Freedom writers summary essay
Tuesday, November 5, 2019
Netflix Case study - SmartCustomWriting.com Samples
Netflix Case study - SmartCustomWriting.com Netflix Case studyIntroduction According to Reed Hastings, Netflix have been facing a lot of competition in the video renting market and thus the need to come up with most effective strategies that may help it in improving its productivity. Netflix is a new adventure brought into the market through the internet commerce and the advent of DVD that aided in securing movie rentals. He says that the new strategies that they have employed such as the recommendation system and also focusing on enhancing their clientsââ¬â¢ experience concerning their website. It is clear that through such strategic focus Netflix has been able to grow into one of the largest online entertainment subscriptions service in the United States with a total of more than 6.3 million subscribers. Netflix has been in one of the most competitive fields as a business venture. It has been competing with companies such as the Blockbuster. It is therefore vital for Netflix to employ a strategy that will ensure that it gets secondary markets. It is important to develop and implement a flexible and disciplined business strategy that will aim at driving revenue growth, minimizing operation costs and profitability, and maximizing store level productivity. The profitability of the market is the determining factor of the attractiveness of this movie industry. Even though the industry has high burrier to profitability, it also contains various factors that validate its attractiveness. As a result of increased buyer demand, online movie renting is presently one of the fastest growing markets globally. An attractive feature in the market of movie renting is the possibility of having newcomers who develop strong competition, revenue, brand recognition, and strong lead of customers. The main vision of Netflix is to change the manner in which people access and view the movie of their zeal and love. For that reason implementation of present strategies will enable Netflix to reach their objective and guarantee the accomplishment of their vision (Willy, Stephen, David, 2009). Business strategy of Netflix After Netflix realized that the traditional merchandizing system was ineffective, its engineers came up with a proprietary recommendation system in order to balance the needs of their customers. Netflix also signed a new signing account which made customers to be capable of identifying new favorite movie genre, including rating specific movie titles from one to five. Netflixââ¬â¢s proprietary algorithm was a strategy that solely depended on the results of these surveys. The surveys help both the company and its clients in placing their orders or choosing the movies they prefer. This recommendation page also included information on why the movie was being recommended apart from just the title and rankings. This kind of strategy ensured that customerââ¬â¢s gotten what they preferred most. Moreover, Netflixââ¬â¢s software refined its understanding of the clientsââ¬â¢ preference (Willy, Stephen, David, 2009). The company also did the screening of movies through its inventory management with the aim of avoiding frustrating its customers. The system increased utilization Netflixââ¬â¢s library of films in order to be in short supply. It was an important strategy since it satisfied the needs of the customers since it picked the needs of the customer. SWOT Analysis of Netflix Netflix has a number of strengths which include: a) a strong e-commerce expertise, b) knowledge about technology, c) defect free merchandise to the clients, and d) expertise that are capable of providing consistent customer services. It also has experienced and capable workforce, valuable physical assets, and proven managerial know-how (Willy, Stephen, David, 2009). Netflix also has a number of core deficiencies in comparison to other companies that puts it at a disadvantage in the marketplace which include: a) inventory control is one of the most difficult things in Netflix since DVDs are sent to the clients through the mail, and this means that the DVDs may arrive late or may be broken or even lost in the delivery process, b) it is also hard to determine the number of DVDs that reach customers since they have the right of keeping them as long as they wish, c) Netflix also does not distribute videotapes, but just DVDs, this can make the company loose customers, and finally, d) even though it is not expensive but convenient, it is less economical to those client who watch less than one movie every week (Willy Smith, 6). Netflix also has some opportunities such as: a) Netflix will provide a service that will allow its customers to download movies online, b) it will also give lower variable costs which will be profitable in the long run, c) its feature (SamGoody.com) will be a service that will enable its clients to access discs if need be, and finally, d) it has a rapid growth potential that will enable it to gain popularity and development (Willy, Stephen, David, 2009). Netflix has threats that do not allow them to be more competitive in the online video market; it also has some features that do not satisfy the needs of the clients. It is also faced with competition from other companies offering online rental services. Conclusion In order for the company to gain a large base, it must begin to implement its long term goals and advertise to specific consumer needs which have been assured by the recommendation system. Since technology is ever changing, Netflix will have to devise it marketing strategies to march those that other companies use in online market. It is also vital to look at globalization which is another long term goal since it has various guiding principles to worry about when venturing into the global market. Finally the whole team at Netflix needs to target on the research development in order to improve on their strategies (Willy, Stephen, David, 2009). Work Cited Willy Smith, Stephen Kaufman, and David Spinola. ââ¬Å"Netflix Case from the Business Harvard School, Case # 9-607-138, (2009), pp 2-15.
