Rawaa Alhousari (AutoRecovered) (AutoRecovered) Essays - Diets

Rawaa Alhousari (AutoRecovered) (AutoRecovered) Essays - Diets Rawaa Alhousari ESL 151 Research paper 5/18/17 Is low carb-diet healthier than low fat-diet? "take care of your body. It's the only place you have to live," by jim rhon "Change your mind to change your body," it is a quote which summarize the one and only way to be healthy. I f you have ever tried to lose weight, you have probably gotten drawn into the argument over whether it is better to cut carbs or fat from your diet. Low-fat diet higher in carbohydrate and restricted in fat such as grain starchy vegetables and fruit . On the other hand, l ow-carb diet emphasizes foods high in protein and fat and limits carbohydrate . In order t o have a successful diet, you need to understand how food and nutrition effect your body. Cutting fat from your food, has been for a long time the best and healthy way for healthy heart and l oss weight. Even though most nutritionist and dietitians recommend low-fat diet for their patients , recent studies show that low-carb diets have much more beneficial effects in the body such as lose weight, store energy, and stay healthy. Kevin Hall at the National Institute of Diabetes and Digestive and Kidney Diseases argues that increase fat in the body will cause all kind of health problem, especially heart disease as well as obesity. He says, "That theory, as it stands - that very stron g claim - is certainly not true " (online, qtd. In "you don't need). He thinks that this increase of fat in the body will absolutely lead to chronic diseases. An article in LA Times by Axel F. Sigurdsson "[ a diet] contain high amount of saturated fat and cholesterol may cause unfavorable changes in blood lipids and thereby incr ease the risk of heart diseases " (print) . It is true that low-carb diet insists to eat a lot of fat which it as kno wn can cause chronic diseases. H owever, it reduces the production of insulin which increase burning fat. In addition, low-carb diet lower blood Triglyc erides and the LDL cholesterol which is bad and raised the HD L cholesterol which is good . Other research finds that diets rich in protein can help fighting some common diseases. A 2012 study published in The American Journal of Epidemiology showed that low-carb diet help reduce the risk of metabolic syndrome and heart disease (Dr. Axe) . The study found that both low-carb and low-fat diets improved metabolic risk factor. However, people who on low-carb diet experience an increase in HDL cholesterol and decrease the triglycerides. In fact, this study proved that such a diet higher in fat can beat heart diseases as same as diets lowered in fat. Type-2- diabetes Furthermore, low-carb diet lower the risk of Type-2 Diabetes. A 2005 study published in The Upsala Journal of Medical Science showed a significant effect on the glucose level in the people who followed low-carb diet (Dr. Axe) Cancer obesity, osteoporosis, and diabetes. The two main reasons why low-carb diets are so effective for weight lose are the high protein content and low level insulin. A Johns Hopkins University study found that a diet rich of protein can reduce blood pressure, LDL cholesterol levels, and triglycerides better than a traditional higher-carb diet. In addition, it's obviously that protein can re duce appetite . Thus, it leads to reduction in calorie intake. By Cutting carb, body's insulin , hormone that regulates blood sugar level and stores energy, d rop down, and that is essential in order to burn fat. Because of the reduction in water weight for those who follow low-carb diet, people tend to lose more weight. There are two reasons behind that. Fist, the insulin level goes down which cause the kidneys to release some sodium along with water. Second, the glycogen stores in the muscle and liver goes down along with the water they are holding on. S ome might use this as an argument against low-carb diet. However, reduced water weight should be consider ed an advantage. Some studies that compared low-carb and low-fat showed that people who followed the low-carb diet lost more of the body fat,

