American history Essay Example for Free

the Statesn history EssayIn American history, there discombobulate been numerous instances in which a greater degree of damage and death which visited out shores. In the three day battle of Gettysburg, more than 51,000 s grey-headediers fell. (Burns, 1989) The invasion of France on June 6, 1944 took more than 6,000 lives. Pearly Harbor claimed more than 2300 lives and introduced Americans to a war that would take more than 400,000 lives. However, the events which transpired on September 11, 2001 impart always serve as unitary of the defining moments for those who lived through it. As with the assassin ion of John F.Kennedy was to our parents generation, September 11, 2001 will be for our generation. The news is fill with a multitude of calamities. The Asian tsunami in declination of 2004 which claimed 200,000 lives or any number of events which take a toll on the human population, due to the fact that the evening news is saturated with events which should horror us yet whic h real dont as we have become apathetic against its stimulus, there are sometimes, national tragedies which affect the average American in ways that are hard to explain and fathom for those who are on the outside and looking in.This was the case for Natasha capital of Mississippi a 27 year old African American female who lost two family members on September 11. For her, the day is more than just a time to rally behind the multitude and to take time out of ones day to remember those who died. For Natasha Jackson, 9/11 does not stop except continues 365 days a year. Natasha Jackson grew up in the suburbs of Chicago. Her have was a police chief in DuPage County Illinois. Natasha was in college while the events of September 11 were transpiring. At the end of her 8am class, which ended at 915, and upon walking to her contiguous class, she was overhear some talk more or less a major news event.She did not realize exactly what had happened until the professor in her next class, told her and the rest of the class what had happened. All of the details would not be known until months and years later. However, by the time the second plane hit the tower, it had become intelligible that this was no accident. We had hoped that all of the more than 50,000 people, who, on a daily basis, worked in the Twin looms, would have been able to vacate the building while it was still standing. This was not the case for nearly 3,000 people who perished when the towers fell.(Burns, 2003) Since I had not known anybody in New York or who were on those planes that were hijacked, I was glad that as for me, the event did not take any of my loved ones. However, I knew that was not the case for thousands of families across the country. America was now at war to defeat bratwurstism and this would take an additive four thousands American lives to date with more casualties being reported daily. I did not know that the events of September 11 would affect somebody so windup to me as I wou ld eventually find out to be the case.Towards the end of September, 2001, as clean up crews were still busy picking up the perverted metal from the site of Ground Zero and plans for a strike against Iraq were being discussed, I learned that two of Natashas relatives, were not only affected by 9/11, exclusively were actually killed when the first tower fell. It was something that was hard to realize had hit so close to home even when it was not my relatives that had been affected. More than sextette years later, Natasha sat down to talk to me about the events of that day and what she felt then as well as now. Natasha commented That day is one that I will neer forget for as long as I live. I was horrified by what I saw on television. However, my reaction was one filled with a bit more pan outic than my classmates who were watching the same thing as I was. I knew that my aunt, Marilyn Jackson worked in Tower One at Canter Fitzgerald. I would later find out that nearly 800 employee s of that firm would die on September 11. (Burns, 2003) When chooseed exactly what her initial reaction was, Natasha still finds it unwieldy to accurately explain what she was feeling. I though that I was seeing a movie and that the events in New York was an examples of special effects or something. I really didnt know what to think.I sat transfixed at what I was seeing and I didnt get around to calling my father until a couple hours after the towers fell. I just didnt know how to react. In the immediate hours after the first tower fell, I actually ran into Natasha. We were not our brisk self for obvious reasons and I assumed that it was due to the events in New York, Pennsylvania and at the Pentagon earlier that day. I did not think to ask Natasha if she had known anybody who was killed that day. I knew that she had always had a love affair with New York and hoped to complete her Masters Degree at New York University one day.I did not know that she had two relatives who lived there in the city. Natasha then explained what her immediate actions were in the hours following the destruction of the first tower and then the second. I called my father to ask him the whereabouts of my aunt. He said that he didnt know and that he would not know for some time. Not only was the event very chaotic, but the fact that he was a police chief in a Chicago suburb, his force went on high alert as there was rumors that The Sears Tower might be targeted. People didnt know what to think.Everything was a mess. I was a mess as well. I pride myself on being a rational and independent person. I never get anxious but am rather calm and have a strong demeanor. That day, I was not able to contain my composure which only compounded my feelings of anxiety as I did not know how to gather my thoughts. Natasha then comments on the time when she heard that her aunt was missing and then, a few days later, opined to be dead. The next few days, nobody knew where my aunt or many of the oth er were. I waited by my phone and could not go to class.I tried to separate myself from the various news accounts as there was no shortage of coverage on television. I tried to go for a walk or to go and work out. My attempts did not come to fruition and it only served as a momentary fault from the inner pain and confusion that I was feeling. Eight days later, I received a call from my father who told me that my aunt was probably dead and the supposition of there being any survivors of the attack from those who were in the towers at the time it fell, was very unlikely. The country would later learn that there would not be a single survivor from the fall of the Twin Towers.It seemed unlikely, even before being told that was the case, that anybody could survive that. I still held out hope until I received that call. The terror that Natasha would feel, would not be confined to only the loss of her aunt, who alone, would be more than anybody could really fathom. What served as a sour ce of added stress, not only was Natashas aunt murdered on 9/11, but so too was her uncle. The aunt was from her fathers side and her uncle came from her mothers side. Gerald Smith was a fire-eater and one of the 343 New York City firefighters who died trying to save others in the Twin Towers.(Burns, 2003) It is really hard to fathom such a combination punch that guide and evil people gave to our family. I had been close to my uncle as a child but when he moved to New York, we lost touch. However, as it is the case with close people, those who touch their lives as a child, even though communications might have dropped off, they still reside in an important part of that persons heart. I had not known that my uncle was still a New York firefighter. However, when my mother called me, not more than two days after being told that my aunt had died, I was told that my uncle died as well.There are no words that could describe what I felt that week. I could not go to class, I barely ate an d did not take any visitors at all for the rest of the year. If somebody told me that they I had their condolences and that they understood how I felt, I was so angry inside, that I had to restrain myself from precisely punching them in the face. And I am not a violent person by any means. I have strong opinions but usually delight in others and would much rather avoid an insulting argument than to engage in one. I just became a very angry and bitter person. In perspective, I asked Natasha how she now viewed 9/11 and all of the ramifications that it has now had for the country. I have considered myself a Democrat for most of my life. However, even though the war in Iraq has been mishandled on a dozen different fronts, I become so angry when I hear politicians from both political parties proclaim that we should simply leave Iraq and that terrorist act is really not worth fighting. It seems to me that since America is a very disposable society, people have forgotten what happened o n 9/11.I will never forget seeing people jumping 1000 feet to their deaths while the towers burned. When I hear reports of Glasgow, London, Bali and Madrid being victims of more terrorist attacks from a small portion of the Moslem community who have been steered the wrong way, I become very frustrated. Does one have to lose two members of their family in a terrorist attack to remember that America is a very dangerous place and that there are millions of people who would love to attack this country. I still am a Democrat and believe in the principles of the party.I just feel so frustrated, as does most Americans, about the level of unity and as a result, progress that is being achieved in this area. Natasha spent most of the Fall of 2001, dealing with the deaths of her family members. Since there were no remains that were found of both my aunt and uncle, I really didnt know what to do. I still go to their grave sites but I know that their body is not there. In time, the body would slowly disappear but I wanted to have the same experience that anybody would want who receive some comfort in visiting the gravesite of their loved ones.At least, I wanted to experience that but have been unable to. However, I feel additionally cheated by the fact that the only place where I can visit my aunt and uncle is in my mind. When asked, Natasha speaks about her life since 9/11. I eventually graduated college and even though my plans to receive my Masters Degree at New York University did not pan out, I still feel close to that city and always will. I went to Boston to work for the Democratic National Convention in the months leading up to the 2004 election. With a degree in political science, I always have been politically aware of my surroundings.I knew that I needed to expand my sphere of figure out beyond college and felt that my effort in the DNC, although not successful, still did prove some good. I honored my aunt and uncle in that respect. It was a trying but su ccessful time for me as I actually got to meet President Clinton while dining at a restaurant in Boston. I walked up to both him and his wife Hillary and introduced myself beyond the Secret Service and Mr. Clinton actually said that he had heard that we were doing good work. Perhaps that was just lip service but it was a great honor for me nevertheless.

