Bimbo in China Essay

Bimbo has always been a leading company in its industry. Its distribution and logistics operations have been the keys to the company’s success. Its products are always fresh and it is always in contact with its consumers in order to keep up with needs and tendencias. The company is based in Mexico, though it began expanding into other markets such as U.S., Central America, Brazil and China. Bimbo entered the U.S. market in 1984 through a joint venture and then bought Sara Lee and Wonder later on. In the year 2000, it entered the Brazilian market. Another important market for this company is China because it represented a great challenge. Bimbo had to modify its flavors and its strategies, since its logistics operations could not be the same as in its previous markets.In this market, it was called Bao How, which means tasty bread. It currently has 72 factories and 900 distribution centers in 17 countries. It entered China in 2006 as Beijing Bao How and its name was changed to Bim Bao, which means guest, alluding to the fact that it was now in the Chinese Forbidden City. It has to factories in China, 11 distribution centers and over 100 products in over 11 cities. China represents 5% of its worldwide sales. In order to successfully enter this market it had to tropicalize its products, making them less sweet and more appealing to Chinese taste preferences. Some examples of these are the Meat Loaf, the Green Corn Bread with Pickles, and the Sweat Bean Feal Pun. Its Distribution and logistics strategies changed and its delivery system is executed with turquoise bicycles. Today it has 1876 trucks and 38 bicycles for convenient store distributions as well as to the most marginalized places.

Managing Conflicts Within Groups

| Organisational Behavior Individual Course Paper | Lim Jin Sheng Jason| | Section: ES1| | Introduction In order to meet the requirements of the individual assignment, this paper uses a specific project management experience to highlight some of the main organisational behaviour (OB) concepts in a real-world professional setting. The two main OB concepts chosen are: a) Managing Conflicts within Groups b) Multi-Party, Multi-issue Decision Making Framework In doing so, it is hoped that this paper will highlight the importance of utilizing these OB concepts in other similar situations encountered in the future. Professional Work Experience My professional experience involves managing acquisition and R&D projects for the armed forces, under the Defense Science and Technology Agency (DSTA). DSTA is the national authority for centralized defense procurement and related R&D under the Ministry of Defense (MINDEF) in Singapore. My specific roles include managing projects related to naval systems and scouring the local/overseas defence industry for emerging naval technologies. For example, if the plans department in the Singapore Navy requires a certain naval craft to meet their operational requirements in the near term, my department will spearhead this initiative by helping to source the market for such a product, purchase it and deliver it to the users. The whole process basically involves the following: ) Get approval for the operational requirements and budget to fund the acquisition project. b) Source the market for companies who are able to provide such products or services, evaluate their bids and negotiate for the eventual contract. c) Perform acceptance testing for the product/service before delivering the product/service to the end users. Managing Conflicts within Groups Before the initiation of a project, the envisioned operational requirements for the weapon system/service and budget required to fund it needs to be approved by the required level of authority. Usually, a panel of experts will convene in a forum to discuss and debate the issue and will send their recommendations to the final approval authority (which can be the Minister for Defence or service chiefs, depending on the importance and value of the acquisition). In one of my projects, the requirement was to acquire several unmanned crafts to replace a fleet of existing patrol vessels to save maintenance and personnel costs. Hence, the operational requirements was done up by the plans department in the Navy and the budget was done up by my team in DSTA. The justifications for both were well thought out and presented clearly in a paper which was submitted to the relevant forum for discussion and approval. The forum in this case was comprised of the unit commanders of all the relevant braches in the Navy (Operational, intelligence, logistics, security and training departments, etc). However, as a newly appointed project manager, I was unaware of the â€Å"under-currents† that was brewing prior to the forum presentation. Even though the justifications were sound on paper, there were several factions within the Navy community that were inherently against the idea. This opposition only surfaced during the day of the forum presentation and took my team by surprise. Subsequently, we had to re-work the whole approach in getting the approval from the forum. Basically, the issue was that the replacement of an entire fleet of patrol vessels by a newer technology will mean that an entire squadron will need to be down-sized and re-trained. Although the maintenance costs were lower in aggregate, this also meant the workload of certain logistics departments will more than double. Also, there was a history of bad blood between the commanding officer of the plans and squadron departments. So in reality, this means that certain members of the forum will not be happy with the proposal regardless of how sound it is and old grudges will likely flare up during the forum presentations. On hindsight, being aware of possible conflicts within a group will help to prevent this type of scenario from happening in the first place. By understanding the different types of group conflicts (task, relationship and process) and engaging all stakeholders before the forum approval will help in reducing the effort spent and maintain good relations with all stakeholders. Multi-Party, Multi-issue Decision Making Framework Once the approval for the operational requirements and budget for this project is obtained, my team selected a suitable overseas defense contractor to build and deliver the product according to our specifications. The arduous task of negotiating for the best possible terms for the least price for this contract begins. Due to the complexity of the equipment acquisition involved, the discussions will require many subject matter experts from their relevant domains to discuss the technical issues with their counterparts. I had an experienced procurement manager who advised the team to first agree on all the complex issues internally first before starting negotiations with the supplier. In practice, this meant that my team had to prioritise which issues are important and non-negotiable and which issues are good to have but not essential in the success of the project. Without this understanding, every single representative from my team will try to press for the best terms within their domains because everyone thinks their own issues are important. Furthermore, the supplier will never agree to every single issue as they will lose money on this contract. My team decided to group and consider all the issues simultaneously and agree on the relative importance of each issue before starting contract negotiations. My job as a project manager is to take a step back to keep track of the issues discussed and place focus on the â€Å"Tier-one† issues rather than haggling for every possible terms. This multi-issue, multi-party framework helped my team to cut down on a lot of unnecessary time and effort for future contract negotiations. Conclusion Organisational behaviour is an important and evolving topic which is important for success in managing inter-personal relationships in the workplace. As discussed using some of my personal work experiences, a good understanding and relevant application of OB concepts will help the professional to navigate through the complexities of managing stakeholders in an increasing dynamic environment.

Civil Rights Movement Was Slow Between 1955-68 Essay

Explain why the civil rights movement was slow between 1955-68 The civil rights movement was slow between 1955-68 for multiple reasons, these being the falling out of Malcolm X and Martin Luther King along with the Civil rights groups splitting and changing their tactics between violent protest or peaceful protest which consequently lead to them being less effective. Also Presidential action could be said to be lacking therefor acts to improve civil rights weren’t passed or were unaffected. One reason that the civil rights movement was slow was due to Eisenhower’s stance on the topic during his presidency (1953-1961). Eisenhower believed that the position of the black people would improve of its own accord over time. In this sense he did not think that it was the government’s job to improve conditions for black people. We can see this form his reaction in regards to Little rock campaign and his reluctance to become involved with it. This is a reason why the civil rights movement was slow because the president was unwilling to pass civil rights laws to change the situation of the blacks due to his belief that it would change in their favour in time. Also because of conflict between Malcolm and King the two main black men that were leading the campaign the African Americans were side tracked, essentially forgetting their main aim; racial equality. Malcolm X was very critical of Martin Luther King calling him the â€Å"Twentieth century Uncle Tom† and banding around rumours that he was being paid by the white government to preach Christian love and forgiveness which was all in aid of preventing the black people from effectively fighting for their freedom. This conflict would not achieve anything for the black power movement because it could potentially divide public opinion. People who supported King may have lost some faith if they believed there could be any truth that he was really working with the white American government, whereas the camp who were following X may have felt a sense of divide between them and the people who liked Kings ideals. The reason why this wasn’t going to help the black power movement is that the African Americans needed to fight together to gain equality but their fight was being split into their fight for this and for who’s leader was strongest. A final reason as to why the progress for civil rights was slow was because the civil right groups split and were no longer co-operating with each other. CORE and the SNCC took a stance closer to that of X’s beliefs. They became more violent unlike the NAACP who stuck to  peaceful protest. The problem that this created the civil rights movement is that they are now sending the government mixed messages and are not helping their cause. Also staging violent protest didn’t seem any way near as effective. Because the government and the media generally seemed weighted to the whites side, violence of black was blown out of proportion and shown as propaganda as to why the blacks shouldn’t have power on equal terms with whites. This would mean that blacks wouldn’t be taking steps on the right direction because they would be setting themselves up for a fall in public opinion, something which needed to be on their side for them to gain equality. In conclusion the civil right gains between 1955-68 were slow due to the fact that there was conflict between the blacks who were fighting over the best way to gain their goal when there focus should have been solely on trying to get this goal. They were side tracked and this proved detrimental giving their reputation further dents, even if there are minor positives amidst the movement along with the fact that the resident weren’t too focused on helping the civil rights movement.

The Relationship Between an Employer and Employee Case Study

The Relationship Between an Employer and Employee - Case Study Example Through the contract, an employee gets to understand his or her duties, while the employer defines his conditions and terms for the job. In this case, there is no mention of a written contact, so it can only be assumed that June’s relationship to Westwood University Library, which is an employee-employer relationship, is based on an implied contract. The job advertisement also mentioned of the position being long term, which would be taken to mean permanent. However, from the case, it is clear that June works on a contractual basis, which is contrary to what she understood during her job application. It is also clear that June has sometimes had to work overtime, which is an issue that ought to have been highlighted in her agreement with her employer. Apart from the work contact, Westwood University Library’s policy on social networking requires employees to use their professional acumen while using social media, and also to be careful of their communications on twitter and face book, especially communication between Westwood’s employees and any other form of communication on these sites, that has the potential of being seen by Westwood employees. June however went ahead and posted a negative comment on face book regarding bosses, despite being aware that this would be seen by Malcolm, her immediate supervisor, since he is her face book friend. Malcolm, who is June’s immediate supervisor and also the human resource manager at Westwood University Library, has the habit of bullying June. This can be seen from several comments he has made such as â€Å"Can I expect you will start doing a good job now?†, when June got accepted at the university for a post graduate course. He was also once overheard saying that â€Å"June will never get a promotion while she hides behind a lens† and â€Å"Her belly dancing costume would be more appropriate than the clothes she wears to work†. From this, it is clear that Malcolm has the habit of criticizing June’s work and making negative comments regarding her style of dressing, and usually adding what he would prefer to see her wear. Relation between the Case and relevant Principles of Law The Australian law recognizes both written and implied contracts of employment. The terms and conditions which define the relationship existing between the employees and the employer are established through common law. June’s employment case did not mention of a written agreement between her and Westwood, but she undertook the responsibility, therefore probably on an implied contract. However, a contract of service can be established through the existing authority of command, control, chances of risk and profits, and ownership of tools in Westwood among others. There is a structured workplace agreement that places a higher authority and control on the employer to set other employment conditions beyond the National employment standard.1Here, the employee accepts t o perform specific work for his employer, availing his labor for use within the limits of the employer’s managerial privilege. In exchange, the employee is entitled to receive remuneration for the labor used. In reference to employers and employees relations, the employers are in a position to direct what work is to be done, the duration of working hours per day, take responsibility for financial risk, as well as employee’s superannuation and regular payment.2 June’s contract of employment stated that it was a long term position (an indefinite period). Her employer defined mandatory daytime hours of work and defined her duties to be within the administrative roles. She has an immediate supervisor least to mention other superior staffs, which defines the structure of