Using Delphi Queries With ADO

Using Delphi Queries With ADO The TADOQuery component provides Delphi developers the ability to fetch data from one or multiple tables from an ADO database using SQL. These SQL statements can either be DDL (Data Definition Language) statements such as CREATE TABLE, ALTER INDEX, and so forth, or they can be DML (Data Manipulation Language) statements, such as SELECT, UPDATE, and DELETE. The most common statement, however, is the SELECT statement, which produces a view similar to that available using a Table component. Note: even though executing commands using the ADOQuery component is possible, the  ADOCommandcomponent is more appropriate for this purpose. It is most often used to execute DDL commands or to execute a stored procedure (even though you should use theTADOStoredProc  for such tasks) that does not return a result set. The SQL used in a ADOQuery component must be acceptable to the ADO driver in use. In other words you should be familiar with the SQL writing differences between, for example, MS Access and MS SQL. As when working with the ADOTable component, the data in a database is accessed using a data store connection established by the ADOQuery component using itsConnectionString  property or through a separate ADOConnection component specified in the  Connectionproperty. To make a Delphi form capable of retrieving the data from an Access database with the ADOQuery component simply drop all the related data-access and data-aware components on it and make a link as described in the previous chapters of this course. The data-access components: DataSource, ADOConnection along with ADOQuery (instead of the ADOTable) and one data-aware component like DBGrid is all we need.  As already explained, by using the Object Inspector set the link between those components as follows: DBGrid1.DataSource DataSource1 DataSource1.DataSet ADOQuery1 ADOQuery1.Connection ADOConnection1 //build the ConnectionString ADOConnection1.ConnectionString ... ADOConnection1.LoginPrompt False Doing a SQL query The TADOQuery component doesnt have a  TableNameproperty as the TADOTable does. TADOQuery has a property (TStrings) called  SQL  which is used to store the SQL statement. You can set the SQL propertys value with the Object Inspector at design time or through code at runtime. At design-time, invoke the property editor for the SQL property by clicking the ellipsis button in the Object Inspector.  Type the following SQL statement: SELECT * FROM Authors. The SQL statement can be executed in one of two ways, depending on the type of the statement. The Data Definition Language statements are generally executed with the  ExecSQL  method. For example to delete a specific record from a specific table you could write a DELETE DDL statement and run the query with the ExecSQL method.The (ordinary) SQL statements are executed by setting the  TADOQuery.Active  property to  True  or by calling theOpen  method (essentialy the same). This approach is similar to retrieving a table data with the TADOTable component. At run-time, the SQL statement in the SQL property can be used as any StringList object: with  ADOQuery1  do begin  Close; SQL.Clear; SQL.Add:SELECT * FROM Authors SQL.Add:ORDER BY authorname DESC Open;   end; The above code, at run-time, closes the dataset, empties the SQL string in the SQL property, assigns a new SQL command and activates the dataset by calling the Open method. Note that obviously creating a persistent list of field objects for an ADOQuery component does not make sense. The next time you call the Open method the SQL can be so different that the whole set of filed names (and types) may change. Of course, this is not the case if we are using ADOQuery to fetch the rows from just one table with the constant set of fields - and the resulting set depends on the WHERE part of the SQL statement. Dynamic Queries One of the great properties of the TADOQuery components is the  Params  property. A parameterized query is one that permits flexible row/column selection using a parameter in the WHERE clause of a SQL statement. The Params property allows replacable parameters in the predefined SQL statement. A parameter is a placeholder for a value in the WHERE clause, defined just before the query is opened. To specify a parameter in a query, use a colon (:) preceding a parameter name.  At design-time use the Object Inspector to set the SQL property as follows: ADOQuery1.SQL : SELECT * FROM Applications WHERE type    :apptype When you close the SQL editor window open the Parameters window by clicking the ellipsis button in the Object Inspector. The parameter in the preceding SQL statement is namedapptype. We can set the values of the parameters in the Params collection at design time via the Parameters dialog box, but most of the time we will be changing the parameters at runtime. The Parameters dialog can be used to specify the datatypes and default values of parameters used in a query. At run-time, the parameters can be changed and the query re-executed to refresh the data. In order to execute a parameterized query, it is necessary to supply a value for each parameter prior to the execution of the query. To modify the parameter value, we use either the Params property or ParamByName method. For example, given the SQL statement as above, at run-time we could use the following code: with ADOQuery1 do begin Close; SQL.Clear; SQL.Add(SELECT * FROM Applications WHERE type :apptype); ParamByName(apptype).Value:multimedia; Open; end; As like when working with the ADOTable component the ADOQuery returns a set or records from a table (or two or more). Navigating through a dataset is done with the same set of methods as described in the Behind data in datasets chapter. Navigating and Editing the Query In general ADOQuery component should not be used when editing takes place. The SQL based queries are mostly used for reporting purposes. If your query returns a result set, it is sometimes possible to edit the returned dataset. The result set must contain records from a single table and it must not use any SQL aggregate functions.  Editing  of a dataset returned by the ADOQuery is the same as editing the ADOTAbles dataset. Example To see some ADOQuery action well code a small example. Lets make a query that can be used to fetch the rows from various tables in a database. To show the list of all the tables in a database we can use the  GetTableNamesmethod of the  ADOConnection  component. The GetTableNames in the OnCreate event of the form fills the ComboBox with the table names and the Button is used to close the query and to recreate it to retrieve the records from a picked table. The () event handlers should look like: procedure TForm1.FormCreate(Sender: TObject); begin ADOConnection1.GetTableNames(ComboBox1.Items); end; procedure TForm1.Button1Click(Sender: TObject); var tblname : string; begin if ComboBox1.ItemIndex then Exit; tblname : ComboBox1.Items[ComboBox1.ItemIndex]; with ADOQuery1 do begin Close; SQL.Text : SELECT * FROM tblname; Open; end; end; Note that all this can be done by using the ADOTable and its TableName property.