Organic vs. non organic Essay Example for Free

original vs. non organic EssayOrganic vs. non organic thither is a vast majority of food in our world today, when we consume this food we must stop to think or so what exactly it is pick out of. In todays society we are continuously looking for the best healthy foods that are available to us. We want good, nutritious, healthy foods so that we butt joint live a wide and healthy life. We live in a world where we have fast, cheap and processed foods all around us. Have you ever analyseed going a different route? Organic is a different way to eat, a way that could change the way you live your life.While all types of foods are beneficial to the body, organic and non organic foods differ in the way that they are farmed, fully grown, and packaged. This information can hopefully give you an insight to a better way of life. America is slowly becoming a race of a population of obese sick people. What we are eating everyday affects our health. Foods are full of preservatives and u nhealthy that people eat more junk than food. Did you greet that foods are packed with preservatives, sugars and fats that make people addicted to the foods?We are always seeking the quickest cheapest foods even though they are non healthy for us just to save some time. People become overweight do so beca pulmonary tuberculosis of poor eating habits not knowing that at that place are consequences in doing so. There are diseases that come along with making these poor eating choices. Some of the diseases related to overweight are heart disease, high blood pressure, diabetes airing problems and trouble sleeping. Some people seem that we are stuck eating foods that make us overweight and obese. There are however ways to eat healthier.There are foods that are all natural, they are called organic foods. Organic foods are farmed in natural ways than non organic foods. Non organic food has to be grown very quickly to meet the consumer demand and there for is grown with chemicals that ma ke it grow accelerated. Non organic grangers are allowed by the FDA to use steroids, pesticides and fertilizers in their food products. eventide the soil gets contaminated with these harmful products. Non organic farmers contaminate the soil with the over use of fertilizers and pesticides and have polluted our waterways.On the other had organic farmers can use a farming method that does not harm the environment. Organic famers use the natural way in their farming systems. Organic farmers use the land that has not had any pesticides or fertilizers in the soil in the past three years. Crops are rotated from field to field instead of growing the same rake over again. There are alternative ways to eat food. There are foods that are grown all natural, they are called organic foods. When you think of organic, do you think it has to be held to a certain standard? Certain requirements have to be met for a food product to be certified organic.When a farmer grown their crop their crop dif fers from the way non organic foods are grown. Organic food tends to have more insect damage that non organic food because since no pesticides are being used on their crop it is harder to keep the insects from damaging the crop. Non organic food can grow at a much faster rate and have less damage done to the food because it is grown with pesticides. One of the standards to be certified organic is to be cage let off. Cage free is when the animal is not confined to a cage it is allowed to roam freely.Non organic animals are mostly in cages so they can be able to put out more food faster. Many people do not like the fact that animals are caged up and are sometimes treated badly in order to produce the food they need. When you go to the grocery store and buy a food product you should stop to see what the packaging material is made of. Most producers use recycled products to package their food products. Organic foods and non organic foods differ in the way that they do their packaging. One bad involvement that comes to mind just about organic food is that it can travel hundreds of miles to get to the grocery store.Non organic food can have the convenience of coming from local farmers that may not grow organic but are grown locally. Non organic food on the other hand may travel to get to the store because there are really not that many locally organic farmers. When we think about our planet we try to think of ways to be less wasteful. Organic foods try to use less wasteful materials concerning packaging their foods. Organic producers try to use recycle material and try to use eco friendly material. Non organic producers can sometimes use recycle materials but are not considerate of the waste they produce in the making of the packaging material.As where organic producers they consider every last detail to make sure they do not affect the environment as little as they can. This is a good thing because we want to make sure we do not affect our planet with all our argufy we accumulate in our life time. We must eliminate the trash we leave lowlife in order to leave our planet clean for our children and their children. If we do not do something about the wasteful material we leave behind we might leave a big mess for our children and grand children to clean up long after we are gone. There has been much controversy about whether organic food is better than non organic food.Honestly one has to make their own personal decisions about what they choose to eat. No one can make that decision for you. Organic is less harmful to the environment and non organic has to produce such large amounts that it can be hard to do that without having some cause on the environment. Remember what we put in our body is important because we want to do whatever it takes to be as healthy as we can be in order to live longer. So if organic food is the right choice for you then you should do it in order to live a long and healthy life.

