Sunday, October 13, 2019

The Obesity Epidemic Essay -- Obesity in America

In 1990, obese adults made up less than 15 percent of the population in most U.S. states. By 2010, 36 states had obesity rates of 25 percent or higher, and 12 of those had obesity rates of 30 percent or higher. (Centers for Disease Control and Prevention, 2015) Even more alarming, the prevalence of overweight and obesity in children and adolescents is on the rise, and youth are becoming overweight and obese at earlier ages. One out of six children and adolescents ages 2 to 19 are obese and one out of three are overweight or obese. (Ogden, 2012) This essay looks at the question of what are the main causes of obesity and what steps the school system can take to assist in the reduction of childhood obesity. While childhood obesity has been increasing, the school system continues to struggle with what exactly their role is in the fight against this epidemic. With these rising concerns from not only the parents, but also the government, our school system has now placed important emphasis on physical fitness and offering children a physical education program that will not only reduce the childhood obesity rate here in America, but also increase the child’s academic skill levels through motivation and exercise. While the school system is offering this physical education to the children, the need for educators to be equipped with the educational knowledge base to offer the children is a subject of great concern. Many teachers today lack the education themselves to properly instruct children within the physical education classroom and there for need to acquire additional edification themselves. The demand for superior physical education at the basic levels of education is extremely vit al as research has shown that there is a relati... ...or Physical Education. In Dynamic Physical Education For Elementary School Children (pp. 1-19). San Francisco, CA: Pearson Education, Inc., Publishing as Benjamin Cummings. Tinning, R. (1990). Chapter 1Physical education, curriculum, and culture:Physical Activity and knowledge. In D. Kirk (Ed.), Physical Education, Curriculum And Culture: Critical Issues In The Contemporary Crisis (pp. 1-18). doi: ISBN 1-85000-674-1 Wall, S., Rudisill, M., Goodway, J., & Parish, L. (2004). A comparison of three movement settings on the development of fundamental motor skills in young children. [Supplemental material]. Journal of Sport and Exercise Psychology, 26(S194.). Wong, A. K., & Chueng, S. (2010). Confirmatory Factor Analysis of the Test of Gross Motor Development-2. Measurement in Physical Education & Exercise Science, 14(3), 202-209. doi: 10.1080/10913671003726968

Saturday, October 12, 2019

Welcome to Life :: Essays Papers

Welcome to Life "Dear mother, can you hear me whining? (Green Day)" When something was difficult what did you do, especially when you were a young child? You whined. That was the way you got people to pay attention to you. You hoped that this way they could make life better for you. Complaining to your mother will make everything better. That is the logic that many young children are taught. Life is different as you reach different stages and becomes more difficult each time you reach a new challenge. The stages start with your being comfortable in your surroundings, well protected by your family. As you grow older, you begin to grow apart from the people and the area that you were once close to. You start to go on your own path. This path leads you to a new place with which you may not be as comfortable. The song "Welcome to Paradise" by the punk-rock band Green Day explains the difficulty of moving away from home and how eventually life will get better and you will find that you are not as dependant on your family. The song "Welcome to Paradise" begins a mere three weeks after the boy has left his home. He is writing a letter telling his mother how horrible it is to be away from home. He feels he is alone; this is a scary feeling. He reaches out to the audience by discussing a feeling that many young people have recently experienced. I remember when I first started college, whether I want to admit it or not, I was scared. I moved to a new location three hours away from my warm room and, for the first time, I had to do my own laundry, take care of myself, and keep my area clean and livable. These were new and challenging tasks. At times, even though there are forty-two thousand people here, it feels very lonely, as if you are the only one going through this situation. Everyone experiences some sort of uncomfortable feeling when they have to move to a new location and start a new stage in their lives. From personal experience a college senior explains how he felt the first day he moved to live at college, "I definitely felt like I was in some strange limbo Twilight Zone kind of place†¦It wasn’t a very comfortable feeling at all.

