Handwashing Essays (Examples)

22+ documents containing “handwashing”.
Sort By:
By Keywords
Reset Filters

Example Essays

Essay
Handwashing
Pages: 8 Words: 2520

Abstract
Handwashing is always an important way to help preserve health and safety.  Thorough washing can help kill bacteria and viruses, which reduces the risk of contact disease transmission.  However, a surprising number of people do not engage in routine recommended handwashing.  This handwashing essay will cover the basics of handwashing.  It will discuss how handwashing improves public health and if there are any risks associated with handwashing.  It will cover the different types of things people can use to wash their hands.  It discusses different alternatives people can use when traditional handwashing is impossible.  The essay also covers how handwashing is used in medical environments.  There are cultural components to handwashing and the essay will discuss handwashing in developing nations as well as the social and cultural aspects of handwashing. 

Introduction

Handwashing is always an important way to help preserve health and safety.  Thorough washing can help kill bacteria and viruses,…...

mla

Resources

Centers for Disease Control and Prevention.  “When and How to Wash Your Hands.” CDC.  2 April 2020.  Accessed 15 April 2020.

Gupta, Sanjay.  “Dr. Sanjay Gupta Shows the Proper Way to Wash Your Hands.  CNN.  2020. https://www.cnn.com/videos/health/2020/03/27/how-to-wash-hands-gupta-vpx.cnn/video/playlists/cnn-coronavirus-town-hall/.  15 April 2020. 

Helmenstein, Anne Marie.  “Detergent Definition in Chemistry: How to Define a Detergent.”

ThoughtCo.  16 January 2020. https://www.thoughtco.com/definition-of-detergent-in-chemistry-604428.  15 April 2020. 

Hickok, Kimberly.  “Why Do We Use Soap?”  Live Science.  5 March 2020.  https://www.livescience.com/57044-science-of-soap.html.  Accessed 15 April 2020.

Manning-Schaffel, Vivian.  “How to Wash Your Hands Properly, According to Doctors.”  NBC

News.  19 December 2019.  https://www.nbcnews.com/better/lifestyle/how-wash-your-hands-  properly-according-doctors-ncna1102746.  Accessed 15 April 2020. 

Rush University Medical Center.  “Does Hand Sanitizer Work?”  2020. https://www.rush.edu/health-wellness/discover-health/does-hand-sanitizer-work.  Accessed 15 April 2020. https://www.cdc.gov/handwashing/when-how-handwashing.html. 

Essay
Hand Washing
Pages: 3 Words: 985

Handwashing
Hand washing is the most fundamental step of hygiene. According to the Centes for Disease Control and Prevention, a million deaths per year could be prevented if everyone in the world washed their hands properly (CDC). Yet only five percent of people are actually washing their hands long enough and with the proper technique (Jaslow). As many as 15% of men do not wash their hands after using the bathroom! Women are better, but not by much. About seven percent of women do not wash their hands after using the bathroom. More women than men are prone to using soap too. Almost 80% of women, but only fifty percent of men, used soap in one study (Jaslow). Therefore, it is important to be reminded of the importance of hand washing, or why we do it, and also how to wash hands properly so that we are actually preventing disease.

Why Washing…...

mla

References

CDC. "Hygiene fast facts." 2013 Retrieved online:  http://www.cdc.gov/healthywater/hygiene/fast_facts.html 

Jaslow, R. 95% of people wash their hands improperly: are you one of them? CBS News. 2013. Retrieved online:  http://www.cbsnews.com/news/95-percent-of-people-wash-their-hands-improperly-are-you-one-of-them/ 

Massachusetts Department of Public Health. Handwashing brochure. 2003

Public Health England. "Handwashing." Retrieved online: http://www.hpa.org.uk/handwashing

Essay
Hand Hygiene among Nurses Giving Quality Care
Pages: 1 Words: 370

Hand washing is a quality care issue because it is such a simple step in care giving that often can be ignored by care providers, especially if nurses are busy or burned out on the job (Manomenidis, Panagopoulou & Montgomery, 2019). And yet hand washing is crucial to the prevention of spreading germs among patients; additionally, it can give patients a better sense of quality care, trust and satisfaction when they see their care providers take the time to wash their hands before treating them (Bouzid, Cumming & Hunter, 2018). As a nurse, I can contribute to improvement in this quality of care issue if it existed in my workplace by demonstrating hand washing quality in my own approach to providing care. It is important that leaders of change demonstrate the example they want others to follow. They should show in their own actions what the correct approach should be. One…...

mla

References

Bouzid, M., Cumming, O., & Hunter, P. R. (2018). What is the impact of water sanitation and hygiene in healthcare facilities on care seeking behaviour and patient satisfaction? A systematic review of the evidence from low-income and middle-income countries. BMJ global health, 3(3).

