Oprah Winfrey Essay Example for Free

Oprah Winfrey Essay Oprah Winfrey, born on a farm in Mississippi to a teenage mother in 1954 came from nothing yet again is the world’s most successful lady who is a role model to many and has made it on her own. She is a success story, some one who has made history on American television by producing and hosting her own TV show, â€Å"The Oprah Winfrey Show† the show has won her countless awards and praises since its start in the year 1987. It is the top ranked show on television till this day (Oprah Winfrey Biography, 2006). She runs her own company. She has been the richest African American lady and the only Black billionaire in the world at one time and the most highly paid television host today. Success and Oprah have been together from the longest time. She has managed to win the hearts of all the Americans today with her hard work, determination, and dedication and confidence and has become the most watched television celebrity. She has been ranked the most influential lady of the 20th century from the past five years by the Time magazine (Oprah Winfrey Biography, 2006). She is considered as someone who can bring an enormous change because her popularity is beyond the pop culture and she has the capability and credibility to influence others. She has left a mark on everyone. Leadership is the ability to influence others by gaining the trust and support of the followers and Oprah has been able to do that. She is a born leader. She has all the attributes to become a successful leader and she has proved it to the world. It is her leadership qualities only that she has been able to maintain the standard of her show and live up to the expectations of her viewers. She runs a show, is an owner of a magazine, she’s into movie production, is a successful actress and all of these are her profitable businesses. She has become a brand name. She has set an example of being a superior and effective leader. She is intelligent and an educated lady, she is self confident she knows what she’s talking about. She has spoken on all kinds of issues on her show and brought the facts and figures in front of the world (Oprah Winfrey Biography, 2006). She is a stable lady, and flexible and honest and has an internal locus of control. She had the luck and believes in herself. She has the ability to understand others therefore she has created social awareness such as her effort to increase the awareness of child abuse where she was honest and bold enough to share her own child hood incident in front of the world. She has the communication skills to convince others and leave an impact and create a connection with the masses. During the time of Hurricane Katrina she made an appeal to everyone to openly donate and everybody did. Oprah runs her own charity too. She is a woman of high energy; she is running the show from the past sixteen years. Her role as the leader has been goal oriented and focused. She campaigned for Barack Obama last year. Only an effective leader can do so many things at one time. She takes timely decisions. She has adequate effort and talent and she knows how to spend it wisely. That is what leadership is all about. The queen of day time television has been an effective leader. She went through rough times during her childhood but she was a pessimistic and never lost hope. A positive attitude is an effective leader’s quality. Only when you yourself are positive you can motivate your subordinates. She was alert she wanted to create a change. She planned, organized, controlled and led while success followed her. She is good at what she is doing. Though she had all the fame and fortune this did not stop her from helping the under privileged. Oprah contributes millions of dollars every year for charities. She runs her own charity too. Good leaders make successful nations therefore the world needs more people like Oprah Winfrey.

Non-communicable diseases Diseases of Excess

Non-communicable diseases Diseases of Excess Non-Communicable diseases often referred to as Diseases of Excess or Diseases of Affluence are increasing in both rich and poor countries. What factors are contributing to this trend? What are the implications for public health policy? Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 1948) where as Disease is a condition where any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown (Dorlands Medical Dictionary, 2007). Disease can be divided broadly into two categories as Communicable and Non Communicable Diseases (on the basis of its spread). Communicable disease is a disease which can spread from one individual to other through any carrier/organism (Malaria, HIV/AIDS, etc). It is also known as Infectious or Contagious disease. There are many factors responsible for the cause of communicable diseases like social, environmental, sanitation and education. Non Communicable disease is a disease which is not communicated from one individual from another (Hypertens ion, Cancer, etc). It is also known as Chronic diseases because these diseases takes lot of time to show the sign and symptoms within an individual. The major causes for NCDs are lifestyle, habits like smoking and alcohol, inadequate diet and physical inactivity. Communicable diseases was reported to be the major cause of death in earlier time where as Non Communicable diseases(NCDs) are of major threat in current era except in some countries like Africa where still people die out of infections. In some countries like USA, the leading cause of death in 1900s was tuberculosis and pneumonia where as these diseases are secondary nowadays and their places are acquired by the cardiovascular diseases on the top and cancer being the second. The main reason for the reduction in communicable diseases are the improvement in diagnosis, treatment, sanitation, nutrition, housing, working conditions, preventive measures such as immunization, evolution of life saving drugs like antibiotics and sulpha drugs. Non-Communicable diseases or Non-Infectious diseases are caused by factors mainly behavioural, lifestyle and heredity and which cannot be transmitted to other individual. It is also caused as the Disease of Affluence or the Disease of Excess as it is caused due to negligence or disturbance caused in the normal routine lifestyle which is mainly found in the upper class of the society where there is more chances of misbalance between diet and work can be seen. Few of the examples which come under non communicable diseases are Heart diseases, Stroke, Obesity, Diabetes, Cancer, etc. Acc. to WHOs statistics in 2008, Heart Stroke has become the leading cause of death globally leaving behind the infectious diseases like HIV/AIDS, TB, Malaria, etc. In 