Exam on inpatient and outpatient codinhg Essay Example for Free

Exam on inpatient and outpatient codinhg Essay 1. The three goals of the Physicians Payment Reform are to decrease Medicare expenditures. As well as redistribute physician’s payments more equitably. Also to ensure quality health care at a reasonable rate. 2. I would use modifier -57, decision for surgery with the E/M code for this case. Due to the E/M service and the decision for surgery were made earlier that same day. 3. There are three components of the relative value unit the first component is work, which is the amount of time, the intensity of effort and the technical expertise required for the physician to provide the service. The second would be the overhead component also known as the practice expense, it is identified as the allocation of cost associated with the physicians practice (ex. Staffing) that must be expended in order to provide a service. The third component is malpractice and is identified as the cost of the medical malpractice insurance coverage/ risk associated with providing the service. 4. People age 65 and older, along with patients who are experiencing end-stage renal disease are both eligible for Medicare. As well as people who are eligible for disability benefits from social security, they are too covered by the Medicare program. 5. To find the main terms in the index of the CPT you must use these basic location methods, you must search by the service or the procedure, the anatomic site, condition or disease. You also could use synonyms, eponym’s or abbreviations to find main terms in the index. 6. The E/M code 99253 would be used to report an initial impatient consultation. With a detailed history and exam along with a MDM of low complexity. 7. There are many elements when considering the correct E/M code. There are four elements of history which include chief complaint, history of present illness, as well as review of symptoms and past, family, and/or social history. 8. The complexity of medical decision making is base doff of three elements which are the number of diagnosis or management options. These options can be minimal, limited, multiple or extensive. The nest element is the amount and/or the complexity of data to review. The data can be minimal or none, limited, moderate or extensive. The last element of medical decision making is the risk of complication or death if the condition goes untreated. This risk can be minimal, low, moderate or high. 9. The correct CPT code is 99214 due to the detailed history. As well as the detailed exam and a MDM of moderate complexity. 10. There are three key components present in every patient’s case except counseling encounters and/or time based codes. The three components are the history, the level of examination, the level of medical decision making. These components allow us coders to choose the appropriate level of service.

Organizational Ethics Essay Example for Free

Organizational Ethics Essay My intent in writing this paper is to describe how ethical principles can address organizational issues. The organization that I have chosen to explore is the Boeing Company specifically and the aerospace manufacturing industry as a whole, more generally. I will cover the role that external social pressures play in influencing the industry in both their compliance with government and professional ethics. I will also endeavor to highlight how the pressures brought to bear on the industry by the public and the government is relevant to their decisions both corporately and individually by their employees. Finally, I will share my thoughts on the relationship between legal and ethical issues with regard to the industry. To begin then, let’s explore what role external social pressures have in influencing the Boeing Company and by extension, the aerospace industry’s organizational ethics. The level of trust that must be present by the public in the company that builds the airplane they fly in is best described in the words of the Boeing employee code of conduct â€Å"†¦must not engage in conduct or activity that may raise questions as to the companys honesty, impartiality, or reputation or otherwise cause embarrassment to the company.† (Boeing, 2014) Boeing and the entire aerospace industry are hyper aware of their image and the perceptions of the flying public. When social pressure is brought to bear the entire industry takes notice and works to renew and enhance the public’s trust. For example, last year Boeing experienced a public relations nightmare when their new 787 Dreamliner aircraft experienced problems with Lithium Ion Batteries. An aircraft caught fire while waiting to be refueled and prepared for its next use. When news of the incident became known it was received with widespread fear and seeded mistrust of the airframe in the public, in the airline customer and the Federal Aviation Administration (FAA). The entire 787 worldwide fleet was grounded until resolution could be  made to ensure public and aircraft safety. The speed with which Boeing and the FAA dealt with the problem shows beyond any doubt that social pressure influences Boeing and the entire aerospace industry. Aerospace companies are constantly working to keep and enhance the trust of the public and to remain in compliance with the strictest government standards. The Core Values of the Boeing Company are Integrity, Quality, Safety, Diversity and Inclusion, Trust and Respect, Corporate Citizenship and finally Stakeholder Success. (Boeing, 2014) It is interesting to me that stakeholder success is the last item on the list. Boeing sees their public owners as being lowest on their corporate priority list with regard to ethics. In other words they see the need to be ethical as higher than being profitable. The need to be perceived in the public arena as ethical and trustworthy while also remaining in compliance with very lofty government standards demonstrates how Boeing and the aerospace industry strive to perform at a level which helps to mitigate the need for public or social pressure to influence their decisions. The issues the aerospace industry routinely deals with remain relevant and continually influence the decisions made and direct the way the companies involved expect their employee’s personal decisions to be made. Everything Boeing and its employees do have the potential to impact the public trust. In a broader sense the organizational ethics of the aerospace industry are determined by multiple factors. As already mentioned the flying public’s trust is a major factor but added to that are the airlines which operate the aircraft, the government agencies who retain oversight on the industry as a whole and the corporate citizens who build the aircraft. A great deal of effort goes into ensuring each of these levels of influence are balanced and mesh as seamlessly as possible with the core values mentioned above. As I have discovered, the aerospace industry is heavily influenced by many