to the efficacy and success of multi-skilling which could impinge on the integrity of healthcare and patient safety in the workplace. The review considers general effects of multi-skilling with the aim of identifying the problems which may have in impact on healthcare and patient safety and considers the drivers of multi-skilling as it influences the approach and required focus of controls. Because this term applies to a broad range of industries there can be many definitions and applications to this process. The medical industry has defined it as such: Persons cross-trained to provide more than one function, often in more than one discipline. These combined functions can be found in a broad spectrum of health-related jobs ranging in complexity from the non-professional to the professional level, including both clinical and management functions. The additional functions (skills) added to the original health care worker’s job may be of a higher, lower, or parallel level. (Jacobson and Johnson,1998,p. 79) Other industries describe multi-skilling as a way of working where the traditional divisions between work areas and separate disciplines are removed, and individuals are given the responsibility for a range of different types of task. Vertical Multi-skilling – This is where support personnel have learned enough supervisory and administrative tasks and move up into a supervisor role. This can be either considered a form of empowerment or if this process occurs due to downsizin g, often we see individuals that lack the ability to lead or have not been trained properly. Horizontal Multi-skilling This is learning skills from another discipline or function within an organization. For example an electrician learns some mechanical tasks or a process operator learning some maintenance skills. Horizontal Multi-skilling can be considered as two main types: †¢ Skill broadening – where minor elements and tasks are learned on top of the predominant activity (major task). So expertise is maintained in the major task with elements added to increase efficiency. For example, a mechanical engineer may learn how to isolate and disconnect a motor to avoid the use of an electrician. Cross skilling/dual skilling – where another major activity is learned in addition to the main craft and a person is considered competent to carry out any activity in these two main disciplines. For example, multi-skilled craftsmen considered competent to carry out both mechanical and electrical tasks. Typically some limits will be placed on the types of safety critica l work that can be carried out. (Horbury Wright,2001,p. 3) Depth multi-skilling – This is where more in-depth, complex and specific skills are trained on the same skill set. These skills can either be acquired as part of an individual effort to support a team or be incorporated into multi skill set teams. Multi Skill Set Teams (Skill Mix) – This should not be confused with multi-skilling although it does encompass some of the same processes but does not have the same dynamics involved with multi skilling. Multi skill set teams try and align job specific personnel in order to stream line a certain process or to make time and room for more people to be served or more products to be produced. This of course involves multiple team members with all different skill sets where the strengths and specialties are combined and then are managed by an individual in that group. Because multi-skilling can be used in various industries there are numerous models and stages that each industry applies to their application of multi-skilling. For the purposes of this literature we will look at what appears to be the predominant model used in most settings. I. Initial conception – There are usually a number of reasons why organizations choose to multi-skill these primarily fall under four main areas: Organizational flexibility – companies are starting to go away from the worker that can only perform at one job task. This hinders the company’s ability to work efficiently and stay competitive. Now organizations are looking for employees that can function across several levels of job tasks and experiences and are reducing the functional demarcations previously instituted so they remain flexible. Reduce labor costs – Multi-skilling is often a reaction to a reduction in personnel rather than a deliberate strategy. The direct labor costs were found to be reduced by between 20 and 25% following organizations implementation of multi-skilling. Further benefits were a reduction in overtime and a decrease in personnel needed to perform the tasks (Horbury Wright,2001). Reduced downtime/Streamlined jobs – It is often found when multi-skilling tasks to different workers and after eliminating excess workers you can streamline the process for specific tasks or related jobs into a more efficient and less time consuming procedure. Human resource issues – numerous human resource issues can lead to multi-skilling, weakening the power of trade unions, enhancing skill sets, ersonnel development, and empowerment initiatives, enhancing skills and increasing job security. II. Imagining change Once a decision has been made to take the next step in the multi-skilling process the organization can approach the implementation in several different manners. â€Å"Wait and See†, this approach is fundamentally reactive and was found that companies which operated off this premise often lacked the focus on proper training of e mployees on relevant skills, was unwilling to invest the proper resources and were