2003, there was an estimated 56 million death globally, out of which 60% death was supposed to be due to non-communicable diseases (WHO, 2003). Among NCDs, 16 million deaths resulted from cardiovascular disease (CVD), especially Coronary Heart Disease (CHD) and Stroke; 7 million from Cancer; 3 ·5 million from Chronic Respiratory Disease; and almost 1 million from Diabetes (Ibid). Apart from these, mental health problems are also the leading contributors to the burden of disease in many countries nowadays and play a major role in contributing to the severity and incidence of other NCDs. NCDs are now considered to be the major threat contributing 59% of death in 2000 and predicted to account for 73% by 2020 (WHO, 2002). NCDs are also termed as a Disease of Affluence due to incidence and prevalence mainly in the developed countries (Anand K et al, 2007). But according to them, this seems to be a misleading term as the NCD trend is increasing at a higher pace in middle and low income countries leaving them in a double burden of Communicable diseases as well as NCDs. It can more appropriately be labelled as Disease of Urbanisation (Ibid). Several studies done by them have proved that the NCDs and its risk factors are found in higher proportion among urban population than rural population. Their study shows that urban population has increased during past decade due to migration where as urban growth is stabilized at 3%. Contrary to it, the urban slum growth rate has doubled which has made the situation worse as these migrated poor people living in urban areas will adopt the NCD lifestyle but will not be in a condition to access the healthcare due to their poor purchasing ability. Study shows a high prevalence of NCDs risk factor in the urban slums of Haryana, India. The population residing in the slums is at high risk than the urban population due to poor access as well as no social and health support system for them. This requires an urgent intervention which can work at national, community as well as local level. A framework of the policy is required at national level which has tobacco and alcohol control measures, promotion of good diet and involvement of proper exercise. Simultaneously, reorientation and strengthening of the governments health system is needed to face the challenge of NCDs community level efforts to create an environment which promotes adoption of healthy behaviors. To overcome this situation, government has started the Integrated Disease Surveillance Programme (IDSP) which provides a rational basis for decision making and impl ementing public health interventions and also ensures involving the slums as well (Ibid). A survey was being conducted by Anand et al in urban areas slums of Faridabad District, Haryana, India, in February 2003 to June 2004 for checking out the prevalence of NCDs in urban poor people. Their study followed the STEPS approach of WHO where questions related to tobacco use, alcohol intake, diet, physical activity were included and history of treatment for hypertension, diabetes, physical values like height, weight, waist circumference and blood pressure were also measured. They surveyed 1260 men and 1304 women of age 15-64. The result came out of this survey was very alarming. The rate of smoking and alcohol drinkers were high among urban slums male population. Almost one third of the population had at least one risk factor. Alcohol consumption among younger population indicates gradually falling economy of the country in the coming future. The table 1 (Appendix) shows that NCDs are the leading cause for the death in both developed and developing countries except some countries like Africa where still today, there is more number of death due to communicable diseases than NCDs. In 2003, 2 ·8 million CVD deaths occur in China and 2 ·6 million in India. NCDs contributed substantially to adult mortality with central and eastern Europe having the highest rates (WHO, 2003). The Table 2 (Appendix) shows that the developed countries have seven NCDs out of ten leading risk factors which are contributing to the global burden of disease, where as six and three out of ten with low and high rates of mortality respectively, in the developing countries. These NCD risk factors are increasing at a higher rate in the developing countries and assumed to continue in the same manner for the next two decades. Chronic diseases attribute to the 46% of the global burden of the disease, Cardio Vascular Diseases (CVDs), in particular. Although some of the communicable diseases are still prominent in the some parts of the Africa, Asia and Latin America, deaths mainly due to chronic diseases were reported in five out of the six WHO regions (Africa, America, South east Asia, Eastern Mediterranean, Western Pacific and Europe). In developing countries also, 79% of the deaths are reported due to the chronic diseases. Incidence and prevalence of obesity, diabetes, cancers, respiratory diseases and other NCDs are increasing all over the world (Murray and Lopaz, 1996). Developing country like China has experienced an epidemiological transition shifting from the infectious to the chronic diseases in much shorter time than many other countries. The pace and spread of behavioral changes, including changing diets, decreased physical activity, high rates of male smoking, and other high risk behaviors, has accelerated to an unprecedented degree. As a result, the burden of chronic diseases, preventable morbidity and mortality, and associated health-care costs could now increase substantially. China already has 177 million adults with hypertension; furthermore, 303 million adults smoke, which is a third of the worlds total number of smokers, and 530 million people in China are passively exposed to second-hand smoke. The prevalence of overweight people and obesity is increasing in Chinese adults and children, because of dietary changes and reduced physical activity. Emergence of chronic diseases presents special challenges for Chinas ongoing reform of heal th care, given the large numbers who require curative treatment and the narrow window of opportunity for timely prevention of disease (Gonghuan Y et al, 2008). Common Non-Communicable Diseases Cardiovascular diseases include all the heart diseases like hypertension, stroke, atherosclerosis, etc. Annually, 17 million deaths are reported mainly due to the CVDs globally out of which 80% are reported in low and middle income countries with a continuous increasing trend (Reddy and Yusuf, 1998). Acc. to Lenfant, CVD will be the leading cause of the death by 2010 in the developing countries due to changes brought about by urbanization and industrialization. Due to costly and prolonged treatment cost of CVDs, developing