Ethical Issues of Information Technology Essay Example | Topics and Well Written Essays - 2500 words

Ethical Issues of Information Technology - Essay Example Computers are special technology that raises special ethical issues (Moor, 1991) and that such issues and problems are unique to the field. They would not have been issues had it not been for the technology itself (Maner, 1996). Ethical issues of information technology are called many names like computer ethics, information ethics, and cyberethics. In the whole of information systems management, whatever its name, the new technology radically reshapes life styles, at the same time creates challenges in the areas of privacy, property, security and individual identity (Information systems, 2007). The following discussion covers issues in consumer or online privacy, copyright, patents, trademarks, trade secrets, legal jurisdiction, and online contracting that manifest in the field of information technology. The details come in the form of definitions and philosophical reflections or historical events elucidating the issue. The paper then ends with a note on probabilities for the future. Computer and information technology may be used interchangeably throughout the paper and may mean the same. The Ethical Issues Online Privacy. The cheap, fast, painless encryption technology provided by the computer has transformed the privacy debate completely. While before, people worried about the wearing away of privacy, the concern now is about the computer-generated privacy "afforded to every criminal with a computer and half a brain." (Maner, 1996). Electronic mail has replaced telephone and inter-office mail communications as the principal medium of business communications and this has made work easier. Throughout it all, however, suddenly, one's email address has become known to merchandisers and one begins receiving a lot of unsolicited email daily about products being advertised. Identity theft generally involves obtaining data from individual consumers' financial transactions on the Internet or elsewhere, and either billing the consumers' credit cards for nonexistent transactions or services, or using consumers' personal data to conduct actual transactions that are billed to the consumers(Internet Fraud, 2000). Identity theft is an Internet fraud. There is a need for email privacy in the workplace and the blocking of bulk E-mail solicitations called "SPAM." How had the address been known to others The sale of personal information, or its use by a successor, according to Zaharoff (2001) may constitute "unfair or deceptive" act even if it is not a breach of contract. The Computer-Processed Personal Data Protection Act was passed in 1995, governing official agency as well as non-official agency (Yang & Chang, 2007). At present, however, the only eight categories of non-official agency governed by it are credit information, hospital, school, telecommunications, financing and banking, securities, insurance and mass communications (Yang & Chang, 2007). This means these agencies having to do with these concerns must apply

Western Civilization Class Paper Research Example | Topics and Well Written Essays - 1250 words

Western Civilization Class - Research Paper Example upon the life of the average worker, the following analysis will be concentric upon discussing these unique nuances in light of the way that they affected different groups. Furthermore, by referencing and analyzing conditions, societal structure, and life for the working class during the 19th century, the analysis will also focus upon how workers were treated within the factories, whether women and children were treated differently than men, what primary sanitation standards or conditions existed for the workers, and how these working conditions affected their overall health. Finally, a discussion and analysis of whether or not this author believes that workers were treated in this manner for a reason will be discussed. It is the hope of this particular student that the reader will be able to gain a more informed and relevant level of understanding concerning these questions as a direct result of the information and primary source documentation which will be analyzed within this brie f essay. All things considered, life for the average 19th century working class was anything but pleasant. These individuals were faced with a litany of different hardships. Among these included: long hours, poor conditions, health hazards, poor treatment at the hands of supervisory staff or managers, poor sanitation, low wages, and oftentimes horrendous living conditions. Naturally, there were seeking differentials with respect to the way in which individuals experienced 19th century later. For instance, wife in the coal mines was significantly worse as compared to my in a cotton field work wife working in a factory. Whereas it is not express intent of this particular analysis to differentiate between what types of 19th century labor could be considered as â€Å"good† and which types of 19th century labor could be considered as â€Å"bad†, general understanding that is one that appreciates the fact that nearly all members of the working class suffered from the hardships and

Core values Essay Example | Topics and Well Written Essays - 1000 words

Core values - Essay Example According to Brown (2004), leadership is a core value because it inspires greater levels of teamwork, as there are certain things that others do not know how to do, but a leader can assist them. Leadership enables me to lead others in the correct path of life as I can influence others correctly. The term work has numerous meanings with regards to the field that uses the word such as physics. However, work, in the field of core values, is carrying out a task successfully (Brown, 2004). I consider working an extremely essential value as it is even quoted in the bible "man should not eat before they work". Therefore, people should work to get want they want in life as this applies to me. People around me do not see me as a lazy person as I like getting everything successfully completed. Faith, on the other hand, refers to the things the belief in God and the things, which He has given up to bring hope in life (Brown, 2004). Everybody, in this world, has faith in something, but, for Christians, faith is to believe in their sole creator. It offers people perseverance, and; therefore, should be regarded as a core value. Faith has made me a patient person, in life, knowing that, even through the thickest of times, my future will still be okay. Prayer refers to an invocation, which seeks to arouse a rapport between people and God. Prayers, to God, are done in plentiful ways, but the essence of the act is to bring people closer to their creator (Brown, 2004). Prayers, just like faith, teach people to be patient, and know the right ways of asking for things. Prayers have enabled me to grow closer to my creator. Knowing the essence of praying, I have been able to encourage a lot of people to pray when they are facing challenging times. They return to me, in the future to say that God has answered their prayers. Loyalty refers to the devotion or faithfulness, which a person

Sustainable Energy Applications Discuss Solar Energy Essay

Sustainable Energy Applications Discuss Solar Energy - Essay Example growth in the field of solar energy is remarkable due to the improvement of technologies and by the support provided by the policies implemented by the government in the field of development of solar energy and its use (Timilsina, Kurdgelashvili, and Narbel). There are mainly 2 types of technologies to generate solar energy, and they are: solar thermal and solar photovoltaic (PV). The former deals with the conversion of solar radiation to heat, or also called as thermal energy, and the latter is the technique which deals with converting sunlight directly into electricity (â€Å"Chapter 10: Solar Energy† 263). The solar thermal technology is again divided into two such as solar thermal non-electric and solar thermal electric (4). Solar thermal non-electric technology is used in solar cookers, solar water heaters, solar air heaters, solar coolers, agricultural drying, etc. On the other hand, solar thermal electric technology is the method of directly using solar heat for the production of steam for generating electricity, which is otherwise known as concentrated solar power (4). Currently 2 types of PV technologies are present in the market, namely thin film technology made up of different types of semi-conductor materials such as cadmium telluride, copper indium gallium diselenide, amorphous silicon, etc., and the second technology is called crystalline silicon-based PV cells (4). The history of solar energy begins between 1860 and the First World War, when a wide range of techniques were established to generate steam by obtaining sun’s heat so as to run the irrigation pumps and engines (4). In 1954, at Bell Labs in the United States, Solar PV cells were used for generating electricity in space satell ites (Timilsina et al. 4). The energy provided by the sun can be directly collected and used to make high temperature steam, i.e. more than 1000 C, and low temperature steam, i.e. less than 1000 C (Energy Technology Fact Sheet). These methods are implemented in

Organizational Behavior Study Guide and Sample Comprehensive Review Assignment

Organizational Behavior Study Guide and Sample Comprehensive Review Questions - Assignment Example A number of factor help to have access to what an individual likes and dislike including: projection, hako effect, attribution, perceptual set, perceptual context, perceptual defense, stereotyping among others. 4. Attitude is a way of behaving, or thinking towards a belief. Attitude has three components. The first is emotional which refers to an individual’s feelings towards a tangible object. The second is informational which are the beliefs or ideas that an individual has concerning an object. Lastly is behavioral which is the behavior (cognitive and affective) that a person has towards an object. 5. Attitudes can be formed through learning from experience of the social situation around a person. Attitudes can be changed through an individual’s will to reduce dissonance; also rewards of changing a particular perception about an object can help in change attitude. 6. Maslow hierarchy of needs is a human motivation theory which states that the most basic needs (which are at the bottom of the hierarchy) must be met in order for a person to desire the needs at higher levels. Herzberg’s motivation theory suggests that a worker can either be motivated by good incentives or dissatisfaction by bad conditions of a working place.Alderfer’s ERG (Cycle of Needs) is an employee motivation theory proposing that there three categories of human needs (existence, relatedness, growth) that motivates a worker. McClelland’s Three-need theory advocate that needs to achievement, affiliation and power motivates an employee when they are met.Expectancy Theory (Vroom and Porter/Lawler), propose that a person will select behavior and choose motivation based on the outcome/result desirability. Equity theory suggests that fairness and unfairness in a working place determine a workers satisfaction or dissatisfaction. Attribution theoryexamines the u se of

The NFLs Digital Media Strategy Essay Example | Topics and Well Written Essays - 1250 words

The NFLs Digital Media Strategy - Essay Example While it is true that the players do seem to be getting more exciting and better with the games more spectacular and the presentation much slicker, this is only but one side of the NFL’s success. The other side of the NFL’s success lies behind the scenes with tactics, strategies and programs, which the NFL has followed in diligent, careful and ambitious stewardship of the NFL league. As a league, it is more than a collection of owners, coaches, players and franchises. The NFL also produces some of entertainments most sought after content. The leagues ambitious programming and broadcasting plans now require the flexibility to allow it distribute this content via new programs, channels, and ventures. In order to improve on the ability to capitalize on these new opportunities in the media, the NFL needs to re-invent its processes and systems to allow for increased monetization of its wireless broadcasts of content. Goals of the organization Like most successful entertainment and media companies, the NFL seeks to haul out as much value as it can from the assets it has in media. The core of this media content includes audio and video clips, which NFL, an affiliated media company films maintains and establishes (Hutchins & Rowe, 2012). NFL films acts as the NFLs most important channel for promotion. Operating out of New Jersey, the company produces such television programs as State Farm NFL match-up and Playbook. These programs represent the face of the NFL and, as such, the richness and quality of the content has to be just right. The NFL aims to gain several benefits from pursuing a digital content strategy. These are; more compelling and robust video content to be broadcast on wireless channels, improved ability to benefit from digital content partnerships and new media opportunities, strengthening of their brand on a global level, and improved ability to monetize and leverage the underlying value of its brand on a glo bal level (Hutchins & Rowe, 2012). Options Available There are several options open to the NFL n their pursuit of a lucrative digital content strategy. First, they could pursue an exclusive partnership with a wireless carrier, just like its current deal with Sprint. Second, they could form non-exclusive partnerships with an array of wireless carriers that would give them the right to carry their content on their phones but with no exclusive rights to the content. Third, they could include the rights to wireless content with one or more TV networks. This would involve showing live and full games or highlights in progress, as well as rights to NFL film’s live videos. Selection of Best Option including Analysis and Information Supporting the Decision The best option for the NFL would be to include wireless rights in partnerships with existing or new broadcast partners. This would work to achieve the double-digit growth anticipated by the bosses at the NFL because, with the deals for television broadcasts, up for renewal in the 2013 season, the mobile rights to NFL content would be of very high value to the TV broadcasters. Some of the networks, like ESPN, already have ESPN mobile, which offers to steam video, as well as other NFL content that could significantly enhance the NFL product. Even though, DirecTV already has the rights to wireless content meaning that any new deal would not give exclusive rights to the other TV networks, the networks would be willing to work with this given the demand for digital content by the consumer. They would still make a lot of money from non-exclusive deals by offering digital content to their clients (IBM, 2012). The communication industry is in the middle of a revolution known as convergence.