Lays A Potato Chips And Company Marketing Essay

Lays A Potato Chips And Company Marketing EssayLays established in India in 1965 and introduces international and Indian flavours in Indian market place.Lays introduces pure vegetarian flavours in Indian market.The most famous flvours are Lays Spanish Tango,Classic Salted,Lime , Indias Massala Masti,American style Cream and Onion and Indian Magic Massal(http//www.dillogical.com/lays.html) tally to Business dictionary SWOT analysis is a situation analysis of an organization to find out internal strengths and weaknesses and external opportunities and strength of company to take a crap a strategy.Lays is a multinational company who has strong distribution earnings. Its easily available to everywhere. Although Lays has a strong distribution network, they are trying to expand their network in all areas of the country.Lays has a strong brand value itself but there are some differential service which makes Lays above then its competitors and that advantage is Pepsico.Lays is a brand of Pepsico company who has strong reputation in the world.Frito-Lay sales forces enjoys excellent reputation over its competitors(Marketing Management,p325)Market sementation means division of a market into different segments of buyers with different wants and behaviours,wo wants different products or marketing mix.The companies used different methods to segment the market and develops profiles for those segments.(Principles of Marketing 4th European Edition,P 391)

Impact of Brexit and US on NATO

Impact of Brexit and US on NATONATOOrigin, membership, rolesThe Brussels agreement of 1948 marked the setoff step in the creation of the jointure Atlantic Alliance, culminating in April 19491 with the signature of the Treaty of Washington. The outcome of that Treaty was a joint warranter system among 12 countries Belgium, Canada, Denmark, France, Iceland, Italy, Luxembourg, the Netherlands, Norway, Portugal, the united Kingdom, and the United States. NATO is an intergovernmental political and array bail of collective defence, through which its 28 member states agree to mutual defence in response to an attack by whatsoever external party. Moreover, 23 other(a) countries cooperate through NATO league for Peace program which began in 1991. Seeking to stabilize the Middle East, in 1994 The Alliance launched the Mediterranean Dialogue with Algeria, Egypt, Israel, Jordan, Mauritania, Morocco, and Tunisia. In 2004 NATO began the Istanbul Cooperation Initiative with four countries of the Gulf Cooperation Council, Bahrain, Kuwait, Qatar and the United Arab Emirates. Fin all toldy, NATO cooperates in joint shelter issues with five countries in Asia, Australia, Japan, Republic of Korea, Mongolia and New Zealand, and ii in the Middle East, Pakistan and Afghanistan. Until the Korean contend, NATO was predominantly a political brass instrument. Following the war an integrated soldiers framework was established under the command of two US supreme commanders. To prevent a nuclear war, the Alliance expanded its rush and adopted the Massive Retaliation policy. After the collapse of the Soviet Union, it conducted a series of military interventions in Bosnia in 1992 and later in 1999 in Kosovo. Politically, the organization sought better relations with former Warsaw Pact countries, several of which linked the alliance in 1999, 2004 and 2009. Since then the Alliance has performed a variety of additional roles, such(prenominal) as providing trainers to Iraq and Afg hanistan, assisting in counter-piracy operations2 as comfortably as imposing a non-fly zone over Libya based on UNSC Resolution 1973. Member states view of the institution, wallop of BREXIT and US pivotMember states view of the institutionSupport for NATO is general among member nations, is the conclusion of the Spring 2016Global Attitudes Survey.3 This survey, held by Pew ResearchCenter included nine EU countries such as theNetherland, Poland, UK, Italy, Germany, Hungary, France, Spain and Greece, aswell as the U.S. and Canada, finds mostly positive views of the Organization. Around57% of them expressed positive opinions of the Alliance, with only 27% of themvoicing negative views. The strongest support for thealliance comes from the Netherland and Poland while Greece appears to be the most critical NATO member. Even though Mr.Trump the Republican presidential nominee at that time, has regarded NATO asbeing obsolete, when asked if being a member of thepost-World War II security a lliance was good or bad for the U.S., 77% respondedyes, while only 16% expressed negative views. However, regardless ofincreasing security threats, most member states surveyed remain reluctant to increasetheir countries falsifying spending. Around 32% of the members surveyed say their fields military spending should be boosted, almost 47% of them favorcontinuing with the same spending and only 14% say their military spendingshould decrease.Notwithstanding, growing tensions with Russia over the conflict inUkraine, the alliance members polled remain divided on whether their countries should provide military support to an allyif it got into a military conflict with Russia.4 Approximately 48% amongeight NATO countries favored their country providing military support to defendallies, and 42% across the eight members opposed the use of force.Impact of BREXIT and US pivotAlthough we moderate heard much about(predicate) the political and economic consequences from BREXIT, there areinsuff icient arguments about its security and geopolitical fallout. Even thoughin the short run there efficiency non be any negative impact, there are reasonable concernsabout Brexits impact on NATO in the long run. Among many convert europiumaniststhere is a group of far-right parties, in France, Slovakia, the Netherlands, Denmark,Italy and elsewhere which not only are anti-European, xenophobic and profoundlyanti-American, just now they are great sympathizers of Putins authoritarian regime.If those parties come into power, it might fluctuate the politics of theircountries against NATO, and destruct the alliance from providing securitywithin and beyond its b instals.Anotherreason for concern might be the emerging prospect of Scotlands secession andan uncertain future of sumern Ireland which might cause the UK to be moreisolationists and less militarily engaged. Brexit might impact the future ofmilitary cooperation between France and Britain, two European NATO members withthe largest military firepower, regarded as the engine of Common Security andDefense insurance of the European Union. With the UK leaving the Union, if notimpossible it will become distant, and in the coming divisions the responsibilityfor European security will immensely rest on NATO.On the other hand, maintainingNATOs coherence and available hard-hittingness lies to a great degree on America.Recently, Washington has made it clear that it expects member countries to spendmore in defense and is urging the European Union to ca-ca a leading role incrisis management and decrease its dependence on the U.S.During his electoral compress president Donald Trump dismissed NATO as obsolete,while his Secretary of State James Mattis told NATO defence ministers inBrussels that Americans cannot care more for your childrens future securitythan you do5. However, atthe Security Conference, held from 17-19 February 2017 in Munich, the US Vice President, Michael Pence seemed to reaffirm Alliance members tha tthe US would remain committed to continue to extend Russia accountable6 for its illegal actions inCrimea and Ukraine.Approach to the risks and effectiveness of that approachRussiaNATObegan to interact with Russia in 1991, when Russia became member of the NorthAtlantic Cooperation Council and later in 1994 member of the Partnership forPeace programme. However it was NATO-Russia Founding Act of 1997 which definedthe formal foundation for future relations. For more than 25 five years, NATOhas attempted to develop a federation with Russia, building dialogue and reasonablecooperation in fields of common interest. Such dialogue and cooperation culminatedwith the foundation of the NATO-Russia Council (NRC) in 2002, which served as aconsultation forum for security issues and cooperation in a wide span of fields.Formal meetings of the NRC and cooperation submit been suspended until spring2009, in response to Russias military intervention in grand 2008 in Georgia.The Alliance persistentl y has required from Russia to reverse its recognitionof Abkhazia and South Ossetia as independent states. Russian aggression inUkraine led to suspension of all civilian and military cooperation of the NRC inApril 2014. However, channels of political dialogue and military communicationremain open. During the Wales Summit in September2014, NATO leaders condemned Russias military intervention in Ukraine anddemanded that Russia comply with international law and its internationalobligations and responsibilities.7NATO remains concerned about Russias increased and destabilizing