government agencies. Through regulation and legislation these agencies impact the aerospace industry’s relationship with both the public and its stakeholders. The relationship which exists between these entities creates in many instances a legally mandated set of codes which govern the way the aerospace industry conducts business. In the United States the FAA has the ability and, arguably, the responsibility to mandate that certain rules and standards are met in the construction and operation of airplanes. Whether the airplanes are used to transport the flying public  or are designated experimental and only flown under strictly controlled circumstances makes no difference. The ability of a government agency to enforce rules or a code at a level as invasive as exists in the entire aerospace industry creates a question of whether the ethics embraced by the aerospace industry would be at the level they currently enjoy if the amount of regulation was not the same. In a more direct fashion the question then begs itself; given the influences of the public, the airline operators, and the government agencies with oversight, is the aerospace industry as a whole independently ethically responsible or are they forced to be so? When I attempted to determine if there is a clear definition of what ethically responsible means I fell short. The definition is subjective at best and invariably indistinct. I can therefore only use my personal definition to gage what I can research and see for myself to make a determination much as you the reader must do. As I stated my intent in writing this paper was to describe how ethical principles can address organizational issues. Strictly speaking, I may have drifted afield of a clear presentation of that description. However, the role that external social pressures play in influencing the aerospace industry in both compliance with government and professional ethics was demonstrated throughout as well as how the pressures brought to bear on the industry by the public and government is relevant to their decisions both corporately and individually by their employees. Last but certainly not least, I sought to determine the relationship between legal and ethical issues in reference to the aerospace industry which left me with an unanswered and perhaps unanswerable question. Works Cited Boeing Company. (2014). Boeing.com. Retrieved Dec 1, 2014, from Boeing Ethic Home Page: http://www.boeing.com/boeing/companyoffices/aboutus/ethics/

Kicking Performance and Kick Co-ordination Training

Kicking Performance and Kick Co-ordination Training The effects of a strength and kick co-ordination training programme on lower limb velocity, ball velocity and knee extensor strength: Differences between male and female football players. Football (also known as soccer) is one of the most popular team sports worldwide (Katis Kellis, 2007) with hundreds of millions purported to play (Masuda et al, 2005) and in accordance is watched on 6 continents (Ekstrand, 1994). Due to this popularity, football is a widely researched area with the volume of literature extensive. Various research programmes have been undertaken in the area of football kick biomechanics with a range of parameters being measured and analysed, in an attempt to understand the fundamental skills required by the sport, especially the maximal soccer kick (Lees Nolan, 1998). Although the field is widely researched gaps still transpire. One of these gaps is gender differences; little research is documented on the kick biomechanics of womens football as said by Barfield et al (2002), who states the rapid rise in female participation in soccer worldwide has not been followed by a corresponding increase in the number of studies biomechanically that target fema le kicking patterns to determine if differences exist between males and females. Lee and Nolan (1998) state that success in football depends on kicking performance, with new aspects of this being identified (Kathis Kellis, 2007). Shan and Westerhoff (2005) believe that the scientific understanding of the sport is not yet on the same echelon as its practice, subsequently its partakers acquire their skills not through research based instruction but through individual experience; suggesting that biomechanical feedback may facilitate an athlete further. Kicking performance and kick co-ordination Biomechanical kicking success in football has been measured predominately by maximum ball velocity (Markovic et al, 2006) with Dorge et al (2002) stating it could be this speed that is particularly important when kicking towards goal. When kicking a ball, players will use the most appropriate form dependant on the intent and nature of the outcome (Numone et al, 2002) and according to a study by Grant et al (1998), who analysed data from the 1998 World Cup, the instep kick (IK) (see figure 1) and sidefoot kick are the most commonly used techniques to score. The ball velocity of the maximum IK is the main indicator in kicking performance (Orloff et al, 2008) and has been said to be the result of various factors including technique (Lees and Nolan, 1998), gender (Barfield et al, 2002), muscle strength and power of players (De Proft et al, 1988; Dutta Subraminium, 2002). The IK is a fundamental skill that is used on many occasions during football (see figure 1), with Orloff et al (2008) stating that the mechanics in instep kicking are critical in determining kick performance. Transfer of momentum from the thigh to the leg is believed to play an important role in instep kicking, however these claims have not been conclusively quantified (Dunn Putnam, 1988). The IK involves a sequence of momentum from proximal (thigh) to distal (shank and foot) body segments in the kicking limb as it is a swing action (Barfield et al, 2002) that should be a natural fluid motion (Clagg et al, 2009). When a kick is performed the proximal segment initiates the movement taking the kicking leg backwards, with the distal segment lagging behind, forward movement of the leg occurs when the proximal segment has reached its potential at backswing and is brought forward whilst the knee continues to flex (Wickstrom, 1975; Dorge et al, 2002). This is followed by a deceleration of the proximal segment due to motion dependant moments from the shank (Putnam, 1991); upon ball impact the proximal segment is almost stationary, at which point the distal segment is accelerating and vigorously extending about the knee to almost full extension at ball impact (Wickstrom, 1975) (see figure 2). At the point of contact, of instep to ball, powerful kickers keep the foot/ankle compl ex locked and plantarflexed, as a consequence the forces that propel the ball are maximised (Hay, 1996; Tsaousidid and Zatsiorsky, 1996). Lower limb velocities (Levanon Dapena, 1988) are said to be an important determinant of ball velocity. Manolopoulos et al (2006) state that a greater shank velocity is indicative of a more powerful shot, the study conducted by