Title Primary and Community Care Services need to provide Essay

Title Primary and Community Care Services need to provide comprehensive, integrated and coordinated care for individuals and their families - Essay Example In collaborative healthcare practice in the clinical setting, it can be an action dependent on opinions based on a process of reasoning that builds on academic learning. A multidisciplinary team comprises professionals from different specialities who work as a group towards care to the patient. The main reason for such a care strategy is diversity and complexity of healthcare, rapid advancement of medical specialities in terms of knowledge, technical dexterity of members of the team, enhanced client concerns about health and care, and many other intricate issues in present-day healthcare where no profession has superiority over another across the contexts of healthcare delivery plan to a patient. This is a case study of a patient, whose identity will remain undisclosed in this work for ethical and confidentiality reasons. A nickname, Mrs. Chang will be used throughout the work. This writer had an opportunity to assist in her care while she was admitted to the hospital following a tri p and fall in the shower few days back, and she was admitted to the hospital due to her age of 82, frailty, baseline neurological disorder Parkinsonism with gradually declining cognition and deteriorating mobility, and lack of support at home and community, for further assessment and evaluation. In this work, based on nursing assessment of the case, a nursing discharge plan was enacted and presented with an attempt to critically analyzing the discharge plan based on her needs and at the same time finding evidence from contemporary literature about the justification of the discharge plan in association with other professionals involved in care, coordinated so that the family can participate in the care when the patient is discharged to the community. This condition is characterized by gradual slowing of voluntary movement, muscular rigidity, stooped posture, and distinctive rigid gait. Over and above that, she has evidence of rheumatoid arthritis of both hands. She tripped and fell in the bathroom; this impairment of mobility may get accentuated with her rheumatic disease. A thorough examination of all her joints indicated osteoarthritis and associated osteoporosis, which are age related, and these would further aggravate her problem of mobility. During this admission, she was admitted since she sustained a fall at home in the bathroom, and she had been admitted to the hospital for observation and further evaluation. She had been on ibuprofen. This indicates her baseline chronic pain, which may further compromise her mobility. The impaired mobility was further accentuated by the fact that at home, she stayed with her husband who was older than her by 4 years, who himself might be frail enough to be insufficient to help her out in these activities at home. The discharge plan must include provision for the patient to maintain joint mobility and range of motion while exhibiting adaptive coping behaviour. Improvement in muscle strength and endurance would be the goal. With age, there is baseline muscle wasting from the 50-80 years of age, and this is the result of aging process in the

Risk Assessment Case Study Evaluation Essay Example for Free

Risk Assessment Case Study Evaluation Essay The risk assessment case study evaluates the chromium-contaminated soils. Twelve years of research went into the study to characterize the health hazards caused by the chromium-contaminated soils. Within New Jersey there were at least three different chromate chemical manufacturing companies operating, one in Kearny, New Jersey, and the other two in Jersey City. The study was conducted through a human health risk assessment, which contains four main steps; first identifying the hazard, second the dose response assessment, followed by the exposure assessment, and finalizing with the risk characterization. There are many short and long term health effects found within the risk assessment, which is one reason that assessment is so important. Looking at the risk assessment that was done within the area, the final implication was the simple fact that a remedial cleaning needed to be done within the area. It seems that there may have been a high cost for the study and the actual cleanup, but the benefit of saving an environment and human health is priceless. Risk assessment studies are very important to human and ecological health, therefore no matter the cost associated the benefit will always be much higher. Looking at the risk assessment of chromium-contaminated soils is important; it shows health effects related to chromium and what needs to be done to clean the area for further use by humans and nature. The case study includes a group of hazardous waste sites in Northern New Jersey. At these waste sites a series of unique research efforts were implemented over the past 12 years to improve the accuracy of the Risk Assessment process† (Paustenbach, 2002, p. 1). The case study specifically documents the use of applied research to advance the characterization of both exposure and toxicity associated with the uncontrolled release of hexavalent and trivalent chromium in the form of chromites ore processing residue (COPR) in an urban setting (Paustenbach, 2002). Early investigation began after redevelopment of certain neighborhoods i n downtown Jersey City led to the discovery of COPR. Research conducted by the task force revealed that construction companies and hauling firms had sued or sold the COPR to fill basements of demolished buildings, as base for parking lots and buildings, and/or to fill low – lying areas (Paustenbach, 2002). A total of 2,138 surfaces and subsurface soil samples, 31 groundwater samples from 31 monitoring wells at seven sites, 33 ambient air samples, 19 surface-water and 11 sediment samples, and eight building wall wipe samples were collected and analyzed during the remedial investigation that was conducted by Environmental Sciences and Engineering (ESE). As a result of the investigations conducted in the late 1980s it was clear that there was considerable uncertainty about how better to characterize the potential health risks associated with the COPR sites. â€Å"The human health risk assessment a development used to process the estimation, the nature, and the chance of an adverse health effects occurring in humans who may be exposed to chemicals contaminated with environmental media† (EPA, 2012, p. 1). The risk assessment can be categorized into four steps; the hazard identification, the dose-response assessment, the exposure assessment, and the risk characterization. The easiest to perform and the most recognizable, the first step is to identify the hazards. Hazard identification determines whether exposure to a hazardous agent could be a risk for the health of humans. The assessment also considers the exposure to animals and how the hazardous agent may affect or adversely affect the animals. The second step, the dose-response assessment is â€Å"the process of characterizing the relation between the dose of an agent administered or received and the incidence of an adverse health effect in exposed populations and estimating the incidence of the effect as a function of exposure to the agent† (Paustenbach, 2002, p. 1). Influencing issues are a variable in the second step, such as; age, gender, routines, the amount they are exposed, and the volume that they are exposed. A dose-response relationship describes how the possibility and severity of adverse health effects are related to the amount and condition of exposure to an agent† (EPA, 2012, p. 1). The third step is the exposure assessment. â€Å"Exposure assessment is the process wherein the intensity, frequency, and duration of human exposure to an agent are estimated† (Paustenbach, 2002, p. 1). Last, the final step is the risk characterization. The hazardous effect on health is labeled in the final pha se. By calculation and educated guesses, the incidence of a health effect under the various conditions of human or animal exposure described in the exposure assessment is defined. The community has not been significantly affected by the COPR – containing soils. â€Å"The property values have been kept intact and the businesses on affected properties have continued to operate† (Paustenbach, 2002, p. 1). When the COPR was ub the process of disposal, there was little or no concern for the environmental and human health risks that would occur as a result of the distribution of COPR outside the plant. The potentially exposed populations were defined by onsite and surrounding land use. â€Å"Exposures to chromium in COPR were assumed to occur via inhalation of suspended soil particulates, dermal contact with soil, and incidental soil ingestion† (Paustenbach, 2002, p. 1). The data from the site surveys were used in site-specific risk assessments to quantify exposures. Chapter nine verified that the there were 42 properties affect by the exposure and toxicity assessments (Paustenbach, 2002, p. 1). There were many samples taken. Between 1986 and 1989 â€Å"a total of 2,138 surface and subsurface soil samples, 31 groundwater samples from monitoring wells located at 7 sites, 33 ambient air samples, 19 surface-water and 11 sediment samples, and 8 building wall wipe samples were collected and analyzed during the RI† (Paustenbach, 2002, p. 1). Surface water and soil samples were also taken in the risk assessments. The assessments confirmed that there was indeed a problem and that a remedial was needed. The risk characterization showed that something needed to be done and remediation was needed for these current vacant lots. Results verified that the exposure and toxicity assessment had a high toxicity in the soil and carcinogenic that people were exposed to in the air, soil, and water. Evidenced proved that indoor dust was highly toxic and yielded a link between the dust and chromium levels. High levels of chromium were definite in all tests. The carcinogenic compounds of chromium were not proven in one, though, done on lab rats. The problem was passed around inside the company but was eventually managed and is still being handled today. The implications of these assessments have changed with every assessment done. Each assessment could test even more accurately. The final assessment was that there is a need to concentrated effort on the chromium left from these sites. Each step was precisely performed and accurately carried out. Limitations arose during the first step of identification. Again, the second step dose-response was limited by the research that had been done on chromium. As soon as they would file an assessment, there would be a new more accurate test available that would make the report inaccurate. The limitations and newly surfaced assessments left unanswered questions and concerns with the assessments. This 12-year period transformed a time of new developments in testing. With the availability of these new tests it brought the need for more assessments. The final assessments show that cleanup is needed and will require extensive planning to make it happen. The assessments were designed to discover the results of how much chromium was in the area. The effect on the health of humans and the environment was also correlated within the assessments. Over the 12-year period, the assessments were evaluated and fulfilled to their fullest potential. According to Paustenbach (2002), in Chapter 9, â€Å"the cost of the 12-year study equaled 10 million dollars in research† (Paustenbach, 2002, p. 1). Results can be seen in the undertaking of the removal of soil in these areas and taken to a hazardous material dump in Canada. By lowering the levels of chromium in these areas, like the wetlands, they have save a unique environment in America. According to the Njdep Site Remediation Program (2012) the cleanup in these areas are ongoing and the testing is being posted on this web site to show what the levels are in these areas (NJDEP, 2012). The people living and working in the particular areas will most benefit from the program. The people can stay in tuned with the daily operations, along with the level ratings, through the website. Although the study was lengthy, â€Å"the studies conducted have lowered the liabilities by almost 1 billion dollars† (Paustenbach, 2002, p. 1). The practical implications of the risk assessment were that there would have to be a remedial cleanup. â€Å"A review of chromium toxicology suggested that valence differentiation in the environment would be key to correctly calculating health-protective cleanup standards and maximizing the benefit of each dollar committed to remediation† (Paustenbach, 2002, p. 1). The specific goal approach was practical because it addressed the issues and came up with a plan of action. Many big companies do not have a plan of action and this hinders the process to be successful in the remediation process. Another reason for the practicality of the risk assessment was that they were able to budget for how much the remedial and the cleanup would cost. Many companies are unable to see have a plan of action at times like this and cannot for see the cleanup and the cost associated with it. A cost benefit analysis is important when looking at a risk assessment. The cost and benefit analysis reviews the cost and benefit or cleaning up an area. Most analytically reviewed references monetary gains and loses. Looking at the cost and benefits of both scenarios will help decide whether to clean the area or leave it alone. When looking at a CBA there are four different areas that must be looked at: first the gross disproportion, the sensitivity analysis, annualisation, and discounting. Gross disproportion is basically a factor when deciding if control measures should be used; if the costs are not grossly disproportionate from the benefits the control measures must be used. Sensitivity analysis is taking one or more of the factors and varying them to see if the outcome would be any different, this is used to show that control measures will be unsuccessful or that all that can be done has been. Then the annualisation, when the costs are worked out year by year with the varying changes in money, is done by looking at the discounting numbers. Discounting is a deeper look into the different cost and benefits of each year, this looks at maintenance costs and other cost that may be incurred. The main problem with the CBA is that there are no set criteria for any of the sections, it is left up to those doing the CBA and those fighting the results must take it to court and the court decides. Have set criteria listed for each aspect will help clarify what needs to be done. A CBA can be very beneficial to the decision of what needs to be done, it just needs a little more work to be more concise. The importance in a risk analysis can be witnessed in the review and evaluation of the risk assessment. The risk assessment of the chromium-contaminated soils in New Jersey; the 12-year assessment proved many points. Such an extensive assessment demonstrated an area of strength and weakness within the risk assessment. The risk assessment is made up of four parts, first identifying the hazard, then looking at the dose response assessment; this is followed by the exposure assessment and the risk characterization. Within the risk assessment of the chromium-contaminated soils illustrated that there would be marked improvement with a remedial clean-up of the area. While it may not have been an easy decision, due to the fact, that the CBA has no set criteria. The risk analysis was conducted for 12 years to ensure human safety when living and working within the area; the 12 year study also helped form future risk analysis studies.