pattern ofmilitary activities along NATO borders as well as aggressive rhetoric, which makethe security environment unstable and unpredictable. The Alliance and Russiahave deep and continuous discrepancies yet, NATO does not strive for confrontationand does not represent threat to Russia.terrorismInternational terrorist act we currentlyface, presents a complex, perpetual threat that demands for an all-inclusive, mu ltidimensionalstrategic approach which encompasses NATO as well. The early line of reasoning on NATOs propercounterterrorism roles and missions mirrored two approaches thewar approach adopted predominantly by the United States and therisk-management approach, supported by many European ally. These Alliessee the war approach as unsuitable, because terrorism cannot bedefeated unless its root causes are being addressed which for them cannot bedone by military means. The war approach has the tendency to employ a strategythat stresses offensive and preventive measures, while the risk-management approachhas the tendency to call for more defensive measures. Therefore, an effectivecounter-terrorism approach must encompass elements of both strategies. Regardless of these discrepancies allallies are in unison about the danger posedby terrorism and have decided to face it. Followingthe attacks on theTwin Towers, the NATO allies for the first time invoked Article 5 of theWashington Treaty the collective defense clause8by deploying troops in Afghanistan under theNATO-led ISAF. Meanwhile, immediately after 11September 2001, NATO changed almost in a radical manner its strategicpriorities and geopolitical vision, in order to adapt the organization and itsmember states to the nature of the threat. The fundamental approach, defined inNATOs military judgment for defence against terrorism, encompasses fourcomponents anti terrorism defensive measures consequence management counter terrorismoffensive measures and military co-operation to include partners, and internationalorganizations such as the United Nations, the Organization for Security andCooperation in Europe and the European Union.9Through its programme of exercises, NATO play a key role in training forfighting terrorism which offers unique opportunities for integratedcivil-military operations to counter terrorist attacks. Alliance also plays a substantialearly warning role through. achievement Active Endeavour10,with i ts unique capabilities for aircraft and missile early warning. In drop anchorof consequence management, NATO provides unique support capabilities to facethe consequences of a terrorist attack, through its Euro-Disaster ResponseCoordination Centre11.Moreover, Alliance is well-suited to play a preventive role by providing itsassets such as AWACS aircraft, maritime patrols and CBRN defence capabilities.A good example to be mentioned is the support given to Greece during theOlympic and Paralympics Games. Contributionto the global approach by the Alliance on fighting against terrorism wasarticulated openly in the NATO CT Policy Guidelines, endorsed at the ChicagoSummit of 2012.12 Twoyears later, on May 2014, NATO sanction an Action Plan which defines the tasks and assigns responsibilities based on the policyguidance.13Refugees illegal migrationTherefugee and migrant crisis of the recent years is by all means the worsthumanitarian crisis Europehas faced after the World War Two. Challe nges in the Europeanneighborhoods coming simultaneously from both the Eastern Flank by Russia andthe Southern Flank, by refugees, migration and terrorism, have imposed NATO to reshapeits capabilities. In addition to its commitment to reassurance measures in theEastern Flankas well as its contribution to transatlantic intelligence coordination againstterrorism, NATO is combat-ready in the international endeavor to hold backillegal migration and trafficking in the Aegean. The Alliance is closelycooperating with national coastguards, and Frontex, the border managementagency of the EU, in order to monitor the illegalcrossings in the Aegean Sea and combat human trafficking. Followingthe NATO Defence Ministers meeting on 26 and 27 October last year inthe context of the implementation of Resolution 2292 UNSCR on the situation inLibya the Alliance agreed to support the EU-led Operation Sophia in the central Mediterranean. This commitmentincludes a scaleof capabilities such as Intelligence , Surveillance and Reconnaissance,logistics support as well as contribution to capacity building of the Libyancoastguard and navy, if requested. In that context on 9 November 2016, NATO launched Operation Sea Guardian with an extensive scope inresponse to awide- ranging maritime security threats.14Inter-institutional cooperation, coordination and integrationThe gravity of challenges posed by the Balkanconflicts since 1991, and NATOs commitment in Afghanistan a decade later, havebeen the key drivers of its progressively immense cooperation with otherinternational organizations. Such organizations posses mandate and capabilitieswhich the Alliance lacks, but that are vital to meeting international securitychallenges. NATO and the United NationsThe Alliance needs the UNSC resolutions as alegal foundation for non-Article 5 operations as well as to justify thelegitimacy for such operations. On the other hand, the UN needs NATO for its expertise,resources, and unmatched capabilities to pro vide far-reaching support and to sustainan extended commitment. Coordination between the two organizations has occasionallybeen dissatisfactory, particularlyin Bosnia and Herzegovina where NATO and UN Protection Force (UNPROFOR) failedto defend Srebrenica designated as safe area by UN. This flawed experiencehas been contributing to better formula and renewal of UNSC resolutionsmandating operations, especially in the field of command and controlarrangements.In September 2005 a NATO UN frameworkagreement was proposed, designed to provide a twist for continuous cooperationat all levels rather than crisis situations collaboration. Such cooperationcould help the UN and many of its member states -which perceive NATO as a ColdWar military organization tobetter understand the Alliances consensual decision-making processes. Inthe Comprehensive Political Guidance endorsed at the Riga summit of November2006, NATO members agreed that, As in Afghanistan, success in Kosovo willdepend on a con certed effort. Accordingly, NATO activity to provide a secureenvironment will continue to be coordinated with the activities of the UN, theEU and the OSCE to build governance and support reform.15NATO and the European UnionNATO-EUcooperation dates back to the Cold War. However an important step towards aneffective cooperation was marked at the Washington Summit in April 199916,where the cooperation principles of the June 1996 agreements in Berlin knownas Berlin Plus where approved. It took the two organizations from April 1999to declination 2002 to formalize this agreement, in order to allow NATO to supportEU-led operations. Operation Concordia from inch to December 2003, in theFormer Yugoslav Republic of Macedonia was the first EU-led peacekeeping operation,commanded by a NATO operational commander, where Alliances assets were providedto the EU. Comparably, in December 2004 the NATO-led operation StabilizationForce (SFOR) in Bosnia and Herzegovina, began to transition to an EU-l edoperation named Althea under the Berlin Plus framework. Once again, thecommander responsible for this Operation was NATOs DSACEUR. In addition, KFOR,NATOs peacekeeping force in Kosovo, cooperates closely with EULEX, the EUsRule of Law Mission quite alike as NATO-led ISAF and RSM missions inAfghanistan have cooperated with EUPOL, the EUs Rule of Law Mission. NATOsOcean Shield and the EUs EUNAVFOR Atalanta naval forces are cooperatingclosely for anti-piracy missions, since September 2008, in Somalia. At thestrategic level, NATO and the EU meet on a regular basis at the level offoreign ministers, ambassadors, military representatives and defence advisors. Regularmeetings also take place for staff-to-staff talks at all levels between AlliancesInternational Staff and International Military Staff, and their EU counterparts.For mutual cooperation at the operational level, in 2005 NATO established aPermanent Liaison Team at the EU Military Staff. Similarly, an EU Cell was setup in 2006 at Alliances strategic command for operations in Mons, Belgium.NATO and the Organization for Security and Cooperation in Europe (OSCE)Distinctlyfrom the UN, NATO, and the EU, the OSCE is based on political commitments noton treaty arrangements. Generally speaking, Alliance has not been directly engagedin OSCE operations, it has only been providing support for planning, information,and communications, security and logistics, of OSCE activities in places where NATOforces have already been deployed. The first notable cooperation of this kind wasthe operation in Bosnia and Herzegovina in 1990s. Few years later, in order tosupport OSCEs verification mission on the ground in