Manolopoulous et al (2006) concluded that a strength and kick co-ordination training programme over a ten week period can cause an improvement in angular velocities of segments. A study conducted by Barfield et al (2002) found that a greater ball velocity was found with greater angular velocity of the distal segment (in male footballers). From this literature it can be assumed that a person with a high lower limb velocity should have a high ball velocity. It has been theorised that the length, speed and angle of approach are the most important aspects of the preparatory phase, before movement transpires, having a significant effect on football kick success (Isokawa Lees, 1988; Kellis et al, 2004).When a football kick is performed the athlete may kick the ball from a stationary position or approach the ball from a certain distance (Kathis Kellis, 2007), Opavsky (1988) states that higher ball velocities are established when there is a running approach, of at least two to three steps, to the ball in contrast to a stagnant approach. Another important point is that a ball will in most cases be moving towards the player; consequently the player will not be hitting a stationary ball as is often the case in laboratory conditions, supported by Tol et al (2002). Kellis and Katis (2007) state that higher ball speed values have been during competition in contrast to a laboratory setting. Isokawa Lees (1988) concluded that on average maximum swing leg velocity occurred at an approach angle of between 30 ° and 45 °, with a maximum velocity ensuing at 45 °. From this finding it can be alleged that 45 ° is the optimal approach angle for a maximal velocity instep soccer kick (Clagg et al, 2009). Maximum ball speed and its relationship with accuracy is one which has been investigated with interesting results. Asami et al (1976) reported that by demanding both speed and accuracy from players, an 80% drop of the maximal value occurs as a result, this is a considerable reduction; however is further supported in literature stating that accurate kicking is achieved through slower ball velocities and kicking motion (Katis Kellis, 2007; Lees Nolan, 1998; Teixeira et al, 1999). Katis Kellis (2007) deduce that a defined target, such as a goal, will determine the actual constraints on accuracy, with its manipulation leading to a trade-off between speed and accuracy of ki ck. Another factor that could inhibit a maximal velocity IK is the kicking limb chosen. Many studies have found that higher ball velocities are found when football players kick with their dominant limb as opposed to kicks with the non-dominant limb; this has been attributed to higher foot speeds and a better inter-segmental pattern (Numone et al, 2006; Dorge et al, 2002); Manopoluous et al (2006) state that ball speed is the result of several segmental actions of the body during a kick, figure 3 illustrates the movements of the body segments during different phases of the kick. Female and Male footballers Studies regarding male football performance in relation to kick biomechanics is a well researched area, however this does not correlate to the lack of knowledge gained when researching for female information. This statement is supported by McLean et al (2005) and Hewett et al (2006) who both acknowledge that few studies have characterised or examined female athletic performance in specific sports such as soccer, along with the assertion from Barfield (2002) that the rapid rise in female participation in soccer worldwide has not been followed by a corresponding increase in the number of studies biomechanically that target female kicking patterns to determine if differences exist between males and females. It is thought that the identification of kinematic differences between the sexes could potentially play a critical role in the teaching and training of aspiring female soccer players (Barfield et al, 2002). Consequently it can be assumed that female studies should be regarded to be o f high importance and those found could help to eradicate huge differences between the sexes. With this said there are a few studies that have compared male and females, and studies that have solely looked at females. A study by Barfield et al (2002) investigated differences between elite female and male soccer players. The study concluded that males kick the ball with greater ball velocity on the instep kick than women (see table 1 for mean ball velocity achieved in this study) and the differences in kinematic variables investigated were significantly different between the sexes, although this was small. However in this study there was one exception to the case, as it was found that one female generated greater ball velocity on two of her three kicks than the males on her dominant side, suggesting that not everyone follows the trend. A study by Tant et al (1991) supports Barfield et al (2002) findings, as it was found that male players produce greater ball speeds than their female counterparts, they attributed this finding to greater strength that males recorded; as tested on an isokinetic dynamometer. In contrast to these findings, a study by Orloff et al (2008) comparing the kinetics and kinematics of the plant leg position between males and female collegiate soccer player during an instep kick, found that ball speed did not differ significantly between the two sexes as was hypothesised. Table 1 illustrates mean ball velocities, ranging from 15 to 30 m.s-1, achieved during a number of studies most of which occurred with the instep kick. Only one study shown provides details of a mean female ball velocity once more indicating the lack of research on female football participation. Strength training It has been stated that kicking performance when measured by means of maximal ball velocity, can be improved by strength training (DeProft et al, 1988; Jelusic et al, 1992; Taiana et al, 1993), relating to Wisloff et al (2004) who states that maximal strength is an important factor in successful soccer performance; this is because of the apparent demands visible from the game. Strength has been defined as the integrated results of several force producing muscles performing maximally, either isometrically or dynamically during a single voluntary effort of a defined task (Hoff Helgerud, 2004); Schmidtbleicher (1992) states that strength influences all other components and thus it is located in an upper hierarchal level. The use of strength training is a common means of improving muscle function and has been said to develop performance of kicking skill through apposite training (Masuda et al, 2005). Gomez et al (2008) believe that the coalescing of strength training with technical training involving motor tasks is required for improvements in performances to occur, this relates to the traditional training principle of specificity; Behm Sale (1993) and Sale (1992) support this principle as they believe that training is intended to correspond to specificity in sport itself, this is in