countries are at greater prevalence for the risk factors, higher incidence of disease and higher mortality (Reddy, 2002). Diabetes is increase in blood sugar level in a person. International Diabetes Federation has released the statistics in 2003, according to which diabetes patients will going to increase from 194 million in 2003 to 330 million in 2030 and at that time every 3 out of 4 living person will be diabetic. The age of diabetic patients in developing countries is comparatively more than developed countries. The cases found in developing countries are above the age of retirement which may lead to conditions like blindness, amputations, kidney failure and heart diseases (Boutayeb and Twizell, 2004). Cancer and its type are increasing at an alarming rate worldwide. It is known to be the major cause for the mortality and morbidity. More than 10 million new cases and over 7 million deaths from cancer occurred in 2000 (Shibuya et al., 2002). Developing countries contributed by 53% in incidence and 56% in deaths. By 2020, there will be an increase of around 29% cases in developed countries and 73% in developing countries (Mathers et al., 1999). Lung, breast, stomach, colorectal and liver cancer are the most frequent in developing countries. Cancer and its related types can be treated on a preventative basis. Early detection and control of risk factors like tobacco and alcohol can be said to be the cornerstones in this process because it is estimated that over one third of the cancer types are preventable and around one third are potentially curable if they are detected early (Alwan, 1997). Other NCDs includes chronic respiratory diseases like asthma and chronic obstructive pulmonary diseases, mental and depressive disorders, osteoarthritis, hearing loss and disorder of vision (WHO, 2003). They all contribute mainly to the burden of disease in developing countries. Conditions such as obesity and high blood pressure also has a double impact, either as a disease or as a risk factor for other NCDs (WHO, 2004). Risk Factors The life expectancy at birth has increased since 1970 in all the high, middle and low income countries (UNDP, 2005). Due to this factor, longer life span has resulted in the predominance of the chronic diseases in the population. The epidemiological transition has resulted in the higher proportion of the adults population due to decline in fertility rates and the infant mortality rates. The behavioural risk factors like smoking and nutritional transition towards diet having high fat, high sugar with low carbohydrates and fruits along with the physical inactivity and increase in alcohol consumption have become the greatest health challenge in the 21st century (Magnusson, 2007). The environmental causes are also responsible for the emergence of NCD as an epidemic. These factors have brought up the nutrition transition by industrialisation of the food production, expansion of the market economies in the developing countries, the growth of the complex supply chain management at a global level, rapid growth of supermarket in the developing world and the growing concentration of global food manufacturers (Ibid). Some other key factors like rising incomes, production of cheap and low energy-dense foods, growing urbanisation and increase in growth in demand for pre-packed food are also the major risk factors for NCDs (Ibid). The evolution of NCDs has put up a double burden on low and middle income countries. Diabetes and lung cancer are also reflecting rise in the rate of smoking and obesity which are called to be the major risk factors for the NCDs (Leeder, 2004). In the year 2001, 17 million people died due to heart diseases where as 3 million people died due to AIDS (Ibid). During this year, heart disease and stroke were the leading cause of death in both high income and low-middle income countries, accounting for 27 and 21% population respectively. Out of all, 83% of death occurred in the developing countries (Ibid). Evidence has shown that CVD occurs at an early age in developing countries, consuming their productive years of life. Globally, obese people are also increasing at a higher pace with a far higher number overall in developing countries. Due to this, diabetic patients are also increasing with more number falling in the 45-65 age group (Ibid). Tobacco causes 4.8 million premature deaths in the year 2000, half of which were in the developing world (Ezzati and Lopez, 2003). Since 1975, cigarette consumption has decreased sharply in the developed countries, but it is continuously rising in developing countries due to the rapid increase in population. More than 1 billion smokers lives in the developing counties out of 1.3 billion smokers globally which indicates that forthcoming threat of tobacco related epidemic will impact the developing world. Even after non smoking awareness programme through out the world, there will be around 1.45 billion smokers in 2025 (Guindon and Boisclair, 2003). Tragically, half to two third of the chronic smokers will die out of their habit (Jamison et al, 2006). Peto and lopez has estimated that if this trend continues, 10 million people will die every year because of tobacco where 7 out of 10 will be from the developing countries resulting in around 150 million death till 2025. The ageing of populations, mainly due to falling fertility rates and increasing child survival, are an underlying determinant of non-communicable disease epidemics. Additionally, global trade and marketing developments are driving the nutrition transition towards diets with a high proportion of saturated fat and sugars. This diet, in combination with tobacco use and little physical activity, leads to population-wide atherosclerosis and the widespread distribution of non-communicable disease. Globally, many of the risk factors for heart disease, diabetes, cancer and pulmonary diseases are due to lifestyle and can be prevented. Physical inactivity, Western diet, alcohol and smoking are prominent causes for the NCDs and its risk factors. Tobacco is number one enemy of public health (WHO, 2000). It is the most important established cause of cancer but also responsible in CVDs and chronic respiratory disease. In the twentieth century, approximately 100 million people died worldwide from tobacco-associated diseases such as cancer, chronic lung disease, diabetes and CVDs. Half of the 5 million deaths attributed to smoking in 2000 occurred in developing countries where smoking prevalence among men is nearly 50%. Today, 80% of the 1.2 billion smokers in the world live in poorer countries and, while tobacco consumption is falling in most developed countries, it is increasing in developing countries by about 3.4% per