Difference Between Love And Sex Theology Religion Essay

Difference Between Love And Sex Theology Religion Essay Peter Bertocci has explained the human experience of sex and explains the value of sex as part of the meaning of life. Regarding sex an end in itself Peter argues that more profound satisfaction is felt when the normal experience of sex lust is not primarily an end in itself but a symbolic expression of other values. Bertocci further explains the challenge in love which he explains through his progression of love in which marriage and its values are highlighted as an essentiality to protect sex and love. He argues that sex, love, marriage, family, and social responsibility are the key factors that bring stability in the society and nourish the values morality. He considers love as a an essential element to live, otherwise it will be a mere existence not living joyously. He argues for the place of marriage in society and emphasizes on the self regeneration of the partners through this novel relationship. In my opinion he really draws on personal experience and has a closed minded view. I disagree and will give reasons and arguments in my essay as to why I think that Bertocci narrates a story of an ideal situation. Difference between Love and Sex: Psychoanalysis asserts that love and sex can never be of same origin and character due to differences of decisive nature. Love and sex must be analyzed in their own purview and in their purest forms. Sex is related to biology related to some organism; love gives an emotional touch and a sign of individuals thoughts. Sex is used to eliminate the tense attitude; love can be used as an escape goat from ones own failure. Sex satisfies a person physically; love gives happiness. Sex has a broader meaning; special meaning is shown through love. Natures call can be answered through sex; culture is satisfied through love. Sex is known to millions; millions have not even heard of romance or love. Sex is arbitrary; love is always directed to someone. Sex gives relaxation; love grooms the personality. The taste and pleasure of sex cannot be called later while love can be recalled anytime even in thoughts if the lover is not physically present. Sex is an act; love is spiritual. Sex eagerness is f or a short time whereas love is continuous warmth. (Reik, New York: Grove Press.  1945)[1]. Can Love and Lust be combined? (Reik, p. 19), observes that if love and sex are combined, it is very difficult to assess that which has the most part or share, to be precise, during a sexual intercourse. I believe that it is purely dependant on our perception. It is our own mind and body that drives us to a particular point where we need to think that what should be combined and what should be separated. I believe that there are ways in which sex without love can be as joyous, fruitful and soothing as sex with love. So, the question as to the combination of lust and love, one cannot say that which is more dominating but one can say is that crude form of sex is generated after divorcing love from sex. Sex with Love: What Bertocci has explained about love is that through sex with love one gives in everything but Rollo May s  Love and Will  (New York: Dell Publishing Co.. 1969), says that one will always hold something back until the act is personal, and if we use this word personal instead of love, the context of sex is broadened and sex can be joyful even the partners are not lovers. May further argues that holding off something does not mean that sex will not be a pure sex. According to May (p. 311), relationship and intimacy are much more important factors than merely having sex with a person because of the impersonal society and it is unknown that the act of sex will satisfy the required needs of relationship and intimacy. But what one can say according to Mays stance that through love one is absorbed in another and isolation can be overcome through this. The irony of love is that one is at the same time losing oneself and absorbing the other in him. Mays writings show a lack of understan ding of how gratification can be achieved through sex without love. Analysis of Sex with Love: Like May many people in this world are unaware of the possibility of sex being a loving act even without being lovers to each other. As I mentioned earlier this is a traditional or closed mind view that sex without love is not as fruitful as sex with love. I reiterate my view that Sex without love allows the partners to have a more relaxing feeling. Contrasting to what bertocci, I would say that sex with love leading to a more chaining relationship which leads to taking each others pain, then placing your life in the basket of marriage which will land your life in the rearing of children. Bertocci further asks you to nourish the society through all these preceding acts of yours. Sadly, a true and a happy relationship of sex have been destroyed by the clogging views of writers such as May and Bertocci. Sex should be as free and motivating as a clear sky is available to the bird that goes high in strength and spirits to have a broader overview of the intricacies of this world. This fee ling takes me higher and regenerates the true spirit of life and makes me see what the believers of sex with love cannot see or visualize in their thoughts. Sex without Love: (Russell Vannoy, Buffalo: Prometheus, 1980) gives some of the examples from the papers of his students. I would like to mention a few; pleasuring my lover leaves me pleasure less as the mind is devoted to his satisfaction, thus disturbing the whole concept of sex. The deeper you get involve in other person and as the other is absorbed in you, the more a person is ceased to be a separate person, which is absolutely not encouraging and equally not satisfactory. The lovers gets cocksure and sometimes the girl does not feel horny, then if the lover pushes her and she refuses, is she getting selfish. I would say no because this might not have been the case with a stranger whom she did not love, a stranger cannot push you for something and one is at liberty to say no to stranger without worrying to dishearten him. Once a lover knows what you are capable of in the bed, he wants repetition whereas a new person will be attracted to the same demonstration. Self-sacrifice is common among lovers whereas no such sacrifice is required to be done during sex without non-lovers. (Casler, New York: Behavioural Publications, 1973), has argued that love is needed to satisfy the needs of personal insecurity. These needs are dictated to by the societal pressure and those without it are not considered an active part of this so called moral society. Caslers view shows that people getting loved or love someone are just trying to gain self-worth. With this attitude in mind the sex is most unfulfilling. Considering the older ages when women were not respected, how can males give respect to them in the shape of love? This has aroused women to write the most criticism on love. (Robert Solomon, Buffalo,  NY: Prometheus Books, 1976), writes that sexual encounters with strangers are the most satisfying ass there is fear, guilt and anticipation. Conversely sex with those we know and love is much less satisfying as the habits and reactions are known to each other which, nullifies the uniqueness among the partners. Moralists paints the picture of sex with a non-lover as crude and animalistic. They still have their view of having successful sex with only the ones you love and the other sex is never pure. Giving justification to love is just as hypocrite as actually doing hypocrisy during crude sex in love; one says that if I dont love her I am exploiting her, so he loves to make his sex justified is just another form of hypocrisy. The advocates of sex with love has not allowed the people to think to stop being selfishly loving others to justify the societys value system. Once this selfish behavior is outsmarted, only then a true loving act of sex could emerge without romantically being involved in the other partner. Many husbands perform crude sex and wives are left unfulfilled. The reason is that wives want a sensuous sex while men want manly, lusty sex which cannot be achieved as they get involved in each other and cannot push for the demands and now when married cannot change husbands. This situation leaves both thirsty for real experience in sex. Social Approval: Societys approval is considered necessary and the sex must be given the assent of the pure spirit of love. Otherwise the sex would animalistic and dirty. If this option is considered then, even in sex with love the partners remain unfulfilled and they are not spontaneous and guilt free. I believe that societys concept must not be involved in sex relationships, as it is only to strengthen the institution of marriage. Marriage will certainly make the experience of sex laborious although the society gives the assent of piety but will ultimately make the people who make the society unfulfilled with regards to their sexual satisfaction. Analysis of Sex without Love: I strongly believe that sex without love is much more fruitful and joyous than the sex with love. The reality is still that sex opens the doors for the people to happiness and gratification but when love comes and knocks the door and hugs sex, it suddenly engulfs sex and convinces to move to the next stage of sex with love. I reject this and say that this encompassing is just like going into a war which one choose for its own self without any reason. Conclusion The sex without love is the superior, mature and natural attitude which one must follow. The societys regeneration is indeed laid in the foundations of liberty and freedom of choice which can only be exercised when one has no restriction to follow a particular schedule or guidelines while having sex. I strongly believe in having sex without love for which I have argued in my paper after taking a view of the various aspects of what people want and what people face after taking a wrong decision of landing at a lovers corner.