terms of contraction type, contraction force, movements and velocity. This can be related to football training, since the fundamental aspect of football is kicking and this involves a complex series of synergistic movements of the lower limbs, which in essence would be extremely complex to imitate with simple strength-training movements (Bangsbo, 1994). Therefore strength training should be integrated into football training with several types and speeds of training involving the actual movement pattern in order to increase performance (Masuda et al, 2005). If a relationship between muscle strength and performance exists then it can be assumed that positive effects should become perceptible when measuring ball velocity, if these performance enhancing training benefits are not evident then athletes may not be motivated to participate in strength training (Myer et al, 2005). Myer et al (2005) conducted a study that explored the effects that a comprehensive neuromuscular training programme had over a period of six weeks. The investigators measured performance and lower extremity movement biomechanics in female athletes, it was concluded that female athletes who trained with this six week programme could gain performance enhancements and significant improvements in movement biomechanics. Myer et al (2005) states that female athletes may especially benefit from multi-component neuromuscular training, as females often display decreased baseline levels of strength and power when compared with their male counterparts. The previous statement is supported by Kraemer et al (2003) and Kraemer et al (2001) who believe that a comprehensive training programme may significantly increase power, strength and neuromuscular control and therefore decrease gender differences in these measures. Campo et al (2009) conducted a study over a period of 12 weeks on female soccer players; this involved the undertaking of a plyometric program. It was found that this program produced improvements in explosive strength in the female athletes and consequently this improvement could be transferred to soccer kick performance in terms of ball velocity; this study also lends evidence to the use of plyometrics in a strength training program. Studies by Aagaard et al (1996) and Trolle et al (1993) found similarities within their results, since no significant improvements in kicking performance were established after knee-extension strength training. However De Proft et al (1988), Gomez et al (2008) and Monolopoulos et al (2006) all conducted strength training programmes that combined strength with another form of training, football training, plyometric exercises and technique exercises (kick co-ordination) respectively, found significant improvements in kicking performance (maximal instep football kick). The studies by Gomez et al (2008) and Myer et al (2005) took place over a 6wk period, with the study by Monolopoulos et al (2006) taking place over 10 weeks and Campo et al (2009) over a 12 week period, suggesting that the length of a training programme is interchangeable to gain relevant results. Hoff Helgerud (2004) state that research based on strength training is often not conclusive; this may be due to the variances in measurement techniques. Knee muscles Various studies have examined the muscle activation patterns that arise during a football kick; one of the findings to come from studies is the high activation of knee muscle groups (De Proft et al, 1988). To examine this further, maximal isokinetic data has been undertaken to study the moment of force of the knee extensors and flexors, this has been investigated in male players (Brady et al, 1993; Oberg et al, 1984; Oberg et al, 1986), female players (Reilly Drust, 1997) and in relation to football kick performance (Cabri et al, 1988; Poulmedis, 1988; Reilly Drust, 1997). Rapid knee flexion and extension is an important part of a football kick as the knee flexes then extends at impact, this movement is accompanied by a stretch of the knee musculature during backswing ensued by immediate shortening during distal segment movement (Katis Kellis, 2009). The action of the proximal segment being brought forward whilst the distal segment lags behind (as the knee is still flexing) serves to stretch the extensor muscles of the proximal segment before shortening of them is needed, this necessitates the generation of large end-point speed (Lees Nolan, 1998). It can be assumed that if the knee extensor muscles are powerful then they should facilitate in large end point speed (greater ball velocity). Isokinetic muscle testing is often used to evaluate strength within sport, with a range of data obtainable from its use (Ozcakar et al, 2003) however controversy surrounds its application. Wisloff et al (2004) believe that isokinetic tests do not reflect the actual movements of the lower limb segments during a football kick, and Dvir (1996) states that this is due to the nature of testing knee extensors, as it is a single-joint configuration, it is limited in functional scope. A study by Reilly Drust (1994), have reported results for female soccer players that show a high correlation between ball speed and knee extensor strength, this is supported by McLean and Tumilty (1993) who state that maximal strength of knee extensor muscles is an important determinant of kick performance. Asami et al (1982) report that the ball velocity and knee extensor strength relationship of the kicking limb may well depend on the skill level of the players, suggesting that the strength of the muscles in the knee has less input on ball velocity in football players whom are more skilled. This statement implies that less skilled players rely more on their muscular strength than skill. De Proft et al (1988) conducted a strength training programme for footballers and found a 25% increase in concentric muscle strength of extensors. Studies have shown that knee extensor strength and kick performance however did not have a positive relationship, as for example Masuda et al (2005) found that knee extension/flexion strength was not correlated with the ball velocity and Aagaard et al (1996) conducted a 12 week training programme on the isokinetic strength of the knee extensors and flexors, with an increase in isokinetic and concentric strength found, but it was concluded that this gain did not help facilitate improvements in performance. Expectations and hypotheses From current literature it is expected that the use of a strength training programme integrated with technical game play, will have a positive significant improvement from pre-test to post-test on both females and males as previous research has shown that a strength training programme improves performance (Manolopoulos et al., 2004; De Proft et al., 1988; Dutta Subramanium, 2002), however the female group are expected to have a bigger improvement as they often have lower level of strength to start (Myer et al, 2005) leaving more room for improvement, and men