annum. However, albeit these striking facts, the majority of developing countries which signed the Framework Convention on Tobacco Control (FCTC) (Joossens, 2000) remain passive about the control of smoking. Obesity and dietary habits represent potential risk factors for CVDs (Kenchaiah et al., 2002), type 2 diabetes (Drewnowski and Specter, 2004), and some types of cancer (Key, 2002), especially in absence of physical activity (Derouich and Boutayeb, 2002 and WHO, 2003b). Fish is considered to be a useful food intake to prevent CVDs and reduction of CVD associated deaths (Stampfer, 2000). Similarly, intake of an adequate quantity of fresh fruit and vegetables is recommended to help reduce the risk of coronary disease, stroke and high blood pressure (WHO, 2002). But, developing countries finds it more fruitful to export most of the quality fruits and vegetable production in exchange of the foreign currency. Alcohol causes more than 2 million deaths every year in the world. It is particularly associated with liver disease and esophageal cancer. The increase in alcohol consumption in developing countries will add other hazards caused by violence and road accidents to the burden of disease. Public health policy and its implications Lee, Fustukian and Buse provide a helpful framework for disentangling four dimensions of global health policy-making (Lee et al, 2002) as:- * Policy Actors They are the power (political) who can drive the policy and decision making at a global level. In case of NCDs, United Nations, WHO, FAO, WTO, World bank, Codex Alimentarius Commission, etc. * Policy Process Process through which policy is developed and implemented. Interactions and relationship between policy actors. * Policy Context For NCDs, its global. * Policy Content Effective strategy should address universal prevention , selective or primary prevention for high risk group and targeted or secondary prevention and treatment for those with existing conditions. It is pretty clear that NCDs has its roots in unhealthy lifestyles or adverse physical and social environments. Risk factors like unhealthy nutrition over a prolonged period, smoking, physical inactivity, excessive use of alcohol, and psychosocial stress are among the major lifestyle issues. Now to our understanding, it is known that what has to be done so we have to work more on how to do it (Aulikki et al, 2001). Well planned community programmes can be a successful step towards this process. Several factors like cultural, psychological, political and economical factors has created a gap between what needs to be done and day to day happening in the developing countries because of which major health challenges cannot be achieved. So, a community programme will help in bridging this gap and also helps in changing the NCD related lifestyles (Ibid). . The policies made at an international level also require global processes which can help to achieve a stable policy change at a country level, thus reducing the long term harm associated with it. International law is an example for this type of process. Multilateral agreements contain legally binding obligations, such as the WHOs Framework Convention on Tobacco Control (FCTC). FCTC includes hard law conventions. FCTC is an evidence-based treaty that identifies core areas of agreement over regulatory measures that involved countries are leally required to implement within their own domestic systems (WHO, 2005). Apart from FCTC, there are some soft law resolutions and declarations too, like United Millennium Declaration and WHOs Global Strategy on Diet, Physical Activity and Health (GSDPAH). WHO also worked in the area of chronic, lifestyle related diseases through Global Strategy on Diet, Physical Activity and Health (GSDPAH, 2004). It works on a strategy which builds on the role of t obacco, unhealthy diet and physical inactivity in the most NCDs. GSDPAH works in close relation with the UN agencies, the WTO, World Bank, other Development banks, Codex Airentarius Commission (WHO, 2004). One of the most significant health development programs within the United Nations system is the Millennium Development Goals (MDGs). The MDGs are a global partnership embracing ambitious goals to be achieved collectively within 15 years timeframe from 2000-2015 (Magnusson, 2007, p 6). The MDGs and FCTC serve as helpful models when considering ways of strengthening the global response to non-communicable diseases. The ideal step for developing countries to overcome the NCD epidemic and they have to plan and implement accordingly to control NCDs. Each community based prevention programmes require the same principles to be followed. As an example, The North Karelia Project in least developed areas of Finland which was based on low cost lifestyle modifications and community participation (Puska P et al, 1981). The reason to follow the general principle can be the collaboration between countries and different international organizations working on the similar fields and projects like WHOs countrywide Integrated Non Communicable Disease Intervention (CINDI, 1985). Even these sort of integrated programmes like CINDI were implemented in developed countries; they are now followed by the developing countries too. Many of these programmes are carried out in conjunction with the WHO integrated programmes, which was started in 1986. After the success of CINDI programme, American regional office had also l aunched CARMEN (AMRO) programme in 1990s. With the regional development experience, WHO has launched similar programme in Asian and African networks. In Latin America, Cuba is carrying out the NCD prevention programme from long time with the collaboration with the WHO activities where Havana and Cienfuegos as the main sites. Chile also participated in the Interhealth Programme CARMEN and was the first Latin American country to join this programme and many other countries followed it. Argentina has started PROPRIA heart health intervention as an active network at various demonstration sites (Aulikki, 2001). Africa has started community based CVD prevention programme long time back. Nigeria, Mauritius and united republic of Tanzania participated in Interhealth Programme and gained the positive responses. Mauritius intervention programme recorded considerable effect of nutrition policy and education interventions on diet and serum cholesterol levels, although rates of obesity and diabetes increased (Dowse G et al, 1995). Asias community-based initiatives have been initiated in Sri Lanka, Thailand, Singapore, India, Pakistan, Malaysia, Iran and other countries. Particularly active development has taken place in China, where the Interhealth Programme was involved in initiatives in Tianjin and Beijing (Tian et al, 1995) . The Tianjin project in China was one of the major project launched in 1984 in China. This project was also cooperating groups in Finland, China and USA for NCD control since 1989. This project focused on 4 leading NCDs of China, i.e. stroke, coronary heart disease, cancer and hypertension. The aim of this project was to reduce sodium intake in the population, decrease smoking especially among men and provide hypertension care by reorganizing the existing primary health care services. The result of this project shows a significant reduction in the sodium intake after three years and also reduction in number of patients of Obesity and hypertension among 45-65yrs old after five years of the intervention. Smoking cases were also reduced among men, especially those with the higher education (Aulikki et al, 2001). Health education and the media campaigns also play an important role in the community programmes. Media campaigning although leaves the less impact on the population, it is one of the effective measure in the comprehensive package. Health service intervention such as primary care centre in the long run can also be one of the most effective intervention tools. This strategy can more appropriately work where certain biological risk factors such as hypertension and high blood pressure are dealt with. Primary health care workers played an important role in both North Karelia project and Tianjin project (Ibid). The North Karelia project worked on a concept of Community organization where various sectors of the community were collaborated and involved. It involved many non governmental organizations (NGOs), such as Housewives` organizations. It is not easy to collaborate with the industries and businesses at a small community but a classic example for it is finlands cholesterol level, which reduces with the support and collaboration of the food industries, who supported the policy decisions (Puska P et al, 1986). Aulikki et al had made some recommendations for a successful NCD prevention program which must include the following factors. A good understanding of the community, close collaborations with the various community organisations and the involvement of the local population is important for any community intervention programme. It should combine well planned media and provide some communication messages in the community activities. It should involve different elements such as primary health care workers, food industries and supermarkets, voluntary organisations, schools work places, and local media for its success. It should be cost effective, mainly in the developing countries. For this reasonable outcome, effective dose intervention is a very important requirement (Aulikki et al, 2001). The increasing NCDs burden should be controlled by the developed and developing countries as a global health priority. International organisations with the national, regional and each individuals contribution can make these programme a success. Controlling of risk factors like smoking, alcohol, obesity, diet and inactivity, sexual and environmental factors are must and should be considered seriously and worked upon to treat it. The poverty and the high cost of prevention and treatment of chronic diseases causes burden on many countries and thus demands for international solidarity and public private partnership. The coordination of health decision makers, non-governmental organizations, research institutions, community groups and individuals is must for controlling the incidence of diseases, preventing the spread of epidemics and regulate the health management of human and material resources (Boutayeb, 2005). WHO is a political champion for coordinating global response. The developin g countries face problem in the implementation and enforcing the policies that are set up by the international legal standards which have a normative role and also these legal standards are not self executing, so compliance can be monitored by the NGOs and government. A global approach in a way like this could reduce health inequalities (Magnusson, 2007). REFERENCES  · Anand K, Shah B, Yadav K, Singh R, Mathur P, Paul E, Kapoor S K (2007), Are the urban poor vulnerable to non-communicable diseases? A survey of risk factors for non-communicable diseases in urban slums of Faridabad, The National Medical Journal of India, Vol. 20, No. 3,   p 115-120.  · Aulikki Nissinen, Ximena Berrios, Pekka Puska (2001), Community-based non-communicable disease interventions: lessons from developed countries for developing ones, Bull World Health Organvol.79no.10.  · Beaglehole R, Yach D (2003), Globalization and the prevention and control of non-communicable disease: the neglected chronic diseases of adults, The Lancet; 362: 903-08. * Boutayeb Abdesslam (2006), The double burden of communicable and non-communicable diseases in developing countries, Royal Society of Tropical Medicine and Hygiene, Volume 100, Issue 3, Pages 191-199 .  · Countrywide integrated non-communicable diseases intervention (CINDI) Programme. Copenhagen, WHO, Europe, 1995. * Dowse G (1995), Changes in population cholesterol concentrations and other cardiovascular risk factor levels after five years of the non-communicable disease intervention programme in Mauritius, British Medical Journal, 311: 1255 ¾1259. * Ezzati M, Lopez A (2003), Estimates of Global Mortality Attributable to Smoking in 2000. TheLancet, 362:847-852. * Guindon G, Boisclair D (2003), Past, Current and Future Trends in Tobacco Use-Health, Jamison D, Breman J, Measham A, Alleyne G, Claeson M, Evans D (2006), Priorities in Health, Washington DC, World Bank.  · Horton Richard (2005), The neglected epidemic of chronic disease, The Lancet, Volume 366, Issue 9496, Page 1514. * Lee K, Fustukian S, Buse K (2002), An Introduction to Global Health Policy, Health Policy in a Globalising World, Cambridge, Cambridge University Press; 2002:3-17. * Leeder S, Raymond S, Greenberg H, Liu H, Esson K (2004), A Race Against Time: The Challenge of Cardiovascular Disease in Developing Economies, New York, Columbia University. * Magnusson R S (2007), Open Access Non-communicable diseases and global health governance: enhancing global processes to improve health development, Globalisation and health; 3:2.   (http://www.globalizationandhealth.com/content/3/1/2). * Mehan M B, Srivastava N, Pandya H, (2006), Profile of noncommunicable disease risk factor in an industrial setting, J Postgrad Med;52:167-173. * Miranda J J, Kinra S, Casas J P, Smith G D , Ebrahim S (2008), Non-communicable diseases in low- and middle-income countries: context, determinants and health policy, Trop Med Int Health; 13(10): 1225-1234. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687091). * Murray J L and Lopez A D (1996), The global burden of disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020, Harvard School of Public Health, Cambridge, MA.  · Puska P (1981), The North Karelia Project: Evaluation of a comprehensive community programme for control of cardiovascular diseases in North Karelia, Finland, 1972-1977, Copenhagen, WHO, Europe. * Semenciw R M, Morrison H I, Mao Y, Johansen H, Davies J W , Wigle D T. (1988), Major Risk Factors for Cardiovascular Disease Mortality in Adults: Results from the Nutrition Canada Survey Cohort, International Journal of Epidemiology, Vol.17, No.2, p 317-324.  · Reddy K S (2002), Cardiovascular diseases in the developing countries: dimensions, determinants, dynamics and directions for public health action, Public Health Nutrition 5, pp. 231-237.  · WHO (2002), Reducing Risk: Promoting Health Life, World Health Organization, Geneva, Annual Report. * WHO (2003b), Diet, Nutrition and the prevention of Chronic Diseases, World Health Organization, Geneva, Technical Report Series No. 916.  · WHO (2004), Global Strategy on Diet, Physical Activity and Health, WHA57.17.  · WHO (2005), WHO Framework Convention on Tobacco Control, WHA56.1 * Yusuf S, Reddy K S, Ounpu S, Anand S (2001), Global burden of cardiovascular diseases: Part I: General considerations, the epidemiological transition, risk factors, and impact of urbanization, Circulation 1

A World Without Cars Essay -- Environment Pollution Ecology Essays

A World Without Cars James Q. Wilson the author of the article "Cars and Their Enemies" briefly ponders the possibility of our world without personal automobiles. He speculates whether our current society would welcome the invention of the personal automobile into a fictitious world without cars. Wilson immediately answers no. Wilson knows, as many well-informed individuals and experts do, that the personal automobile is responsible for contributing to pollution, destruction of rural and wilderness land, and depletion of natural resources. And an advanced society such as we live in today would not likely choose to burden our health, land, and resources for the sake of luxury and convenience, or at the very least, the personal automobile would not be as accessible as it is today. Because, in all reality, our current society does embrace inventions that compromise our society's well-being such as oil and chemical refineries, pesticides, and even convenience foods such as fast food and many refined prepacka ged foods. Wilson's opinions in his article, "Cars and Their Enemies" and discussions I have had on-line in the 305 class about Wilson's article have demonstrated to me that the personal automobile is an example of how many people are unwilling to acknowledge how personal convenience and luxury contribute to the deterioration of our world. Wilson's encouragement to the readers of his article to imagine life as we currently know it without the automobile begins with Wilson outlining exactly why the personal automobile is destructible in so many ways. He points out that academic and social critics believe that cars "burn fuel inefficiently" (304) ejecting "large amounts of unpleasant gases into the air" (304); "vast quantiti... ... of the personal automobile has damaged and continues to damage our world certainly provides a more informed awareness. Awareness, knowledge, and understanding possibility can lead to solutions to work towards improving the world we currently live in and the world in the future. However, I feel that it is a battle between selfish and personal desires and the urgent needs of our society and world. Even if an increased awareness and desire to work towards alleviation of the problems of pollution, outward expansion, and depletion of natural resources occurs, I'm afraid, as time goes by, it is becoming increasingly too late. I think the cliche, hindsight is 20/20 is certainly applicable here. Works Cited Wilson, James Q. "Cars and Their Enemies." The Presence of Others. Ed. Lunsford, Andrea A., and John J. Ruskiewicz. Boston: Bedford/St. Martin's, 2000. 303-313.

Essay --

Few people know but, more than half of americans own an Apple product. The huge tech company was founded on April 1, 1976 by Steve Jobs and Steve Wozniak. The company was later incorporated on January 3, 1977. Apple is known as one of the most advanced technology companies in the United States. Apple is behind the largest technological revolution in history. Apple has set itself above all other technology companies. The company has a certain way of leaving customers on the edge of their seats waiting for the latest and greatest Apple product. Steve Jobs and Steven Wozniak had been friends since high school, and they both were very interested in electronics. After they both dropped of school, both of them end up in a profession related to electronics. Jobs got a job at Atari, and Wozniak at HP. Wozniak had been the initial designer for the very first Apple computer. Jobs had an eye for the future and convinced Wozniak that they should sell the computer. Soon enough on April 1, 1976, Apple had begun. In the beginning people did not take Apple very seriously. In 1977 however Apple introduced the Apple II, that when the company took off. The introduction of the Apple II opened doors for the company. It was the first computer with a hard plastic outer shell, it also was the first computer that had color graphics. The Apple II was basically the start of the company. Another thing that boosted the company in 1978 was the Apple Disk II, which was just an easy, inexpensive floppy drive. With all the sales rising, the companies n umbers began to rise as well. In 1980 Apple had a few thousand employees. 1980 was also the year Apple released its latest computer the Apple III. It was in 1979 when Jobs and a few engineers began working on ... ...that received the licensing felt that Apple was too restrictive on their agreements. Through the years, Apples big problem was not just selling the computers, but building them. In June of 1995, Apple had over one billion dollars worth of backorders, and did not have the materials to build them. On top of the current problems Apple was facing, Windows had released its latest version of its software, Window ‘95, which was too similar to the Mac and yet more simplistic. Pretty soon Spindler was asked to resign due to major losses the company faced when Apple had posted a loss of sixty-eight million dollars due to a misjudge of the market. Spindler was replaced by Gil Amelio, who was previously the president of the National Semiconductor. Through 1996 and part of 1997 Ameilo did his best to help Apple bring back is profit, but in the end his efforts were unsuccessful.

