Principlies of Humanities Essay Example | Topics and Well Written Essays - 1000 words

Principlies of Humanities - Essay Example Jubal, the seventh descendant of Adam was the father of them that play upon the harp and the organs (Renehan 2). Music falls into the natural subdivisions of Uncivilized, Semi-civilized or Civilized depending on the people it is associated with. Uncivilized music is primitive in form and exists among races that have not reached the point of artistic organization (Pratt 18). Semi-civilized music falls into two distinct groups, one for people existing now for example, Chinese and Hindus and the other for ancient people for example, Hebrews and Egyptians both of whose music has a real system not relating to our own (Pratt 19). Civilized music falls into three groups marked by centuries namely, Greek and Roman, Mediaeval and Modern music (Pratt 19). This paper covers the song â€Å"Amazing Grace† by English poet turned Clergyman, John Newton. Although born to a religious mother, Newton always abandoned the Christian faith in pursuit of his own interests. At some time in his life, he commanded an English slave ship that he owned and would supply for slave trade. The song dates back to a time between 1760 and 1770 composed in Olney. Newton wrote it after experiencing a tumultuous life in slavery and brutal abuse that led to his conversion. Unpredictable events in his life included, the early death of his mother, adolescent passions, seizure by naval press gang, servitude in Africa, disaster and deliverance at sea, tales of whippings and sudden deaths, climatic religious conversion, romance, an epileptic fit, unemployment, a succession of job opportunities, failed attempts to enter the ministry and so on (Hindmarsh 2).After his experience he got to believe in God and sought Him. The song was originally a poem with its basis derived from works of the New Testament in the Bible. The first verse for example, is derived from the parable of the prodigal son. â€Å"‘My son, you are always with me, and everything I have is yours. But we had to celebrate

Nokia Term Paper Example | Topics and Well Written Essays - 1750 words

Nokia - Term Paper Example The complacency or lack of proactive action by Nokia is in line with the psychic prison metaphor. â€Å"This metaphor joins the idea that organizations are ultimately created and sustained by conscious and unconscious processes, with the notion that people can actually become imprisoned in the images, ideas, thoughts, and actions to which these processes give rise.† (Morgan 207). These aspects of self-limitations could develop in an employee, then in a team and could occur in an entire organization, causing negative impacts like non-growth and further slide. After reaching the top, Nokia from its top management to the lower-level employees allowed this psychic prison factor to creep in, thereby forming a false sense of security. Nokia not only avoided improving its existing strategies but also avoided carrying out key innovations particularly in the aspect of its operating system, thus allowing its competitors to leapfrog over it. Thus, the psychic prison factor made Nokiaâ₠¬â„¢s growth a stagnant one, and in course of time caused a downslide. As its market share continued to slide, Nokia decided to come up with strategic changes to avert the slide and emerge successful. In that direction, Nokia found that it’s Operating System (OS), Symbian was not able to compete with newer and more advanced OSs like iOS and Android, thus contributing sizably to the slide in Nokia’s Market Share. This perspective was validated by Gartner analyst Nick Jones, who stated, â€Å"Market share is an existential threat to Symbian, it imperils the very existence of the platform, and the main reason Symbian is losing share is the user experience, which isn’t competitive with Apple or Android.† (Chen). Key issue or issues to be investigated Due to this understanding, Nokia went in search of other OSs, which can be incorporated into its devices. After doing in-depth study, Nokia and in particular its recently appointed CEO, Stephen Elop, who is actua lly a former head of Microsoft business division, decided to form a strategic alliance with Microsoft in early 2011, thereby replacing not only Symbian but also MeeGo with Microsoft's Windows Phone operating systems particularly with Windows Phone 8. Although, Nokia decided to run its low-to-mid end mobile devices on Symbian and MeeGo, majority of its devices especially Smart Phones were planned to be migrated to Windows OS. After being attached with Symbian OS for many years, this decision to incorporate Windows OS is not an easy process to adopt and implement, as it involves sizable changes to the whole organization including its different departments. Any change in strategy will have to be accompanied by a sizable amount of change within the organizational structure. This need to actualize changes in various departments is line with the metaphor of Flux and transformation. This metaphor focuses on how entities including organizational bodies will be in a constant state of change, based on the changes that are happening in their external and internal environment. â€Å"Everything flows and nothing abides; everything gives way and nothing stays fixed.† (Morgan 241). If the organization maintains a rigid stance, without changing and flowing with the flow, then it will stagnate. Only if the organization in line with Flux and Transformation updates its organizational processes, filtering out failing processes and