will have a better kicking performance determined by ball velocity as they possess more power (Barfield et al, 2002; Tant et al, 1991). It is also expected that an improvement in knee muscle strength, limb velocity and foot velocity at ball contact will lead to an improvement in ball velocity as it can be said that kicking performance can be related to leg muscle strength as it is the muscles which are directly responsible for t he increasing speed of the foot and therefore resultant ball velocity (Lees Nolan, 1998). This information leads to the hypotheses for this study. It is hypothesised that after a strength training and kick co-ordination programme both men and women will find significant improvements in their kicking performance and knee extensor strength, females will have a greater improvement in the pre to post test results than their male counterparts, men will have greater ball velocity both pre and post test than women, improvements in knee strength, limb velocity and foot velocity will lead to an improvement in ball velocity. Materials and methods Pilot testing Before any real data collection commenced two pilot tests were conducted. This was to enable any aspects of the testing procedure to be checked, allowing areas of weakness and uncertainty to be enhanced and/or changes needing to occur to be implemented before actual testing transpired. The first pilot test involved kinematic analysis data collection, using Qualysis Oqus 3D motion capture system, at a sampling rate of 500 Hz, under laboratory conditions. A participant was marked up with a lower limb marker set (see figure 7 and 8), a warm up and relevant instructions were given. 5 maximum velocity kicks were performed with the dominant foot at a target (1.82m x 1.2m) set 6 metres away from the position of the ball, a 2metre approach distance of self selected approach angle was allowed and a Sports radar precision gun (SRA 3000) was positioned behind the target. Uncertainties regarding target size, approach distance and quality of data collection were put under scrutiny. Collaboration with the participant allowed for uncertainties such as target size and distance of approach to be modified. Quality of data was checked and it appeared not all parts of the movement were captured or markers visible at all times (see figure 4). Due to these findings the pilot testing res ulted in changes to the planned protocol, such as approach distance (an extra metre allowance was given), bandage size (was halved to prevent covering of markers), calibration technique in regards to area dynamically covered was increased (to cover all movement performed) and appropriate marker placement took place (incorrect palpitation had previously taken place). The second pilot test was an extension of the first, relevant changes were made as noted in pilot test 1, with testing on the isokinetic dynamometer (ISOCOM- isokinetic technology, eurokinetics) included for strength data. A warm up was conducted prior to use, with the involvement of dynamic movements to help replicate the movement on the isokinetic dynamometer, once completed 5 practice trials took place followed by 3 trials that were collected as the data. This allowed for any time restraints for the two conjoined to be noted. It was found that the testing on the isocom took longer than the kinematic data, as it was expected that this would be roughly the same time; so implementation of a suitable time system could occur. Marker issues previously noted in pilot 1 were not problematic; this could be due to the increased area of calibration and anatomical landmark markers not being covered by bandages. Figure 5 shows that most data was captured and tracked, giving evidence to improve ments made being effective, when comparing figure 4 and 5 against each other. The extra metre approach distance allowance proved successful with collection of data running more smoothly. Participants Sixteen amateur football players volunteered to participate in this study, eight females and eight males. Participants were split with regards to gender and assigned to either the female control group (FCG) (n= 4 females; age 20  ± 0.8 years; height 169  ± 5.8cm; body mass 68.9  ± 11.1 kg; all mean  ± std), the male control group (MCG) ( n= 4 males; age, 21  ± 1 year; height 177.5  ± 7 cm; body mass 77  ± 10 kg; all mean  ± std), the female strength training experimental group (FTG) (n= 4 females; age 20  ± 1.3 year; height 160  ± 1.8 cm; body mass 58.1  ± 4.3 kg; all mean  ± std ) or the male strength training experimental group (MTG) (n= 4 males; age 17  ± 1. 2 year; height 174.9  ± 4.1 cm; body mass 73.1  ± 13.7 kg; all mean  ± std). All females were right foot dominant, with 6 males being right foot dominant and 2 left foot dominant. Foot dominance was self selected based on the players reply to which foot they preferred kicking with to gain a maxi mal ball velocity outcome. Subjects were informed about the requirements, benefits and risks of the study, and completed an informed consent form and Par- Q prior to any testing (see Appendix). Kick performance test / Biomechanical testing In accordance to the study of Masuda et al (2004) kick performance was evaluated by measuring the maximal and mean velocity of the ball, by the use of Sports radar precision gun (SRA 3000), and a set number of trials in which the ball hit the target (5 times). Other measurements from this maximal kick were also taken by means of Qualysis Oqus 3D motion capture system, this uses multiple cameras (an eight camera system) to reconstruct three dimensional movement data; this was captured at a sampling rate of 500 Hz for 5 seconds. This enabled human movement analysis during the execution of a motor task (instep kick) to be traced via the use of reflective markers, gathering quantitative information (Cappozzo et al, 2005). The calibrated anatomical system technique (CAST) marker set was used (Cappozzo et al, 1995), each participant was instrumented with 44 retroflective markers (see figure 7 and 8). All markers and clusters used when capturing the data was with the aim to: not significant ly modify the performance being captured and measured as stated by Brand and Crownshield (1981). These markers were placed on anatomical landmarks (medial and lateral side of proximal and distal end of segements) by palpation using guidance from Croce et al (2005), and on segments using clusters in accordance with Manal et al (2000) who state that a rigid shell with a cluster of four markers is the optimal configuration for a cluster set. Specific shoes were provided for all participants, with the anatomical landmarks placed on these prior to testing (figure 6). Before data collection of each participant commenced, the motion capture system was calibrated (see figure 9a) to allow information gathering of spatial location of anatomical landmarks in regards to a known frame of reference (Cappozzo et al, 1994). This occurred by the use of a wand, which carries two