Friday, October 11, 2019

Employe Loyalty in Hotel Essay

The essence of competition among hotels is the competition of human resource. If a group of skilled, sophisticated, and loyal employees can be retained by hotels, high quality of service, hotel brand and honor, and revenue can be guaranteed to a large extent. As a result, employee loyalty is one of the core competitiveness of hotel, largely influencing and determining the further development. Also, employee loyalty is one of the indicators of the performance Human Resource Management in a hotel. Employee loyalty is expressed by the behaviors and attitudes that are showed by hotel employees (Ineson & Berechet, 2011). With increasingly severe competition, the quality of product and productivity determine the destiny of a company. The employees who work longer are more familiar with the mission and vision of the company and regular working procedures, with the understanding of how to improve productivity and quality and save the costs, which are the competitive advantages of a company. Employees are part of hotels assets. The society also raises attention to employees’ loyalty, since employees turnover rises with low loyalty, which leads to a series of problems, like unemployment. Before a hotel employs new staffs, the on duty employees will undertake loads of responsibilities. High employee turnover will bring hotel to a chaos and revenue loss. Consequently, employee loyalty counts when dealing with high employee turnover. High employee loyalty can bring in lucrative benefit to hotel by reducing the recruitment and training costs, improving labor productivity, and creating more revenue. Also, the organization structure will be stable with high employee loyalty, stimulating the execution of tasks of related departments and achieving the continuing development. Besides, a specialty of hospitality management is that part-time employees play an important role in the delivery of guest service. Hotel could benefit a lot from properly managing part-time employees by saving training costs. So, part-time employees are another potential group of loyal employees, from which talents might be discovered. Currently, with much more choices are provided to the market, people are given more alternatives and chances, among which there is one that they cherish most and is suitable for their career development, the high employee turnover is a serious problem, which is urging to solve. In the following content, this article is going to talk about the factors that impact employee loyalty, both full-time and part-time, and different ways to improve employee loyalty. Factors that impact employee loyalty Individual Characteristics Individual characteristics, such gender, age, job tenure, and job position, have some impact on employee loyalty. For instance, for older (>40 years old) employees, job security, good maternity/paternity packages, a convenient workplace location, and a planned career path are most important, which reflect their life cycle priorities (Ineson & Berechet, 2011). Also, young employees (25-35 years old) have more ambitious to break rules and make decision without hesitation as long as there are more promising opportunities. Gender difference is obvious in hotels. Traditionally, men are supposed to be the bread-maker in a family, so most cleaning is done by women in the hotel, including the public area and guest rooms. Besides, job position has an impact on employees’ attitudes towards employee loyalty, which means that different hierarchical positions show different employee loyalty in hotel (Ineson & Berechet, 2011). Attitude toward Work With the globalization of economy, the facilities and techniques in hotel industry improve a lot, and so does employees attitude towards career path, changing from consistency to variety—developing through career ladder. In the past, most people’s first job is the last one, whose attitude toward job is that the more stable, the better. Now, however, it is not rare to be told that one’s colleague left to another hotel for further development, mostly because of better opportunities for personal development. Other employees may pay much attention on relatively clean and comfortable working environment offered by most hotels. Since the product of hotel is service, which relies on the direct communication between frontline employees and guests, both frontline employees and managers will deal with all kinds of relations with guests and colleagues, or physical work. If employees’ attitude toward their job is uninterested from the beginning, it’s very hard for hotel to build up employee loyalty. Attitude is everything. Job Commitment and Job Satisfaction Job commitment is measured by how employees feel about the hotel as a whole. It is the degree to which an employee identifies with the organization and is the desire to staying with the organization (Wanda & Salazar, 2011). Job commitment refers to both employees and hotels share goals and values, and willingness to work on behalf of the hotel. Employees can achieve their goals through the success of hotel, which is a win-win situation. Job commitment and job satisfaction are related: job commitment is to measure how’s the employees feel about the hotel; job satisfaction is to measure fulfillment with a specific job. Job satisfaction is strongly associated with employee loyalty. It is easy to work out that satisfied employees will work hard and provide high quality service to guests. Then employees will receive positive response from satisfied guests, which will give employees a sense of fulfillment and increase their loyalty. A virtuous cycle begins. Payroll and Benefits Payroll and benefits are the most direct factors that influence employee loyalty. A high payroll and benefit packages can always retain employee, which just satisfied the most basic needs of living. The most common situation in China is the huge gap between the payroll of managers and frontline employees. Undertaking loads of work and directly dealing with various guests, frontline employees are always offered low payroll, compared with the payroll of hotel managers or with the average salary in the market. Payroll is the most direct factor and may have negative impact on employees’ motivation and it is often the first consideration when people choose jobs. People will naturally compare the payroll and benefit with different hotels. When a feeling of unfairness on payroll arises, the tendency of leaving and slowing down will increase. Training and Opportunities to Develop New Skills Training is one of Human Resource most visible functions. The opportunities of develop new skills measure the management of training program. Training will not only enhance the skills and proficiency in dealing with regular working, but also give employees a sense of fulfillment through learning and making progress. It is also a way to show the care to employees. Hotels who do not invest in employee training cannot see the progress their employees made and the rise of productivity, which is not a long-tern development trategy. Mastering more skills after training, employees will have a much better understanding of their responsibilities, become more qualified to their positions and provide much better service to guests. Training management can be measure by employee satisfaction and guests satisfaction. Factors mentioned above are those that mainly impact full-time employees. Some of them may also work on part-time employee, but the ma in factor that impact part-time employees’ loyalty and commitment is the levels of support received from hotels and supervisors. As mentioned above, employees’ strong commitment will result in greater loyalty and better behaviors. Hotel manager should understand that commitment is a double- way communication. Research indicates that employees who perceive their managers’ commitment will be also committed to their organizations, resulting in much better performance and exceeding hotels’ expectations (Misty, 2009). Additionally, since part-time employees expect less than full-time employees, they will savor the moment of value when treated as part of the organization.