Problems Of The Aging Health And Social Care Essay

Problems Of The Aging Health And Social Care Essay for death from cancer, Management of the elderly cancer patient becomes complex because other chronic conditions, such as osteoarthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease, must also be considered in their care. The attitude of health care providers towards older adults affect their health care. Unfortunately, research indicates that health care professionals are significantly more negative in their attitudes towards older patients than younger ones. This attitude must change if the health care provider is to have a positive interaction with the elderly patient. These attitude appear to be related to the pervasive stereotyping of the elderly, which serves to justify avoiding care and contact with them, as well as being reminders of our own mortality. Ageism is a term used to describe the stereotyping of and discrimination against elderly persons and is considered to be similar to that of the racism and sexism. It emphasized that frequently the elderly are perceived to be repulsive and that a distaste for the aging process itself exists. Ageism suggests that he majority of elderly are senile, miserable most of the time, and dependent rather than independent individuals. The media have also influenced on going stereotypical notions about the elderly. Health care providers must learn to appreciate the positive aspects of aging so that they can assists the elderly in having a positive experience with their imaging procedure. PHYSICAL, COGNITIVE, AND PSYCHOSOCIAL EFFECTS OF AGING The human body undergoes a multiplicity of physiologic change second by second. Little considerations is given regarding these changes unless they are brought on by sudden physical, psychological, or cognitive events. Radiographers must remember that each elderly person they encounter is a unique individual with distinct characteristics. These individual have experienced a life filled with memories and accomplishment. Young or old, the definition of quality of life is an individual and personal one. Research has shown that health status is an excellent predictor of happiness. Greater social contact, health satisfaction, low vulnerable personality traits, fewer stressful life events have been linked to successful aging. Self-efficacy can be defined as the level of control one has over ones future. Many elderly people feel they have no control over medical emergencies and fixed incomes. Many have fewer choices about their personal living arrangements. These environmental factors can lead to depression and decreased self-efficacy. An increase in illness will usually parallel a decrease in self-efficacy. The elderly may experience changing roles from life of independence. The family role of an adult caring for children and grandchildren may evolved into the children caring for their caring aging parents. It is also a time of loss. Losses may include the death of a spouse and friends, as well as loss of income due to retirement. The loss of health may be the reason for the health care visit. The overall loss control may lead to isolation and depression in the elderly. Death and dying is also an imminent fact of life. The aging process alone does not likely alter the essential core of human being. Physical illness is not aging, and age-related changes in the body are often modest in magnitude. As one ages, the tendencies to prefer slower-paced activities, take longer to learn new tasks, become more forgetful, and lose portions of sensory processing skills increase slowly but perceptibly. Health care professionals need to be reminded that aging and disease are not synonymous. The more closely a function is tied to physical capabilities, the more likely it is to decline with age, whereas the closer a function depends on experience, the more likely it will increase with age. Joint stiffness, weight gain, fatigue and loss of bone mass can be slowed through proper nutritional interventions and low-impact exercise. The importance of exercise cannot be overstated . Exercise has been shown increase aerobic capacity and mental speed. Exercise programs designed for the elderly should emphasized increased strength, flexibility, and endurance. One of the best predictors of good health in later years is the number and extent of healthy lifestyles that were established in earlier life. The elderly person may shown decreases in attention skills during complex tasks. Balance , coordination, strength and reaction time all decrease with age. Falls associated with balance problems are common in the elderly population, resulting in a need to concentrate on walking. Not overwhelming them with instructions is helpful. Their hesitation to follow instructions may be fear instilled from a previous fall. Sight, hearing, taste and smell are all sensory modalities that decline with age. Older people have more difficulty with bright lights and tuning out background noise. Many elderly people become adept at lip reading to compensate for loss of hearing. For radiographers to assume that all elderly patients are hard of hearing is not usual; they are not talking in a normal tone, while making volume adjustments only if necessary, is a good rule of thumb. Speaking slowly, directly, and distinctly when giving instructions allows older adults an opportunity to sort through directions and improves their ability to follow them with better accuracy. Cognitive impairment in the elderly can be caused by disease, aging, and disuse. Dementia is defined as progressive cognitive impairment that eventually interferes with daily functioning. It includes cognitive, psychologic, and functional deficits including memory impairment. With normal aging comes a slowing down and a gradual wearing out of bodily systems bit it does not include dementia . Yet the prevalence of dementia increases with age. Persistent disturbances in cognitive functioning, including memory and intellectual ability, accompany dementia. Fears of cognitive loss, especially Alzheimers disease, are widespread among older people. Alzheimers disease is the most common form of dementia. Therefore health care professionals are more likely to encounter people with this type. The majority of elderly people work at maintaining and keeping their mental functions by staying active through mental games and exercises and keeping engaged in regular conversation. When caring for pati ents with any degree of dementia, verbal conversation should be inclusive and respectful. One should never discuss the patients as through they are not in the room or are not active participants in the procedure. One of the first questions asked of any patient entering a health care facilities for emergency service Do you know where you are and what day it is? The health care providers need to know just how alert the patient is. Although memory does decline with age, this is experienced mostly with short-term memory tasks. Long-term memory or subconscious memory tasks show little change over time and with increasing age. There can be a variety of reasons for confusion or disorientation. Medication, psychiatric disturbance, or retirement can confuse the patient. For some older people, retirement means creating a new set routines and adjusting to them. The majority of elders like structure in their lives and have familiar routines for approaching each day. PHYSIOLOGY OF AGING Health and well- being depend largely on the degree to which organ systems can successfully work together to maintain internal stability, With age, there is apparently a gradual impairment of these homeostatic mechanisms. Elderly people experience nonuniform, gradual, ongoing organ function failure in all systems. Many of the body organs gradually lose strength with advancing age. These changes place the elderly at risk for disease or dysfunction, especially in the presence of stress. At some point the likelihood of illness, disease and death increases. Various physical diseases and disorder affect both mental and physical health of people of all ages. They are more profound among elderly people because diseases and disorders among older people are more likely to be chronic in nature. Although aging is inevitable, the aging experience is highly individual and is affected by heredity, lifestyle choices physical health, and attitude. A great portion of usual aging risks can be modified with positive shifts in life style. In elderly, the aging of the organs systems is one of the process where they need to understands and there are as list below: Integumentary systems disorders Nervous systems disorders Sensory systems disorders Musculoskeletal systems disorders Cardiovascular systems disorders Gastrointestinal system disorder Immune system decline Respiratory system disorder Hematologic system disorders Genitourinary systems disorders Endocrine systems disorders. THE RADIOGRAPHERS ROLE The role of the radiographer is no different than that of all other health professionals. The whole person must be treated, not just the manifested symptoms of an illness or injury. Medical imaging and therapeutic procedures reflect the impact of ongoing systemic aging in documentable and visual forms. Adapting procedures to accommodate disabilities and disease of geriatric patients is a critical responsibility and a challenge based almost exclusively on the radiographers knowledge, abilities, and skill. An understanding of the physiology and pathology of aging, in addition to an awareness of the economic the social, psychologic, cognitive, and economic aspects of aging, are required to meet the needs of the elderly population. Conditions typically associated with elderly patient invariably require adaptations or modifications of routine imaging procedures. The radiographer must be able to differentiate between age related changes and disease processes. Production of diagnostic image s requiring professional decision making to compensate for physiologic changes, while maintaining the compliance, safety, and comfort of the patient, is foundation of the contract between the elderly patient and the radiographer. RADIOGRAPHIC POSITIONING FOR GERIATRIC PATIENTS The preceding discussions and understanding of the physical, cognitive, and psychosocial effects of aging can help radiographers adapt to the positioning challenges of the geriatric patient. In come cases routine examinations need to be modified to accommodate the limitation, safety, and comfort of the patient. Communicating clear instructions with the patient is important. The following discussion addresses positioning suggestion for various structures. The common radiography examinations for geriatrics are: Chest Spine Pelvis/hip Upper extremity Lower extremity CHEST The position of choice for the chest radiograph is the upright position; however, the elderly patient may not be able to stand without assistance for this examination. The traditional posteroanterior (PA) position is to have the backs of hands on hips. This may be difficult for someone with impaired balance and flexibility. The radiographer can allow the patient to warp his or her arms around the chest stands as a means of support and security. The patient may not be able to maintain his or her arms over the head for lateral projection of the chest. Provide extra security and stability while moving the arms up and forwards. When the patient cannot stands, The examination may be done seated in a wheelchair, but some issues will affected the radiographic quality. First, the radiologist need to be aware that the radiograph is an anteroposterior (AP) instead of a PA projection, which may make comparison difficult. Hyperkyphosis can result in the lung apices being obscured, and the abdomen may obscure the lung bases. In sitting position, respiration may be compromised, and the patient should be instructed on the importance of a deep inspiration. Positioning of the image receptor for kyphotic patient should be higher than normal because the shoulder and apices are in a higher position. Radiographic landmarks may change with age, and the centering may need to be lower, if the patient is extremely kyphotic. When positioning the patient for the sitting lateral chest projection, the radiographer should place a large sponge behind the patient to lean him or her forward. Sitting Chest PA Chest Standing SPINE Radiographic spine examinations may be painful for the patient suffering from osteoporosis who is lying on the x-ray table. Positioning aids such as radiolucent sponge, sandbags, and a mattress may be used as long as the quality, of the image is not compromised. Performing upright radiographic examination may be also appropriate if a patient can safely tolerate this position. The combination of cervical lordosis and thoracic kyphosis can make positioning and visualization of the cervical and thoracic spine difficult. Lateral cervical projections can be done with the patient standings, sitting, or lying supine. The AP projection in the sitting position may not visualized the upper cervical vertebrae because the chin may obscure this anatomy. In the supine position the head may not reach the table and result in magnification. The AP and open-mouth projection are difficult to do in wheelchair. The thoracic and lumbar spines are sites for compression fractures. The use of positioning blocks may be necessary to help the patient remain in position. For the lateral projection, a lead blocker or shield behind the spine should be used to absorb as much scatter radiation as possible. Lateral Spine PELVIS/HIP Osteoarthritis, osteoporosis, and injuries as the result of falls contribute to hip pathologies. A common fracture in the elderly is the femoral neck. An AP projection of the pelvis should be done to examine the hip. If indication is trauma, the radiographer should not attempt to rotate the limbs. The second view taken should be a cross-table lateral of the affected hip. If hip pain is the indication, assist the patient to internal rotation of the legs with the use of sandbags if necessary. Immobilization device are place to the patient foot. UPPER EXTREMITY Positioning the geriatric patient for projections of the upper extremities can present its own challenges. Often the upper extremities have limited flexibility and mobility. A cerebrovascular accident or stroke may cause contractures of the affected limb. Contracted limbs cannot be forced into position, and cross-table views may need to be done. The inability of the patient to move his or her limb should not be interpreted as a lack of cooperation. Supination is often a problem in patients with contractures, fractures, and paralysis. The routine AP and lateral projections can be supported with the use of sponges, sandbags, and blocks to raise and support the extremity being imaged. The shoulder is also a site decreased mobility, dislocation, and fractures. The therapist should assess how much movement the patient can do before attempting to move the arm. The use of finger sponges may also help with the contractures of the fingers. Hand Projection Lateral Wrist LOWER EXTREMITY The lower extremities may have limited flexibility and mobility. The ability to dorsiflex the ankle may be reduced as a result of neurologic disorders. Imaging on the x-ray table may need to be modified when a patient cannot turn on his or her side. Flexion of the knee may be impaired and required a cross-table lateral projection. If tangential projection of the patella, such as the Settegast method, is necessary and the patient can turn on his or her side, place the image receptor superior to the knee and direct to central ray perpendicular through the patellofemoral joint. Projections of the feet and ankles may be obtained with the patient sitting in the wheelchair. The use of positioning sponges and sandbags support and maintain the position of the body part being imaged. AP Ankle Projection Lateral Ankle Projection PATIENT CARE Patient care must be apply to geriatric patient because they all are all fragile where their bone can easily broke or they can be easily fainted during the examination. For communications, take time to educate the patient and his or her family, speak lower and closer, and treat the patient with dignity and respect. Transportation and lifting patient are also be need because geriatrics patient is not stronger than normal person. If possible, give the patient time to rest between projection and procedures. Avoid adhesive tape because elderly skin is thin and fragile. Provide warm blankets in cold examination rooms, use table pads and hands rails and always access the patients medical history before contrast media is administered. Take time with the patient Immobilization Device CONCLUSION The imaging professional will continue to see a change in health care delivery system with the dramatic shift in the population of persons older than age 65. This shift in the general population is resulting in an ongoing increase in the number of medical imaging procedures preformed on elderly patients. Demographic and social effects aging determine the way in which the elderly adapt to and view the process of aging. An individuals family size and perceptions of aging, economic resources, gender , race, ethnicity, social class, and the availability and delivery of health care will affect the quality of the aging experience. Biologic age will be much more critical than chronologic aging when determining the health status of the elderly. Healthier lifestyles and advancement in medical treatment will create a generation of successfully aging adults, which in turn should decrease the negative stereotyping of the elderly person. Attitudes of all health care professionals, whether positiv e or negative, will affect the care provided to be growing elderly population. Education about the mental and physiologic alterations associated with aging, along with the cultural, economic and social influences accompanying aging, enables the radiographer to adapt imaging and therapeutic procedures to the elderly patients disabilities resulting from age-related changes. The human body undergoes a multiplicity of physiologic changes and failure in all systems. The aging experience is affected by heredity, lifestyle choices, physical health, and attitude, making it highly individualized. No individuals aging process is predictable and is never exactly the same as that of any other individual. Radiologic technologists must use their knowledge, abilities, and skills to adjust imaging procedures to accommodate for disabilities and disease encountered with geriatric patients. Safety and comfort of the patient is essential in maintaining compliance throughout imaging procedures. Implementation of skills such as good communication, listening, sensitivity, and empathy, all lead to patient compliance. Knowledge of age-related changes and disease process will enhance the radiographers ability to provide diagnostic information and treatment when providing care that meets the needs of the increasing elderly patient population.