Generational Welfare Essay Example for Free

Generational Welfare Essay Generational Welfare For most of America’s history, farmers, entrepreneurs or shop owners could live their entire lives without getting any assistance from the federal government except maybe mail. But those days are long gone. In 2012 the total number of Americans on government assistance or welfare reached 4,3000,000. Many of which are 4th or 5th generation Welfare recipients. For whatever the reason, we have become a culture of dependency in which poverty is a trap. Long-term recipients loose job skills, work habits as well as work contacts. For this reason the government should require recipients to work as much as they can. It could be called â€Å"workfare† and could help recipients increase potential long-term earnings. Generation poverty is defined as children of parents in poverty grow up to live in poverty themselves in a continuous cycle for at least two generations. All too often this is a result of a traumatic event-taking place such as a illness or divorce that alters the family structure Hard working, self-reliant men and women built this country, but these work ethics began to change during the great depression in the 1930’s. A federal welfare program was introduced, it granted monthly cash and food coupons to assist with basic living needs, it was established to assist those who were living below the poverty line. This system went virtually unchanged since 1930, and was due for a much-needed reform. In 1996 President Bill Clinton made great strides to give welfare a long overdue facelift. He gave the duties of welfare to the states by implementing the Personal Responsibility and Work Opportunity Reconciliation Act. This act restricted aid to most legal residents. The bill had a 5year lifetime maximum for cash assistance and, required recipients to search for employment among other requirements. This welfare reform law was very successful. More than 60% percent of recipients were able to get off the welfare program. However, the core of this program was done away with in 2012 by the Obama administration. A directive was issued stating that TANF (Temporary assistance for needy Families) work requirements could be waived or over ridden by section 1115 waiver authority under the Social Security law. This has fueled an ongoing debate over whether welfare dependency in one generation causes welfare dependency in the next generation. Psychologist, Albert Bandura is considered the pioneer  behind the Social Learning Theory. This theory states that people learn from their so cial contexts and much of social behavior is learned through observing and practiced through modeling. This observational learning can occur in three ways: live modeling, symbolic learning and instruction. This explains the cycle of generational welfare among our nations poor. Last year the Wall Street Journal reported that 49% of the population of the United States lives in a household where at least one person receives some type of government assistance. The Heritage Foundation’s annual Index of Dependence on Government, tracks government spending, and the score is adjusted for federal programs that contribute to government assistance dependency. In 2010 the foundation reported that nearly 67.3 million Americans received Social Security, TANF (Temporary Assistance for Needy Families, educational support for higher learning, or some other assistance that was once considered to be the responsibility of families, individuals, churches, and neighborhoods. A culture has developed within families in which welfare is reinforced and sometimes even encouraged by parents who are also receiving benefits and their children. Children also become more accepting of the idea of assistance because their parents are currently receiving welfare benefits. The goal of public policy should be reducing poverty, not just the reduction of caseloads. The plan that was implemented by former President Clinton did just that. Jobs have to be created and av ailable before we can reduce the number of persons receiving government assistance. More often than not, when jobs are created they are low-skill jobs and do not pay enough to meet employees basic needs which results in many quitting and going back on government aid. We need more programs set up to provide training in work skills or a trade so that citizens will be able to receive wages that will easily sustain their families and encourage them to become self sufficient and non dependent on government assistance. It gives great satisfaction for a person to know that they are completely self-sufficient and can provide their family with at least its basic needs. It gives a sense of purpose and builds self-confidence that you do not have when you have to rely on the government or another person for financial help. It requires decision, determination, and discipline. Some may argue that generational poverty is determined by poor health across generations and not by observation or modeling of ones parents. However the statistics  from the changes made during the Clinton administration, give proof that the Personal Responsibility and Work Opportunity Reconciliation Act, that works and should be reinstated. Most citizens have a desire to be successful but just don’t have the skills or self-esteem they need to accomplish these goals. Sometimes it takes a little push to get them headed in the right direction and this program seems to do just that. It provided nearly any means of assistance for individuals to become job ready. It provided assistance with transportation problems; self-esteem issues like dental work or even haircuts. Individuals were coached in interview skills and good work ethics. Many classes were provided to help assist in lifestyle and finance management changes. Individuals were encouraged to further their education and were given assistance with college enrollment applications as well. All of the qualities that are needed to preform a job to the fullest of ones ability were provided to wean recipients off of welfare. We have to reach the core understanding of why some people get stuck in a cycle of generational poverty and work on the core problem if we want long-term results. In which individuals receive jobs, perform their duties to the best of their ability and take pride in being self-sufficient. When individuals are proud of their accomplishments and are confident that they will be able to provide for themselves and their family, then we will begin to see a decline in numbers of generational welfare recipients and will be able to witness our economy grow and flourish. Works Cited Axelrod, Norman. Chicago Tribune: Chicago Breaking News, Sports, Business, Entertainment, Weather and Traffic Chicagotribune.com. Chicago Tribune: Chicago Breaking News, Sports, Business, Entertainment, Weather and Traffic Chicagotribune.com. Chicago Tribune, 14 Aug. 2011. Web. 01 Aug. 2013. . Bowen, Barry D. 1996 Welfare Reform Facts. 