Business Memo Essay Example | Topics and Well Written Essays - 250 words

Business Memo - Essay Example ittee believes that, thought we have already passes the deadlines for certain construction works due to unexpected circumstances, we should move forward with engineering and customization of the equipment to be installed in the new facility, as well as with the development of sales and marketing strategies for the new drug. This will enable us to work in full and introduce the new drug to the market immediately after the facility is launched. Secondly, since we consider the delay in environmental assessment to be the major, and critical, problem as for now, and taking into account the fact that ET had 3 months for solving it, but has presented no conclusive reports, we strongly recommend taking immediate measures for eliminating this problem. In particular, since ET shows not to perform its immediate responsibilities in the scope and within deadlines critical for our company, we recommend replacing the firm with another environmental consulting company. In such a way we can speed up the environmental assessment process in order to move on to the next stages of construction or clean up, if

Mission Vision and Objectives of TATA Case Study

Mission Vision and Objectives of TATA - Case Study Example Graham (2010) pointed out that â€Å"TATA’s business structure includes 11 charitable trusts that together earn 66% of TATA Sons and that are intimately involved in its governance. (Family members own only 3%)†(Graham, 2010, p.8). No other company in the world may have the same reputation as TATA has as far as social service is concerned. TATA is currently funding many social service activities such as clean water deliver, literacy, prenatal care etc. Moreover Indian Institute of Science, Tata institute of fundamental research, the national center for performing arts, Tata memorial hospitals, etc are founded or supported by the TATA group (Graham, 2010, p.8). In fact TATA is spending a substantial portion of their business profits for charity activities. Because of the huge attention given to social activities, members of TATA family are comparatively poorer than their business counterparts in India. In 2009, TATA spent $ 159 million for social service activities (Graha m, 2010, p.8). TATA believes that community support is the most important requirement for a business group to sustain its growth. It should be noted that Coke like international giants failed to operate successfully in India because of their failure to offer something to the community in which it operates. Coke’s bottling plant in Kerala was closed recently because of the allegations against Coke with respect to the exploitation of underwater resources in Kerala. At the same time, it should be noted that millions of hectares of land in Kerala are used for tea plantation by TATA and the people in Kerala do not have much problems with that. This is because of the fact that TATA is servicing the people in Kerala in many ways even though they use Kerala’s land for tea plantation. Recently TATA has introduced world’s cheapest passenger car (NANO) priced only $ 2500. In fact TATA wants to help the poor people with this product. Poor families of medium income families can afford a car with the introduction of NANO. While most of the other car manufacturers are trying to develop luxury cars, TATA thinks in the opposite direction. They wanted to make car which is affordable to even poor people and the outcome was NANO. Contaminated drinking water is causing thousands of deaths in India. In order to help poor people to purify drinking water, TATA introduced TATA Swatch or water purifier priced less than 1000 Indian rupees in 2009(Graham, 2010, p.9). It should be noted that there is no need for TATA like big companies to introduce products such as water purifier. However, they introduced this product only to demonstrate their social commitments. â€Å"The TATA group has a set five core values; integrity, understanding, excellence, unity and responsibility† (Angwin, 2011, p.133). These core values can be seen in every TATA business segments. Even though TATA’s business groups are operating independently, they understand each other work s trictly in accordance with the vision, mission and core values of TATA group. In short, TATA’s business culture is more oriented towards the servicing of poor. For TATA, business is not at all about making money or profits; it is about how well an organization can service the community without sins.