markers of a given distance (750.5mm), and is made to coincide with the target anatomical landmarks by moving dynamically through the volume of cameras (Cappozzo et al, 2005; Richards, 2008) over a calibration frame placed in the data collection area (see figure 9b), this is removed so data for the intended activity (instep kick) can be performed and recorded. A static of each participant with clusters and anatomical markers was then taken (see figure 10) asking participants to gain a posture where anatomical markers can be seen by two or more cameras for at least a frame. Once this was achieved only tracking markers were kept on (thigh and shank clusters, anterior superior iliac spin e (ASIS), posterior superior iliac spine (PSIS), greater trochanter, iliacs, foot markers except 1st and 5th metatarsals), as Cappozzo (1984) states markers used for identifying anatomical landmarks should be removed before physical movement is performed. Qualysis Track Manager (QTM) was the software used to capture the data including statics, dynamic movement and calibration. The set-up design for the kick performance test can be seen in figure 11. Specific instructions were given to participants regarding their kicks, it was stated that although the kicks that missed the target would be repeated, they should not sacrifice speed in order to improve accuracy. A ball of standard size and standard inflation (Fà ©dà ©ration Internationale de Football Association, FIFA, standard) was used. A warm-up was conducted, this took place on a treadmill (5-10 mins) followed by stretching, once the candidate felt they had been sufficiently warmed up practice trials took place. 2-3 practice trials were implemented allowing participants to acquaint themselves with test equipment and kicking conditions. Participants were allowed to self select their approach angle to the ball (between 0 ° to 60 °), the only restraint utilised was the approach distance to the ball; participants were allowed a run up of between 2 to 3 metres this distance was marked and made noticeable to the participants. 5 successful trials were recorded on the dominant leg, a successful trial was classed as one which hit the target and the motion capture data was seen to be adequate, only 3 of these trials were analysed (data deemed as poor quality was discarded). This testing took place both pre and post intervention. Once data collection had been completed in QTM, the information was used and markers labelled; including both static and dynamic data. For dynamic data, this took place through naming the markers in a dynamic frame and processing this to the corresponding data. An aim model was built, this was then generated and batch processed to all the dynamic trials, the checking of each anatomical frame ensued to ensure all markers were labelled correctly. Once this procedure was completed data was then exported to Visual 3D for further analysis and model building. Data from QTM (see figure 10) was built in to actual body segments that could be visually seen and recognised; this occurred through model building on Visual 3D. Figure 12 shows some examples of how the right hand side of the body was built; the same was done for the left side. Once model building had been completed, all trials were checked and different pipelines were put in place (a set of commands that can change or produce data wa nted). An interpolation pipeline was conducted on the data to fill in missing data points, a ten frame gap fill was instrumented, filling in gaps more than this suggest that data is of poor quality. A low pass filter (using Butterworth filter) pipeline was put in place on the data, to smooth and remove noise that could be due to relative and absolute errors (soft tissue artefacts) (Richards, 2008), with a cut of frequency of 6 Hz used. Cut off frequencies previously used in other literature are between 6-18 Hz (Andersen et al, 1999; Dorge et al, 2002; Nunome et al, 2002; Teixeira, 1999). To determine heel strike of the non-kicking leg at placement the event minimum pipeline was used on the non-dominant leg (heel), to find the lowest point of the heel in the z axis (see figure 13). For information between a range of movements to be determined, the event ball contact was defined (see figure 14). Segment velocity (in x axis) of the thigh, shank and foot was extracted from the data, in the reports section, using the range of events previously defined (non-dominant leg heel contact and ball impact) to visually see data between and up to those chosen points. Muscular strength test Isokinetic concentric peak torque of the dominant leg was measured using an isokinetic dynamometer (ISOCOM- isokinetic technology, eurokinetics) see figure 15. The strength test involved movement of the knee (extension and flexion) to detect muscular strength in the knee extensor muscle groups. The angular velocity used for the movement was 60 ° s-1; this angular velocity has been used by many investigators to evaluate knee muscular strength of football players (Kellis et al, 2001; Ergun et al, 2004; Dauty et al, 2002). Prior to undergoing the test a warm-up was conducted, consisting of a 10 min warm up of cycling and 5mins of dynamic stretching, completion of this lead to the familiarisation process of the test protocols for the isokinetic movements that were tested including practice trials. Three maximum voluntary repetitions of flexion and extension at 60 ° s-1 took place in a seated position, with five familiarisation trials taking place beforehand, the participants were war ned as to when the real trials were about to commence. The peak torque value was used to represent muscular strength; this is considered to be the gold standard in isokinetic measurement (ISOCOM testing and rehabilitation user manual). This testing took place both pre and post intervention with the same protocol applied for both testing. Training programme The training programme undertaken in this study was a synthesis of findings derived from published articles for example training books and journals (Manolopoulous et al, 2006; Zatsiorsky Kraemer, 2006; Chu, 1998). The FTG and MTG followed a 6-week training programme consisting of 1 session per week (each session consisting of up to an hour and a half) including a warm up and main activities. The main activity consisted of a circuit style fashion plyometrics, kick co-ordination and strength work ensemble, with exercises such as; lunges, squat jumps, resistance band work, core stability ball work and hurdle work included. Technical game play was incorporated into each session at the end of the circuit; with the aim of improving k

Costs And Contributions: The Wave From South Of The Border :: essays research papers