Saturday, November 2, 2019
Sustainability In Business Essay Example | Topics and Well Written Essays - 2500 words
Sustainability In Business - Essay Example As a result, the question arises as to how organizations as well as societies which are capable of sustaining exceedingly productive performance can be developed. Moreover, it has become increasingly comprehensible that ââ¬Å"sustained economic success and quality of community life depends on developing a different relationship with the natural environmentâ⬠(Dunphy, 2000, p.5), and hence, it is necessary to realize the fact that much of the economic affluence has been attained at the cost of global resources that have been exploited at an unsustainable rate. In the light of these facts, the current research will aim at evaluating the corporate sustainability of three global majors, viz. Royal Dutch Shell plc (Shell), Fluor Corporation (Fluor), and The Kuwait Oil Company (KOC) in terms of the sustainable profiles of different countries wherein they operate. The report will address a range of corporate sustainability issues that organizations commonly face, in order to substanti ate the fundamental premise of this research. The major strengths of the Shell include its internal factors that have lead to rapid growth of the company. It is one of the largest oil companies and it has acquired very strong market position in global oil industry. It enjoys an upper hand position in the market. The company has taken vertical integration for its operations that allows it to enter downstream and upstream activities like oil and gas exploration and refining, business-to-business sales etc (Shell-b, 2009). The company internal strategies and management team are efficient in maintaining the global operational business operations. The company has acquired high technical advancements for their business operational projects. Since last five years, the weaknesses of Shell have become more prominent due to certain negative factors. Firstly, the decreasing profit and sales margins are the major weakness of the company.
Thursday, October 31, 2019
Tourism Management Research Proposal Example | Topics and Well Written Essays - 750 words
Tourism Management - Research Proposal Example The charm of Cancun lies in the fact that this secluded island offers all kinds of facilities within the island so that tourists do not need to leave the island in order to get any kind of necessities. It has hotels for all classes of tourists and caters to a variety of tastes and preferences as well. In fact, Cancun has 140 hotels, which translates to 24,000 rooms. There is something here that everyone can afford. In addition there 190 flights plying to and from Cancun daily - so getting there is not a problem. This is a definite draw for a large chunk of tourists. Further, it has over 600 restaurants which ensure that people with varied tastes can find their ideal kind of cuisine in this island. In this regard, sustainable tourism is an important feature that can be built into the tourism of the area as this area garners a major proportion of income from the tourism industry in Mexico. Sustainable tourism in this region can flourish mainly as this island has a rich heritage of dive rse vegetation and scenic beauty apart from sea world vegetation and rare species of fish and other such species. Sustainable tourism in a beautiful island like Cancun is like a dream come true for environmentalists as well as policy makers who believe in green politics and green economy. Premises Premises of Analysis: Hypothesis: The study of sustainable tourism in the island of Cancun will be based on the following aspect. The case of Benidorm in the South of Spain as a model upon which the sustainable tourism model for Cancun can be fashioned. Owing to the fact that the basic issue in the case of studying the South of Spain region in terms of scope for sustainable development with an eye on positive and negative impact of such a strategy on the physical environment as well as the socio economic structure of the region in context of legislations of the regional, national and supra national organisations, there has been a use of ontology. The questionnaire method will be the following: the tourist will have to evaluate the island from the following points of view: price, range of accommodation and exposure of tourists. Literature: For the reasons mentioned above, many literary sources attached a particular to this island. In context of the impact of sustainable tourism on the physical environment and socio economic structure in the region, an important book that has helped in setting the criteria for analysis is Mediterranean Tourism: Facets of Socio Economic Development and Cultural Changes. This book has covered 13 countries and has relevant factual information upon which the analysis was based in the dissertation. The chapter titled Towards a Sustained Competitiveness in Spanish Tourism is of special relevance to this dissertation as it creates a nexus between sustainable tourism management and competitive advantage in the tourism industry. The book titled The Tourism Area Life Cycle is another relevant work that helped gain an insight into specific areas and the tourism life cycles enjoyed by the same. (Butler, 2006). In context of tourism life cycles, this book has important and relevant infor mation on the various legislations by the various supra national, national and regional organisations in case of the tourism indus