General Motors Essay Example for Free

General Motors Essay 1. The history, development, and growth of the company over time (e. g. , critical incidents) General Motors (GM) was founded in 1908. William C. Durant brought together 25 independent car companies to form one large corporation. Each company held its own identity as GM operated as central administration office for the 25 divisions. Due to high cost in manufacturing of automobiles, GM was only able to target wealthy customers who could afford cars. Then Henry Ford, owner and founder of Ford Motor Company, revolutionizes the production process of manufacturing cars and takes the lead in the industry. With this new process, Ford becomes GM’s largest competitor, rapidly growing their market share by mass produce affordable cars, the Model T. GM did not have the same competency to mass produce affordable as efficiently as Ford and their sales plummeted. GM was in a bad situation, producing a wide range of expensive cars for a small target market of middle class customers. From 1910- 1920 Ford grew stronger and wealthier while GM struggled to stay afloat. In 1920, Alfred P. Sloan became the CEO for GM and made major changes to GM’s strategy to more effectively compete with Ford. Sloan restructured GM to regain its competitive advantage, targeting a different segment in the market. His consolidation of the 25 companies into 5 major self-contained and operated divisions: Chevrolet, Pontiac, Buick, Cadillac, and Oldsmobile proved to be successful. In 1925 GM took the lead in the industry, hurting Ford’s sales of the Model T so bad that Ford had to shut down his factories for several months to redesign his production line and produce new models. GM became the United States car market leader with the largest market share, 70% at its highest. 925 to 1975, GM expanded its product line to all kinds of vehicles to full-size trucks, light weight trucks, and various specialized vehicles such as vans and ambulances. GM also started to vertically integrate and at one point, made more than 65% of its cars components. From 1925 to 1975, GM dominated the United States market holding approximately 65% of domestic sales. Together, GM, Chrysler, and Ford, held more than 90% of the United States market. Due to the global oil crisis and low cost/high quality Japanese cars in 1970’s, GM lost its lead in the industry. The oil embargo of 1973 revealed the inefficiency of the American â€Å"gas guzzlers†. Neither GM nor its American competitors at this that time had the competence to build fuel efficient cars. Japanese cars now entered the American market and not only were they fuel efficient, there were reliable and affordable. In the 1970s and 1980s, demand for large sedans fell and thousands of GM workers got laid off. By the end of 1970s Americans flocked to Japanese economy cars or sleek European luxury cars and ignored high cost and low quality American cars. In 1980, GM still earned 3. 3 billion on more than 60 billion in sales. With its large cash flows, GM was still able to act as a dominant competitor. Roger Smith, GM’s new CEO aimed to regain GM’s competitive advantage and launched several major programs to reduce cost and improve quality. By 1990, these programs had cost the company over 100 billion dollars, which at the time, was enough to buy out Toyota and Honda. Smith had the most the difficulty lowering cost due to the high cost labor agreements with the UAW (United Auto Workers). GM invested more than 50 billion to improve and update technology and in 1980 started to develop automated factories using robotics to increase quality and efficiency. GM lacked the competency to effectively operate automated factories and was costing them twice as much in producing parts the traditional way. In 1982, GM created a new division called Saturn to develop low-cost manufacturing skills and produce quality cars by imitating Japanese manufacturing companies. It cost GM 2 billion to build Saturn’s plant, GM largest construction project in history. Saturns were priced to compete with Honda Civic and Toyota Corolla. Saturn did not meet its quotas and 1991 and lost $800 million dollars. The next year, Saturn sales picked up and were ranked top 10 in customer satisfaction but still had a loss of $700 million. Saturn could not replicate Toyota and Honda efficiency, especially its low cost supply chain. Same as other divisions, Saturn had difficulties reducing costs because high labor cost due to previous agreements with UAW. To learn Japanese manufacturing techniques GM had a joint venture with Toyota in 1983 called new United Motor Manufacturing, Inc. NUMMI). NUMMI reopened a failed plant in California under Japanese management in 1984. By 1986, with the use of flexible work teams, plant productivity was higher than any GM factory and twice as much as with the old GM management. The flexible teams were regularly rotated, trained to perform the jobs of other works in the team, taught the procedures to analyze jobs to improve work procedures, designed all the teams’ jobs. This freed managers to focus other tasks. GM quickly implemented this system to all its plants and by 2005; GM was laiming to be the most efficient United States carmaker. However, due to tariffs and high costs involved to bring foreign car to the United States, foreign car makers were eager to open their own car plants in the United States. By 1995, foreign controlled plants were making more than 1. 5 million cars a year in the United States. Although GM’s market share declined from 50% in 1978 to 35% 1992, it had not reduced it number of plants or downsized its work force significantly. In 1990 Robert Stempel became the new CEO and like Smith, Stempel did not want to down size the company at all. However, an activist GM director, John Smale, set out to stop GM’s losses and convinced the board to appoint Jack Smith as the new CEO. Smith made drastic changes and down sized the company dramatically. His new strategy for GM was to once again become profitable by aggressively focus on cutting cost, aggressive use of marketing of new designed vehicles that better satisfy customer’s needs, and create a new more-flexible decentralized organizational structure. He also reduced number of models and platforms in which they were built. In 2000, GM built a $1 billion state-of-the-art manufacturing plant in Michigan to raise quality to Japanese levels. In 2005, GM did receive higher quality level similar to Japanese competitor but could not preform to be profitable due to high labor costs. In another attempt to lower value chain cost, GM closed down it Oldsmobile division in 2004. GM then focused on improving efficiency with its parts, components and suppliers, making various changes there. In 2000, GM, Ford, and Chrysler formed an organization called Covisint to gain power over global suppliers. Toyota launches program that reduces the number of steps needed to make components and car parts reducing its costs by 2. 6 billion. In 1992, it consolidated its nine groups into five and combined all its car divisions’ engineering and manufacturing units to eliminate redundancy. Also the five design and technical departments were combined into three to speed product development. To promote and improve coordination between departments, GM changed its organizational structure to a global matrix structure and invested heavily in IT to support this new global matrix structure. With the help of IBM, GM was now able to speed information transfer between its divisions all around the world. In attempts to quickly lower its cost, GM spun off several of its component parts divisions and vertically disintegrated. In 1996, form joint ventures with Isuzu Motors and Suzuki to establish facilities and make specialized engines and transmissions for GM. In 2000, GM acquired a 20% equity stake in Fuji, the manufacturer of Subaru cars and received a new CEO, Rick Waggoner. GM also establishes a strategic alliance with Honda. In 2001, GM’s new assembly plant in China begins production. In 2002, GM formed an alliance with Russian company. During this time, GM attempts to rapidly grow globally and competes with Ford to acquire premium European carmakers. GM bought many other European carmakers but did not find any to be profitable, only costing them more money and more failures. GM also acquired Daewoo and Hummer brand in hopes to strengthen product line and market share. All failed. In 2008, GM fell with the recession and spun off, sold, or digested many of its global assets. GM asked the government for bailouts and in the end filed for bankruptcy.