Manomenidis, G., Panagopoulou, E., & Montgomery, A. (2019). Job burnout reduces hand hygiene compliance among nursing staff. Journal of patient safety, 15(4), e70-e73.

Essay
Why Hand Washing Reduces Infection Rate
Pages: 5 Words: 1439

Quality Improvement ProposalHand hygiene compliance among healthcare providers is a critical issue in nursing organizations, particularly in acute care settings such as hospitals. Non-compliance with hand hygiene protocols can lead to the spread of healthcare-associated infections, resulting in increased morbidity, mortality, and healthcare costs. This paper proposes a quality improvement initiative aimed at improving hand hygiene compliance rates among healthcare providers in nursing organizations. The initiative is based on evidence-based practices and is expected to lead to a reduction in the incidence of healthcare-associated infections and associated healthcare costs.Overview of the Problem and SettingIn many nursing organizations, hand hygiene compliance rates among healthcare providers are often suboptimal, leading to the spread of healthcare-associated infections (HAIs) (Boyce, 2021). This problem is particularly prevalent in acute care settings such as hospitals and can lead to increased morbidity, mortality, and healthcare costs. It is certainly a problem in my healthcare setting where I…...

mla

References

Bezerra, T. B., Valim, M. D., Bortolini, J., Ribeiro, R. P., Marcon, S. R., & Moura, M. E. B. (2020). Adherence to hand hygiene in critical sectors: Can we go on like this?. Journal of Clinical Nursing, 29(13-14), 2691-2698.

Boyce, J. M. (2021). Hand hygiene, an update. Infectious Disease Clinics, 35(3), 553-573.

Cawthorne, K. R., Dean, J., & Cooke, R. P. (2020). The financial impact of improved hand hygiene on healthcare-associated infections in the UK. Canadian Journal of Infection Control, 35(3).

Essay
Does Antimicrobial Soap Promote Drug Resistance in Children
Pages: 3 Words: 1036

Antibacterial Soap by Children Promote Antimicrobial Drug esistance?
Patient Problem:

Today, young people are encouraged to wash their hands several times a day in order to stay healthy (Clean hands save lives, 2015). This guidance is based on research that confirms that regular handwashing is the most cost-effective approach to keeping young people healthy (Clean hands save lives, 2015). For instance, the U.S. Centers for Disease Control (CDC) emphasizes that, "egular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others. It's quick, it's simple, and it can keep us all from getting sick" (Clean hands save lives, 2015, para. 1). The potential exists, though, that using antibacterial soap versus regular soap and water causes antimicrobial drug resistance in children. These concerns are similar to concerns that the over-prescription of powerful antibiotics for routine…...

mla

References

Clean hands save lives. (2015). Centers for Disease Control. Retrieved from cdc.gov/handwashing/index.html.http://www.

Forrester, M. A. & Borthwick-Hunter, E. (2015, April 1). Understanding the development of musicality: Contributions from longitudinal studies. Psychomusicology, 25(2), 93-96.

QSEN. (2015). Frances Payne Bolton School of Nursing. Retrieved from  http://qsen.org/about-qsen/ .

Rogers, C. (2015). FDA taking a closer look at "antimicrobial" soap. U.S. Food and Drug Administration. Retrieved from   / consumer updates/ucm378393.htm.http://www.fda.gov/forconsumers 

Essay
Technology to Enhance Learning Distance and Online Applications
Pages: 6 Words: 2163

Order Number - A2053702 Order Status: In progress
* Details
* Messages
* Order Files
Pages
Payout
Arrival Date…...