Tuesday, October 29, 2019
CUSTOMER SERVICE Essay Example | Topics and Well Written Essays - 1000 words
CUSTOMER SERVICE - Essay Example In addition, if the language used in the query or reply is not courteous and polite, the customer is most likely not to reply back. Directly addressing customers or Phone call follow-ups: This type of follow-up has mixed results. Either they will be annoying for the customers making their responses the same annoyed ones or planning to get rid of the person or honest opinion will be given. Usually this is entirely dependent upon the person calling or talking to the customer. If they are polite, friendly and precise, the customer is more likely to give an honest opinion rather than just wanting to get rid of the question being asked. The call centre is outsourcing its services to various small companies. Their aim is to expand their services to larger outlets. For the time being, their focus is providing the best possible services to the customers. These services are prompt and accurate. For this purpose, they train every employee in the specified product information they are servicing before letting them work in the call centre (Kotler et al., 2009). This training enables them to be precise and helpful to the customer as much as they can. They also focus on hiring people with a pleasant personality, clear accents and voices so that the customer does not feel offended talking to them. Professionalism is highly encouraged here in all aspects whether it is answering queries or helping a difficult customer out. Rewards are also given to employees who offer the best support for the month. Employee input for improvement in service is also taken under consideration. The local mart also has a high value of customer service. It is a family run business and slowly they are expanding due to their high service quality, word of mouth and repeat customers. Their policies include always putting the customer first. Any sign of discomfort or dissatisfaction is
Sunday, October 27, 2019
COPD with Cognitive Status in an Elderly Sample
COPD with Cognitive Status in an Elderly Sample COPD with Cognitive Status in an Elderly Sample using the Third National Health and Nutrition Examination Survey Dean Sherzai, MD MAS PhD(c), Rachel Schade, Sonia Vega, Ayesha Z. Sherzai, MD Authorââ¬â¢s Affiliations: 1Department of Neurology and Neurological Sciences, Cedar Sinai Health System, Los Angeles, CA, USA; 2Keck Science Department, Pitzer College, Claremont, CA, USA; 3Department of Epidemiology and Biostatistics, Loma Linda School of Public Health, Loma Linda, USA; Department of Neurology, The Neurological Institute of New York, Columbia University Medical Center, New York, New York, USA. Keywords: COPD, cognitive status, dementia, aging Abstract Purpose: Chronic Obstructive Pulmonary Disease (COPD) has been associated with dementia and cognitive impairment. We attempted to assess the relationship between COPD and cognitive impairment in a nationwide database, the National Health and Nutrition Examination Survey (NHANES III). Methods: Data was analyzed from the NHANES III database, a nationally representative cross sectional observational study among older adults. The diagnosis of COPD was based on calculation of FEV1/FVC ratio, with a cutoff of 0.7. The odds of having poor cognitive status was assessed using logistic regression models between COPD and three cognitive tests (immediate recall, delayed recall, and serial subtraction tests), adjusted for demographic variables and medical comorbidities. Results: We identified 17,181,182 individuals with a diagnosis of COPD. The mean age of was 71.5 à ± 0.19 years. In the crude model, there was a strong relationship between those with COPD and poor cognitive test scores. This relationship was strengthened in the multivariate model adjusted for demographic variables and vascular comorbidities, such that those with COPD had a higher odds of having impaired immediate recall (OR 2.56, 95% CI 1.44- 4.53), delayed recall (OR 3.10, 95% CI 1.73- 5.52), and serial subtraction tests scores (OR 2.74, 95% CI 1.17- 6.40). Conclusions: Individuals with COPD have a higher odds of having cognitive impairment in this large nationally representative database. Introduction Approximately 35.6 million currently suffer from dementia worldwide, and this number is expected to double by 2030 and triple by 2050 [1]. In the last few years we have become more cognizant of the importance of identifying cognitive decline at the earlier stages when it is more amenable to treatment. We have also become more knowledgeable about possible comorbidities that may propagate the process of cognitive decline and ultimate dementia. Causes of cognitive decline, and possible progression to dementia, are believed to be multifactorial. Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease that affects more than 13.5 million people in the United States and has been associated with cognitive decline [2]. To date, there are no definitive treatments for dementia; therefore, much emphasis had been placed on the prevention of dementia, and identification of modifiable risk factors early in the disease process. Multiple studies have reported the association between COPD and either global cognitive deficits with the most severe deficiencies in specific cognitive domains such as perception, motor function or memory [3]. Despite the current body of evidence, the majority of studies are based on a single region, and there are a few studies that used a nationally representative data (Health and Retirement Study). Given that society is facing an increase in the rate of chronic diseases of aging [4], and the lack of large scale investigation on the relationship between COPD and diminished cognitive status, we analyzed this nationwide database, the National Health and Nutrition Examination Survey (NHANES III), to better elucidate this relationship. Materials and Methods NHANES III is a cross sectional health survey conducted by the National Center for Health Statistics (NCHS), performed from 1988 to 1994 in persons aged two months and older in the United States. NHANES has a multistage, probability sampling design used to select participants representative of the civilian, non-institutionalized US population. Our study population consisted of 39,488,973 adults 60 to 89 years. Of these, participants were included if they had measurements for spirometry and the cognitive tests. Based on The Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD) standards, cases of COPD were defined based on the patientââ¬â¢s ratio of forced expiratory volume (FEV1) to the forced vital capacity (FVC). Patients with a ratio of less than 0.7 were classified with COPD. Our control group, patients without COPD, was classified by a ratio greater than 0.7. For the older population, NHANES-III measures cognitive status with three cognitive tests: an immediate a nd delayed logical verbal memory test from the East Boston Memory Test, a three word registration/memory task (ââ¬Å"apple,â⬠ââ¬Å"tableâ⬠and ââ¬Å"pennyâ⬠) and five serial subtractions by intervals of three. A point was awarded for every correct answer from the three word memory task and the logical verbal memory test. For immediate memory, using a summary score of logical memory (0-6 points) plus three word task (0-3 points), we considered less than 5 out of 9 points to be impaired (low), such that individuals with 0-4 were score ââ¬Ëlowââ¬â¢, and those scoring 5-9 were scored ââ¬Ëhighââ¬â¢. For delayed memory, a summary score of less than 4 out of 9 points was considered impaired (low). Both summary scores are consistent with previous NHANES-III reports. For the test of serial subtractions, any miscalculation during the five trials was considered impaired, and only a perfect score was considered ââ¬Ëhighââ¬â¢. The reported race and ethnicity includes non-Hispanic Whites, non-Hispanic Blacks, Mexican-Americans and ââ¬Ëotherââ¬â¢. Smoking was defined by a ââ¬Å"yesâ⬠response to the following two questions: ââ¬Å"Have you smoked at least 100 cigarettes during your entire lifeâ⬠and ââ¬Å"Do you smoke cigarettes nowâ⬠. These questions can be found on the NHANES III household adult questionnaire. Education was stratified in three categories: 12 (some college and beyond). We performed an X2 and t-test analysis to compare demographic characteristics between patients with COPD and patients without COPD. To assess the association between COPD and a low cognitive test score (with high score as reference) crude and adjusted logistic regression analysis were performed. Adjusted potential confounders were age, race-ethnicity, sex, BMI, education status and smoking. Appropriate NHANES-III weighted sampling was applied during this analysis. All data analyses were conducted using SAS (v 9.3; SAS Institute Inc., Cary, NC). Results Table 1 presents the demographics of the population. There were 17,181,182 individuals with COPD; 50.1% were females, 49.9% males and 85.9% were non-Hispanic White. The mean age for patients with COPD was 71.5à ±0.19. In both groups, patients had less than a high school education, were non-smokers and had both hospital and medical coverage. Majority of individuals with COPD scored low on each cognitive test as compared to those without COPD (Table 1). Coronary artery disease was the most prevalent comorbidity in patients with COPD (31.9%) and in patients without COPD (30.4%). In