Kosovo, NATO conducted an airreconnaissance mission named Operation Eagle Eye from October 1998 to March1999. During the same period the Alliance organized an Extraction Force brisk to evacuate OSCE personnel from Kosovo in an emergency. NATO has alsocooperated with the OSCE and the EU during the 2001 crisisin the Forme r Yugoslav Republic of Macedonia.Apart from NATO-OSCE cooperation during Balkan crisis, the two organizations have interacted in other areas such as border security issues, anti-terrorism, combating human trafficking, regional cooperation, etc., mainly in Central Asia, SE Europe and the south Caucasus. It is worth mentioning that there has been little mission competition between NATO and the OSCE due to the fact that the later is particularly focused on specific domains. ReferencesNorth Atlantic Treaty Organization, The North Atlantic Treaty, Washington D.C. 4 April 1949, NATO e-Library, accessed at http//www.nato.int/cycles/second/en/natohq/official_texts_17120.htm.North Atlantic Treaty Organization,Counter piracy operations, NATO Newsroom, 19 December 2016, accessedat http//www.nato.int/cps/en/natohq/topics_48815.htm.Charter, David and Wright, Oliver, US gives ultimatum over NATO spending, February 16 2017, The Sunday Times, accessed at http//www.thetimes.co.uk/article/us-deliver s-ultimatum-over-nato-spending-rg55vrrbvThomas, Ken, Rising, David and Moulson, Geir, Mike Pence Says US To Hold Russia Accountable, Stand With Nato, The Independent, accessed at http//www.independent.co.uk/news/world/americas/mike-pence-nato-hold-russia-accountable-munich-angela-merkel-vladimir-putin-a7587891.htmlNorthAtlantic Treaty Organization, Wales Summit Declaration, accessed at http//www.nato.int/cps/en/natohq/official_texts_112964.htm.Cuddington, Danielle Support for NATO is general among member nations, July 2016, Spring Global Attitude Survey, Pew Research Center, accessed at http//www.pewresearch.org/fact-tank/2016/07/06/support-for-nato-is-widespread-among-member-nationsCuddington, Danielle Support for NATO is widespread among member nations, July 2016, Spring 2015 Global Attitude Survey, pew Research Center, accessed at http//www.pewresearch.org/fact-tank/2016/07/06/support-for-nato-is-widespread-among-member-nationsNorthAtlantic Treaty Organization, NATOs military t heory for defence againstterrorism, 21November 2002, accessed athttp//www.fransamaltingvongeusau.com/documents/dl2/h3/2.3.25.pdfNorthAtlantic Treaty Organization, Operation Active Endeavour, 27 October 2016,accessed at http//www.nato.int/cps/en/natohq/topics_7932.htm?selectedLocale=enNorth Atlantic Treaty Organization, Euro-Atlantic Disaster Response Coordination Centre, 7 April 2016, NATO e-Library, accessed at http//www.nato.int/cps/en/natohq/topics_52057.htm?selectedLocale=enNorth Atlantic Treaty Organization, NATOs Policy Guidelines on Counter-Terrorism, accessed at http//www.nato.int/nato_static_fl2014/assets/pdf/pdf_topics/ct-policy-guidelines.pdfArgano, M. Elena, A stronger NATO means a stronger Europe. Sea Guardian and Operation Sophiatogether, 15 November 2016, accessed at https//europe-liberte-securite-justice.org/2016/11/15/a-stronger-nato-means-a-stronger-europe-sea-guardian-and-operation-sophia-together/.North Atlantic Council,Riga Summit Declaration, 29November 2006, p ar. 9,accessed athttp//www.nato.int/cps/en/natohq/official_texts_37920.htm.NorthAtlantic Council, Washington SummitCommuniqu, 24 April 1999, par. 10, accessed at http//www.nato.int/docu/pr/1999/p99-064e.htm.1 AtlanticTreaty Organization,The North Atlantic Treaty, Washington D.C. 4April 1949, http//www.nato.int,(Accessed on 04 March 2017).2North Atlantic TreatyOrganization, Counter piracyoperations,NATO Newsroom, 19 December 2016, http//www.nato.int, (Accessed on 04 March 2017).3 Cuddington, Danielle Supportfor NATO is widespread among member nations, July 2016,Spring Global Attitude Survey, Pew ResearchCenter, http//www.pewglobal.org(Accessed on 04 March 2017).4 Cuddington, Danielle Supportfor NATO is widespread among member nations, July 2016,Spring 2015Global Attitude Survey, pew Research Center, http//www.pewglobal.org/, (Accessedon 04 March 2017).5Charter, Davidand Wright, Oliver, US gives ultimatum over Nato spending,February 16 2017, The Sunday Times, http//www.thetimes.co.uk , accessedon 12 March 2017.6 Thomas, Ken, Rising, David and Moulson, Geir, Mike Pence says US to hold Russia accountable, standwith Nato, The Indipendent, http//www.independent.co.uk,accessed on 12 March 2017.7Wales Summit Declaration, North Atlantic Treaty Organization http//www.nato.int(Accessed on 04 March 2017). 8NorthAtlantic Treaty Organization, The NorthAtlantic Treaty, Washington D.C. 4 April 1949, NATO e-Library, http//www.nato.int(accessed on 3 April 2017).9North Atlantic Treaty Organization, NATOsmilitary concept for defence against terrorism, 21November 2002, http//www.fransamaltingvongeusau.com(accessed on 4 April 2017).10North Atlantic Treaty Organization, OperationActive Endeavour, 27 October 2016,NATO e-Library http//www.nato.int(accessed on 4 April 2017).11North Atlantic Treaty Organization, Euro-AtlanticDisaster Response Coordination Centre, 7 April 2016, NATO e-Library, http//www.nato.int(accessed on 4 April 2017).12 North Atlantic Treaty Organization, NATOs poli cyGuidelines on Counter Terrorism, 20-21May 2014, http//www.nato.int/nato (accessedon 4 April 2017).13 This is a classified document, not for public release.14 Argano,M. Elena, A stronger NATO means a strongerEurope. Sea Guardian and Operation Sophiatogether, 15 November 2016, https//europe-liberte-securite-justice.org,(accessed on 12 April 2017).15North Atlantic Council, Riga Summit Declaration, 29 November2006, http//www.nato.int, (accessed on 4 April 2017).16 North Atlantic Council, Washington Summit Communiqu,24 April 1999, http//www.nato.int,(accessed on 4 April 2017).

Prevention of Chronic Obstructive Pulmonary disease (COPD)

Prevention of Chronic Obstructive Pulmonary indisposition (COPD)Title Discuss the cling to led intervention in relation to secondary prevention for COPDChronic Obstructive Pulmonary disease (COPD) is a growing wellness concern at once all everywhere the world. The World health Organization predicts that by 2020 COPD will rise from its current ranking of 12th most prevalent disease worldwide to 5th and from 6th most common cause of death to 3rd.(Murry 1997) A nonher study by WHO(2002) states that COPD is the third largest cause of respiratory death and vizor for 20% of respiratory mortality. According to research conducted in UK, around 900000 endurings be suffering from COPD in England and Wales currently (NICE 2004). Numbers of patients affected by COPD argon change magnitude in UK and it has taken over the place of heart diseases as single of the major killer diseases leading to 30000 deaths per year. (Gibson 2003). Reason for dramatic growing in COPD includes bring down mortality from other diseases like heart diseases in industrialization countries and infectious diseases in developing countries with marked increase in arses smoke and environmental defilement all over world.COPD is a chronic progressive disorder characterized air right smart restriction with little or no reversibility. COPD affects bronchi, bronchioles and lung pargonnchyma with predominance on distal airways. It involves dickens clinical condition- chronic bronchitis and emphysema. Most patients with COPD have both pathological condition but relative extent of emphysema and chronic bronchitis is variable in singular patient.Chronic Bronchitis and EmphysemaChronic bronchitis is delimitate as a cough productive of sputum on most days for 3 months for successive 2 years. Cough is collect to hyper secretion of mucous secretion not necessarily accompanied by air f junior-grade obstruction.Chronic bronchitis is characterized by enlargement and multiplication of mucus glands, r esulting increased airway mucus production. Evidence suggests that apart from quantity, quality in the form of composition of mucus is also altered becoming more viscous.mucus is unmatched of the meaning(a) comp angiotensin-converting enzyment in pathophysiology of COPD. Increased secretion of mucus is the result of goblet cell hypertrophy on exposure to various perverting stimuli. This mucus affects pulmonary function in various ways. Increased secretion for prolong period leads to decrease in FEV1 which is promotional to degree of hyper secretion .Excess mucus causes airway obstruction by accrual in peripheral airways and increased airway resistance.Additionally, there is thickening of airway wall and infiltration with lymphocytes, neutrophils and macrophages leading to fibrosis. In contract to asthma, infiltration of lymphocytes and neutrophils are found in greater number in airway lumen. In the event of exaggeration of COPD, Eosiniphils are also observed in airway lumen. In flammatory process in COPD is powered by interaction of proteolytic enzymes and several(prenominal) chemokines, as sputum of patients with COPD shows