The Thrill of It All by Sam Smith free essay sample

â€Å"I wasn’t trying to make a big pop record when I made this album.I was actually trying to make it something personal; like a diary.†Sam Smith stated in an interview with the American entertainment media brand, Billboard.â€Å"The Thrill of It All†, Smith’s new album, was released in November 2017.This is his second complete album filled with sob songs following his debut album â€Å"In the Lonely Hour†.The album has been awarded No. 1 on the Billboard 200 chart.I have realized that the album is so much more than just some irrelevant songs.When interpreting the lyrics, I can tell it has a lot of meaning behind it.I feel that there are three primary songs that impact this album significantly:â€Å"Too Good at Goodbyes†,â€Å"HIM†,and â€Å"Nothing Left For You†.They each add a lot to the soundtrack and send a different message. The song â€Å"Too Good at Goodbyes† has been the most successful song on this album. We will write a custom essay sample on The Thrill of It All by Sam Smith or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page It hit number one on the iTunes charts in September 2017 and has been extremely popular ever since.In this song he sings about being in a rocky relationship; he was continuously getting dumped but kept going back for more.As this happened Smith got used to the feeling of the pain.It starts off with a snappy remarkable beat combined with the artist’s calming voice.I think this song is so well-liked not only because of the catchy beat, but the impressive lyrics too.Many people can relate to this song which makes it more appealing and Sam’s soothing voice comforts them while listening.The next song like this one goes deep into his personal experiences as well. â€Å"HIM† is a heartbreaking song that is one of my personal favorites.It tells a story about a boy coming out not only to his own father but the holy father too.The singer also incorporates a conflict between his sexuality and religious background in the song.An empowering gospel choir in the background really makes the song stand out.The lyrics are saddening but bittersweet at the same time.A section of the chorus states this â€Å"Holy Father, we need to talk/ I have a secret that I can’t keep/ I’m not the boy that, you thought you wanted/ Please don’t get angry, have faith in me.†Smith says that he wanted to write a song for his community, the LGBT community.This song shows an element of the gay experience which is what Sam’s intentions were.It is definitely not a normal song that’s on the radio every day which adds a unique aspect to the album.Another significant track on this record is â€Å"Nothing Left For You†.It talk s about opening up also, but in a different way. In â€Å"Nothing Left For You†, Smith sings about despair once again.The artist tells a story about being in a relationship with someone he thought he trusted.Sam opens up but it turns out the person never deserved it.As a result, his ex took everything away from him and now he will never be able to open up again.This song has a very powerful message with a strong compelling tone, and the lyrics show that: â€Å"I’ll never love you/ ‘Cause I gave, my heart, to a goddamn fool/ I gave him everything/ Now there’s nothing left for you.†His vocals combined with those lyrics make every word feel like a teardrop rolling down his face.This track is very deep and makes the album even more irresistibly sad. Overall, I feel that there are three main songs that substantially impact Sam Smith’s new album â€Å"The Thrill of It All†.Those songs are â€Å"Too Good at Goodbyes†, â€Å"HIM†, and â€Å"Nothing Left For You†.Each one tells a different story and conveys a different feeling.I think that this album is a very vulnerable, unique album that has so much meaning inside of it.The artist is very bold and brave for sharing something so personal with the world.Like I stated before, Smith wanted to make this like a diary and I think that he did just that.Music is so much more than just a catchy beat and I love this album because it shows that.

Origins of the à in Spanish

Origins of the Ñ in Spanish The Spanish letter à ± is original with Spanish and has become one of its most distinctive written features. Where Did the Ñ Come From? As you could probably guess, the à ± came originally from the letter n. The à ± did not exist in the Latin alphabet and was the result of innovations about nine centuries ago. Beginning in about the 12th century, Spanish scribes (whose job it was to copy documents by hand) used the tilde placed over letters to indicate that a letter was doubled (so that, for example, nn became à ± and aa became ). How Is the Ñ Used Today? The popularity of the tilde for other letters eventually waned, and by the 14th century, the à ± was the only place it was used. Its origins can be seen in a word such as aà ±o (which means year), as it comes from the Latin word annus with a double n. As the phonetic nature of Spanish became solidified, the à ± came to be used for its sound, not just for words with an nn. A number of Spanish words, such as seà ±al and campaà ±a, that are English cognates use the à ± where English uses gn, such as in signal and campaign, respectively. The Spanish à ± has been copied by two other languages that are spoken by minorities in Spain. It is used in Euskara, the Basque language that is unrelated to Spanish, to represent approximately the same sound as it has in Spanish. It is also used in Galician, a language similar to Portuguese. (Portuguese uses nh to represent the same sound.) Additionally, three centuries of Spanish colonial rule in the Philippines led to the adoption of many Spanish words in the national language, Tagalog (also known as Pilipino or Filipino). The à ± is among the letters that have been added to the traditional 20 letters of the language. And while the à ± isnt part of the English alphabet, it frequently is used by careful writers when using adopted words such as jalapeà ±o, pià ±a colada, or pià ±ata and in the spelling of personal and place names. In Portuguese, the tilde is placed over vowels to indicate that the sound is nasalized. That use of the tilde has no apparent direct connection with the use of the tilde in Spanish. The Rest of the Story After this article was published, this site received additional information from Robert L. Davis, associate professor of Spanish from the University of Oregon: Thanks for including the interesting page on the history of the à ±. In a few places you express uncertainty about some of the details of this history; below I offer the information you need to complete the story. The reason the tilde appears over an N (as in Latin ANNU Sp. aà ±o) and Portuguese vowels (Latin MANU Po. mo) is that scribes wrote a small letter N over the preceding letter in both cases, to save space in manuscripts (parchment was expensive). As the two languages developed phonetically away from Latin, the double N sound of Latin morphed into the current palatal nasal sound of the Ñ, and Portuguese N between vowels got deleted, leaving its nasal quality on the vowel. So readers and writers began to use the old spelling trick to indicate the new sounds that did not exist in Latin. (Its really nice the way you framed the Ñ as the only Spanish letter of Spanish origin!) Also of potential interest to your readers: The word tilde actually refers to both the squiggle over the Ñ as well as the accent mark used to mark phonetic stress (e.g., cafà ©). There is even the verb tildarse, which means, to be written with an accent mark, to stress, as in La palabra cafà © se tilda en la e.The unique character of the letter Ñ has led to its becoming a marker of Hispanic identity in recent years. There is now a generacià ³n Ñ, the children of Spanish-speaking parents in the U.S. (parallel to Generation X, etc.), a stylized Ñ is the logo of the Cervantes Institute (cervantes.es), and so forth.The squiggle under the à § in Portuguese and French has a similar origin as the à ±. It is called a cedille, meaning little Z. It comes from the diminutive of the Old Spanish name for the letter Z, ceda. It was used to represent the ts sound in Old Spanish, which no longer exists in the language. E.g., O.Sp. caà §a (katsa) Mod. Sp. caza (casa or catha).Restaurants in the U.S. now offer dishes made with a very spicy pepper, the habanero, which is frequently mispronounced and misspelled as habaà ±ero. Since the name comes from La Habana, the capital of Cuba, this pepper should not have Ñ. I think the name has been contaminated by jalapeà ±o, which of course is simply a pepper from Jalapa, Mexico.