the unadjusted model, participants with COPD had increased odds of impaired scores on each of the three cognitive tests: the immediate recall (OR 2.18, 95% CI 1.81- 2.62), delayed recall (OR 2.25, 95% CI 1.87- 2.70) and serial subtraction test (OR 1.44, 95% CI 1.10-1.90). We then examined the association between COPD and the cognitive tests, initially adjusted by age and race, which diminished the relationship slightly for all three tests, but the relationship was rendered insignificant for the serial subtraction test (OR 1.29, 95% CI 0.95-1.69) (Table 2). Then, we adjusted for age, sex, height, body mass index and education, which did not change the relationship significantly. In the third model, further adjustment for race, poverty income ratio, and medical coverage did not appreciably change the relationship. In the last model, we additionally adjusted for vascular risk factors such as smoking, stroke, hypertension, CHF, diabetes and coronary artery disease. This increased the odds for poor scores for all three tests; immediate recall (OR 2.56, 95% CI 1.44- 4.53), delayed recall test (OR 3.10, 95% CI 1.73- 5.52), and serial subtraction (OR 2.74, 95% CI 1.17- 6.40). Discussion We were able to identify a strong association between COPD and diminished cognitive status across three common cognitive tests. Individuals with COPD had significantly greater odds of impaired verbal memory, and this relationship remained robust after adjusting for potential sociodemographic and vascular risk factors. The relationship between COPD and the serial subtraction test scores was rendered significant after it was adjusted for vascular risk factors. Despite evidence in the extant literature showing an association between race with cognitive status [10], race was not a factor in the relationship between COPD and cognitive status. Our results are consistent with a growing body of evidence that has revealed a strong association between COPD and poor cognitive function. In one of the largest epidemiological studies, The Health and Retirement Study (n=4,150), patients with severe and non-severe COPD had significantly lower cognitive test scores compared to healthy controls. In adjusted models, only patients with severe COPD had the lower scores on the cognitive tests [5]. Furthermore, a dose-response relationship between COPD severity and cognitive dysfunction was previously established, with more severe COPD cases performing worse on the cognitive tests [6]. Notably, a 2013 study demonstrated significantly reduced memory tests scores on the Mini Mental State Exam (MMSE) among patients with COPD but without hypoxemia [7]. Further evidentiary support for global cognitive impairment in patients with COPD was also shown in a study that observed significant differences in executive functioning, working memory, episod ic memory, processing speed, and visuospatial ability [8]. Recently, several COPD studies have combined cognitive testing with neuroimaging, which have revealed significant white matter pathology in this population, with varying degrees of cognitive impairment [8,9,10,11]. The mechanism by which COPD causes cognitive decline is not very clear. COPD results in hypoxemia and hypercapnia, which has been implicated in diminished cognitive status [3,5]. Recent imaging studies have pointed to possible microvascular damage [3], and other studies have implicated chronic inflammatory process causing cognitive decline [12]. Yet others believe that the hypoxic process may cause direct neuronal damage, glial activation and the generation of free radicals which could affect cognitive functioning [13]. Given the prevalence of both COPD and cognitive decline in the elderly population and a probable causal relationship, it is important to further investigate the mechanism underlying the relationship. Limitations As all studies, this one has many limitations that need to be visited. One of the limitations unique to our study was that majority of the individuals in our elderly NHANES population had less than high school education. Given that educations has repeatedly been found to be strongly correlated with resilient cognitive function as well as less susceptible to neurodegeneration, our results could have been confounded by the lower mean education level in our population[14-18]. Another limitation lies with the cognitive testing used by NHANES. Only three cognitive tests were utilized, which does not provide a comprehensive assessment of cognitive function. In addition, the cognitive tests used most likely overlap in the cognitive function they measure, not allowing for specificity. However, the cognitive variables have been validated as a good tool for testing memory [19]. Furthermore, the cross-sectional nature of this paper does not allow us to make a causal link. In addition, the restr icted scope of lifelong socioeconomic status is a limitation, which is strongly associated with both cognitive impairment and COPD. However, it has