increased amount of Leucotriene B4, interleukin- 8 and tumor necrosis element.Emphysema is defined as enlargement of airspaces distal to terminal bronchioles with destruction of alveolar wall resulting loss of elasticity of lung and closure of fiddling airways. Elastic recoil of alveolar attachment helps to maintain the patency of airway lumen especially during expiration. With destruction of connective tissue matrix of alveolar walls by proteolytic enzymes called proteases, released by inflammatory cells in the alveolar wall causing destruction of elastin, affects structural integrity of alveolar wall. Pathological changes in emphysema are think to proteolytic activity of these enzymes.In peripheral airways of patients with COPD, there is airflow limitation due to loss of alveolar attachments, inflammatory obstruction of airways an d luminal obstruction with mucus. The airway narrowing in COPD is the end result of combination of structured inflammatory narrowing, loss of elastic recoil and loss of alveolar attachments.One of the cardinal motions of risk factors of COPD is abnormality in ciliary function. Airway wall is lined by cilia which act as a force to propel mucus or foreign body towards trachea for coughing it out. Mucociliary function is affected by thick and tenacious mucus. It also increases the risk of infection due to accumulation in airway causing recurrent infection in lungs and further lung damage. Mucus plugging and pulmonary infection contributes to V/Q mismatch and hypoxia eventually. Acute hypoxia ca utilise dyspnoea poignant other systems of the body. Chronic hypoxia leads to pulmonary hypertension and right rampd failure. Other pathophysiological consequences of COPD include abnormalities in pulmonary function, the mechanism of gas exchange.Risk factors for COPDThere are several factor s responsible for increment of COPD called risk factors.Smoking cigarettes, both active and passive voice, is considered the major causative factor in development of COPD. More than 80% of COPD patients are or were smokers (Gibson 2003).Air pollution, industrial smoke and chemicals used in industry are responsible for development of COPD. Exposure to industrial dust is a causative factor in diseases like asbestoses, mesothelioma and black lung disease. Infection especially in early childhood and frequent exposure to allergens leading to changes in airway are alter factors in development of COPD. People with Alfa -1 antitrypsin deficiency are more likely to develop COPD due to genetic defect in production of enzyme alfa-1 antitrypsin. It is believed that patients having periodontal diseases are more likely to develop COPD as the bacteria casing periodontal diseases travel to lung and cause infection and inflammation.Babies with low birth weigh have shown increase incidence of COPD and poor nutrition during fetal development leading to small dysfunctional lung is considered the responsible factor for development of COPD. COPD in more common in men, over sixty years of age. At this age it is at its highest level of development, which started in young age.Out of all the risk factors discussed smoking cigarettes is most important factor in causing COPD. Effects of smoking cigarettes on human body are due to nicotine present in a cigarette. Nicotine molecule was produced over 60 million years ago by tobacco plant plant to overcome insect herbivores. Tobacco introduced in Europe in 1492 when Christopher Columbus sailed to the States and its cultivation then spread to many parts of world (Corti 1931). Today tobacco is widely prevalent in society in the form of cigarette smoking. Typical cigarette contain 9 mg of nicotine of which 1 mg is absorbed by smoker.Burning tobacco produce a complex florilegium of compounds divided in gas and particulate phase components. In gas phase component, carbon monoxide (4%) forms the signifi advi draw amount in concentration in extension to nitrogen, oxygen and carbon dioxide. The particulate phase component is consisting of aerosol of tar. Tar is the sticky, brown, residual substance left later on removal of nicotine and moisture. Both gas and particulate phase are responsible for COPDDelivery of smoke compound is variable according to type of tobacco used in cigarette, addition of filter and the cipher with which an individual smokes cigarette. Smoking affects lung at the level of bronchi, bronchiole and lung parenchyma. Tobacco smoke affects structure and function of bronchial mucous gland. Number and size of mucus secreting glands increase due to smoking leading to more production and deposition of mucus in airway. Tobacco smoke also produces structural changes in airway cilia. These changes are related to dose and continuation of smoke exposure. It also affects the function of cilia with abnormal cle arance of secretion. Additionally, it also cases narrowing of small airways with inflammation and fibrosis. Apart from this, smoking has some misfortunate term personal effects like increase in carboxyhaemoglobin, decreased appetite and emotional dependence on nicotine.COPD is treated with elimination of risk factors, bronchodilators such as beta-agonists and anti-cholinergic, corticosteroids, low concentration of oxygen and mucus thinner like guaifenesic. The cost of COPD is enormous as economic burden on health care system, society, patients and their family is significant. An size up of 1400 patients admitted in a hospital revealed that 34% patients readmitted and 14% had died within 3months. (Roberts 2002)It is imperative to act upon risk factors responsible for COPD. Smoking is major risk factor for development of COPD and it is never too late to stop smoking and benefits starts immediately. (Price 2004).Usually smoking starts in teen age and continues for long time, but thos e who have never smoked outride non-smoker for many years.Study indicated decline in number of male smokers in UK from 70% in 1950 to 28% in 1998 (Macfadyen 2001).More positively, men are giving up smoking in increasing number. These changes in behavior of people in society towards smoking are the result of implementation of health promotion strategies in communities. health promotion is the science and art of helping people changing life style to move towards the state of optimum health. Optimum health is defined as a balance of physical, emotional, social, spiritual and intellectual health (Irwin 2005)Health promotion is directing the plan to foster communities abilities to take effective actions at local anesthetic level. It covers the methods to map and mobilize local resources, to activate citizens, government for management of positive changes, and transform institutions into health promoting environment. It involves the actions to mitigate ability of health care system for old and secondary prevention and assist citizens in taking control and improve their own health by behavior and lifestyle changes. Life style changes can be facilitated with combination of enhanced awareness and creating environment that support good health practice.Health promotion is that element of public health that focus on social conditions for maintenance and development of better health for productive society. Evaluation of health fosterage broadcasts reveled that change in knowledge did not result in action and improved health. Knowledge alone is not fitted but people need the confidence that they can change their lives.Hubley (2002) explained that health empowerment has cardinal components self efficacy and health literacy. Self efficacy implies feeling of power and control and confidence of taking action. Health literacy is related to ability to communicate health related issues..Health literacy is achieved only by means of health education leading to perceiveing of health issues and application of it in decision making. Many traditional health education methods rather disempower person by creating more dependency on health professionals. Important element in health promotion is to provide cognitive input through educational process which will not undermine community confidence. Health education using participatory learning methods creates a way forward for heath literacy and self efficacy. shields in health care set up facilitate these components of health promotion by helping smoking surcease in society and directing health care for secondary prevention of COPD. go fors as health care professionals act by providing information and support to smokers all by telephone contact or nurse led clinic to obtain objective of reducing smoking in communities. There are clear objectives for nurses in smoking cessation programmes of advocating positive social and environment changes for health promotion and organizing supporting activities that leads to secondary prevention of health related morbidity and mortality. It is important for nurses to evolve the people to influence the positive behavior changes in health related issues. Apart from providing information, it is important for nurses to use the information