Government Intervention at Boeing and Airbus Case Study

Government Intervention at Boeing and Airbus - Case Study Example Globalization led to the cross-border free flow of capital, labor, information and other resources. Countries began to realize that the only way to reap the fruits of comparative advantage was to compete internationally. FDIs and generation of government revenues were common results of international business in technology intensive areas (page 33) (Cavusgil, Knight, & Reisenberger, 2012) and, thus, the collaboration of various European governments in this respect can be attributed to this reasoning. The major reason behind Boeing’s complains is that the provision of subsidies by the EU government to its competitor Airbus is preventing both the companies to compete on equal footing. It is seen as an unfair trade practice by the U.S, although, the case reflects that the country itself is offering protection to its airline Boeing, albeit, in a different way. Thus, although the U.S government is not providing outright subsidies to Boeing, it is still protecting its business by bes towing it with military contracts. The key elements highlighted in the case are those of intervention through provision of subsidies, development of infrastructure, tax rebates and strategic national contracts. Part of the explanation underlying government support for Airbus is grounded in the democratic socialism political system of the EU. As learnt in the text, this form of system called social democracy is characterized by government intervention in private enterprises and in business activities.... To this extent, as pointed out in the case study, the governments of various EU countries including the French, German, Spanish and British governments have embarked on a mission to enhance the international competitiveness of its national airline, Airbus, through the provision of subsidies primarily. A major implication of globalization has been that in the midst of cut-throat competition, companies often find themselves competing on costs. The text also supports the fact that the costs of doing business are relatively higher in the EU which is largely because of high corporate taxes (page 178) (Cavusgil, Knight, & Reisenberger, 2012). This is a major reason behind the government rationale to support Airbus financially. To this extent that the cost of capital in EU is higher than that in U.S, the government’s intervention in Airbus’s operations is justified. The defensive rationale of government intervention manifests itself along these lines of thinking by claiming th at protection of the national economy is a major factor behind government intervention (page 204) (Cavusgil, Knight, & Reisenberger, 2012). The offensive rationale is also applicable here, since one of the major reasons for government intervention in the case of Airbus was to protect the infant industry that could not compete effectively with the two giants (Mac Douglas and Boeing) and the creation of tax revenues. Also one of the fundamental justifications for the same was the generation of jobs and employment opportunities that were created once Airbus had its operations all over Europe (Cavusgil, Knight, & Reisenberger, 2012). Furthermore, this move of European governments to support Airbus and make it

Case analysis Study Example | Topics and Well Written Essays - 750 words - 2

Analysis - Case Study Example , they have not managed to make significant inroads into the rapidly expanding Indian economy which despite being Asian and sharing a common border with them practiced a different culture. In recognition of this scenario, Haier launched in India in 2004 and appointed Banerjee T. K., an Indian National as its president for the country’s operations. They adopted the three-in-one strategy that had been successfully adopted in other global markets like America and Europe. The first step of the strategy involved exportation with no fixed distributor. The second step introduced a centralized distributor. The third step saw the company set up a manufacturing plant in the country. Their market analysis determined that for Haier to break into the top three home appliances brands in India the company had to adopt a localization strategy and an aggressive marketing campaign. They adopted this measures but despite their efforts the company only managed a 7.7 percent turnover increase within India in the 5 years of Banerjee’s presidency. With respect to the situation and the fact that the Indian investment was not paying off Erick Braganza was appointed as president in 2009. The company’s human resource underwent an overhaul, operations streamlined and a new marketing strategy adopted. In response to this measures the company experienced a period of growth and increase in turnover, though the sustainability of this growth was questioned. Determining the sustainability of Haier’s growth in India necessitates a market and situational analysis. A situational analysis of Haier’s position in India shows that they; had a bad reputation as low quality electronics imitators whose only advantage was low product prices; cultural differences, most of India’s population residing in rural areas meant that there was a cultural clash between the Chinese owned company and rural Indian market; high Indian government imposed tariffs on foreign owned business establishments that

Pediatric Issues Paper Essay Example | Topics and Well Written Essays - 750 words