1996 Welfare Reform Facts. N.p., 1996. Web. 01 Aug. 2013. . Gaiser, Elliot T. Obama Guts Welfare Reform. Heritage.org. N.p., 8 May 2013. Web. McLeod, Saul. Bandura Social Learning Theory. Albert Bandura. Simply Psychology, 2011. Web. 01 Aug. 2013. . Generational Welfare For most of America’s history, farmers, entrepreneurs or shop owners could live their entire lives without getting any assistance from the federal government except maybe mail. But those days are long gone. In 2012 the total number of Americans on government assistance or welfare reached 4,3000,000. Many of which are 4th or 5th generation Welfare recipients. For whatever the reason, we have become a culture of dependency in which poverty is a trap. Long-term recipients loose job skills, work habits as well as work contacts. For this reason the government should require recipients to work as much as they can. It could be called â€Å"workfare† and could help recipients increase potential long-term earnings. Generation poverty is defined as children of parents in poverty grow up to live in poverty themselves in a continuous cycle for at least two generations. All too often this is a result of a traumatic event-taking place such as a illness or divorce that alters the fami ly structure Hard working, self-reliant men and women built this country, but these work ethics began to change during the great depression in the 1930’s. A federal welfare program was introduced, it granted monthly cash and food coupons to assist with basic living needs, it was established to assist those who were living below the poverty line. This system went virtually unchanged since 1930, and was due for a much-needed reform. In 1996 President Bill Clinton made great strides to give welfare a long overdue facelift. He gave the duties of welfare to the states by implementing the Personal Responsibility and Work Opportunity Reconciliation Act. This act restricted aid to most legal residents. The bill had a 5year lifetime maximum for cash assistance and, required recipients to search for employment among other requirements. This welfare reform law was very successful. More than 60% percent of recipients were able to get off the welfare program. However, the core of this program was done away with in 2012 by the Obama administration. A directive was issued stating that TANF (Temporary assistance for needy Families) work requirements could be waived or over ridden by section 1115 waiver authority under the Social Security law. This has fueled an ongoing debate over whether welfare dependency in one generation causes welfare dependency in the next generation. Psychologist, Albert Bandura is considered the pioneer  behind the Social Learning Theory. This theory states that people learn from their social contexts and much of social behavior is learned through observing and practiced through modeling. This observational learning can occur in three ways: live modeling, symbolic learning and instruction. This explains the cycle of generational welfare among our nations poor. Last year the Wall Street Journal reported that 49% of the population of the United States lives in a household where at least one person receives some type of government assistance. The Heritage Foundation’s annual Index of Dependence on Government, tracks government spending, and the score is adjusted for federal programs that contribute to government assistance dependency. In 2010 the foundation reported that nearly 67.3 million Americans received Social Security, TANF (Temporary Assistance for Needy Families, educational support for higher learning, or some other assistance that was once considered to be the responsibility of families, individuals, ch urches, and neighborhoods. A culture has developed within families in which welfare is reinforced and sometimes even encouraged by parents who are also receiving benefits and their children. Children also become more accepting of the idea of assistance because their parents are currently receiving welfare benefits. The goal of public policy should be reducing poverty, not just the reduction of caseloads. The plan that was implemented by former President Clinton did just that. Jobs have to be created and available before we can reduce the number of persons receiving government assistance. More often than not, when jobs are created they are low-skill jobs and do not pay enough to meet employees basic needs which results in many quitting and going back on government aid. We need more programs set up to provide training in work skills or a trade so that citizens will be able to receive wages that will easily sustain their families and encourage them to become self sufficient and non dependent on government assistance. It gives great satisfaction for a person to know that they are completely self-sufficient and can provide their family with at least its basic needs. It gives a sense of purpose and builds self-confidence that you do not have when you have to rely on the government or another person for financial help. It requires decision, determination, and discipline. Some may argue that generational poverty is determined by poor health across generations and not by observation or modeling of ones parents. However the statistics  from the changes made during the Clinton administration, give proof that the Personal Responsibility and Work Opportunity Reconciliation Act, that works and should be reinstated. Most citizens have a desire to be successful but just don’t have the skills or self-esteem they need to accomplish these goals. Sometimes it takes a little push to get them headed in the right direction and this program seems to do just that. It provided nearly any means of assistance for individuals to become job ready. It provided assistance with transportation problems; self-esteem issues like dental work or even haircuts. Individuals were coached in interview skills and good work ethics. Many classes were provided to help assist in lifestyle and finance management changes. Individuals were encouraged to further their education and were given assistance with college enrollment applications as well. All of the qualities that are needed to preform a job to the fullest of one s ability were provided to wean recipients off of welfare. We have to reach the core understanding of why some people get stuck in a cycle of generational poverty and work on the core problem if we want long-term results. In which individuals receive jobs, perform their duties to the best of their ability and take pride in being self-sufficient. When individuals are proud of their accomplishments and are confident that they will be able to provide for themselves and their family, then we will begin to see a decline in numbers of generational welfare recipients and will be able to witness our economy grow and flourish.