U.S. and Global Media Perspectives on Afghanistan: Evaluating the Roles of the United States and the United Nations in Preserving World Peace :: Essays Papers

U.S. and Global Media Perspectives on Afghanistan: Evaluating the Roles of the United States and the United Nations in Preserving World Peace I. Intro Afghanistan was a neutral country in the 20th century, receiving aid from the United States and Soviet Union until the 1970s. In the 1970s, Afganistan’s King Muhammad Zahir Khan was forced to deal with serious economic problems caused in large part by a severe national drought. These economic problems caused a general unrest among the people of Afghanistan, and in July of 1973 a group of young military officers took things into their own hands. King Zahir Khan was unseated, and this group proclaimed Afghanistan to be a republic with Zahir Khan’s cousin, Lt. Gen. Muhammad Daud Khan, becoming president and prime minister. Daud’s reign was short-lived; in Afghanistan’s coup d'Ã ©tat of 1978, Daud was deposed by a group led by Noor Mohammed Taraki, who instituted Marxist reforms and aligned the country more closely with the Soviet Union. These events marked the beginning of what would become known as the Afghanistan War, a devastating conflict between anti -Communist Muslim Afghan guerrillas (mujahadeen) and Soviet forces and Afghan government. Mohammed Taraki was killed in September of 1979 and Hafizullah Amin took power. With Amin taking the throne, the USSR did not hesitate to send troops into Afghanistan and had Amin executed, with the Soviet-supported Babrak Karmal becoming president. The United States, along with China and Saudi Arabia, channeled funds through Pakistan to the mujahadeen. The civil war ensued, and through the course of this war over six million people of the Afghanistan population fled the country, giving it the largest refugee population of any country in the world. By 1991-92, the US finally reached an agreement with the USSR that neither would continue to supply aid to any faction in Afghanistan. Out of these previously US funded factions rose the Taliban, an armed Aghan faction which apparently was an Islamic movement. The Taliban, funded by the CIA during this war, fought with other factions for supremacy following the departure of Soviet troops; as history would show, the Taliban became the dominant force in Afghanistan in the 1990s. The Taliban did not really exist as a coherent politico-military faction or movement before late 1994; prior to this time, they were members of other factions such as Harakat-e Islami and Mohammad Nabi Mohammadi, or operated independently without a centralized command center.

Native American Literature Essay

This piece of literature, â€Å"Superman and Me† by Sherman Alexie, reflects what it means to be an Indian in today’s culture written in first person. Alexie utilizes memories from his childhood to develop his thesis: reading and writing saved his life and allowed him to overcome poverty and be successful. They were an Indian family and his father owned an enormous amount of books. He learned to read at an early age with a Superman comic book. He writes about the stereotypes of Indians expected to be stupid and fail in the non-Indian world. He, on the other hand, declined this pity and refused to fail; he was a smart Indian that read as much as he could. He grew up to be a writer and visited the schools unfailingly to save the lives of Indian children. The purpose of this article is to improve the lives of Indian children. LaFarge, Oliver. â€Å"Myths that Hide the American Indian. † Historical view point. New York: John A. Garraty, 1991. 3-5. Print. In this essay, Oliver La Farge writes about the true civilization of the American Indian in â€Å"Myths that hide the American Indian. † Europeans made inferences without understanding them. La Farge describes the impact of the white men’s negative perception of Indians as ruthless, faithless, savages, drunken, and lazy good-for-nothings. The most important influence the Indians had on western civilization was their political economy where they had one ruler. Later, England formed a constitutional monarchy. All in all, this article’s purpose was to illistrate the Europeans’ views of Indians as savages was wrong; they were merely advancing to civilization. â€Å"The World on Turtle’s Back. † McDougal Littell Literature: American Literature. Evanston, IL: McDougal Littell, 2008. 34-40. Print. â€Å"The World on a Turtles Back† describes the world before land, creatures, or people. The Sky-World consisted of multiple gods, a great ocean, birds of the sea, fish, creatures of the deep, and most importantly the Great Tree that grew right in the middle. The author states that a couple was expecting a baby in the Sky-World the man went to fetch some bark from the roots of the Great Tree. He accidently dug a hole through the Sky-World and his pregnant wife fell through capturing a piece of the bark’s root. The woman planted the roots, and as she walked around the earth it grew into nurturing food. Later, the lady gave birth to a baby girl, and when the girl got older she had twins. the right handed-twin appeared to be god-like, while the left-landed twin comply with the devil. Both twins possessed their own powers; however one twin would use it to perform kind acts, and the other used it to pursue evil. They fought till the end, but both had to exist to maintain balance in the world. The purpose of this story is to show there has to be evil in the world to balance with the good. Momaday, N. Scott. â€Å"The Way to Rainy Mountain. † McDougal Littell Literature: American Literature. Evanston, IL: McDougal Littell, 2008. 52-58. Print. N. Scott Momaday’s â€Å"The Way to Rainy Mountain† utilizes imagery to enhance the impact of his deceased grandmother’s life and old customs while he makes his journey to her grave in Rainy Mountain. Aho, Momaday’s grandmother, belonged to the last tribe that migrated to North America. The Kiowas made a legend that explained that seven sisters form the Big Dipper. Aho honored the sun by attending the Kiowa Sun Dances. Prayers kept her memory since she was always praying even when she died. Momaday believes his grandmother’s death was whole and eternal for her to have lived and died in the same place: Rainy Mountain. The purpose of this story is to inform the reader about the cultural history of the Kiowa Indians. Tempus, Allie. â€Å"A Tribal Tragedy: Suicide Rates Soar Among Native Americans† New America Media November 29 2010 Posted. Web. Native Americans’ suicide rates are evaluated in Allie Tempus’, â€Å"A Tribal Tragedy. † They have the highest rate of all other ethnic and racial groups. The suicides are traced back to their mental health, including depression. Poverty and family issues resulted in depression which led to drug and alcohol use. Many users experienced an abusive childhood and turned to drugs to alleviate the pain. Native Americans involuntarily lost the balance in their lives as their traditions and customs died out, but today there are prevention efforts made to reduce suicide rates. The purpose of this news is to inform the reader about the history and hopeful future for Native Americans’ suicide rates. Popick, Jacqui. â€Å"Native American Women, Past, Present and Future. † Lethbridge Undergraduate Research Journal. 2006. Volume 1 Number 1. Jacqui Popicks’s â€Å"Native American Women, Past, Present, and Future† is an informative article that evaluates the different generations in the life of a typical Native American woman. In the past, women were treated equal and with respect because they have the power to give life. In present day, a drastic changed occurred because women face sexism, racism, and they are not generally respected as well as before. The Bill of Rights finally gave women their rights after a long, hard battle but that was not enough. As time progressed, Native American women initiated programs of awareness, AIDS, suicide, violence, prevention, and education to renew lives and overcome the feeling of hopelessness. The purpose of this journal is to show a comparison of the treatment of Native American women in the past and present, as well as goals for the future.