Costs and Contributions: The Wave From South of The Border Every year, hundreds of millions of people enter the US via land ports of entry, and the INS each year apprehends over 1.3 million aliens at or near the border. Over 90 percent of those apprehended near the border are Mexicans, and some who enter the US legally and illegally are carrying drugs into the US. This influx of illegal immigrants from south of the border has created quite a stir in many places. Is this good that people are coming to the U.S.? What will happen if this pattern keeps up? Will they steal our jobs? What effect will this wave of people have on us? These questions plague many and deserved to be answered in the following paper on: "Costs and contributions: The Wave From South of The Border". "Dowell Myers (USC) reported on his double cohort method--by age and year of entry-- of analyzing what happened to immigrants arriving in the seven southern CA counties after 1980. His analysis shows that especially young immigrants make considerable economic progress after their arrival--as measured by their total incomes--and that some of their behavior converges rapidly to that of natives, e.g., they rapidly abandon buses and drive cars to work. In southern CA, one-third of all bus riders are recent immigrants. Myers noted that immigration is raising other issues, including overcrowded housing. The US definition of acceptable housing was two or less persons per room until 1960, when the definition was change to one or less per room. However, as immigrants moved into southern CA, overcrowding jumped, raising questions about how aggressively cities should enforce housing codes developed during a non- immigrant era." Many are haunted by the question: will we be hurt? Over crowding has had a major impact on families living near the Mexican border lowering standards of living and living space as well. Also, citizens wonder about the filthy scum that comes from south of the border-are all illegal immigrants scum? George Vernez outlined an ambitious project that is dealing with the question of whether immigration is a plus or minus for CA by examining the effects of immigration on internal migration, on wages, and on public finances since 1960. Those studies showed that immigrants from most countries do catch up to similar natives in average weekly earnings after 10 to 20 years, but not immigrants from the major country of origin--Mexico. Furthermore, immigrant children tend to follow in their parents' footsteps, meaning that the children of Asian immigrants tend to do well in school, etc., while the children of

gatmoral Moral Responsibility in The Great Gatsby :: Great Gatsby Essays

Moral Responsibility in The Great Gatsby Bang! Gatsby's dead! George Wilson shot Gatsby! However, who is morally responsible for killing Gatsby? The obvious answer would be George since he pulled the trigger. However, it is clear, if for no other reason than for the unimportance of George in the book, that others were also partly responsible. In The Great Gatsby, by F. Scott Fitzgerald, Tom, Daisy, and George are morally responsible for the death of Gatsby. Tom, because of his tattling on Gatsby, can be morally blamed for the murder of Gatsby. When George talked to him, Tom told George it was Gatsby's car that hit Myrtle, but he failed to mention that it was Daisy driving. Even though it was never directly mentioned, it is shown that Tom knew Daisy was the one who killed Myrtle when Nick said, "...and anybody would have said that they were conspiring together," (p.146) when referring to Tom and Daisy talking in their house. This "conspiring" was probably a plan to get Daisy away from the whole incident. Furthermore, Tom and Daisy leave town the next day, proving Tom's knowledge of Daisy's guilt by just trying to escape with her. Even knowing this, Tom still had the indecency to tell George it was Gatsby's car. Tom can also be morally blamed for the killing of Gatsby because of his affair with Myrtle. George killed Gatsby not only because he thought he killed Myrtle, but also because he was under the impression that Gatsby was the one having the affair with his wife. Tom knew George was thinking this and when George talked to him, Tom seized his opportunity to get off the hook for his sin and directed it to Gatsby, making himself even more morally incorrect for doing it. It is clearly justifiable to blame Tom for Gatsby's death. Daisy can also be put morally responsible for Gatsby's death. Her bad morals relating to Gatsby's death are displayed when Gatsby said, "Anyhow - Daisy stepped on it. I tried to make her stop, but she couldn't..." (p.145) Daisy was not morally responsible enough to stop the car after she hit Myrtle. She would also not take the rap for driving the car later, but instead, left town.

Finding Peace in Siddhartha Essay -- Hesse Siddhartha Essays

Finding Peace in Siddhartha "I have become distrustful of teachings and learning and that I have little faith in words that come to us from teachers." (Page 18) Siddartha experienced this when he was with the Samanas, still seeking for peace of the innersoul. He distrusted teachings because to attain peace, he must learn everything from himself. However, along his journey, he was indebted by a beautiful courtesan, a rich merchant, a dice player, a Bhuddist monk, and Vasudeva, for they had influenced him and he gained great knowledge from each of them. After leaving Gotama, the Illoustrious One, Siddhartha entered the life of a human being. He met a beautiful courtesan named Kamala and asked her to teach him the art of love. She said anyone who came to see her must be wealthy and therefore, she wouldn't teach Siddhartha for he was just a ragged Samanas. She introduced him to a rich merchant named Kamaswami and from this man that Siddhartha learned to trade and became rich. Obviously, Siddhartha came back to see Kamala and she accepted him. They learned the game of love together and she taught him many many love lessons that she knew. From her that he learned love could not be forced, people could buy love, ask for love, but could not steal love. He also learned that people must grow old and die and that there was no endless life. Together, Siddhartha and Kamala had a son, Siddhartha, who could not love anyone, loved his son with all of his heart. Kamaswami, a richest merchant in town, hired Siddhartha as his assistance and from this man... ...river and finally, they attained peace. When he reached peacefulness, Siddhartha became the ferryman. He delivered people across the holy river just like Vasudeva once did and yet, deep within himself, there was an eternal peace. On the other hand, Govinda was still struggling with desire for knowledge and had not yet attained what he was seeking, so he came to learn from Siddhartha. Surprised when he heard Siddhartha mentioned the five considered teachers Siddhartha had during his quest for peace, Govinda thought Siddhartha was joking. Saw the confusion in his friend's face, Siddhartha told Govinda to bend and kiss him on the forehead and as Govinda did this, he understood everything Siddhartha had said. Siddhartha, whose smile was similar to the Illustrious One's, finally attained peace for his Self.