Pediatric Issues Paper - Essay Example Since the nutrient mix of breast milk is yet not fully known, giving DHA in infant formula can cause negative impacts. Secondly, the DHA added to infant formula is highly synthetic oil, extracted by growing fungus and algae in laboratories, through processing a toxic chemical hexane. It can at no chance be compared to breast milk. For gathering the required information, the WIC clinic in the area decided to take two measures. First was to ask, as a routine from every mother on their visit, about the method they use to nourish their infant. If the answer was Formula, they were further inquired about which formula they were using. Secondly, a representative was sent to every home in the nearby location to question different mothers about how they nourish their infant and incase of formula, which brand they use. Data was searched over the internet, locally published journals and magazines over infant health and growth. The research was thorough and focused on the rate of formula fed and breast fed babies and the effects on them of the chosen method of nourishment. (Positive or negative) The results raised an alarm to take the matter into serious consideration. Having DHA added, the formula was marketed ‘as closest to breast milk as ever’. With increased marketing, the number of mothers who believe that both methods are equally good also took a height. After the advent of the idea in 1996, the survey results showed that 12% of mother had this believe in 2003, which rose to a disappointing 24% in 2004 (results shown in appendix). The manufacturing companies had no way to control the demand by controlling the number of babies born, therefore, through intensive marketing, they changed the perception and succeeded in convincing and discouraging mothers to breast feed in order to increase their sales. It was shocking to hear firsthand horrible stories from mothers of how their infants