Compare The Strengths And Limitations Of A Range Of Assessment Methods

Compare the strengths and limitations of a range of assessment methods with reference to the needs of individual learnersDirect observation in the primary source of gathering evidence within NVQs as it is the most appropriate way of presenting naturally occurring evidence. You’re watching the candidate carry out his routine work but on the other hand the candidate may perform for you or become very nervous with you watching. Performance evidence demands consistent and repeated performance to the required standard.Work products might be pre op checks, job descriptions, duty rosters, check lists, accident forms, policies and procedures, records of phone calls, records of correspondence communication book records.Work products about clients or staff should not be photocopied and put in the portfolio. Assessors should view them and fill in the relevant sheet showing what was read, where its kept and for which PCs, it is relevant and attach it to an Evidence Record sheet.The candid ates contribution to the Work Product needs to be made clear. Putting in an organisational policy or procedure does not show evidence of the candidate’s skill or knowledge unless there is evidence to show. They understand the policy or procedure or they have applied it to their own area of work or they have trained their staff in it or they have used the policy or procedure.Generally certificates only provide proof of attendance at a course and are not a test of knowledge or competence. Assessors may need to ask questions to test competence or knowledge. Some assessors now show proof of competence across defined situations and this provides good evidence. If candidates are keen to keep certificates in their portfolio don’t discourage them, these could be kept in the â€Å"Supporting Evidence† section at the back.Check and fill in the Witness Status List at the front of the candidate’s portfolio with regards to who can be used as a witnessA witness should ideally hold the NVQ assessor award and be in a supervisory capacity to the candidate. Colleagues can give Witness statements but in a small environment issues of pressure and collusion can arise.Assessors can use witnesses to confirm the content of a Candidate Report by writing a supporting statement at the end of the evidence record sheet. There are two types of witness – the expert witness and the non-expert witness.An expert witness is someone given the role of regularly and systematically observing and reporting on candidates when they are performing tasks which produce evidence towards an NVQ and who is occupationally competent, with the necessary expertise in the area for which they are providing testimony. This information should be noted by the assessor.Briefed by the QA to ensure that they understand the standards to which the evidence relates because the expert witness testimony is more rigorous and covers a wider range of the candidate’s performance, it usu ally has greater weight than the testimony of other witnesses. Non experts my also be used as witnesses, however, their evidence may be less reliable than that of the expert witness as they are unlikely to be familiar with the standards being assessed.Assessors must judge the validity of all witness testimonies. NVQ units cannot be achieved by relying on witness testimony alone.Achievement of an NVQ unit will always involve observation of the candidate by a qualified assessor taking account of the evidence provided by witness testimony.Simulation This is where the candidate cannot provide evidence to cover PCs and where  asking questions may be insufficient. Examples might be dealing with a health emergency or working with someone who challenges the service.Recognising Prior LearningSTRENGHTS:1. If a learner had a previous rpl , it can be used to support their other assessments. Accrediting their prior learning assessment makes a learner feel that any work done in the past in this area was not a waste of time 2.qcf is giving learners the opportunity to use rpl more and they define it as â€Å"a method of assessment that considers whether a learner can demonstrate that they can meet the requirements of a unit through knowledge, understandingand skills they already possess and do not need to develop through a course of learning†. Limitations:1.may be time consuming for the assessor as will need to validate the rpl not all of it may be relevant to the current criteria they are assessing. 2.each assessor needs to check the guidance for their relevant qualification, as the guidance varies for different qualifications.Written questioningStrenghts:1.Can take the form of essays, short answer questions or multiple choice questions. Short and multiple choice questioning are examples of objective testing as there is only one correct answer. This form of assessment is quick and easy to mark wich means feedback can be given quickly to learners.Limitations:1.Multip le choice questions can be guessed if the learner is unsure so they might not be the best way to get an accurate measure of whether the learner has understood something. If more depth on short answer questions is requied, essays can be used to assess understanding, literacy and high level comprehension although they take time for the learners to complete and for the assessor to mark.Oral questioningStrenghts: 1.Can form a secondary or backup assessment to check for comprehension. They can be used to support theory while the learner is practising their skills or at work and they can be adapted or changed quickly depending on the situation. 2.open oral questions should be used to draw out the information from the learner. Limitations:1.Assessors should be careful not to use closed questions unless testing agreement.