Thursday, October 10, 2019

Handmaid’s Tale †the character of Offred Essay

Margaret Atwood’s novel The Handmaid’s Tale houses a very authentic range of characters, in a complex world. Set in the Republic of Gilead, a totalitarian and theocratic state, where a reproduction rate is rapidly decreasing, some women are labeled as handmaids and assigned to elite couples that have difficulty conceiving. The personality of one character in particular, however, may seem hasty and misunderstood at first glance. But given the circumstances, she proves to hold the values of humanity: she has her own set of opinions, flaws, and habits; has regrets; and a balance of courage and fear. Furthermore, the setting this character must survive in is not much different from today’s society. The government is deemed corrupt, fear of punishment is instilled, and the leaders ensure that the citizens adhere to the law. Finally, the aid and support that she receives, the faith and hope she has, and the development of friendships she makes also has a likeness to ordinary relationships in our world. Hence, the novel’s protagonist, Offred is a relatively relatable individual, especially in terms of her character, her surroundings and her supporting roles. Offred conveys a sense of reality in her personality as she is not perfect and has her own set of opinions, flaws, and habits. For instance, Offred has many moments and flashbacks where she reminisces about her past. This implies that she has regrets and obstacles in her life, just as every human being does. When Offred describes her appearance, albeit briefly, it signifies the insecurities that she keeps bottled up inside â€Å"I am thirty-three years old. I have brown hair. I stand five seven without shoes. I have trouble remembering what I used to look like. I have viable ovaries. I have one more chance† (Atwood, 143). Had she been proud of what she looked like, she most likely would have gone into more detail, but the lack of words plainly states that she thinks nothing special about herself. At one point that she mentions that she does not like to look at herself in the mirror. This shows that she does not look at her self as superior and she is also self-conscious of her own appearance. She also possesses a certain attributes that any person would possess; she is rebellious and disobedient in constricting situations. This is what makes her more interesting and what sets her apart from the rest. Although Moira, Offred’s best friend, was an even more revolutionary character, she seemed too daring to be true. A real life person would not be likely to pull off stunts that Moira had accomplished, for example escaping from the Red Centre â€Å"She had both hands on the lid when she felt something hard and sharp possible metallic jab into her ribs from behind. Don’t move, said Moira, or I’ll stick it all the way in, I know where, I’ll puncture your lung†, â€Å"I couldn’t believe how easy it was to get out of the Center. In that brown outfit I just walked right through. I kept going as if I knew where I was heading, till I was out of sight† (Atwood, 130, 244). Offred had just enough courage and just enough fear to seem realistic. Keeping these points in mind, it is clear that Offred could have been an ordinary character in our society. The Republic of Gilead, as strange as it may seem, actually has some similarities to the modern day and this is primarily seen by Offred’s response to its laws and regulations that they instill. To her, the government appears as corrupt as most governments in this world, and dictators still thrive, just as they do in Offred‘s society. Offred responds to this by doing nothing, which would be the decision of most people if forced to live under these conditions. The leaders of Gilead, after all, employ obedient enforcers to make sure that citizens abide by their laws. She mentions this in the book when she retells how the changes in her nation started. She describes in full length that she, along with all women in the U. S. , were forced from their jobs by men in uniform carrying machine guns â€Å"Not fired, he said. Let go. You can’t work here anymore, it’s the law† (Atwood, 176). The fear of punishment is