Essay
Primary Health Promotion and Prevention
Pages: 7 Words: 1949

Teaching Plan Summary
In developing countries, Handwashing with Water and Soap (HWWS) is one of the most economical yet effective approaches to treating faecal-oral vectored diseases (Curtis, 2009). Consequently, a good HWWs campaign would benefit many in the society, especially school going children (Biran et al., 2009). The following paper will investigate teacher response to driving effective HWWS intervention in different schools across the globe (Xuan et al., 2013).

There are different HWWS campaigns going on in a wide variety of schools. These could range from in class lectures, advice from student advisors to talks during school meetings or common school meetings. Statistics show that HWWS promotional campaigns take place at least once a month for the entire school and at least once a week in each individual class.

According to the research, up to 35 HWWS promotional classes took place over the test period with up to 566 students in each of…...

mla

References

Biran A, Schmidt WP, Wright R, Jones T, Seshadri M, Isaac P, (2009). The effect of a soap promotion and hygiene education campaign on handwashing behavior in rural India: a cluster randomized trial. Trop Med Int Health; 14: 1303_14.

Bowen A, Ma H, Ou J, Billhimer W, Long T, Mintz E, (2007). A cluster-randomized controlled trial evaluating the effect of a handwashing-promotion program in Chinese primary schools. Am J. Trop Med Hyg; 76: 1166_73.

Curtis V. (2009). Planned, motivated and habitual hygiene behavior: an eleven country review. Health Educ Res; 24: 655_73.

Elliott J. (1991). Action research for educational change. Milton Keynes: Open University Press.

Essay
Epidemiological Study Proposal Nursing Hand
Pages: 20 Words: 5318

These are questions dealing with attitude and are the most important questions when doing qualitative social science research to gauge relationships among events. In addition to construction questions about attitudes, it is important to have the questions drafted in the correct format (Nachmias, 2008).
The Quantitative methodologies will be the statistical tests designed for the overall model to incorporate the information provided through one, two or all of the Qualitative data analysis methodologies. The tests used to determine the relationship between these "qualitative" factors and increases in Infection rates, will be the Chi-Square, Student's T-Test, ANOVA (to test for variations among the data), the construction of a Linear Regression Model and the calculation of the Pearson Correlation Coefficient, otherwise known as "R-Squared" (Nachmias, 2008).

These tests will be utilized in conjunction with a predetermined level of significance, or alpha. Since these tests will all be measuring the means and relationships of…...

mla

Works Cited:

Barrett, R. & Randle, J. (2008). Hand hygiene practices: nursing students' perceptions. Journal of Clinical Nursing, 17(14), 1851-1857.

Beggs, C.; Noakes, C.; Shepherd, S.; Kerr, K.; Sleigh, P. & Banfield, K. (2006). The influence of nurse cohorting on hand hygiene effectiveness. American Journal of Infection Control, 34, 10, 621-626.

Larson, E.; Quiros, D. & Lin, S. (2007). Dissemination of the CDC's Hand Hygiene Guideline and impact on infection rates. American Journal of Infection Control, 35(10), 666-675.

Roberts, C.; Roberts, J. & Roberts, R.J. (2009). Investigation into the effect of an alcohol-based hand product on infection rate in a nursing home setting. Journal of Infection Prevention, 10(4), 138-142.

Essay
Nurse Lit Review Type of Research Study
Pages: 3 Words: 929

Nurse Lit eview
TYPE OF ESEACH STUDY - Quantitative or qualitative

Descriptive, correlational, experimental, quasi-experimental, phenomenological, grounded theory ethnographic, historical

SAMPLE METHOD & SAMPLE SIZE

Knoll, Lautenschlager & Lipp (2009). British Journal of Nursing.

Impact of workload on hygiene practices.

Quantitative.

Experimental.

trials of nursing staff.

Statistical.

Enforcing hygiene practices has practical healing benefits for nurses.

Souweine, B. et al. (2009). Intensive Care Medical Journal.

Compared hygiene practices. Hand rubbing vs. hand washing.

Quantitative.

Experimental.

person nursing staff.

Workers completed self report questionnaires.

Hand rubbing with alcohol is preferred to handwashing in some instances.

Creedon, S. (2006). International Journal of Nursing Technologies and Classifications.

Observe health worker compliance in handwashing guidelines.

Quantitative.

Quasi-experimental.

73 doctors and nurses in an Irish ICU.

Questionnaire responses.

Knowledge of handwashing guidelines can lead to positive outcomes.