Tuberculosis (TB) in Prisons and Immigration Removal Centres

Tuberculosis (TB) in Prisons and Immigration Removal Centres An evidence-based partnership approach to tackling Tuberculosis in Prisons and Immigration Removal Centres in London Abstract Background The World Health Organization (WHO) have declared TB as a global emergency with 8.6 million cases of active TB and 1.3 million deaths. The incidence of TB in the UK remains high compared to most other Western European countries, with 8,751 cases reported in 2012, an incidence of 13.9 per 100,000 population. London accounts for the highest proportion of cases in the UK (39%) and the highest rate of disease (41.8 cases per 100,000). Left untreated, one person with pulmonary TB may infect around 10–15 people every year. People in prison and IRCs represent a population who are at particular risk. National estimates for TB prevalence in the prison population are 208 per 100,000 and amongst Londons 10,000 or so prison population we would expect 20 cases, but we are seeing more than double. The cost of treating ‘normal’ TB is around  £5000 and is much greater for more socially complex cases (estimated at  £50,000– £70,000). There is considerable variation in the delivery of some aspects of TB services. A co-ordinated national TB strategy is required to support locally designed and implemented services, and monitor achievements against national standards. This paper presents findings from a partnership between NHS England, PHE and NOMS to tackle TB across its prison population in the overall approach to the overall TB strategy in London. Aims/objectives To establish whether national NICE guidance for TB in prisons and immigration removal centres is being met. Methods Target population included all 9 prisons and 3 IRCs for which NHS England (London region) are responsible. Methods used: 1) An organisational clinical audit during January 2014 using the NICE baseline assessment tool; 2) Stakeholder engagement through a steering group and a wider reference group. Results Effective stakeholder engagement contributed to a 100% completion rate. All establishments had referral pathways in place and a named contact within the local Multidisciplinary TB team and the local Public Health England health protection team. 2/12 establishments did not screen for TB within 48 hours of arrival. 3/12 did not have a local TB policy. 2/12 did not have a named TB lead. None of the DH funded x ray machines were being used in line with NICE recommendations. Latent TB was not being diagnosed or managed. Conclusions Active and systematic case finding is needed within a prison and IRC setting as well as more rigorous and standardised contingency and follow up care plans after release (or transfer). Introduction The World Health Organization (WHO) have declared TB as a global emergency with 8.6 million people with TB and 1.3 million deaths due to TB (World Health Organisation, 2013). The six point Stop TB Strategy (World Health Organisation, Europe, 2013b) explicitly addresses the key challenges facing TB with the goal to dramatically reduce the global burden of TB by 2015 by ensuring all TB patients benefit from universal access to high-quality diagnosis and patient-centred treatment. However, there have been challenges in developing and implementing program-wide interventions in both high income(Migliori, Sotgiu, Blasi, et al., 2011) as well as middle and low income countries(Cobelens, van Kampen, Ochodo, et al., 2012). England and Wales have responded to the need to tackle TB where the NHS and the Department of Health have developed a national Action Plan for ‘Stopping Tuberculosis in England’(Department of Health, 2004). NICE have also developed a set of National guidance fo r the identification and management of TB across a number of settings(NICE public health guidance, 2011) which highlights the need for a multi-agency approach. There has been little evidence evaluating the implementation of these guidance. What is TB? TB is caused by Mycobacterium tuberculosis, which spreads in airborne droplets when people with the disease cough or sneeze. Most people infected with M. tuberculosis never become ill as their immune system contains the infection. However, the bacteria remain dormant (latent) within the body, and a latent TB infection can cause active disease many years after the initial infection if immunity declines. The symptoms of TB include a persistent cough, weight loss, and night sweats. The BCG vaccine (Bacillus Calmette-Guà ©rin vaccine) protects against TB and it was thought possible to wipe out TB through a vaccination programme. The BCG vaccine is made from a weakened form of a bacterium closely related to human TB. Because the bacterium is weak, the vaccine does not cause any disease but it still triggers the immune system to protect against the disease, giving good immunity to people who receive it. In the past, the BCG vaccination programme was delivered to all teenagers in the UK but as TB is a difficult disease to catch because it requires prolonged exposure to an infected person, it was changed so that now only people inat-risk groups are given the vaccination. The vaccine is 70-80% effective against the most severe forms of TB, such as TB meningitis in children but It is less effective in preventing respiratory disease, which is the more common form in adults(Trunz, Fine Dye, 2006). Even with the high coverage now achieved, BCG is unlikely to have any s ubstantial effect on transmission. Risk factors that seem to be of importance at the population level include poor living and working conditions associated with high risk of TB transmission, and factors that impair the hosts defence against TB infection and disease, such as HIV infection, malnutrition, smoking, diabetes, alcohol abuse, and indoor air pollution. Preventive interventions may target these factors directly or via their underlying social determinants. The identification of risk groups also helps to target strategies for early detection of people in need of TB treatment(Là ¶nnroth, Jaramillo, Williams, et al., 2009). How common is TB in the UK? It has been difficult to eradicate TB both globally and in the UK. Vaccination programs and improvements in housing, nutrition and access to treatment have been largely the reason for a global decrease in TB. However, TB is still rife in less developed countries where poor conditions are still present. Several strains of TB bacteria have developed a resistance to one or more anti-TB medications, making them much harder to treat. Theglobal epidemic of HIV that began in the 1980s has also led to a corresponding epidemic of TB cases. This is because HIV weakens a persons immune system, making them more likely to develop a TB infection. The rapid growth of international travel has allowed people to travel widely and this has helped to spread of the disease. Although the rates of TB have stabilised in the UK over the past seven years, following the increase in the incidence from 1990 to 2005, the incidence of TB in the UK remains high compared to most other Western European countries(Hayward, Darton, Van-Tam, et al., 2003). There were 8,751 cases reported in 2012, an incidence of 13.9 per 100,000 population (Health Protection Agency, 2013b). The majority of TB cases (73%) occurred among people born in high-incidence countries and are generally concentrated to large urban areas with a high proportion of people born outside the UK where the rate of TB among the non UK-born population is almost 20 times the rate in the UK-born (Health Protection Agency, 2013b). London accounts for the highest proportion of cases in the UK (39%) and the highest rate of disease (41.8 cases per 100,000), followed by the West Midlands (12%; 19.3 cases per 100,000). Left untreated, one person with pulmonary TB may infect around 10–15 people every year (Department of Health, 2004). TB in prisons It is important to identify settings where the risk of TB transmission is particularly high. Groups at risk not only include people born in high prevalence areas (e.g. sub-Saharan Africa, South East Asia, Eastern Europe), but also people with reduced immunity (e.g. HIV, diabetes, renal failure), those with alcohol or drug problems and people who are homeless or living in overcrowded conditions (Story, Murad, Roberts, et al., 2007). These risk factors are over represented in prison populations with high levels of social and health needs. A systematic review on the incidence of TB in prisons globally (largely in the USA), showed that TB was about 26x higher than in the general population(Baussano, Williams, Nunn, et al., 2010). In the London prison population, the incidence of TB has been estimated at about 208 per100,000 (Story, Murad, Roberts, et al., 2007). Figure 1: Incidence of TB in different locations and settings[A1] Across the London prison and IRC estate, prisons are at or very close of operational capacity (ranging from 72% 103%) and with the high churn rate which increases the risk of TB transmission and poses significant challenges for TB identification