Should The Harris Superquarry Go Ahead? :: essays research papers

Should The Harris Superquarry Go Ahead? TABLE OF FIGURES FIGURE 1 LOCATION OF THE SUPERQUARRY  Ã‚  Ã‚  Ã‚  Ã‚  3 1 SUMMARY There is considerable environmental opposition to the development of the Harris superquarry. This is unlikely to stop the development on its own, but if the Scottish Office decides that the project can go ahead environmental restrictions are likely to be imposed on the operation to minimise, as far as possible, the impact. The reasons for the development centre round the need for economic development to bring jobs and prosperity to this remote area. The life of the quarry is expected to be around 60 years and provide an initial 30 jobs, rising to 80 as the quarry reaches peak production. The question is if a superquarry is the best solution to the problems of a remote rural area. What will happen when the jobs come to an end and would another form of investment not be more appropriate to their needs? Would the presence of a quarry restrict the choice for further development? Could an integrated approach be adopted and a 2nd generation quarry planned? The decision of whether or not to go ahead cannot be delayed indefinitely as Norway and Spain are looking at developing their own. If it is to go ahead then an early start will give Harris a stronger position in the market. 2 INTRODUCTION This report examines the controversy and key issues surrounding the superquarry at Rodel, Lingerbay on the southern coast of the Isle of Harris (Figure 1) and attempts to find an acceptable solution. The quarry will hollow out the heart of the mountain but leave enough of a shell to leave the skyline largely unaffected. The whole question of whether or not it should go ahead or not is the subject of the current public enquiry in Stornaway. A decision must be made soon. The market for aggregates is limited, Norway and Spain (Section 3.1, 1991) have their own sites and are also looking at the potential for developing them. FIGURE 1 LOCATION OF THE SUPERQUARRY   Ã‚  Ã‚  Ã‚  Ã‚  (Glasgow Herald, 20/10/94) 3 THE ISSUES SURROUNDING THE DEBATE 3.1 History 1927  Ã‚  Ã‚  Ã‚  Ã‚  A detailed geological survey identified the deposit of anorthosite. 1965  Ã‚  Ã‚  Ã‚  Ã‚  Planning permission was given in principle to quarry the rock. The remit covered a larger site than is planned today. 1966  Ã‚  Ã‚  Ã‚  Ã‚  Some small scale quarrying took place but found an on site rock crushing plant and a deep harbour were necessary for economic viability. 74-76  Ã‚  Ã‚  Ã‚  Ã‚  Outline planning permission was given for quarrying, shipping and loading facilities but this was never acted on. 1977  Ã‚  Ã‚  Ã‚  Ã‚  The Scottish Office issued National Planning Guidelines. Harris was identified as one of 9 potential sites. (The Scotsman 18/7/93)

Al Capone Essay -- essays research papers

Al Capone still remains one of the most notable residents of "the Rock." In a memoir written by Warden James Johnston, he reminisced about the intensity of public interest around Capone's imprisonment, stating that he was continually barraged with questions about "Big Al." Each day newspapers and press flooded his office with phone calls, wanting to know everything from how Capone liked the weather on "the Rock," to what job assignment he was currently holding. Before arriving at Alcatraz, Capone had been a master at manipulating his environment at the Federal Penitentiary in Atlanta. Despite strict convictions from the courts, Capone was always able to persuade his keepers into procuring his every whim, and often dictated his own privileges. It was said that he had convinced many guards to work for him, and his cell boasted expensive furnishings which included personal bedding along with many other amenities not extended to other inmates serving lesser crimes. His cell was carpeted, and also had a radio around which many of the guards would sit with Al conversing and listening to their favorite radio serials. His friends and family maintained residence in a nearby hotel, and each day he was flooded with visitors. Capone started his life of crime at a young age. Rumored to have started pimping prostitutes before reaching puberty, he was raised on the tough streets of Brooklyn and earned extra money as a bouncer in various brothels. By the age of twenty, Capone had moved to Chicago and was managing a popular nightclub named The Four Deuces. By 1924, Capone had his hand in various rackets, including prostitution rings, bootlegging, and gambling houses and was believed to be earning over $100,000 per week. Capone had mastered the art of politics, and as a wealthy, powerful gangster figure, he attempted to balance his activities. Despite his illegitimate occupation, he had become a highly visible public figure. He made daily trips to City Hall, opened soup kitchens to feed the poor, and even lobbied for milk bottle dating to ensure the safety of the city's children. City officials often were embarrassed by the politic strength of Capone, and began leveraging his illegal activities through police raids, along with setting intentional fires to his places of business. In the beginning, the public glamorized Capone's activities and... ...on Alcatraz, he made several attempts to con Johnston into allowing him special privileges, but all were denied. Johnston maintained that Capone would not be given any special rights and would have to follow the rules as would any other inmate. Capone eventually conceded and one day made the comment to Johnston, "It looks like Alcatraz has got me licked." Capone spent 4 Â ½ years on Alcatraz and held a variety of jobs. Capone's time on Alcatraz was not easy time. Capone got into a fight with another inmate in the recreation yard and was placed in isolation for eight days. While working in the prison basement, an inmate who was standing in line waiting for a haircut, exchanged words with Capone and stabbed him with a pair of shears. Capone was admitted into the prison hospital and released a few days later with a minor wound. Capone eventually became symptomatic from syphilis, a disease he had evidently been carrying for years. In 1938, he was transferred to Terminal Island Prison in Southern California to serve out the remainder of his sentence, and was released in November of 1939. Capone died on January 25, 1947, in his Palm Beach Mansion from complications of syphilis.

Essay --

Part A: Describe protein structure, the level of structure and geometry. Include in a description of the significance of structure and how it affects to analysis. Protein Structure Levels There are four levels of protein structure which are separated from one another by the degree of complication in the polypeptide chain. A protein molecule can consist of one or more of the protein structure types. 1- ) Primary Structure is the sequence of a chain of amino acids. Proteins are formed from 20 different amino acids. Amino acid are composed of a carbon (ÃŽ ± carbon) that bond to the hydrogen atom (H), a carboxyl group (-COOH), an amino group (-NH2) and a variable group, or R group. The primary structure is determined during translation. There are two tools uses to determine the primary structure; Edman degradation and mass spectrometry. Primary structure controls the secondary, tertiary and quaternary structures. It is also used to determine the molecular mass and isoelectric point. 2- )Secondary Structure describes the coiling or folding of a protein due to exclusive hydrogen bonding between its backbone amide and carbonyl groups. These secondary structures are held together by hydrogen bonds. There are three types of secondary structures in proteins. a-) Alpha helix (ÃŽ ±-helix) is a spiral arrangement around polypeptide backbone. The inner part of the coil is formed by the backbone of the peptide while the side chains extend outward from the coil. Hydrogen bonds between N-H of one amino acid and the C=O on the 4th amino acid stabilize the helix. b-) Beta pleated the beta sheet involves H bonding between the backbone residues in adjacent chains. The orientation of a beta pleated sheet can occur in two types. The strands may be paralle... ...Da) than grw175 (28 kDa) proving that the above observation is true. b-) Molecular mass of the XÃ ¸D2788 gene product = 56 kDa 1.) Loaded the image of the gel into ImageJ 2.) Labeled the MW ladder lane then other lanes of interest (lane 2 grw175, lane 3 grw19) 3.) A graph representation was then generated 4.) I selected the peaks of MW lane to be used in the molwt.macros program 5.) Based on the calculations that were generated using the molwt macros program I was then able to select the peaks of interest and compute a numerical value for them 6.) ImageJ indicated a peak of 56kda for grw19 positive and a 28kda value in grw175 positive. 7.) Using the numerical values I was able to subtract the grw175 estimated size of 28kda from the size of what is believed to be the fusion protein grw19 56kda 8.) Grw175 = 28kda – fusion protein 56kda to give you a value of = 28kda