been demonstrated that individuals with poor socioeconomic status may have a higher risk of developing COPD and lower cognitive reserve [20,21]. The strengths of this study are its large, diverse representative sample, that provided extensive medical history and allowed for control of confounding variables, as well as the objective measure of cognitive impairment and COPD. Also, the spirometry data from NHANES III allowed for more accurate diagnosis of COPD. Conclusion We were able to demonstrate a strong relationship between COPD and diminished cognitive status. We were not able to demonstrate any effect of gender, race, as well as sociodemographic or vascular risk factors on this relationship between COPD and cognitive status. The independent relationship between COPD and cognitive status may provide us an important clue into the pathophysiology of dementia, which needs to be further explored. Declaration of Interest References Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and meta-analysis. Alzheimers Dementia 2013;9(1):63-75. Ford ES, Croft JB, Mannino DM, et al. COPD Surveillance- United States, 1999-2011 COPD Surveillance. Chest 2013;144(1):284-305. Dodd JW, Getov SV, Jones PW. Cognitive function in COPD. Eur Resp J 2010;35(4):913-922. Dall TM, Gallo PD, Chakrabarti R, et al. An Aging Population And Growing Disease Burden Will Require A Large And Specialized Health Care Workforce By 2025. Health Aff 2013;32(11):2013-2020. Rusanen M, Ngandu T, Laatikainen T, et al. Chronic obstructive pulmonary disease and asthma and the risk of mild cognitive impairment and dementia: a population based CAIDE study. Curr Alzheimer Res 2013;10(5):549-555. Li J, Huang Y, Fei GH. The evaluation of cognitive impairment and relevant factors in patients with chronic obstructive pulmonary disease. Respiration; International Review of Thoracic Diseases 2013;85(2):98-105. Gupta PP, Sood S, Atreja A, Agarwal D. A comparison of cognitive functions in non-hypoxemic chronic obstructive pulmonary disease (COPD) patients and age-matched healthy volunteers using mini-mental state examination questionnaire and event-related potential, P300 analysis. Lung India: official organ of Indian Chest Society 2013;30(1):5-11. Dodd J, Van Den Broek M, Jones P, Charlton R. S92 cognitive function cerebral white matter tract microstructure in COPD. Thorax 2011;66(Suppl 4):A43-A44. Charlton RA, Dodd JW, van den Broek M, et al. Can brain MRI explain cognitive decline in COPD? A pilot study. Eur Resp J 2010;38(Suppl 55):29-36. Chung A, van den Broek MD, Charlton RA, et al. Cognitive Function And Cerebral Functional Connectivity In COPD: A Resting State Functional Magnetic Resonance Imaging Study. Age 2012:65(68):20-27. Dodd JW, Chung AW, van den Broek MD, et al. Brain structure and function in chronic obstructive pulmonary disease: a multimodal cranial magnetic resonance imaging study. Am J Respir Crit Care Med 2012;186(3):240-245. Borson S, Scanlan J, Friedman S, et al. Modeling the impact of COPD on the brain. Int J Chron Obstruct Pulmon Dis 2008;3(3):429-434. Singh B, Mielke MM, Parsaik AK, et al. A Prospective Study of Chronic Obstructive Pulmonary Disease and the Risk for Mild Cognitive Impairment. JAMA Neurol 2014;71(5):581-588. Schmand B, Smit J, Lindeboom J, et al. Low education is a genuine risk factor for accelerated memory decline and dementia. J Clin Epidemiol 1997;50(9):1025-1033. Stern, Y. Cognitive reserve and Alzheimer disease. Alzheimer Dis Assoc Disord 2006;20(2),112-117. Ngandu T, von Strauss E, Helkala EL, et al. Education and dementia What lies behind the association? Neurology 2007;69(14):1442-1450. Scarmeas, N, Stern, Y. Cognitive reserve and lifestyle. J Clin Exp Neuropsychol 2003;25(5):625-633. McDowell I, Xi G, Lindsay J, et al. Mapping the connections between education and dementia. Journal of Clinical and Experimental Neuropsychology 2007;29(2):127-141. Albert M, Smith LA, Scherr PA, et al. Use of brief cognitive tests to identify individuals in the community with clinically diagnosed Alzheimers disease. Int J Neurosci. 1991;57:167-178. Eisner, MD, Blanc, PD, Omachi, TA, et al. Socioeconomic status, race and COPD health outcomes. J Epidemiol Community Health 2011;65(1):26-34. Stern, Y, Tang, M X, Denaro, J, et al. Increased risk of mortality in Alzheimers disease patients with more advanced educational and occupational attainment. Ann Neurol 1995;37(5):590-595. Table 1. Baseline characteristics by COPD status in the NHANES III population * p values derived from t test comparison of means of COPD by population characteristics SD = Standard deviation Table 2: Crude and adjusted odds ratio for COPD and cognitive tests among 17,134,886 individuals in the NHANES III population OR = odds ratio, CI = confidence interval, ref = reference Model 1: adjusted for age and race Model 2: adjusted for age, sex, height, BMI and education Model 3: Model 2 additionally controlled for poverty income ratio, race, and medical coverage Model 4: Model 3 additionally adjusted for stroke, coronary heart disease, hypertension, congestive heart failure, diabetes. 1