to bring change by communication and convincing smokers and organizing individual action. Government says that smokers are four times more likely to throw overboard smoking using NRT with local NHS stop smoking programme than if they only rely on their will power. (DH 2004)Smoking is seen in three phases initiation, maintenance and cessation. Initiation occurs in early teens and begins with experimentation with cigarettes. There is evidence that jejune of more rebelling or risk taking, out going nature are more likely to take up cigarettes. Individuals of more neurotic personality are also more prone to take up cigarettes. Some degree of genetic predisposing has also been observed, which not particularly specific to nicotine but also for intoxicant and caffeine. High status individuals in media also have great influence in initiation of smoking. Maintenance of smoking is promoted by direct and indirect effect of nicotine releasing central dopamine, noradrenalin and opiate peptides. It helps in coping with stress and also improves performance due to its tranquillizing effect, in a variety of tasks but it eventually leads to dependence, addiction and coitus interruptus symptoms.On initial contact with patient, nurse establishes that the person is a smoker and obtains informed consent from person. Nurse gives a questionnaire to patient to know smoking taradiddle of patient in the form of numbers of cigarettes smoked in a day by a person. It also includes disclosure of information to the highest degree duration and pattern of smoking.Nurses then assess the willingness of the person to stop smoking. By asking smoker to rate the importance of quitting on a scale one to ten, with one number havin g least importance. Smokers are also asked to rate their confidence in their ability to quit. This gives an idea to nurse slightly the readiness of a smoker for quitting.Nurse also assess level of breath littleness in patient with COPD, which is graded as follows (Gibson 2003).Not troubled by breathlessness on strenuous exercise.son of a bitch when walking uphillWalks slower than counterpart on the level because of breathlessnessStops to take a breath later on 100m or a few min on the levelToo breathless leave the home or breathless on dressing.After initial assessment, nurse counsel patient to educate and prepare him/ her to take action to quit smoking. Nurse explains the benefits of smoking cessations with emphasis on the explanation that a person starts getting benefits immediately after stopping and set a quit day with explanation of problem they may come across.In clinic, most patients say they would like to give up and also tried to stay away from cigarette (Percival 2004).A study indicates that long term success of smoking cessation depends on several factors like low daily cigarettes and delayed commencement cigarette of day low consumption of alcohol or caffeine, high socioeconomic class non smoking spouse and less neurotic or depressive personality. Some evidence also suggests that women find it difficult to give up. It is important for the nurses to now the degree of self confidence from the outset that the closing will be achieved and absence of stressful episodes during the therapy as contributing factors for long term abstinence from smoking. Study suggests that, persons usually give up smoking after five to six trial and error sequences. (Gibson 2003)The duration of therapy is usually six weeks. Nurses lead session either in a group or one to one and manage for regular follow up. After initial contact, nurses remain in contact with person by telephone or in clinic at 2 days, one week, three weeks and three months interval. Patients are given booklet about COPD and disadvantages of smoking. Booklet also contains the benefit s of quitting smoking. It also explains the patient about how to quit smoking, how to cope with climb-down symptoms like need to smoke, depression, irritability, insomnia, difficulty in concentration, restlessness and increased appetite Patients with strong withdrawal urge are explained about NRT. At the end of six weeks patients have consultation with nurses. Those who continued smoking or relapsed are offered additional support.Anti smoking public health iron helps smokers by drawing attention more frequently and pushing them to take action. It also helps nurse in facilitating their advice. Self reported motivation of smokers, wish to reverse further health problem and in some cases actual ill health are important factors in giving up smoking. For example, a gravid lady is inclined to give up smoking to avoid harm to her baby. Smokers receiving advice from hospital physician specially after adm ission for myocardial infarction had quit rate of 50%, compared to success rate for advice by physician in general practice of around 5% in unselected patients.(Pety 2000 ) Concern of passive smoking and many times social pressure by family and friends also contributes in moving forward for help in smoking cessation clinic. acclivitous price of cigarettes and ban or restriction of smoking in public places also tend to discourage smokers. Socioeconomic model suggest that for every one percentage rise in cigarette price leads to 0.5 % drop in consumption (NICE 2004).Smoking advertisements and perceived status of smoking from them are significant factors in supporting people to become smoker.Nurse encourages person in finding alternate source of enjoyment and different coping strategies in the event of stress leads to made outcome on long term. Nurse also takes help of specialist in search for other ways of mastering concentration during sustained task. Nurse also asks spouse to quit smoking to create the environment for behavior change. Many smokers have poor central control system for arousal strengthener and punishment, and then alternative strategies may involve physical sports, mental relaxation, assertiveness techniques and different scheduling for exercise activities. Nurses help smokers understanding and reducing the image smoking as something exciting and sophisticated.Most smokers give up with the help of their own efforts but those who cannot manage themselves nurses propose specific methods with the social support. For those , who will not give up in immediate future some damage limitation can be achieved by production of safe cigarettes transfer to thermionic valve or cigar or chewing tobacco other formulation of tobacco like nicotine gum, nasal spray, transdermal patch inhalable aerosol- called nicotine replacement therapy (NRT). Before starting medical specialty nurse rules out contraindication for medication like severe cardiovascular diseas es, recent MI, severe cardiac arrhythmia, recent CVA, transient ischemic attack, pregnancy and breast feeding. admixture of other drugs apart from medications used for NRT are also used in practice which counteract unpleasant aspects of nicotine withdrawal, includes amphetamine, benzodiazepines, ACTH, vasopressin, clonidine, fluoxetine, bupropion and naloxone. Mecamylamine (nicotinic antagonist) is another important medication used in smoking cessation.Nicotine replacement therapy in the form of nicotine gum or patch is better than smoking and decrease health risk. NRT and bupropion are prescribed to those who have set a date as a target to stop smoking. Transfer to pipe decrease the risk of lung damage, but can not protect hurrying oesophageal tract. With nicotine nasal spray, absorption from mucosa is much faster than gum and the blood level achieved are comparable with cigarette smoking. Nicotine aerosol has irritant sensation in nose but it is still the attractive option in sw itching from cigarettes. Nicotine patches application on skin promotes slow absorption of nicotine from the skin .It is devoid of sufficient sensory stimulation involved in smoking. It has limitation in alleviating withdrawal symptoms during smoking cessation therapy.Practically more useful are nicotine gum, transdermal nicotine patch, nasal spray and antidepressant bupropion. They are equally effective and safe, doubling quitting rate. Study indicates less than 5% drop out rate due to adverse effects if these drugs, but combination is superior in effects compared to single drug (Gibson 2003).Combining medication with counseling by nurse boost the quit rate. Nurse explains side effects of NRT like headache, nausea, dizziness, palpitation, dyspepsia, hiccups, insomnia, myalgia, anxiety, and irritability to patients before starting it.For many novice ex-smokers major difficulties emerge after initial euphoria of successfully having overcome the first week of withdrawal symptoms. The m ore complex task then begins to manage and overcome withdrawal symptoms for longer term for successful outcome. NRT forms the mainstay of management of withdrawal symptoms. There are differences in response from various types of NRT .In case of heavy smokers( more than 20 cigarettes a day) 4mg nicotine gum is more effective than 2mg. In mass medium to heavy smokers standard