and management (see Table 1). In addition, a significant proportion of the prison population are of a foreign nationality (up to 44% in one prison) and on average, just over one quarter (27%) of the prison population are foreign nationals. The majority of the prison and IRC population are under the age of 39 years old, representing another TB risk factor. Table 1: Summary of Prison Establishments Individuals at high risk for TB are typically unwilling or unable to seek and comply with medical care, and are therefore hard to reach. Individuals at high risk are also more likely to be diagnosed at a late stage of the disease and are less likely to adhere to treatment(Health Protection Agency, 2013b). In prison and IRC settings, overcrowding, late detection, barriers to adequate treatment, and poor implementation of infection control measures might also increase the TB transmission rate and improving prison conditions is a priority for any programme to control TB and reduce its spread back into the community (Levy, Reyes Coninx, 1999). TB has been identified as a key health concern where the need for greater TB control in the prison setting was highlighted in the Chief Medical Officer’s (CMO) action plan for England (Department of Health, 2004). The Department of Health (DH) announced that they were to fund the installation of static Digital X-Ray (DXR) machines in large local prisons receiving people from areas with a high prevalence of TB. This led to the installation of DXR machines in 5 London prisons (and 3 out of London). All participating prisons had their machines signed off and handed over by March 2012 but due to changes in commissioners and providers during the lifetime of the project, the impact of the programme to date has been variable. More recently, the new national partnership agreement(Anon, n.d.) just signed between Public Health England (PHE), NHS England (NHSE) and the National Offender Management Service (NOMS) also draws particular focus and commitment to the epidemiology of TB in pris ons, particularly in those that have access to DXR machines. The agreement sets a priority for this year (2013-14) as: â€Å"Priority 11: Improving the detection and management of TB among prisoners at or near reception.† The commitment in the partnership agreement is to ensure that by April 2014, NHSE, NOMS and PHE will ensure that all fixed digital X-ray machines are fully operational and being used as part of an active care pathway in those prisons where they are currently installed. TB in IRCs Robust data relating to TB in IRCs is not routinely collected or available so there are no estimates of the incidence of TB in these settings. However, a sample of detainees in a single IRC within Southern England identified prevalence rates of 3% for TB (McLaren, Baugh, Plugge, et al., 2013) which is considerably higher than those found among the migrant population in England (Health Protection Agency, 2013b). Detainees at Harmondsworth and Colnbrook are men mostly aged 20-40 (see Table 1) and from disadvantaged areas of the world where TB is still rife. The average length of stay is around 2 weeks; although some have been detained for over 1 year. Guidance for best practice NICE have developed national guidance on the ‘Clinical diagnosis and management of tuberculosis, and measures for its prevention and control(NICE public health guidance, 2011), as well as more specific guidelines for identifying and managing TB among hard to reach groups (NICE public health guidance, 2012). This guidance, consistent with World Health Guidance(World Health Organisation, Europe, 2013a), aims to improve the way tuberculosis (TB) among hard-to-reach groups is identified and managed and makes specific reference to using prison and IRC settings to target these groups. NICE recommend that early identification and effective treatment of active TB provides the best outcomes, reduces onward transmission and reduces the development of drug-resistant forms of the disease. The identification and management of latent TB infection is also highlighted. The NICE guidance is based on the evidence resulting from four large systematic reviews(NICE, 2012a, 2012b, 2012c, 2012d) which informed the key recommendations relating to TB in prisons and IRCs. These include the best ways to identify TB, manage TB, organisational factors and identifying and managing latent TB. Identifying TB There are several approaches to identify latent and/or active TB in different populations. The Mantoux test is a widely used test for latent TB. It involves injecting a substance called PPD tuberculin into the skin and those that are sensitive to PPD tuberculin will develop a hard red bump at the site of the injection, usually within 48 to 72 hours of having the test. This is indicative of a latent TB. A very strong skin reaction may require a chest X-ray to confirm if this is an active TB infection(NHS Choices, 2013). The interferon gamma release assay (IGRA) is a newer type of blood test for TB that is becoming more widely available and can also help diagnosis latent TB. It can be used after a positive Mantoux test or as part of a screening or health check process. An active TB infection is usually diagnosed from a chest X-ray and samples of mucus and phlegm which are checked under a microscope for the presence of TB bacteria. A CT scan, MRI and/or biopsy will also be taken if an extra-pulmonary TB is suspected. A lack of information and awareness about TB services has been highlighted as a barrier to successful identification of TB (Brent Refugee Forum, 2007). Studies have highlighted that members of hard-to-reach groups frequently report incomplete or inaccurate information about the cause and transmission of TB with misconceptions included dirty or wet environment, sharing of domestic objects, and punishment from God (Brent Refugee Forum, 2007). Smoking(Brent Refugee Forum, 2007; Brewin, Jones, Kelly, et al., 2006; Gerrish, Ismail Naisby, 2010), poor diet and malnutrition(Brewin, Jones, Kelly, et al., 2006; Gerrish, Ismail Naisby, 2010), poverty (Brewin, Jones, Kelly, et al., 2006) however, were correctly perceived to affect susceptibility to TB. The fear of medical services as well as anxiety around the associations of TB with death have also been highlighted as barriers to diagnosing TB in high risk groups (Gerrish, Ismail Naisby, 2010; Marais, 2007; Brent Refugee Forum, 2007). Stigma is also highlighted as a major issue when diagnosing and screening for TB. Most studies with hard to reach groups describe a sense of shame and forced or voluntary isolation resulting from a TB diagnosis, although stigma was expressed differently in different groups. Homeless participants in London reported that being diagnosed with TB was embarrassing and rarely discussed among the homeless community because of the stigma attached to TB in this population(Whoolery, 2008). TB patients often face dual stigma—from their own communities and their wider communities. Most studies looking at the barriers to identifying TB have been conducted in immigrant groups in community settings and there is a lack of research into the barriers to identifying TB in prison or IRC populations. In addition, there are limited studies that focus on how to improve these passive case detection approaches or contact tracing approaches. With the difficulties in identifying TB in these hard to reach groups, researchers have sought to evaluate the effectiveness of active screening for TB rather than a passive approach where it is up to the individual to make contact with health services. Active screening has been found to be an effective and cost-effective strategy in immigrants and new entrants (Laifer, Widmer, Simcock, et al., 2007; Monney Zellweger, 2005; Verver, Bwire Borgdorff, 2001), homeless and intravenous drug users(Watson, Abubaker, Story, et al., 2007) in identifying active TB cases are an early stage. In particular, the â€Å"FindTreat† service, which is a Department of Health-funded initiative, aims to strengthen tuberculosis (TB) control among hard-to-reach populations through active case finding using a mobile X-ray unit (MXU)(Jit, Stagg, Aldridge, et al., 2011). In addition, the FindTreat service follows up closely those on treatment and provides support in completing treatment. Although the s ervice used to screen a large number of prisoners, it had mostly stopped since the introduction of DXR machines in prisons for active case finding in new inmates. On average, each year the find and treat service identified 16 people with TB in the hard-to-reach population, who may not have been identified and treated and also managed and supports the treatment for a further 100 or more cases. Despite these studies, there is limited direct evidence for the best methods for screening for TB in prisons(NICE, 2012b). Puisis et al conducted an innovative program of high speed radiographic screening for pulmonary tuberculosis (TB) at a large American correctional facility. The case finding rate for active disease with radiographic screening was approximately double the rate