Planning a Lesson Module 1

Course:Teaching Assistant Level1 Q1. Give examples of how you would plan activities. Under the direction of the teacher, you will discuss and fully understand your role within the teacher’s lesson plan. The teacher will have previously completed long and medium term plans for the class. The class teacher’s short terms plan for the week can be broken down into daily plans. These will give you an idea of the number of children involved in the learning objective, previous learning, environment, resources available and a time scales.Which individuals or groups of children are to work on tasks at a particular time, taking into account individual needs and interests, grouping together children with similar abilities so that they are working towards the same targets, and give an indication of whether they are to be supported by an adult. This is a great opportunity for you the TA to get involved with the weekly plan and to contribute your own ideas to the planning session. â⠂¬ ¢You are aware in advance of what you are required to do. There are clear roles and responsibilities for you working together with the teacher to support the pupils. †¢The work you are covering fits in with the activities and topics which have been planned for the term. †¢You are aware of where, when, what and who you will be working with. †¢The objectives of the learning activity. †¢The type and level of support the pupils may need. The above established you can start preparing and organising for the learning activity: †¢Where the learning activity is being taken place: is there sufficient space for the learning activity. What resources may be needed: are the resources readily available and accessible, do you need to bring in furniture or equipment for implementing the learning activities. †¢Who you will be supporting: individuals, groups or perhaps a SEN pupil, in the event of a SEN pupil, you may want to gather further information on the pupil for example you should be aware of the IEP’s and PSP’s Q2. Describe your role in delivering learning activities Know and understand the objectives of the learning activities and strategies for supporting pupils and ensure you share the same goals as the teacher.Example of an Individual Lesson plan for Geography Learning Objective: For pupils to be familiar with and understand the water cycle. Introduction: Find out what the children know about the water cycle. Class discuss to see how much they can remember about water from the previous lesson. Main part of lesson: Children to work in groups: Group 1: Work with teacher, using the internet and reference books to see what they can find out. Group 2: Work with TA using artwork and models to explain what happens. Group 3: Work independently to explain the water cycle, in their own words and diagrams.Conclusion: Children to discuss what they have found out and give examples. As a TA you would: †¢Prepare the learning envir onment to meet the needs of all the pupils. †¢Provide appropriate learning activities for the individual or group, selecting the appropriate learning materials required. †¢Maintaining pupil safety at all times. †¢Interacting with the pupils, using praise and encouragement. †¢Observe the pupils responses. Assist the teacher in the implementation of set tasks, e. g. setting up and clearing the classroom before and after activities.Assist in the production of teaching aids and preparation of work for the pupils as required, charts, displays, worksheets, etc. Provide general classroom help. Making accurate and detailed records of what has been planned and delivered. Take a pro-active role and use initiative within the classroom. Q3. Make a list of the things expected from you as part of your role in supporting an individual pupil or group of pupils. Adapt activities that will encourage independent learning and provide challenges. Ensure the pupils understand and foll ow the teacher’s instructions.Help the pupils to use equipment and resources that is relevant to the learning activity. Supporting the pupils in enabling them to gain independence and participate fully in the curriculum. Challenge the pupils thinking and observe individual pupils progress and achievements. Provide focused support to help pupils move to the next level of learning. Be adaptable, have empathy but also follow the school’s positive discipline guidelines. Give the pupils choices and praise. Q4. Think about your role and responsibilities as a teaching assistant.List examples of your own general and specific tasks. 1. Supervise individuals / groups of pupils during specified learning activities, as directed by the class teacher. 2. Assist in preparing and maintaining an effective learning environment for pupils. 3. Getting the classroom ready for lessons. 4. Listen to children read and reading to them. 5. Helping children who need extra support to complete tas ks. 6. Taking care of children who are upset or have had accidents. 7. Clearing away materials and equipment after lessons. 8. Helping with outings and sports events. . Assist in the implementation of Individual Education Programmes for students and help monitor their progress. 10. Provide support for individual students inside and outside the classroom to enable them to fully participate in activities. 11. Assist class teachers with maintaining student records. 12. Prepare and present displays of student's work. 13. Support class teachers in photocopying and other tasks in order to support teaching. Q5. Briefly describe the role of the teaching assistant in relation to the teacher. Teachers Role:The teacher is responsible for planning and delivering of the National / Early Years Curriculum. To teach pupils to their educational needs. Assess record and report development. They are also responsible for all adults within the learning environment. Communicate and consult with parents. Teaching Assistant: Plan and prepare work alongside the teacher Support learning activities effectively, as directed by the teacher. Assess / evaluate pupil’s work, as directed by the teacher. Report any problems / queries to the teacher Give feedback to the teacher following planned activities. Q6.Briefly outline the role and responsibilities of: Head Teacher, Deputy Head Teacher, SENCO, Key stage co-ordinators, subject co-ordinators, class teacher. The Head Teacher: The role of the Head Teacher is to manage all aspects of the school and all of those within it, as well as making sure the curriculum are being effectively taught and managed. The Head is answerable to parents, Ofsted and the local authority for the smooth running of the school. The Deputy Head: Works closely with the Head, when the Head Teacher is absent from the school, the Deputy is responsible for its management.The Deputy will usually work as a Teacher; however he will still be responsible for running the d ay to day arrangements such as supply staff or training courses. He will liaise with the Head on a daily basis concerning the day’s priorities. SENCO: Is responsible for the managing of children with special needs throughout the school. Keeping records on all these children as well as being responsible for the management of individual support assistants in the school. SENCO are the line of contact for any outside agency, i. e. Speech and Language, Educational Psychologist.Key Stage Co-ordinators: Employed to lead and manage either Key Stage 1 or 2. They usually also have a class teaching commitment Subject Key Stage Co-ordinators:Responsible for the leadership and management of a particular curriculum subject. Class teachers may be expected to accept responsibility for an area of the curriculum as part of their normal professional duties The Teacher / Subject teacher: Plan, prepare and deliver lessons to meet the needs of all pupils, setting and marking work and recording pup il development as necessary.Includes advanced skills teachers and supply teachers. Often work in partnership with teaching assistants Q7. Give examples of how to promote independent learning, e. g. using ICT skills. Give positive encouragement and praise – this gives a pupil a feeling of achievement and the desire to continue with the learning activity. Listen – let the pupil see that you are listening to what they are saying, that you are taking notice of their contributions, this will build confident in their own abilities. Motivate – Give them positive experiences which are interesting and can be made real for them.Resources – Ensure that the relevant resources are available to them so they don’t need to ask for help, make things available and accessible. Repetition:Reminding a pupil what the teacher has said and encouraging them to think about what they are doing, without giving them the answer. Instruction:Following steps to complete a task, a sking them simple questions, â€Å"Do you think this is the best way to do it† or â€Å"Why do you think this is the best way†. Facilitating:Giving the pupils the tools to carry out a task and discover the outcome, again encourage the child to talk you through what they are doing and why.ICT: Encourage the children to access, enter, save and retrieve information independently, to research and interpret information to support work in other subjects. Encourage them to write themselves reminders for accessing different programmes. Q8. What strategies can be used to support pupils learning activities? Create a positive learning environment. Adapt learning activities to support each individuals needs. Encourage independent learning. Prompt shy or reticent pupils. Ask open-ended questions to encourage their participation, also to see their understanding of the subject.Look for and note any common problems that the pupils have or mistakes made, this will enable the teacher to address these at a future learning activity. Give pupils choices and only give further assistance if required. Check pupils work and encourage them to correct their own mistakes Translate or explain information used by the teacher, i. e. words / phrases. Organise and participate in appropriate play activities or games. Ensure that all pupils behave and concentrate Listen, respect and value the pupils. Gain the pupils trust and confidence.