patch of 21 mg is more effective than lower dose patch. Treatment with NRT is continued for 10 to12 weeks with gradual withdrawal. If person is unplaced in quitting after 3 months, the treatment is again reviewed. (West 2000)Addition to anti-smoking measures, nurse should check effectiveness of inhaled drug, its technique and if they are symptomatic despite picayune acting bronchodilators.Nurse also takes care of nutrition and vaccination in COPD case.Nurse led clinic for smoking cessation is a part of pulmonary reformation program which involves exercise and education over 6to 8 weeks to anyone who feels tha t COPD is affecting quality of his or her life. It is closely related to health promotion by creating an environment and providing education for improving personal and community health.Educating people to change behavior and empowering them to take actions leading to smoking cessation are essential elements of smoking cessation clinics.ReferencesCorti C., (1931). A history of smoking. London George G. HarrapDepartment of health, Office of National statistics, (1997). General household survey. London HMSOGibson g., Duncan G., costabel U., Sterk P., Corrin B.,( 2003). Respiratory medicine, 3rd edi, vol. 1 p 645. London ElsevierHubley J (2002). Health empowerment, health literacy and health promotion putting it all together. http//www.hubley.co.uk/1hlthempow.htm (Accessed on May 14, 2005)Irwin J (2005). Health promotion theory in practice an analysis of Co-Active Coaching. supranational Journal of Evidence Based Coaching and Mentoring ,vol-3, no-1.http//www.brookes.ac.uk/schools/educa tion/ijebcm/vol3-1-a-morrowirwin.html (Accessed on May 14, 2005)Macfadyen L., Hastings G., Mackintosh A., ( 2001). Cross sectional study of young people-awareness and involvement with tobacco markets. BMJ. 322, pp 512-517.Murry C., Lopez A., (1997). Alternative projections of morbidity and disability by cause, 1990-2020 Global burden of diseases study. Lancet 349. 1498-1504NICE guidelines (2004). Management, treatment and cure of COPD. British journal of nursing ,vol.13, no18, pp1100-1103NICE (2004). Guidelines to improve patients with COPD. London NICEPercival J. (2004).Make use of all resources to quit smoking. http//www.professionalnurse.net/nav?page=pronurse.articleresource=1454302fixture_article=1454302category=RESPIRATORY_CARE. (Accessed on May 14 , 2005)Pety R., Darby S., Deo H., (2000). Smoking, smoking cessation and lung concern in UK since 1956.Combination of national statistics with both cases control studies. BMJ, 321, pp 323-324Price D., Foster J., Scullion J., Freema n D., (2004). Asthma and COPD. London ElsevierRoberts M., Lowe D., Bucknell C., (2002). Clinical audit indicator of outcome following admission to hospital with acute provocation of COPD. Thorax, 57, pp 137-141West R., McNeill a., Raw a., (2000) .Smoking cessation guidelines for health professionals an update. Thorax, 55, pp 987-999WHO, (2002), reducing risks, promoting healthy life. Geneva WHOLegally Binding Undertaking I, Paulatsya Joshi, undertake that in line with my contractual obligations this work is completely original, and has not been copied from any website or any other source, either in whole or in part. By submitting this work I understand that if my work is found to be plagiarised that I will not only forfeit my fee but also be undecided to wakeless proceedings in order to recover damages for loss of profit and damage to business reputation. Moreover, I understand that I may be subject to legal proceedings from any third parties, such as the end clients and copyri ght holders of the original work who may have had their rights infringed or suffered loss as a result of my actions. I also understand that in addition I will be liable to a 100/$200 governance charge and that I may be liable for legal costs. I understand that this e-mail and the work I am submitting may be used as evidence against me if I breach this undertaking. 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An Examination of Music in The Tempest Essay -- The Tempest Essays

An Examination of melody in The Tempest Compared to plays written for public playhouses, The Tempest offers a unique emphasis on music. Hiring bare(a) musicians, along with the time constraints usually resulted in small attention given to this area (Long 95). Given the large degree of detail allotted to music in the play, it is believed the audience to have been upper class, however, music of The Tempest serves a variety of functions beyond that of mere entertainment. By exploring the evidence provided in The Tempest, we can reveal several(prenominal) of these functions that music serves in the play. Direct roles of music in The Tempest Mental manipulation Music in The Tempest is utilized by Ariel to manipulate his victims in a number of ways, one being a sleight of mind. Take away the enchanted island and Prosperos magic and music still holds a quality which enhances or detracts from ones mood similarly, Ariels songs seem to have a way of creeping into the mind of the lis teners, but his gradually changes their very thoughts. Our first evidence of how this manipulation functions is Ariels song render to Ferdinand This music crept by me upon the waters, Allaying both their fury and my passion With its sweet air thence I have followd it, Or it hath drawn me rather. (1.2.391-95)The music begins to work by evoking a state of passion, then playing upon this heightened sense of emotion, Ferdinand is drawn in a manner which seems similar to that of the call of the sirens. Ariels playing and singing while infrared allows the music to be felt like a subtle presence, perhaps coming from the island, perhaps his own mind. Ferdinand is not sure whether it comes from the wat... ...hich the play leads, it is the conflict in the struggle for the power it represents, and the resolution in the harmony it provides. Works CitedGervinus, G. A review of The Tempest. Shakespearean Criticism 8 (1877) Johnson, W. The Genesis of Ariel Shakespeare Quarterly 11.3 (1951) 205-10.Long, John. Shakespeares Use of Music The Final Comedies. Gainesville University of Florida Press, 1961.Other Voices The Sweet, Dangerous Air(s) of Shakespeares Tempest. Shakespeare Studies 24 (1996) 241-74 Palmer, D.J. The Tempest. London Macmillan & Co., Ltd., 1968.Scott, Mark. Shakespearean Criticism. Detroit Gale Research, Inc., 1989.Smith, Hallett. Twentieth Century Interpretations of The Tempest. Englewood Cliffs Prentice-Hall, Inc., 1969.The Riverside Shakespeare. Boston Houghton Mifflin Co., 1997.

Summary of Walden Pond :: essays papers

Summary of Walden PondFor about the first half of the book Thoreau questions thelifestyles that batch choose. He makes his readers wonder ifthey have chosen the kind of life that will really offer themhappiness. Are they purely living a career or some othernarrowly focused routine or is a worthwhile life cosmos lived.Thoreau wonders if the truly valuable elements of life arebeing taken advantage of if a person isnt living simply. If aperson is so caught up in working or never having enough thereforelife, its wonders, and satisfaction are difficult to obtain.As he states in the beginning (pg4), most men even in thiscomparatively free country, though mere ignorance and mistake,are so occupied with the factitious cares and superfluouslycoarse labors of life that is finer fruits cannot be plucked bythem. This to me means that people care more(prenominal) about the finethings in life and easier work instead of natures gifts andhard work. Thoreau draws a parallel between otherspre occupation wit h money and his let enjoyment ofnon-monetary wealth. Thoreaus statement A man is generous in proportionto the number of things he can afford to leave alone means that richrefers to having the opportunity for spiritual and intellectual gainsand afford refers to the self-actualization rather than to cash in thebank. Those are just some of the materialistic terms that Thoreau usesto refer to non-materialist values, making summercater of the capitalist in theprocess.Thoreau uses the opportunity of the first chapter to discussthe issue of how we spend our time and energies. It is obviousthat his townspeople are not as economical as they spend manyhours working very hard to accomplish very little, showing afalse sense of economy. Thoreau believed that all attempts toredeem mankind from its problems were unreal unless suchattempts began with the person. The individual person had tostop thinking more about the lesson nature had to offer.Thoreau thought that by livin g simply with few needs ormaterial possessions man would have more time to enjoy life toits fullest natural potential. In the other chapters of thebook Thoreau goes on to tell about his experiences with naturewhile living on Walden Pond. The bean field which he grew, andput so much work into. He did not know himself what the meaningwas of put the garden only that he felt self-respect fromdoing so. They attached him to the earth. And he gotstrength from it.