instilled, akin to the terrors of being imprisoned or given a death sentence in our world. Penalties are dreaded so much in Gilead, for most of the time they are unjustly given out and they vary from hanging to ‘Salvaging’; which is being beaten to death â€Å" The three bodies hang there, even with the white sacks over their heads looking curiously stretched, like chickens strung up by the necks in a meat shop window; like births with their wings clipped, like flightless births, wrecked angels† (Atwood, 277). Offred ultimately responds passively, on account of this fear, and because liberal ways are shunned in Gilead. Margaret Atwood was right in not giving Offred any extraordinary abilities to surpass or overthrow the tyrants that ruled over her life as it would result in a loss of Offred’s relatable self. Relationships with other people are a necessity of life that defines human existence. As Offred progresses with day-to-day life, she develops these friendships, which ensure that she exists. The friends and allies that she made were essential for keeping her sanity intact because without any shoulders to lean on in times of sorrow, a person’s mental capacity could break. Amongst her friends were Cora, whom Offred was not very close with but did not have any tension with, Ofglen, Moira, her best friend, and Nick, the Commander’s chauffeur that Offred opens up to and confides in towards the closure of the story. Offred frequently finds herself seeking support and knowledge in people who share the same beliefs and opinions as her, most significantly from Ofglen and Moira. This portrays the doubts about her world that she holds: another human quality. From Ofglen, she realizes that she is not alone in thinking that their country is corrupt and that something must be done to change things â€Å"At last Ofglen speaks. â€Å"’Do you think God listens,’ she says, ‘to these machines? ’ She is whispering: our habit at the Center†(Atwood, 168). However from Moira, Offred finds out that escaping from their strict nation is not as easy as she had thought, as Moira could not even arrive at such a courageous feat. Without her supporting roles, Offred could have been an ignorant citizen in Gilead that was brainwashed into believing every word that the government fed them. If that were the case, Offred’s connection to the readers would have been lost. Furthermore, Offred turns to hope and faith to console her and help her to move on with life. Just as her friends helped her, these virtues aided in protecting her wellbeing; though forced, since she had nothing else to look to. The hope that Offred’s husband is still alive is very similar to the feelings of families in modern day society that pray for the safe return of their lost, loved one from war or other degrees of separation. Faith is introduced to Offred when she acknowledges the pillow in her room with the word ‘faith’ printed on it â€Å"There’s a hard cushion on it, with a petit point cover: FAITH, in square print surrounded by a wealth of lilies† (Atwood, 57). The fact that it is something she can read implies that there is still hope, as not everything has been taken away from her. This knowledge strengthens her belief that change will come, though subconsciously since Offred never mentions it. The faith that she puts into the Commander also ties into the trust she gives him when playing games, reading magazines and when he brings her to Jezebel’s â€Å"He wanted me to play Scrabble with him†, â€Å"He sits me down, and sits himself down beside me. He puts an arm around my shoulder† (Atwood, 144, 236). Trust is a very common issue that people have trouble giving out. But in examining these elements it is clear Offred’s confidantes have impacted her life and how they make her into a real character. The Handmaid’s Tale is appealing due to its main character, Offred, who shows a great deal of realism in a world of impossibilities. Her character itself is strong-willed, but moderate, and is the perfect mix of what it is to be human. Through her, many of the readers can see a bit of themselves in Offred. She is an excellent example of how a regular person would behave if they were thrust into the world of The Handmaid’s Tale.

