A necktie , or simply a tie , is a long piece of cloth, worn usually by men, for decorative purposes around the neck , resting under the shirt collar and knotted at the throat. Managing aggressive patients in a high-stress environment". An additional item of note: As the years went on so did her weight and she got to size until 2yrs ago when the children, doctor and herself decide she had to loose weight. The product is already in the wishlist! The theory is that the physical presence of something around your neck serves as a reminder to knuckle down and focus on the job at hand.