previously achieved with Mantoux skin testing. (Puisis, Feinglass, Lidow, et al., 1996). However, the findings are unclear how much of the difference in prevalence is caused by the different screening strategies and how much reflects different baseline disease prevalence. Another retrospective cohort study, compared the potential impact of limiting screening with mobile X-ray units to prisoners in the UK with symptoms of TB, compared with universal screening regardless of symptoms. Restricting screening just to prisoners with any of the five symptoms would have missed 36.7% of TB cases and more cases of TB would have been missed if screening was limited to a smaller range of symptoms. (S Yates; A Story; AC Hayward, 2009). The st udy is limited because although these symptoms may have been present at the time of screening, it is not known if professionals would have screened for TB based on these symptoms in real practice. Mobile X-ray unit (MXU) screening in those that are homeless, drug users or in prison have also been found to reduce diagnostic delay compared with passive case-detection and cases were less likely to be contagious on diagnosis compared with passive case-detection (Watson, Abubaker, Story, et al., 2007). However, the main limitation of this study is that results for different sub-populations were not reported separately, so it remains unclear whether any one hard-to-reach group benefited significantly from mobile x-ray screening. Chest X-ray screening has also been shown to be more cost-effective than the Mantoux test in immigrants and in prisoners(Jones Schaffner, 2001). However, the start-up costs of implementing the miniature chest radiograph screening were not taken into account. Cons idering the technology and training necessary to implement such a tool in a prison setting, this information could have had an effect on the costs. Active screening seems to increase identification of latent and active TB infection across hard-to-reach groups who are at high risk of infection, compared with passive case-detection, and leads to earlier diagnosis and reduced infective periods in those with active TB. Although the effectiveness and cost effectiveness of mobile X-ray screening is limited in prisons settings, NICE recommend that in prisons housing populations from high incidence areas and where the start-up costs had been largely funded by the DH, it was judged that X-ray screening would be cost effective. For other prisons, initial, symptom-based screening was adequate(NICE public health guidance, 2012). Managing and treating active TB Although TBcan be a very serious disease, it is possible to make a full recovery from most forms of TB with treatment. TB can usually be cured by taking several powerful antibiotics daily for several months. However, the emergence of antibiotic-resistant bacterial strains and the poor adherence to treatment has kept TB high up on the international health agenda with WHO declaring a crisis of multidrug resistant TB (World Health Organisation, 2013). The Health Protection Agency has found that only 79% of people with TB in the UK completed treatment which is below the World Health Organisation target of 85% (Health Protection Agency, 2013c). The mix of drug regimes, treatment isolation and length of time of treatment presents a number of challenges to ensure patients adhere to treatment regimes. Adherence can be particularly difficult in those with multiple needs, e.g. homeless and seeking substance abuse treatment (Whoolery, 2008). Directly Observed Therapy Short course (DOTS) is one method used to increase adherence to TB treatment. DOT is not just the direct supervision of therapy but also considers distinct elements of political commitment; microscopy services; drug supplies; surveillance and monitoring systems and use of highly efficacious regimens (World Health Organisation, Europe, 2013b). It can be difficult to evaluate the effectiveness of DOTS as a complete strategy to increase adherence and the focus of studies have evaluated the direct supervision of therapy. For example, significantly more people adhered to more than six months of treatment when they received DOT in substance misuse(Alwood, Keruly, Moore-Rice, et al., 1994) and in foreign born individuals (MacIntyre, Goebel, Brown, et al., 2003). However, there have been limited studies into prison populations with some suggestions of improved adherence with DOT(Rodrigo, Caylà  , Garcà ­a de Olalla, et al., 2002) and other findings showing no sign ificant differences (Dà ¨ruaz Zellweger, 2004). The effectiveness of DOT across prison and IRC populations still remains unclear. The views of treatment and management of TB can be particularly important when considering adherence. For example, the views on traditional and modern medicine can also vary between different groups which can impact the management of TB. The Brent Refugees Forum reported that Somalis in the UK reported a preference to try traditional medicine as a first choice (Brent Refugee Forum, 2007) whereas Somalis in New Zealand would prefer modern medicine first in response to their experiences of TB related deaths in their home country(van der Oest, Chenhall, Hood, et al., 2005). Some groups preferred approaches to treatment that included both traditional and modern medicines(NICE, 2012a). Talking to the patient to find out their preferences can help patients to make decisions about their treatment based on an understanding of the likely benefits and risks rather than on misconceptions (Nunes V, Neilson J, O’Flynn N, Calvert, N, Kuntze S, Smit, hson H, Benson J,, et al., 2009). Very li ttle is known of the impact of TB treatment on jobs, family and children (NICE, 2012a) and in particular, the psychological impact of isolation. TB treatment should be provided on a voluntary basis and the WHO highlight the importance of â€Å"engaging with patients as partners in the treatment process and respecting their autonomy and privacy† (World Health Organisation, 2013). This can be a particularly important issue when concerned with isolating an individual with a suspected or confirmed case of TB, which should be undertaken on a voluntary basis and involuntary isolation should only be used as a last resort. Few studies have explored the potential benefits that patients may experience when seeking TB treatment. A small number of homeless participants reported that TB treatment helped make further lifestyle changes that improved their health in general. For example, improved living conditions and regaining relationships with family (Whoolery, 2008). Another study reported that immigrants reported a ‘social responsibility’ to seek TB treatment although this was anxiety provoking (Brewin, Jones, Kelly, et al., 2006). Evidence suggests that discussing with the patient why they might benefit from the treatment can improve patient engagement and adherence(Nunes V, Neilson J, O’Flynn N, Calvert, N, Kuntze S, Smit, hson H, Benson J,, et al., 2009). Organisational factors Delays in identifying and successfully managing TB can be the result of individual and service provider factors. The provisions used to deliver care and support can determine how services should be structured to manage people with TB in hard-to-reach groups. These organisational factors can include the settings used to identify and manage TB as well as the type and needs of the healthcare worker. A lack of specialist services and coordination of care can be a major difficulty in TB service provision, since most GPs see few cases of TB a year (Belling, McLaren, Boudioni, et al., 2012; Gerrish, Ismail Naisby, 2010). The complex social and clinical interactions surrounding a patient with TB can be a challenge to participation and adherence and there is a need for TB link workers to facilitate coordination of services (Brent Refugee Forum, 2007; Belling, McLaren, Boudioni, et al., 2012). Healthcare workers may find it challenging to meet the complex care needs of hard-to-reach groups with TB, especially where there are cultural and language barriers that make it difficult to interpret symptoms and explain about the disease and its treatment (Moro, Resi, Lelli, et al., 2005). In addition, service providers can also be afraid of the consequences of contracting TB, including becoming stigmatised. Non clinical healthcare workers may also have limited knowledge about TB, the need for screening and the implications of a positive test result (Joseph, Shrestha-Kuwahara, Lowry, et al., 2004). There is considerable variation in the delivery of some aspects of TB services and more research is needed in the UK on the effectiveness and cost-effectiveness of different service structures to manage TB(NICE, 2012d). In addition to the NICE national guidance, Public Health England have produced London specific guidelines on the management of TB in prisons (Health Protection Agency, 2013a) based on pilot work across a number of London prisons. This guidance aims to minimise the risk of transmission of TB within the prison environment through efficient systems to detect ca