Importance of the Forest in The Scarlet Letter :: Scarlet Letter essays

Importance of the Forest in The Scarlet Letter "The path strangled onward into the mystery of the primeval forest"(179). This sentence displays just one of the multiple personalities that the forest symbolizes in The Scarlet Letter written by Nathaniel Hawthorn. In the Scarlet Letter the forest symbolizes much more than one might imagine. Each character brings out a different side of the forest, however the forest also brings out a different side in each character. For some the forest may be a place of sinister thoughts and wrong doing, but for others it is a place of happiness and freedom. The first encounter with the forest we have symbolizes just some of the evil that lingers within the darkness of the forest. As Hester and Pearl are leaving governor Bellinghams estate they are confronted by mistress Hibbins who explains that the witches are meeting in the forest, and she then invites Hester to become more deeply involved with her evil ways. "Wilt thou go with us tonight"(113) asked mistress Hibbins, yet Hester refused to sign her name in the black mans book on that night. She explains that the only reason she does not sign is because Pearl is still in her life. At this time the forest itself is a open door to another world, a wicked world that would take her away from her present situation, but that is not the only door that the forest holds. The forest is an open door to love and freedom for both Hester and Dimmesdale. It is a place where the letter on their bodies can no longer have an effect on them if they choose. A world ruled by nature and governed by natural law as opposed to the artificial strict community with its man made puritan laws. Its as if the forest represents a key to the shackles the Hester and Dimmesdale have been forced to wear, all that they have to do is unlock it. Although if they choose not to unlock them, they begin to dwell on the things that they have done to deserve the shackles. In this the forest represents a thing of truth, weather it be good or bad. In pearls eyes the forest has a totally different concept.