Allen, L. et al. (2014). Nevada Nformation.

Compared hand washing with hand sanitizer.

Quantitative.

Descriptive.

Literature review.

Statistical.

Hand washing was prescribed for killing certain bacteria.

Evans & Breshears, (2007).

How hand washing affects chiropractic practices.

Quantitative.

Correlation.

150 students randomly selected took survey

Survey results.

easonable control measures regarding hand washing need to be implemented…...

mla

References

Allen, L., & et al. . (2014). Professionalism in Nursing. Nevada RNFormation, 18(1).

Creedon, S.A. (2005). Healthcare workers' hand decontamination practices: compliance with recommended guidelines. Journal of advanced nursing, 51(3), 208-216.

Evans, M.W., Breshears, J., Campbell, A., Husbands, C., & Rupert, R. (2007). Assessment and risk reduction of infectious pathogens on chiropractic treatment tables. Chiropractic & osteopathy, 15(1), 8.

Knoll, M., Lautenschlaeger, C., & Borneff-Lipp, M. (2010). The impact of workload on hygiene compliance in nursing. British Journal of Nursing, 19(16), S18-S22.

Essay
Washing in Nursing and Medicine
Pages: 2 Words: 580


Moreover, the specific cause of transmission are the low compliance rates of hospital personnel with basic antiseptic protocols such as simple hand washing. Surprisingly, the worst offenders were those with the highest degree of formal training: namely physicians and registered nurses. In some studies, compliance rates among hospital personnel were only between fifteen and thirty percent. Finally, empirical studies have also concluded that compliance rates are lowest in high-volume institutions and among understaffed medical units.

Solution

The solution is rather obviously quite simple. Among the most important aspects of reducing hospital-acquired nosocomial hospital infections is increasing the rates of hand washing among hospital personnel. Naturally, the more direct patient contact individual personnel have, the more important adherence to strict hand-washing policy is. Since physicians and nurses routinely care for many patients during a typical shift, it is crucial for them to become the most compliant rather than the least compliant in this…...

mla

References

Sheridan-Leos, Norma. "Oncology care setting design and planning Part II: Designing healthcare settings to prevent fungal infections and improve handwashing."

Clinical Journal of Oncology Nursing (June 1, 2008).

Full Text of Article Below

This is the second in a two-part series on designing healthcare settings to improve patient safety. Part I addressed concepts of error theory and evidence-based practice as they relate to planning safe care environments (Sheridan-Leos, 2008). Part II describes the design and planning of oncology care settings to prevent fungal infections and improve provider handwashing.

Essay
Comparing Qualitative Study Approaches
Pages: 4 Words: 1330

Critical Appraisal of esearch Studies: Surgical Site Infections (SSI)Surgical site infections (SSIs) are a serious source of concern worldwide. They are not only a health risk to patients but also pose a significant risk in terms of an increase in antibiotic-resistant bacteria infections. Yet, there is a gap between theoretical knowledge of how to prevent such infections and how providers implement them. The issue of SSIs has been quantitatively identified as a serious issue and is especially disheartening, given it is a preventable one: an estimated 60% of all SSIs are preventable, if providers follow guidelines (Mengesha et al., 2020).This failure of compliance, however, is not particularly to underserved or low-resource medical systems. Prevalence of SSIs is around 19.6% in Europe, 20% in the U.S., and in Africa as low as 12% in Algeria and as high as 31% in Nigeria (Mengesha et al., 2020). Within Ethiopia alone, infection rates…...

mla

ReferencesMattingly, A.S., Starr, N., Bitew, S., Forrester, J.A., Negussie, T., Merrell, S.B., & Weiser, T.G. (2019). Qualitative outcomes of clean-cut: implementation lessons from reducing surgical infections in Ethiopia. BMC Health Services Research, 19 (1),1-10.   A., Tewfik, N., Argaw, Z., Beletew, B., & Wudu, M. (2020). Practice of and associated factors regarding prevention of surgical site infection among nurses working in the surgical units of public hospitals in Addis Ababa city, Ethiopia: A cross-sectional study. PloS one, 15(4), e0231270.  https://doi.org/10.1371/journal.pone.0231270 Qvistgaard, M., Lovebo, J., & Almerud-Österberg, S. (2019). Intraoperative prevention of surgical site infections as experienced by operating room nurses. International Journal of Qualitative Studies on Health and Well-being, 14(1), 1632109. https://doi.org/10.1080/17482631.2019.1632109https://doi-org.lopes.idm.oclc.org/10.1186/s12913-019-4383-8 Mengesha,