more in a trouble shooting mood. Learn as you Go†, this approach involves a good practice of feedback strategies and requires constant communication at all levels. Management needs to look at the overall cultural view towards change and there should be a widespread sense of ownership. A positive aspect of this approach is the limited start up costs for implementing this system. â€Å"Predict and Preempt†, this approach involves changes in the implementation and content stage. The organization places a series facilitating measures that cover staffing, education, training, and salary issues. Key decisions that should be discussed include, what is the vision the company wants to achieve during this time frame? What kind of risks is the company willing to accept? What can the company do to show it wants to be part of the change process and how can the workforce be persuaded? Finally, the company needs to recognize that it may need to persevere possibly over a number of years and a concerted effort will be required. III. Planning and Enrolling support – This is considered the detail planning stage. This is where you need to consider the wider context of all issues that multi-skilling will affect. Issues such as, human resource agreements, culture of the organization, proper communication of multi-skilling aims and the importance of buy-in by the stakeholders and whether or not the current technical and social system that are in place are consistent with the proposed multi-skilling plan. Enrolling support is about convincing workers within the organization to work together and involve themselves in the proposed changes. Other elements to consider are identification of tasks that are both routine and non routine. Try and optimize the technical and social systems that are already in place. Define the specific knowledge and skills required for multi-skilling. We could go in depth here about task specific items and resource specific ideas but there are far too many to list here. More specifically in the medical field it is felt that the technical specialists are those that should be targeted for cross-training. IV. Implementation and Operation – One of the biggest tasks to complete here is the training and competence step. One of the first steps is to train up staff with the requisite activities and then ensure the training has equipped the staff with the necessary skills and knowledge to competently and safely carry out the tasks at hand. This can be accomplished through defining skill sets to be cross trained, have outside learning provided by third parties, use log books in work area to record daily duties and best practices used reassessment of job skills taught and periodic refresher training. Ongoing management of this process is necessary for multi-skilling to be successful. Following the training that was coordinated and a check on competence to ensure training was successful the review should that organizations with the most success had programs in place to ensure that new and old skills were being used and there was no stagnation taking place. Supervisors and trainers were aware of all the skills necessary to perform job specific tasks by attending some training courses provided to the workers as well. Different organizations then used different means to access the effectiveness of the multi-skilling process and used control measures to try and measure its affects. Some of these performance measures included: job satisfaction, motivation, performance, turnover, health and safety and financial performance. Although we have reviewed the stages that a multi-skilling process should follow the literature also reviewed a model that companies should try and pursue to implement the multi-skilling format. Although it follows the stages very closely in word and format they look a little closer into the lifecycle process used. According to Horbury and Wright (2001), the steps are defined by key management objectives and issues: 1) Starting out – recognize the need for multi-skilling, identify and asses the risks associated with this event, use SOP’s and MOI’s to ensure understanding and compliance, define safety criteria. 2) Planning and assessment – what individuals will be used, what tasks will be used, how will they be trained and supervised, ensure you take into account the workload and competence when making decisions, ensure changes are developed in a planned and systematic manner. ) Implementation – detailed planning is turned into operational reality, ensure proper resources are allocated to change, ensure flexibility is built into the model to allow for change and growth. 4) Implementation check – ensure planned training, supervision, etc has been carried out, achieved required performance objectives, modify implementation if necessary, consider feedback a nd issues that might arise. 