The Future Of Nursing: Leading Change, Advancing Health

We are in a decade of change, as nurses we are set to be challenge on many levels in order to face these challenges we must all prepared. Recently the Institute of Medicine, 2010 (IOM, 2010) released a report on the future of nursing; its content outlines in great detail what changes will take place. A collaboration of many offered their expertise in and out of the field of nursing and how the following three areas may be enhanced or completely changed. This writer will attempt to give a single perspective on the issues of Education, leadership and practice and how they may be transformed over the next decade. The Future of Nursing: Leading Change, Advancing Health There have been many discussions by the IOM over the years about the impact of nurses on the care of patients and the obvious need for change. The pending arrival of the affordable care act (ACA) has propelled many of those changes to the forefront; we must remain steadfast in our goal to provide quality care to that patient who depends on us. When the implementation of transformation becomes not only a report but reality can and will it free us as patient care providers to offer a more advanced method of care? Transforming Education This initial goal will remain intact according to the opinion of the IOM report, that all nurses must be prepared to meet a diverse patient population. With that goal in mind the report indicates that educational requirements for the registered nurse (RN) will ultimately be geared towards higher degree attainment by the practicing nurse. Currently the pathways that are in place to obtain a nursing degree will not change but the nurse will be placed on a course to continue their education goals beyond that of and associate degree (ADN). The goal will be to enhance the programs in place and prepare the student nurse for a place in an undergraduate program; a plan to make that goal possible for all is also a need that the IOM report mentions as the current barrier. Affordability of nursing programs beyond that of the ADN now seems to be the greatest challenge; can these entities create such a pathway? Another proposal that this reader found interesting on education transformation, was the pathway for an increase in masters and doctoral degrees to increase the volume of prepared faculty. The current issues that are being faced now is that of faculty shortages in many of the nursing programs both at community and undergraduate campus’s. The ACA has what is noted as an incentive to offset lower faculty salaries which would provide up to $35,000 in loan repayments for eligible nurses who seek to complete advanced degrees. Patient Protection and Affordable Care Act HR 3590, 2010). With such incentives in place this pathway may be considered as a means to an end in the advancement of education by the career oriented nurse, creating leaders is the way to create change. Transforming Leadership The IOM also reflects on the importance of nurses taking a stronger position in leadership. It is time for nurses to take a place at the table of change, that misconception that we are in pla ce to perform and not create will soon be eradicated. The report indicated there is a lack of nurse participation on many directorial boards this is a reason to transform. The placement of these programs is fundamental (Institute of Medicine [IOM, 2010],) to increasing nurse participation. It is true some leaders are born into their roles but not all and with the implementation of these leadership programs this writer believes future leaders can be created. The creation of mentorship programs is also a way to create leaders, as nurses we must make room for those coming up behind us and nurture the leader that lies in us all. This writer found the idea of creating training programs for nurses to represent us on the political front was the finest of all the recommendations, as nurses we must incite change at the very top and creating voices of change on this level would be an incomparable transformation. The ability to have our contributions heard and implemented will create a movement that will carry nursing forward and upward, can we be the voice of the idea and transformation of nursing practice? Transforming Practice. Our scope of practice dictates the boundaries for which we practice, the idea of the IOM report indicate as nurses we must be able to practice to the fullest potential of our educational backgrounds. This is especially important for the advanced practice nurse (NP), their roles must be universally defined for the future. The increase in patient population will see an upsurge in patient load with a shortage of primary care givers and this can only be disastrous for those seeking care. Creating a universal scope of practice for NP will eliminate this issue and it must happen now. The report indicated the barrier to this was the apprehension of acceptance by physicians; can we change a lifelong idea? As this writer has assessed all the pending changes it was asked how these changes will affect the ability to offer care, it is believed that higher education will create a more diverse approach to care and as a patient educator this is key to this nurse’s specialty. As for the other notations regarding care and leadership, this writer believes leadership roles will enhance the confidence of the role of the patient educator, finally increasing the quality of care provided. Conclusion In closing a transformation of change can only happen with the active participation of all nurses, we must become active in every facet of our future and not leave it up to others to speak on our behalf.