Essay
Typhoid Fever About 400 Cases
Pages: 3 Words: 964

When they enter the gallbladder and lymphatic tissue they multiply in enormous numbers. It is when they re-enter the intestinal tract that the disease can be diagnosed from stool samples.
Symptoms

The first symptoms are usually headache, muscle pain and a fairly high fever. The problem is that these symptoms only occur about ten days after infection. It isn't until four to five days later that a rash occurs. The rash takes on the appearance of small, flat, red spots. A week after that those spots darken and look like bruises. If the disease has progressed this far, the patient begins to have short periods of unconsciousness, then the kidneys fail, a cough begins, and the rash turns to gangrene in the extremities. If no treatment has been given at this point, up to 50 per cent of patients die. It is possible to survive without treatment, with luck, but the…...

mla

Bibliography

CBWInfo.com. "Typhoid Fever: essential data." 1999. cbwinfo.com. 18 February 2010 .

Encyclopedia of Health. "Typhoid Fever." Encyclopedia of Health, Volume 17. New York: The Rosen Publishing Group, 2009. 1052.

National Center for Immunization and Respiratory Diseases. "Typhoid Fever." 24 October 2005. Centers for Disease Control and Prevention (CDC). 17 February 2010 .

Essay
Nurse's Knowledge Migrating Catheters Washing
Pages: 7 Words: 2079


As to catheter straps, if fastened too tightly they can act as tourniquets, cutting off the needed flow of blood and presenting. And at least theoretically, use of straps brings about a risk of increasing the complications such as "…deep vein thrombosis and pulmonary embolism" in those patients with "impaired lower extremity circulation" (Billington 504). Research presented in this article shows that the problem of infection due to poorly attached catheters can be reduced significantly through the use of a product called "Bard StatLock" -- which, the authors insist, is an effective stabilization device because it allows movement (through a swivel clip), because it is a "sterile latex-free, tug-resistant product" (Billington 504). An article in the journal RN, incidentally, states that treating "hemodialysis catheter-related bacteremia" can cost a hospital up to $45,000.

ashing "Bloody Hands": An article in the Australian Nursing Journal asserts, "…hand hygiene is the single most effective method…...

mla

Works Cited

Aziz, a.M., Ashton, H., Pagett, a., Mathieson, K., Jones, S., & Mullin, B. (2009).

Sharps management in hospital: an audit of equipment, practice and awareness.

British Journal of Nursing, 18(2), 92-98.

Billington, a., Crane, C., Jownally, S., Kirkwood, L., & Roodhouse, a. (2008).

Essay
Self-Efficacy Theory Describe Theory Rationale Selecting Theory
Pages: 2 Words: 520

Self-Efficacy Theory
Describe theory rationale selecting theory. 2. Discuss theory works support proposed solution. 3. Explain incorporate theory project.

Self-efficacy theory and the promotion of hand-washing

According to the Centers for Disease Control, hand-washing is one of the most important ways in which to curtail the spread of a wide range of infections and bacteria. Hand-washing can reduce the risks of contracting the common cold, influenza, and other viruses (Wash your hands, 2012, CDC). It can also lessen the chances that bacteria such as E.coli and salmonella will be transmitted from the preparer of food to the diner, or that contaminants from raw poultry and other meats will be spread to fruits, vegetables, and other components of the meal. Hands should be washed thoroughly after preparing food, using the toilet, dealing with animals or children, or handling garbage. But many people fail to take this simple step.