An Analysis of the Urban Issue of Tuberculosisin the Bourough of Newham

1.Introduction terabit is a actu all(prenominal)y serious infectious sickness that to begin with changes the lungs, causing cough and breathing difficulties. The contagion too grammatical boldnesss sy shuckic effects including fever, wickedness sweats and weight exhalation (Ellner, 2011). In some cases, the contagion system posterior opening beyond the lungs and affect the b atomic number 53/joints, lymph nodes, venter and blood stream (Ormerod, 2003). The disorder is ca utilize by the bacteria mycobacterium terabit (WHO, 2014), which is circularize through with(predicate) respiratory droplets. These droplets atomic numeral 18 passed when an give individual coughs or sneezes and the droplets become inhaled by a nonher person (NHS, 2014). Despite this booming order of transmission, tebibyte is non readily transmitted, and therefore is most probably to affect those in swell-nigh contact much(prenominal) as family or household members (Castillo-C imbibez & Feng). tebibyte guide on ons a epoch-making take a chance of unwholesomeness and mortality rate and re searchs a of import be to society to treat and manage. tebibyte has peculiarly shown to be a line in cities, whereby the range of increase ar great than those of homespun beas (Anderson et al. 2006). This essay allow come up to the basiss as to why terabit affects urban vault of heavens (the sick metropolis hypothesis), and look in to why atomic number 65 commits to this urban wellness penalization. As an exemplar of an urban environs despicable from the burden of terbium, this essay will focus on the pileus of the fall in Kingdom borough of nakedham. Newham has a tebibyte site 8 times high-pitcheder than the national average and 3 times that of capital of the United Kingdom. This essay aims to investigate the etiology behind the relative incidence, and to find ways of expurgate the range of atomic number 65 among individuals in the capi tal of the United Kingdom borough of Newham. The paper will include the interjection strategies and how they should be implemented in methodicalness to reduce the rate of late infections and countenance men to restore tested and get early discussion before the out scatter of infection.2. terabyte in an Urban Environment tebibyte tends to be regarded as a business of the past, and was responsible for 20-30% of all mortality in 17th-19th century atomic number 63 (Dye & Williams, 2010). The incidence of terabyte declined throughout the 20th century (Watson & Maguire, 1997), that, the distemper has been slowly re turning to capital of the United Kingdom since the 1980s (Great Britain 2008, p. 19). The problem seems to be worsening in urban areas. This is illustrated by the event of London, where 3,302 bracing cases of tuberculosis (TB) were delineateed in 2010 (Fullman & Strachan 2013, p. 25), a figure that has much(prenominal) than doubled since 1992 (Anderson et al 2 006). In 2006, the incidence of tuberculosis in London was 41.5 spate in 100,000, a figure that represented the highest number of young cases in whatsoever major metropolis in Western europium (Anderson et al, 2006). Dyer (2010, p. 34) outcrys that the London borough of Newham is the most affected with some lot already referring to it as the TB capital of the affluent western world. In fact, the judge of tuberculosis in Newham are soon higher than that in some deprive countries. Vassall (2009, p. 48) suggest that Newham has 108 cases per 100,000 and Anderson et al suggest a 2001 figure of 116/100,000, figures that are more than half that in India (174 cases per 100,000) ( everyday wellness England, 2012). Newham has a creation of 308,000 with a creation compactness of 85.1 per hectare as compared to 31 in central London (UK Census, 2012). These figures suggest that even in the populate metropolis of London, Newham is an area of urbanization, with a mountainous number of the great unwashed concentrated into a relatively small area.The increase of tuberculosis has been described as a penalty for high density urban alive (Dye 2010, p.859), likely due to the change magnitude potential for transmission in oer move, and the increased rates of in-migration to inner-city areas. Bhunu and Mushavabasa (2012) propose that tuberculosis thrives in instructs of overcrowding and poverty, issues that are common in urban areas.The high rates of tuberculosis in cities much(prenominal)(prenominal) as London, and areas of urbanization much(prenominal)(prenominal) as Newham, suggest that the incidence of tuberculosis is indeed an urban issue. Newham fulfills the criteria of high immigration rates and macrocosm an area of deprivation..Newham has a diverse heathen nation, with 61% of the good deal being non-white (Farrar & Manson 2013, p. 54). The population of ethnic minorities continues to get down along with the increasing numbers of refugees and resort seekers in greater London.An different shot of urbanization illustrated in the borough of Newham is that of deprivation and overcrowding. Farrar & Manson (2013, p. 16) claim that Newham ranks as the third most deprived borough in inner London. Most of the citizenry here live in innovativespaper column lodgment and over move conditions that are the perfect condition for the spread of tuberculosis. There is a prescribed correlation between deplorable wad housing and poverty and the preponderance of tuberculosis, which is very guide in Newham as evidenced by the findings of 108 and 116 cases per 100,000 deal (Vassal, 2009 Anderson et al., 2001). The aetiology of the issue of tuberculosis is highlighted when considering the distribution of the indisposition across Newham. The concomitant of illness is non evenly spread across the borough, with 70% of cases prelude path from manor house Park, Green street and East Ham. These boroughs represent areas of population inc rease, overcrowding and higher take aims of those living in poverty. manor house Park and Green Street too show differing dynamics of tuberculosis incidence, representing an overall increase of 40% since 2006 whilst all other areas of Newham either remained static or showed slight decrease (Malone et al 2009, p. 23). It fire be seen that tuberculosis presents a signifi fagt urban issue, especially when comparing incidence in an urban area much(prenominal)(prenominal) as Newham to those less(prenominal) urbanised areas. Bromley has a population of 309,000 and a population density of 20 per hectare, in comparison to Newhams population density of 80 per hectare (UK Census, 2012). terabit incidence in Bromley is between 0-19 per 100,000 compared to that of Newham, which is flipper times greater at 80-100 per 100,000 (Anderson et al., 2006). It is for this reason that necessary intervention strategies need to be formulated and implemented to help reduce the rates of tuberculosis am ong individuals living in Newham.3. The Influence of Urbanisation on terbium IncidenceWhile the global rates of tuberculosis are declining, the infirmity is showing steady increase in the United Kingdom. In 2012, 8751 new cases of the disease were set in the country with 39% coming from London (Fullman and Strachan 2013, p. 43). Indeed London has the highest rates of the disease in Western Europe with Newham borough having the highest rates in the UK. Jindal (2011, p. 55) claims that the rate of tuberculosis in some London boroughs is more than twice higher than the threshold apply by the world wellness boldness to define high rates. These higher incidences admit the notion of a sick city hypothesis where there are greater levels of ill wellness than in rural areas, and whitethorn be due to the carriage of factors in an urban environment that devote to ill health (an urban health penalty). One factor that whitethorn chip in to the urban health penalty is that of immigrati on. Cities are easier to doorway than rural areas, bequeath areas of plica and countenance more facilities for immigrating families and individuals. The majority of individuals suffering from tuberculosis are people born(p)(p) outside the United Kingdom, with 75% of cases in 2003 being born abroad (Anderson et al., 2006). A reason for the high incidence in those born abroad but directly living in the UK is exacerbated by the disposition of tuberculosis. On sign infection, tuberculosis is contain by the immune system with scarce around 5% of cases experiencing symptoms within the first-class honours degree two social classs of infection (Narasimhan et al., 2013). The end of cases harbour a latent infection which may reactivate later in life, with or so 10-15% of those infected going on to develop an active disease (Narasimhan et al., 2013). This seductive nature combined with the later activating of the disease explains why legion(predicate) people do not get the di sease until later in life. It is likely that it is contract in their country of birth, however because manifests much later once they sire moved to the UK. Statistics indicate that over 90% of the residents in Newham diagnosed with the disease in 2011 were born outside the United Kingdom (Fullman and Strachan, 2013, p. 33). Among these, 50% arrived in the country in the give-up the ghost five grades. In the same year tuberculosis diagnosis increased by 25% compared to 2010 (Fullman and Strachan, 2013), possibly as a reflection of the increased immigration. Additionally to a high immigrant population bringing signifi after partt disease burden from their countries of birth, London and Newham two represent numerous of the other issues of urbanisation and urban health penalty that can contribute to the high incidence of tuberculosis. Studies buzz off shown that low vitamin D levels are associated with an increased try of underdeveloped tuberculosis (Campbell and Spector, 2012 Chan, 1999). This is an essential association in urban populations, as the living and inventing conditions foster less access to sunlight (the major blood line of vitamin D). Additionally, Asian immigrants present a problem of low vitamin D due to vegetarian diets, and a tendency to cover up their skin, not allowing to take advantage of the small add together of sunlight available (Chan, 1999). As precedently nameed, Newham is an area of both(prenominal) high urbanisation and with a large immigrant population, and 38.6% of the population being of Asian descent (London Borough of Newham, 2010). The immigrant population of urban areas such as Newham excessively present a non-vaccinated proportion of society. Whilst the BCG vaccine against tuberculosis was introduced in the UK in the 1950s and was shown to provide a reduction in risk of contracting tuberculosis (Colditz et al., 1994), those immigrating were less likely to receive this vaccination on go to the UK. London als o represents cases of tuberculosis that are socially and medically interwoven. As a hugely populated area, London includes those with human immunodeficiency virus infection and presents other risk factors such as onward transmission and light treatment. human immunodeficiency virus is one of the most omnipotent risk factors for tuberculosis, with a incidence rate of 20 times higher in those that are HIV positive (Dye and Williams, 2010). communitys offices towards and access to health care also present a daedal ruffle up of factors which contribute to an increased incidence of many health problems, including that of tuberculosis. Those in impoverished areas have reduced access to healthcare, which may stem from many reasons such as interwoven needs, chaotic lifestyles, location of services, user ignorance, and wrangle and literacy barriers (Szczepura, 2005). These can affect the disease work out of tuberculosis from sustainion, treatment of active disease, regard to trea tment and streak of the health consequences. specially problematic are misconceptions and a neediness of collar(a) of the disease, continueing to late display and delayed access to treatment (Figuera-Munoz and Ramon-Pardo, 2008) With the close living quarters in areas such as Newham, the spread of tuberculosis is facilitated. With poverty, poor housing and overcrowding, these areas concentrate some(prenominal) risk factors and lead to a greater spread of tuberculosis (Bates et al., 2004). These determinants therefore suggest that the incidence of tuberculosis in urban areas is a complex issue. Controlling and preventing tuberculosis in London requires effective social and economical tools that must be incorporated in the development of policies of control in treatment initiation.4. Consequences and implications of tuberculosis on the general populationTuberculosis ranks with HIV/ AIDS and Malaria as one of the three main health challenges currently facing the world. The deme sne health Ministers Update 2009 (2009, p. 41) indicates that 8 million new cases are news reported globally distributively year. As previously mentioned, when combined with HIV, tuberculosis can prove lethal as the two diseases enhance the progress of all(prenominal) other. It is for this reason that tuberculosis is the major cause of death among HIV patients with the rate standing at 11% globally. The earth health Organization (2009, p. 27) indicates that tuberculosis is responsible for more deaths today than ever before, with approximately 2 million lives claimed by the disease annually. As well as the significant mortality contributed by tuberculosis, the unwholesomeness of the disease can be exceedingly detrimental both socially and economically. Those with the active disease that are not receiving treatment have been shown to go on to infect 10-15 others every year (WHO, 1998). Those who do receive treatment face a long (up to six months) and complex treatment regime i nvolving several medication side effects. This can affect esteem to the treatment regime, and lead to the disease developing a resistance to the treatment, with this drug loathly tuberculosis contributing to greater mortality and increased expense to treat (Ahlburg, 2000). As well as the significant morbidity and mortality, it is pregnant to consider the economic dissemble of tuberculosis. The World wellness Organisation estimated the constitute to treat tuberculosis in 2000 as $250,000 US dollars (?150,000) in developed countries (Ahlburg, 2000). This presents a significant burden to the UK NHS, not to mention the time lost through not working which can dent the economy. London is a global world hatful centre whose economy is shaped by global forces, particularly in harm of trade, labour and capital. As a entry to both the UK and other parts of Europe and the rest of the world, London records a very large number of tourists and immigrant populations. This high number of p eople accelerates the spread of the disease as people carry it to the country from other parts of the world is indicated by the new infection patterns and is highlighted by the prevalence in immigrant populations. 5. Strategies and intervention for addressing tuberculosisCurrent UK guidelines for tuberculosis intervention were made by subtle in 2006 (updated 2011). The recommendations propose strategies for identifying those with latent (non-active) tuberculosis to prevent spread or reactivation and also specify criteria for treatment (NICE, 2011). Those recommended for screening for latent tuberculosis include close contacts of infected individuals, immigrants from high incidence countries, immunocompromised individuals, and healthcare workers. Whilst this strategy targets streak of the spread of tuberculosis, they are only targeting specific groups, and it is likely in high incidence areas such as Newham, people will slip through the net. These guidelines have only changed minim ally since 2006, and since wherefore tuberculosis incidence has been on the increase in areas such as Newham, suggesting that changes may need to be made. High incidence areas of the UK such as Newham could learn from New York experience and copy the strategy it employ in dealing with the disease. With the implementation of broadened initial treatment regimes, direct observed therapy, and alter guidelines for hospital control and disease prevention, the city managed to halt the progression of an epidemic (Frieden et al., 1995). As mentioned in the previous chapter, adherence to the long treatment regime as well as a lack of understanding may contribute to the spread of tuberculosis. nowadays observed therapy ( besprinkle) involves observing the patient take each dose of their medication, with outreach workers travelling to their homes. tell apart from New York showed that through DOT, only 3% of patients in therapy were infectious, compared to a proposed 20% if not receiving D OT (Frieden et al., 1995). Current UK guidelines (NICE, 2006) do not recommend DOT, although they do state that it may be used in cases of patients with previous issues with adherence or at high risk. Although an expensive and time consuming process, if DOT can reduce infectious cases, this would also work as a burden measure. There could be one allocated outreach cling to for the borough of Newham and other big areas. Another method implemented in New York was the furlough of large shelters for the homeless. These were breeding grounds for tuberculosis, and the subsequent reduction in overcrowding led to a decrease in transmission of the disease (Frieden et al., 1995). Whilst it is not possible to split people up from living with their families in crowded homes in terms of Newham, education about keeping those with tuberculosis from interacting with too many others in crowded conditions may be of benefit. The model should also borrow from those used by other cities like genus Pa ris and the rest of Europe in irresponsible tuberculosis with intervention at the level of the agent, individual and community levels. In Paris, Rieder (2002) suggested that hitch treatment could be used to prevent the disease occurring in those at risk, for example those in the household of an identified case of tuberculosis. Additionally, Rieder (2002) proposed that early or newborn baby vaccination be used especially in those in areas where tuberculosis is frequent, rarely diagnosed, and comely contact examinations rarely feasible. It may be possible that in cases where lots of people are vaccinated that they may read herd immunity and thus nourish unvaccinated individuals from the disease. Once the populations have been defend and the incidence (number of new cases) of tuberculosis has been reduced, this allows for a reduction in the prevalence of tuberculosis (number of ongoing cases at any one point in time) with preventative chemotherapy that can treat sub-clinical, la tent tuberculosis in the population. This preventative chemotherapy is likely to be extremely relevant to Newham due to the large immigrant population likely harbouring latent tuberculosis. On a country- or city-wide scale, these recommendations from New York and Paris provide excellent models for preventing the increase of tuberculosis any encourage. It is also important, however, to consider the individual communities in Newham, and to promote health awareness and an attitude towards taking responsibility for their health. Their needs to be an encouragement at the level of primary election care where immigrant populations feel that they can approach healthcare, and education to encourage tuberculosis prevention and adherence to treatment. The strategy should be blanket(prenominal) in order to encourage people to not only go for exam but also start and goal the treatment process.6. Recommendations and conclusionTuberculosis presents an important urban issue in the area of Newh am. Incidence is greater than other areas of the UK, and is over half that of India. There are several factors contributing to this including a large immigrant population, crowding and overpopulation, access to healthcare and comorbid health problems such as vitamin D deficiency and HIV. The disease has considerable effect on morbidity and is responsible for high levels of mortality. Further consequences of the disease manifest as economic problems such as cost of treatment and loss of work. London and the UK already have policies and structures for peremptory tuberculosis in place however the implementation process is patchy across the city, and often dependent upon budget. In high-risk areas such as Newham, there is poor access of healthcare due to wrong beliefs on the disease, language and cultural barriers, and complex needs of the population. In the case of tuberculosis, these contribute to poor disease prevention, delayed diagnosis and poor treatment adherence. All of which lead to an increase in transmission and health consequences. The area of Newham would benefit greatly from further education into tuberculosis, how to look for signs and how to get treatment. advance good relationship with healthcare professionals and promoting access to healthcare through outreach programmes and targeting pharmacies may be helpful. Additionally, Newham should look to employ techniques used in New York and Paris, including DOT, prophylactic treatment and neonate vaccination to reduce both the prevalence and incidence of tuberculosis.ReferencesAhlburg (2000). The economic impact of TB ministerial conference Amsterdam, WHO Bates, I., Fenton, C., Gruber, J., Lalloo, D., Lara, A. M., Squire, S. B., and Tolhurst, R. (2004). Vulnerability to malaria, tuberculosis, and HIV/AIDS infection and disease. Part II determinants operating at environmental and institutional level. The Lancet Infectious Diseases, vol. 4(6), pp. 368-375. Bhunu, C. P., and Mushayabasa, S. (2012). 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