Friday, October 25, 2019
Merchant Of Venice - Antonio And Shylock :: Free Merchant of Venice Essays
William Shakespeare shows how two tradesmen can have completely different lives when others view them differently in the play The Merchant of Venice. In the play, Bassanio, Antonioââ¬â¢s friend, needs money to pursue his love. They seek a loan from Shylock, a Jewish moneylender in Antonioââ¬â¢s name. The contract is for three times the value of the bond in three months or else Shylock cuts off a pound of flesh from Antonio. While all this is happening, there are love plots going on. One of which is for Shylockââ¬â¢s daughter to elope with Lorenzo, a Christian. Later on, Antonioââ¬â¢s source of money, his ship, is reported sunken in the English Channel, dooming him to the loss of one pound of his flesh. There is a trial on the bond, and when it seems sure that Antonio will die, Portia, disguised as a doctor of laws legally gets Antonio out of the situation and Shylock recieves harsh penalties. Antonio and Shylock, two similar businessmen of Venice, are viewed differently and are treated oppositely to heighten the drama of the play and mold a more interesting plot. Antonio and Shylock are both successful entrepreneurs in Venice but they both have different attitudes and experiences. When Antonio is asking Shylock for the loan he says, ââ¬Å"Within these two months ââ¬â thatââ¬â¢s a month before this bond expires ââ¬â I do expect, return of thrice times the value of this bond.â⬠(1.3.169-170). Antonio and Shylock both are well off and successful businessmen. Antonio, being a man who is treats everyone nicely, lends his good name to Bassanio to woo Portia. Shylock on the other hand, could never do that and is a very greedy man who asks for three times the value of the loan. Also, Antonio is a risk taker and thinks things will always go the right way for him and his success will continue, which is shown when he accepts the high interest rate and the bizarre payment if the money isnââ¬â¢t received. Shylock handles his business straightforward and charges interest because it is his job, although being a very high amount and if it isnââ¬â¢t carried out, Shylock gets his payment of one pound of flesh. Shylock is depicted as the greedy businessman while Antonio is the nice man who tries his luck. Another way Antonio and Shylock are different is their religion based social status: Antonio is a Christian and Shylock is a Jew. Merchant Of Venice - Antonio And Shylock :: Free Merchant of Venice Essays William Shakespeare shows how two tradesmen can have completely different lives when others view them differently in the play The Merchant of Venice. In the play, Bassanio, Antonioââ¬â¢s friend, needs money to pursue his love. They seek a loan from Shylock, a Jewish moneylender in Antonioââ¬â¢s name. The contract is for three times the value of the bond in three months or else Shylock cuts off a pound of flesh from Antonio. While all this is happening, there are love plots going on. One of which is for Shylockââ¬â¢s daughter to elope with Lorenzo, a Christian. Later on, Antonioââ¬â¢s source of money, his ship, is reported sunken in the English Channel, dooming him to the loss of one pound of his flesh. There is a trial on the bond, and when it seems sure that Antonio will die, Portia, disguised as a doctor of laws legally gets Antonio out of the situation and Shylock recieves harsh penalties. Antonio and Shylock, two similar businessmen of Venice, are viewed differently and are treated oppositely to heighten the drama of the play and mold a more interesting plot. Antonio and Shylock are both successful entrepreneurs in Venice but they both have different attitudes and experiences. When Antonio is asking Shylock for the loan he says, ââ¬Å"Within these two months ââ¬â thatââ¬â¢s a month before this bond expires ââ¬â I do expect, return of thrice times the value of this bond.â⬠(1.3.169-170). Antonio and Shylock both are well off and successful businessmen. Antonio, being a man who is treats everyone nicely, lends his good name to Bassanio to woo Portia. Shylock on the other hand, could never do that and is a very greedy man who asks for three times the value of the loan. Also, Antonio is a risk taker and thinks things will always go the right way for him and his success will continue, which is shown when he accepts the high interest rate and the bizarre payment if the money isnââ¬â¢t received. Shylock handles his business straightforward and charges interest because it is his job, although being a very high amount and if it isnââ¬â¢t carried out, Shylock gets his payment of one pound of flesh. Shylock is depicted as the greedy businessman while Antonio is the nice man who tries his luck. Another way Antonio and Shylock are different is their religion based social status: Antonio is a Christian and Shylock is a Jew.