Supernatural

Annie (Lenore Critical) who Is an emotionally fragile ghost (Icemaker 35). All three of these supernatural monsters live In an apartment together In Bristol while trying to live normal lives (Icemaker 35). I think you should take out this whole sentence – However, their so-called normal lives conflict with their supernatural lives. The series shows Mitchell, George, and Annie trying to lead double lives by attempting to be a part of the human world as well as the supernatural world. Their human flaws however, become evident In their supernatural worlds.The characters are faced tit many challenges while managing to be a part of both worlds, through which they realize that they are actually being given a second chance at life. In Being Human UK, Mitchell, George, and Annie are creatures that are â€Å"fusions of a person with counterintuitive properties† (Petersen 94). Their supernatural lives are burdened with the flaws from their previous lives. Mitchell, as a human, to ok advantage of his good looks and used people. When he becomes a vampire, the ultimate user, and has the desire to drink blood and kill people, he realizes he needs to change.One of the first ways he tries to change is by refraining from drinking blood. He does not want to use people because only death will come from it. On the other hand, George, as a human, did not have any confidence and was socially awkward, especially around women. Becoming a werewolf allowed him to realize that he needs to stop being afraid of the outside world and develop enough confidence to be himself around others. Mitchell even states that George needs to be able to turn into a werewolf inside their house and accept who he is. Watch clip and cite quotation). Annie in her previous life had everything going for her. She went to university, met the love of her life Owen (Greg Chilled), and was happily engaged. She was determined to always get what she wanted. Now as a ghost, only Mitchell and George can see her and she is finding It difficult to accept that her fiance has moved on and she is no longer in control (Lowry 1). Through her ghostly existence, she starts to realize that she can be Independent and happy without Owens presence.All three of these characters â€Å"support each other In an effort to be as normal as possible† and are faced with conflicts because of their double lives (Lowry ). This BBC show allows viewers to witness the characters learning about second chances. Mitchell â€Å"double Identity and ‘normal' aspects of his personally are what attract us to his character (Petersen 105). Throughout the series he Is faced with situations that require him to decide which world he wants to be a part of. One of his struggles, as a vampire, is when he has to decide whether he wants to convert people because of another woman he converted.Here, Mitchell was perplexed by the choice of letting Laura die or saving her life by turning her into a vampire. George yells at Mitchell to do something because she is dying but Mitchell responds by saying â€Å"Not another one I can't† and allows Laura to die (Being Human 1. 1). Mitchell also does not want to seem suspicious, so he tries everything he can to be perceived as ‘normal'. In the second episode in season one Mitchell invites their neighbors over for tea to â€Å"participate and Join humanity' (Being Human 1. 2).In episode two season one, George's transformation is described in great detail and is compared to a human suffering a heart attack (show clip in class). Also, there have been several instances where George says he does not want anything to do with his supernatural life, showing that he is quite ashamed of it and would much rather be human. For example, he says, â€Å"l onto want to allow it into my life†¦. ‘ like to keep things separate, the house is the house and the thing that happens to me every month is something else. I transformed here last month and it doesn't belong here† (Being Human 1. 2).The house that they all live in is where George feels most comfortable with himself because he uses it as a coping mechanism to deal with his supernatural nature and to pretend he is still a part of humanity. When it comes to Annie, her conflicts with the supernatural world and with humanity reside in the fact that she â€Å"does not know why she remains trapped in the unman realm† and as a ghost she Just wants people to be able to see her (Lowry 1). Throughout the show, these characters are always struggling with living their double lives because all they want to do is be a part of the normal human world and be Just like everybody else.Nannies two worlds are colliding because she does not know why she is still haunting her ex fianceg's house and she constantly struggles with the fact that she is a ghost. She is miserable because she recently passed away due to falling down the stairs. The one thing that she wants more than anyth ing is to be able to live her life again and be with her fiance. A few things that Annie does to pretend that she is still â€Å"alive† involve continuing doing her daily â€Å"human† routine. For example, she makes tea everyday to make her feel like she is still alive.George comments and says, Mimi keep making tea, every surface is covered with mugs of tea no tea, it has all been made. And you can't even drink it. † Annie responds by saying â€Å"l like my routine, it makes me feel normal† (Being Human 1. 2). )(maybe show clip). Throughout many episodes Annie is always doing certain routines that she would have done when she was alive such as cleaning, catering to Mitchell and George's deeds, and making food for them. Another conflict that Annie faces involves trying to resolve why she is still a ghost and is still a part of the physical realm.It isn't until episode three season one, when Annie meets Gilbert, (Alex Price) a ghost from the ass's, that she finally uncovers the reason behind her prolonged existence. Overall, Mitchell, George, and Nannies supernatural lives give them a second chance to figure out something about themselves that they never resolved while they were still living as humans. Their supernatural lives are a â€Å"source of identification in which new grounds for selectors can be found† (Petersen 98). Mitchell realizes that he wants to become a better person and stops relying on his good looks to get him places.One of the victims that made him realize his personality faults was his co- worker named Lauren (giftedness). Mitchell mistakenly converted her to a life as a vampire. After watching her being so desperate to feed off people and watching her kill others, it made him realize he did not want his vampire existence to be like hers. Therefore, he learns by watching Lauren, that there is more to life then Just looks, and that people deserve to be treated with respect. George learns that it is possible t o have confidence in himself because of a werewolf named Tail(faded).When George found out that Tail was the one who turned him into a werewolf, he learned that he did not want to associate himself with other werewolves because they could not be trusted. By standing up to Tall, it gave George the courage he needed. This conflict with Tail allowed him to become a stronger person, and gave him the confidence to talk to women. Annie realizes with the help of Gilbert, that she is still around because there is something unresolved in her past life. When her memories start to mom back, she figures out she died because of her fiancà ©'s anger. (show clip in class).Her flange Owen treated her like property and is physically abusive. Unfortunately her fragility tells her that it is all her fault and that she had it coming. Nannies self realization shows that she was insecure and incapable of standing on her own two feet while she was with Owen. However, as a ghost she realizes that she can become independent and does not need Owen. Unfortunately, this realization does not allow her to move on to the next realm. Therefore she continues to exist with lessons still to learn. All three characters were given a second chance at life to redeem themselves so that they could become stronger and better beings.When it comes to Mitchell, George, and Annie as well as other supernatural beings, â€Å"the recirculation of recognizable constructions of them implies that we should consider them as culturally successful and possibly impacting on our thoughts† (Petersen 105). All of us can relate to Mitchell, George, and Annie because we have experienced some sort of arrogance, awkwardness, and self doubt. Matt Insist argued that science fiction and fantasy films â€Å"attack reason, sell reenactment's fantasies, and undermine appreciation for science and supernatural horror transcends simple-minded repudiations of science(Collocation).