Essay --

Peace Amongst All Nations Most religions have a leader to provide spiritual guidance and support for their followers. The Catholics have the pope, the Jewish have their head Rabbi, and the Tibetan Buddhists have the Dalai Lama. The current Dalai Lama is the fourteenth in line. He promotes peace and spirituality for his homeland, Tibet, and for the whole world. Born in 1935 as Lhamo Thondup, His Holiness grew up with simple surroundings in a small farming village in Tibet called Takster. His family were average peasants and they worked hard for their small living wage. He grew up with his mother, father, his four brothers, and his two sisters. His mother gave birth to 17 children but only 7 children survived being a toddler. Lhamo, now named Tenzin Gyatso, was chosen as the next Dalai Lama at the age of two, so that once he was of age, he could immediately start his political and religious career. He began training to be a monk at age six. His schooling consisted of five core subjects: logic, Tibetan art and culture, Sanskrit (ancient Indian language), medicine, and Buddhist philos...

Four Steps for Business Analysis Essay

4. Four steps for business analysis are discussed in the chapter (strategy analysis, accounting analysis, financial analysis, and prospective analysis). As a financial analysts, explain why each of these steps is a critical part of your job and how they relate to one another? Answers: a. Business Strategy Analysis This analysis is help managers to identify key profit driver and strategy risk. Business strategy analysis includes analyzing a firm’s strategy and its strategy in order to create competitive strategy. Most managers set corporate goals and then start to formulate the strategies that help to achieve those goals. However the most critical is how two fundamental problems is the connection in approaching the strategic management. First, most business are engage in concerns and have set in certain activities that are a reflection from decision made in the past. Second, managers are tempted to engage in a strategic of the firm without understanding the health of their existing strategy. This can create a new problem for present strategy. After indicate a strategy process complete, the manager then can assess the quality of the strategy. b. Accounting Analysis The purpose of this analysis is to evaluate accounting quality system in a company by assessing of the stability, viability, and profitability of a business or a project. An accounting analysis carried out by professionals who know how to prepare reports and how to use of info obtained from financial statements and other reports. One of the key areas of accounting analysis is to conclude of company’s past performance into an estimate of future performance. Accounting analysis is includes of calculating ratios from the data to compare with other companies. c. Financial Analysis This analysis is use to calculate the investment value of a business, stock or other asset. There are two important skills need related to financial analysis. First the analysis has to be systematic and efficient. Second, allow the analysis to use financial data to explore company issues. Financial analysis can help an investor to get wealth of information about a company. Knowing relationship between ratios and what the function for future are key to determine future success. Financial statements are essential for business because this can help management to find information and knowledge for investor. d. Prospective Analysis This analysis is focus on forecasting analysis of future financial information of a company and the last step from business analysis. The key areas in this analysis are projecting income statement and projecting the balance sheet. The most important element is the forecasting of the revenue growth. This is based on PEST analysis; industry analysis; company-wide analysis. Forecasting has to be comprehensive including all financial statements. The key should be the key measures such as sales growth, ROE, and earnings. 3 Questions for discussion 1. What is the biggest effect after Dot-Com crash in 2000 for investors? 2. What are the primary factors that led to the burst of the Internet bubble? 3. What is the different between buy side analysts and sell side analysts?

6 WARNING Signs Youre Getting Fired

6 WARNING Signs Youre Getting Fired Afraid you might lose your job? Are you starting to hide from your boss when you see her coming? Rather than live in fear, why not confront the situation and consider the following 6 warning signs you’re getting fired? That way you could maybe even do something about it and avoid the inevitable. You could try to turn things around at your current company or start looking for a new job while you still have the safety net of a paycheck. Here are the top 6 warning signs you’re getting fired:1. Role shiftYour job has changed, and not for the better. If your role suddenly shifts or you’re moved to a different department without explanation, and that move is lateral- i.e. you haven’t been promoted, then you’re probably in the danger zone.2. More responsibilities, same payIf you’ve been given lots more to do, or some more difficult projects, but you haven’t been given a pay bump to go with it, then that probably means you’re absorbing the work of someone who was laid off- or someone they were planning on hiring but didn’t, for whatever reason. It’s never a good sign to be asked to do more without being compensated. Keep your eyes open from here on out.3. The top dogs are jumping shipIf your company’s top performers are bailing and taking jobs elsewhere, then you might do well to follow them. Trust that they best guys know where to go in order to be valued. And ask yourself why you’re not doing the same.4. Your industry is overOkay, maybe not over, but sort of sinking. Your company may be okay, but your industry is experiencing a bit of a lull or lag. Don’t get complacent. Start thinking how your skills and position might translate into other fields and don’t get caught with your pants down.5. Your company has a new strategyThis implies that the old one wasn’t working so well. Try to avoid becoming associated with that old strategy, or risk getting thrown out along with it.6. Your company relocatesAny time a company moves, they jettison a lot of their extra weight and expensive employees. You could be one casualty of their cost-cutting.