Thursday, October 24, 2019
Water issues in the Middle East
There are several factors that have caused such high demand in the Middle East. The water level is a lot shorter than most places and is increasing all the time. The region suffers from droughts every few years. The development of water resources is not making any progress factors such as cost, dealing with neighbouring countries which all delay the progress. Farming results in the highest level of water consuming at 80% leaving 20% for the Middle East. Cities such as Amman in Jordan ration its piped supplies; tankers deport the water which costs more than the poor can pay. The level of population growth is also increasing, which results in rising standards of living increasing the demand of water. The regions water is constantly in dispute. The regions water is spilt which results in confrontation and disagreements. ââ¬ËWater Wars' are improbable as three of the disputed river basins due to the uneven military powers are not equal. Egypt and Israel are downstream, Turkey is upstream and Iraq and Syria are also downstream. MAP SHOWING THE ROUTE OF THE EUPHRATES RIVER The Turkish purpose to use the water for an irrigation project in south-eastern Anatolia, this project will result in Syria's and Iraq's share of the Euphrates by 40% and 60%. This scheme is planned to revitalise the economy of the south east of the country. Eventually 22 dams in the Tigris and Euphrates rivers will provide irrigation and hydroelectric power to transform the local economy. They hope to gain the support from European companies, but in 2002 companies where forced to withdraw from the project, nevertheless Turkey has still continued to develop the dam. The dam will provide a clear positive outcome to the Middle East region. The water will be stored in the dam reducing the water flow, gradually allowing water through to the areas. The dam will provide jobs to the local community; this development will help the poorer citizens. Long term profit and economical issues may increase over the years as its helping the future for the water problems in the Middle East. Migrants will move into the area which may vary to a positive or negative outcome. The dam's main function is to provide hydro-electric power, which is more environmentally friendly. This will provide electricity to communities located around the Middle East. The energy provided is eco friendly and is reliable without using precious fossil fuels. With the new dam created larger business may move into the area, providing primary products to be distributed to other countries. This may provide more business to trade with the countries, developing the countries economical distributions. Although smaller business may lose money and go out of business resulting unemployment. The land used to create the dam, has resulted in angry local people. The local people have now received compensation funds. The amount of money put into the dam has been lost to local people, especially the few powerful landlords who each stand to collect huge compensation funds. Changes in rivers cycles will be vastly effected, rivers will lose millions of mà ¯Ã ¿Ã ½ of water being irrigated into cities located downstream from the upstream contributories. The Agriculture use dropped in all the area's creating a regional water market resulting for people paying for the water use. One example is the Yarmouk River which has a mean discharge of 400 million mà ¯Ã ¿Ã ½ a year, and provides almost half of Jordan's surface-water resources. The water in this river, after allowing some 17million mà ¯Ã ¿Ã ½ a yr for downstream users in the neighbouring countries providing agricultural water needs in the Jordan valley. This example has improved in the water use; this is similar situation to other rivers in the Middle East. Discharge is evenly distributed but resulted in higher levels of Agriculture. Area's downstream have resulted in less water being transported and reduced. Syria dam prevents water flowing restricting water flow to places such as Baghdad. Syria and Iraq have agreed to work together, after problems with bombing back in 1979. The political consequences have resulted in countries signing with each other separating themselves which could lead to future wars. Water extraction from the Euphrates has resulted in the government gaining a profit for charging them for the use of the water. This has also lead to the negative sentiment and response from the poorer citizens. Escalating growth of rising business increasing in the regions resulted in higher proceeds in the area. The government had to make a decision and verdict to their own areas to what they felt was overall best towards the people and for the future. Reponses won't be positive either way but never less the decision were what was felt most paramount and preeminent at the time.
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