Wednesday, October 9, 2019

Diglossia

Hindi as a Diglossic Language Standard (Suddha) Hindi vs Hindustani:- Hindustani,  commonly known as  Hindi-Urdu  and historically as  Hindavi,  Urdu, and, is the lingua franca of north india and Pakistan. It is an  indo Aryan language and it is deriving primarily from the  khariboli of Delhi, and borrows a large amount of vocabulary from  Persian, Arabic, Sanskrit and Turkic. The colloquial languages are all but indistinguishable, and even though the official standards are nearly identical in grammar. They differ in literary conventions and in academic and technical vocabulary.With Urdu retaining stronger Persian, Central Asian and Arabic influences, and Hindi relying more heavily on Sanskrit. Before the  partisan of India, the terms  Hindustani, Urdu,  and Hindi  were synonymous; all covered what would be called Urdu and Hindi today. The term  Hindustani  is still used for the colloquial language and lingua franca of North India and Pakistan, for example for the language of   bollywood  films, as well as for several quite different   varieties of Hindi  spoken outside the Subcontinent, such as  Fiji Hindi  and the  Caribbean Hindustani  of   Suriname and  Trinidad.Standard Hindi, the official language of India, is based on the  khariboli dialect of the Delhi region and differs from Urdu in that it is usually written in the indigenous  devnagari  script of India and exhibits less Persian influence than Urdu. Many scholars today employ a Sanskritized form of Hindi developed primarily varansi, the  Hindu  holy city, which is based on the Eastern Hindi dialect of that region and thus a separate language from official Standard Hindi.It has a literature of 500 years, with prose, poetry, religion & philosophy, under the Bahmani Kings and later on Khutab Shahi Adil Shahi etc. It is a living language, still prevalent all over the Deccan Plato. Note that the term â€Å"Hindustani† has generally fallen out of common usage in modern India, except to refer to a style of Indian  Hindustani Classic Music. The term used to refer to the language is â€Å"Hindi†, regardless of the mix of Persian or Sanskrit words used by the speaker.One could conceive of a wide spectrum of dialects, with the highly Persianized Urdu at one end of the spectrum and a heavily Sanskrit-based dialect, spoken in the region around Varansi, at the other end of the spectrum. In common usage in India, the term â€Å"Hindi† includes all these dialects except those at the Urdu end of the spectrum. Thus, the different meanings of the word â€Å"Hindi† include, among others: 1. standardized Hindi as taught in schools throughout India, 2. Formal or official Hindi advocated by Puushottam Das Tandon who was freedom fighter from Uttar Pradesh. e is widely remembered for his effort in achieving the official language of India status for Hindi  and as instituted by the post-independence Indian government , heavily influenced by Sanskrit, 3. the vernacular dialects of Hindustani as spoken throughout India, 4. the neutralized form of the language used in popular television and films, or 5. The more formal neutralized form of the language used in broadcast and print news reports. Hindi has two forms: the H form called   Shuddha Hind and Hindustani Language.Both are based on the same dialect that is Khariboli. The L variety, Hindustani (often simply called Hindi) contains many loanwords from Persian and Arabic (brought by the Arabic and Persian invaders in medieval times), along with a massive vocabulary of English loanwords which increase day by day. The L variety is identical with spoken Urdu—except for the fact that the latter is written in  Perso Arabic script. The H variety was standardized in the 1960s during the movement to adopt  Hindi  as national language of Indian Union.Shuddh  means pure Hindi primarily uses words from Sanskrit to replace not only English lo anwords, but also loanwords from  Persian language  and Arabic which had been nativized for centuries. These words are called  Tatsama  words, and they even replaced many  tadbhav  words, i. e. words with Sanskrit origin but having undergone profound  phonological  change. The L variety is used in common speech, TV serials and Bollywood movies and songs. The H variety is used in official and government writings, scholarly books and magazines, signboards, public announcements and public speaking.

Tuesday, October 8, 2019

CRISIS COMMUNICATION ASSIGNMENT Essay Example | Topics and Well Written Essays - 750 words