Allen Ginsberg essays

Allen Ginsberg essays Themes and Values of the Beat Generation As Expressed in Allen Ginsberg's Poetry Perhaps one of the most well known authors of the Beat Generation is a man we call Allen Ginsberg, who expresses the themes and values in his poetry. He was, in fact, the first Beat Writer to gain popular notice when he delivered a performance of his now famous poem, Æ’HowlÆ’Â °, in October of 1955. The Beat Generation is typically described as a vision, not an idea and being hard to define. It is characterized as Æ’a cultural revolution in process, made by a post-World War II generation of disaffiliated young people...without spiritual values they could honorÆ’Â ° (Charters XX). Although first condemned and criticized, it became a national phenomenon. Allen Ginsberg expressed the intangible beliefs of this generation in his poems about his childhood, curiosity, war, freedom of thought, and other people. Through Allen GinsbergÆ’Â ­s ideal individualism, he has been able to express the themes and values of the Beat Generation. Because of Allen GinsbergÆ’Â ­s tormented childhood, many of his poems were about his relationship with his mother and his own mental problems. Allen Ginsberg was born in Patterson, New Jersey to Louis and Naomi Ginsberg on June 3, 1926. His mother became insane during GinsbergÆ’Â ­s formative years. She was described as a paranoid schizophrenic, believing she was in danger from assassins and was spied on by everyone, including her own family members. For example, in the poem, Æ’HowlÆ’Â °, Ginsberg writes Æ’ I saw the best minds of my generation destroyed by madness, starving hysterical naked...Æ’Â ° (Charters 62) of his mother, Naomi. This statement employs him as a witness to the destruction. Her struggle for sanity eventually led to the deterioration of her sons sound mind. Kaddish is a poem written by Ginsberg for his mother. It is 2. a relatively confessional poem and indirectly addresses the reader, or...

Theory-Practice Gap Research Paper Example | Topics and Well Written Essays - 750 words

Theory-Practice Gap - Research Paper Example This writing will focus on various measures proposed through which the gap between nursing theoretical frame work and practice can be decreased. Body According to a study conducted by Rolfe, the gap between the theory and practice of nursing is majorly caused because theorists of nursing arena have failed to take into account the real life practices of nurses and health care settings (Rolfe, 1993). He further stated that in order to decrease this gap the theorists need to identify and analyze different nursing situations that take place in real life and base their theories on these situations. He went further to develop a praxis in which what ever happens in practice of nursing is first identified and applied to theory and then theory is created, the created theory is learned in nursing educational settings by nursing students and then applied to real life situations when students transform into practitioners. According to Levin, the gap between nursing theory and practice can be dec reased by allowing a clinical practitioner to guide nursing students while they perform practical tasks during their educational sessions (Levin, 2010). Levin further states that the gap between theory and practice can be reduced by altering the learning and teaching system to constructivist approach while students are under the process of clinical practice educational sessions. When this approach is followed students gain new knowledge by gaining information from the past and present. When this kind of learning approach is applied to the field of nursing, nursing students gain experience by doing what they have learned or learn by doing. Sellman states that the gap between theory and practice is created not by theorists or by students, it is created by the authorities who do not allow the students to practice what they have learned through theory (Sellman, 2010). Sellman suggests that in order to decrease the gap between theory and actual practice, practitioners will have to work a ccording to the situation and have to experience that they do not need to rely on theoretical work in order to practice. This means that nursing students should not try to locate the rationale behind a particular incident taking place; instead they should focus on the cause and effect of practice. While practicing, they should not apply theory, instead they should learn through experience. Wilson in a report named Bridging the theory practice gap states that nursing students experience a gap between what they have learned and what they are practicing because they do not apply what they learn during their educational settings (Wilson, 2008). For this purpose Wilson proposed that while students are under the learning stage they should practice and they should be allowed to practice as nurses. While they will be practicing they will learn through experience and continuous communication with other nursing staff will assist them in gaining more knowledge. This means that students should be allowed to practice with senior nurses as this will help them learn more as they observe other practitioners. This will even assist the health care settings in having enough nursing staff while the demand for nurses are high. Brake in her study states that the gap between nursing practice and theory is caused because nursing students do not attend any other educational arenas other than their own educational setti

Flextronics International Singapore Limited Case Study

Flextronics International Singapore Limited - Case Study Example Though this is not contract manufacturing the company has successfully combined the contract manufacturing with the innovation of the products according to the market need of low cost handsets. At the same time the company acquired to boost its product line by acquiring the Solectron. This denotes the sense of the company that thinks about increasing the production capacity within least possible time. Increasing the production capacity by new constructions can consume time and the company decided to acquire the rival company to boost its production in least possible time. Flextronics International Singapore Limited is the second largest multinational corporate company providing electronics manufacturing services. They are the original equipment manufacturers in networking, computer, medical and consumer products. Flextronics is one of the major global companies engaged in designing and manufacturing operations. They spread over 28 countries in 4 continents. The innovative product design and manufacturing services coupled with specialized services and IT expertise with unique management strategies place Flextronics as a top-tier EMS provider. With 1, 60, 000 thousand employees worldwide and a $12 billion revenue backbone, the company is marching forward to reach its zenith globally. The company's Headquarters is in Singa... The current analytical study of Flextronics International Singapore Limited is carried out considering their marketing strategy of the brand products and services satisfying the innate biogenic and psychogenic needs of the consumers, with that of the company's competitors, on an international level. The assessment of the company's profile and the strategies developed by them to satiate the demands and aspirations of the consumers are done on the basis of the psychological behavioral pattern propagated by the theory of Maslow's hierarchy of needs. The company was founded to satisfy the needs of silicon valley clients by catering to their needs of printed circuit boards. This analytical study of the company is executed on realizing the fact that the consumer's biogenic or physiological needs such as food, water, clothing, housing, sex, reproduction, safety etc., will grow to a certain limit and stand still or will become stable after achieving it to its maximum, whereas the psychogenic needs such as self esteem or ego, self-respect and prestige, status and self-fulfillment, thirst for knowledge, culture, aesthetic sense etc. will never reach that maximum, but will grow and expand its realms, to reach a higher level the moment it is fulfilled and at the same time groping all over without an aim or having any knowledge as to what is that needed and where it could be found. As the company takes into account the psychogenic needs of its customers in developing the products, there can be no limit for the development of its existing products and innovation of the new products. (http://en.wikipedia.org/wiki/Maslow's_hierarchy_of_needs, viewed on 12th Septem ber, 2007). To support the above study the