5) Ongoing skills maintenance and review – ensure skills are maintained at organizational and individual level, detect any latent problems, always seek opportunities to improve the process. How does the issue of multi-skilling, models, and stages presented fit into the healthcare arena? Most organizations look at the multi-skilling model because of a need for downsizing because of staff limitations or possibly related to financial restraints placed on it by failing economics. Healthcare fits into both of these categories. The U. S. now spends over 16 percent of its Gross Domestic Product for healthcare related services. More money is being spent but less money is being generated. We will soon hit a healthcare crisis as the baby boomers which number in the millions and are on a fixed income, and also on fixed Medicare insurance reach ages of 65-85 which will require numerous medical interventions. It is also well publicized that there is a national nursing shortage that has left many hospitals short on required staff. There is also been a recent problem with staffing some of the technical job skills in certain hospitals and there has always been an issue with how do we get healthcare to those urban settings that lack both physical resources and personnel. So the issue of multi-skilling and cross-training has been forced to the forefront in order to try and deal with some of these issues. Many hospitals had started looking into cross-training/multi-skilling its employees over 20 years ago. Most popular use was training medical personnel in the areas of administrative assistance, such as handling phone calls generating reports and data processing. Now with the looming crisis coming even closer they have to think of more innovative ways to tackle these tough issues. In 1995 Greiner described three primary work-restructuring models that hospitals could use to deal with the above stated problems, patient centered care (PCC), patient-focus care (PFC), and operations improvement (OI). Under a PCC model comprehensive survey data are used to determine what organizational changes make hospitals more humane. Detailed patient reports are used to execute structural reorganizations, redesign work processes, and provide ongoing information for quality improvement processes. Cost savings have not been a focus of this model. The PFC model emphasizes both cost and quality and affects a broad spectrum of occupations through multi-skilling, redeployment of ancillary services and teamwork. OI’s primary focus is reducing the number RN FTE’s and using more nurse Aides, while ancillary services remain more centralized (Grenier Pindus,1997). Many hospitals are now struggling with what approach to take, what skills should be multi-skilled and where do you draw the line with patient safety and proper medical care. Under the PFC model a hospital in Illinois found all kinds of issues related to the multi-skilling model. Job redesign seems to imply to workers that even though they’ve been productive and done a good job, the hospital has decided that their job doesn’t contribute sufficiently to the patients well being. One of the hardest things is helping people understand the answer to the questions, â€Å"Why do I have to change? † It’s one thing to understand it intellectually and another to internalize it emotionally. (Hequet,1994) One of the biggest issues that relates to multi-skilling in a medical environment is the licensing issue. Nurses are usually the lowest worker required to have licensure through the state they are currently working. When a legal battle ensues it usually stops at the nurses’ responsibility level. This makes nurses very wary when new training allocates medical duties to non licensed personnel. Certain states are trying out workers called UAPs (unlicensed assistive personnel). Their purpose would be to bridge the gap with nurses and try to perform direct and indirect patient care under the direction of the registered nurse. Duties would include giving the patient a bath, emptying catheter bags or dressing a wound. Some of these activities seem very menial and unimportant when looked at but or a nurse they are direct interaction with their patient that provides relevant information for medical care. For instance, during a bath their is direct patient contact where nurses can asses skin care related issues or use as an opportunity for teaching the patient about his or her condition, emptying a catheter bag a nurse can look at the color of the urine to see if there is blood present or proper hy dration is taking place, also when doing a dressing change they can look for signs of infection and use proper sterile technique (Cameron, as cited in Backman,2000). Healthcare should learn from the presented model and apply the lessons learned to ensure that there is a smooth transition before they run into a case where these matters become a necessity by force. The literature shows that most models can work unless they are used after an organization has a staff decline and then is forced to use the model. Multi-skilling should play a huge role in the future of the healthcare field. This is a dynamic way to quell some of the personnel shortages as well as the financial hardships that plaque the industry today. The medical industry needs to be proactive both in its legislature and its hospitals to implement these action plans. There have already been numerous battles between the nursing associations because they do not want to lessen their craft or release patient control to other job skills. Certain technical job skills are lobbying in court to keep their multi-skilling status as well. The human resource piece to this puzzle is huge of course because this whole issue is tied around how to use your personnel appropriately and how to engage your employees in a process of change. The literature is full of HR related issues, topics and terminology as it deals with the concept of implementing multi-skilling in different organizations. Finally this literature review has clearly shown that there is a lack of studies and research being conducted in the United States concerning these issues. Most literature was taken from studies and reviews conducted both in Canada and the Untied Kingdom.