Hand-washing is one of the ideal ways…...

mla

References

Cherry, Kendra. (2012). Self-efficacy. About.com. Retrieved:

 http://psychology.about.com/od/theoriesofpersonality/a/self_efficacy.htm 

Wash your hands. (2012). Centers for Disease Control (CDC). Retrieved:

 http://www.cdc.gov/Features/HandWashing/

Essay
Cryptosporidium Case Study
Pages: 10 Words: 2638

Cryptosporidium Case Study
Cryptosporidium is reported as a "coccidian protozoan parasite" and one that has received a great deal of attention over the past two decades as a "clinically important human pathogen." (Hannahs, nd, p.1) The discovery of Cryptosporidium is reported as associated with E.E. Tyzzer who described a "cell-associated organism in the gastric mucosa of mice" in 1907 as reported in the work of Keusch et al. (1995). (Hannahs, nd, p.1) Cryptosporidium was believed for several decades to be a "rare, opportunistic animal pathogen." (Hannahs, nd, p.1)

The first case of human cryptosporidiosis occurred in a three-year-old girl in rural Tennessee in 1976 suffering from severe gastroenteritis for two weeks and reported in the work of Flanigan and Soave (1993). Cryptosporidium parvum was discovered through use of an electronic microscopic examination of the intestinal mucosa. Cryptosporidium parvus was associated with AIDS cases in the 1980s and this resulted in renewed attention…...

mla

Bibliography

Cabada, MM (2011) Cryptosporidiosis Medication. MedScape. Retrieved from:  http://emedicine.medscape.com/article/215490-medication#2 

Cabada, MM (2011) Crytosporidiosis Treatment and Management. MedScape. Retrieved from:  http://emedicine.medscape.com/article/215490-treatment#aw2aab6b6b6 

Casemore, D.P., Garder, C.A., and O'Mahony, C. "Cryptosporidial infection, with special reference to nosocomial transmission of Cryptosporidium parvum: a review." Folia Parasitol, 1994; 41 (1): 17-21.

Cryptosporidiosis in Immunocompromised Persons (2012) Illinois Department of Health. Healthbeat. Retrieved from:  http://www.idph.state.il.us/public/hb/hbcrypto.htm

Q/A
I need your help with finding: infectious diseases argumentative essay topics. Could you give me some ideas please?
Words: 338

If you want to find out arguments about infectious diseases, we are tempted to tell you to visit almost any social media site, where you are almost sure to find people debating the efficacy of face masks to slow the spread of COVID-19.  However, the reality is that you actually want to avoid looking at sites like that if you are trying to develop a good essay about infectious diseases because internet arguments notoriously fail to follow the steps to developing a good argument.  You want to make a claim, provide support for that claim, and address....

Q/A
I need help with essay topics on infection control?
Words: 446

Infection control specifically refers to stopping the spread of disease in healthcare settings and during health care procedures, such as surgeries.  It is a catchall phrase that refers to a wide variety of behaviors or practices that can result in the elimination or reduction of disease transmission in these settings.  We are happy to provide you with some suggested topics and titles for an essay about infection control.

Essay Topics

Best hygiene practices for pre-surgical prep of skin to prevent surgical-site infections

Does the routine use of masks in non-surgical medical examinations and routines reduce infectious disease transmission....

Q/A
Can you provide guidance on how to outline an essay focusing on Norovirus?
Words: 530

I. Introduction
A. Definition of Norovirus
B. Importance of understanding Norovirus
C. Purpose of the essay

II. Background information
A. Origin and discovery of Norovirus
B. Transmission and symptoms of Norovirus
C. Impact of Norovirus on public health

III. Prevention and control measures
A. Hygiene practices to prevent Norovirus spread
B. Vaccines and medications for Norovirus
C. Strategies for reducing Norovirus outbreaks

IV. Treatment options
A. Management of Norovirus symptoms
B. Importance of seeking medical attention
C. Recovery and long-term effects of Norovirus

V. Global perspective on Norovirus
A. Statistics on Norovirus cases worldwide
B. Success stories in controlling Norovirus outbreaks
C. Future implications....

Q/A
Can you outline the key steps for effective handwashing technique?
Words: 213

1. Wet your hands with clean, running water (warm or cold) and apply soap.
2. Rub your hands together to lather the soap, making sure to cover all surfaces including the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 seconds. You can hum the "Happy Birthday" song twice to ensure you are washing for the recommended amount of time.
4. Rinse your hands thoroughly under clean, running water.
5. Dry your hands using a clean towel or air dryer.
6. If possible, use a towel or your elbow to turn off the faucet to....

Sign Up for Unlimited Study Help

Our semester plans gives you unlimited, unrestricted access to our entire library of resources —writing tools, guides, example essays, tutorials, class notes, and more.

Get Started Now