CRISIS COMMUNICATION ASSIGNMENT - Essay Example Pirates were armed with deadly weapons including AK-47 rifles, rocket-propelled grenades and Anti-tank rocket launches at the time of the attack that could devastate the ship. The pirates are dressed in military fatigues. Furthermore, they use high tech satellites equipments to communicate with their mother ship. The high tech phones and GPS systems were used by terrorist pirates to coordinate attacks using small but very fast speed boats that are resupplied by mother ship. When the pirates fired on the ship, crew members gathered all the passengers in a central lounge away from decks and windows during the attack. Luckily, no serious hurts have been reported. However, a number of passengers and crew members are under shock and ship sustained minor damages. The pirates followed Smooth Magic ship and boarded it on Monday morning after four hour chase. The ship through its captain sent a distress call but no naval ship was near at that time to rescue it. Following fierce attack on the ship, the captain surrendered the ship to pirates to secure safety of all people on board as well as the entire ship. The Smooth Magic was then commandeered by the pirates to southern part of Somalia. This brings to ten the number of vessels that pirates are holding captive with passengers and crew in the lawless southern section of Somali. ... The hijacking incident is being monitored closely by the company in collaboration with relevant Maritime authorities to protect the lives of passengers and crew members on board and the ship at large. The Smooth Magic cruise ship has six hundred passengers and three hundred crew members on board. On board the cruise ship are American, Europeans, Asians and Africans. According to captain John Williams of the Smooth Magic, the number of pirates who hijacked Smooth Magic is estimated to be about forty eight. The company has been communicating with the Captain, who updates the company on the developments and he has assured the company that no single person has been hurt so far. Furthermore, there are no incidents of pirate’s ruthlessness because our crew members and passengers cooperated. The pirates have also not robbed passengers of their personal belongings because their leader categorically stated that they are only interested on ransom and have instructed his fellow armed pir ates not to rob passengers or crew members. Communication between the company and the pirates via satellite phone revealed that the pirates are demanding a ransom of $500,000. The leader of the pirates only known has Adan refused to divulge more information about themselves but promised to keep the passengers, crew members and entire ship safe if their demands are met. This unfortunate hijacking incident is the first to happen to our ships. However, the company is doing all it can to ensure that all passengers and crew on board as well as the entire ship are safe. The company is negotiating with the pirates on the best possible outcome. The company considers the hijacking incident serious. Hence, it has placed the incident on high dimension/high control crisis.

Monday, October 7, 2019

Do Catheter Washouts Extend Patency Time in Long-term Indwelling Essay

Do Catheter Washouts Extend Patency Time in Long-term Indwelling Urethral Catheters - Essay Example Bladder washouts do not have to be carried out all the time, however they may be essential when there is a significant amount of sedimentation in the urine; and in treating urinary tract infections. In this process, about 60 mls of water is usually introduced into the catheter gently via a syringe; the syringe is then removed and the catheter end is drained into a container. The procedure is repeated until 500 mls of water is used. This topic was chosen because of the growing interest of the impact of catheterization on long-term care patients and on practices which can be used to minimize the negative impact of catheterization. It is relevant to my future practice as a nurse because it would provide me with evidence on the importance of carrying out catheter washouts on patients under long-term care. This aspect of practice personally interests me because I have often encountered long-term care patients under catheterization and I have always been interested in finding ways to impro ve the quality of their lives. Evidence based practice Evidence-based practice is defined by Sackett, et.al., (1996) as the explicit and effective use of current and most appropriate evidence in health care decisions on individual patients. It also means incorporating individual clinical skills with the most appropriate clinical proof from research. Evidence-based practice is basically about getting the patient the best care possible, as proven by evidence, and according to his needs and preferences (Manzoukas, 2006). It also helps ensure that the knowledge of the nurses are up to date, that it supports clinical judgments, and can reduce time in considering appropriate care (Drisko, 2010). There are various forms of evidence which can be utilized including systematic reviews, randomized controlled trials, cohort studies, case-control studies, case series/case reports, and editorials/expert opinion (University of Illinois, 2006). Not all evidence in this case is research base, most e specially in cases of editorials and expert opinion where the weight of the evidence is based on the skill and the authority of the practitioner. The Nursing and Midwifery Council (NMC) Code of Professional Conduct describes the specific duties of nurses. It also specifies that nurses have the responsibility of providing a high standard of care for patients at all times, and this includes providing â€Å"care based on the best available evidence or best practice† (NMC, 2009, p. 16). These provisions form the legal and practice-based support for the evidence-based care required of nurses. Evidence can therefore be used in this case in order to establish whether or not carrying out catheter washouts would extend the patency of catheters among long-term care patients. Moreover, evidence can be used to determine if these washouts would improve the care of catheterized long-term care patients. Literature review Various studies have been carried out on the current topic under study . Hagen, Sinclair, and Cross (2010) carried out their study in order to establish if some specific washout regimens are better than others in relation to effectiveness, acceptability, and quality of life. About five trials were able to meet the inclusion criteria covering 242 patients in two cross-over and three parallel-group randomised control trials. After witling down the studies based on the inclusion criteria, authors reported that there is no difference between the different washout solutions, however these results were not sufficient to support the conclusions.