Ibandronate vs. Alendronate for Osteoporosis

Ibandronate vs. Alendronate for Osteoporosis Cost-Effectiveness of Ibandronate vs. Alendronate used in treatment of osteoporosis, in a specialized clinic in Tirana. Dr. Mirela Miraà §i1; Msc.Arlinda Demeti2; Prof.as Zamira Ylli3; Prof.Mira Zià §ishti3; Prof.As Suela Kellià §i1 Faculty of Pharmacy, University of Medicine, Tirana. Bioparafarmacia Franceze Neostyle Clinic Abstract: Osteoporosis is â€Å"a systemic skeletal disease with a high prevalence. Biphosphonates are medicaments which are chosen for their efficacy in reducing fracture incidence, increasing bone density and improving bone microarchitecture. The aim of the study is to evaluate the effectiveness of the drugs (ibandronate and alendronate) used in osteoporosis treatment, in post-menopausal women over the age of 50 years at a specialized clinic in Tirana; to calculate the annual cost of treatment of osteoporosis and to perform a cost effectiveness analyze. Methods: Retrospective. The patients were all female, in menopause or post menopause, with T-score -1 to -6, treated with alendronate or ibandronate. The effectiveness is calculated as the average percentage of change in bone mineral density (av. % of change in BMD) of year 2011 vs. 2010 baseline. The annual cost of the treatment of osteoporosis according to the protocols and the cost of the examination with DXA scan (dual x-ray absorptiometry) were calculated. Finally a comparison of the cost-effectiveness was performed. Conclusion:  Patients with osteoporosis treated with Ibandronate, at our clinic in Tirana, have an average change from baseline higher compared with patients treated with Alendronate, with statistically significant difference between them (Man Whitney U = 66.0, p The annual cost of the disease when treated with ibandronate is 1.3 times higher than the annual cost of treatment with alendronate. Ibandronate is more cost effective than all other alendronate . Introduction: Osteoporosis is â€Å"a systemic skeletal disease characterized by low bone mass and micro architectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fractures† (1) The World Health Organization defines osteoporosis as â€Å"bone density 2.5 standard deviations (SDs) below the mean for young white adult women at lumbar spine, femoral neck or forearm†. (2) Osteoporosis leads to nearly 9million fractures each year worldwide and over 300,000patients with fragility fractures are registered in UK hospitals each year (British Orthopaedic Association, 2007).(3) Osteoporoza, à «shtà « njà « sà «mundje me njà « prevalencà « tà « lartà « edhe nà « Shqipà «ri (7.28% e popullatà «s dhe 9.6% tek femrat)4, e njà «jtà « me atà « tà « hasur pà «r astmà «n apo sà «mundjet e zemrà «s; †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.. Direct medical costs due to fragility fractures in UK healthcare economy were estimated at  £1.8billion in 2000, with the potential to increase to  £2.2billion by 2025 and the major part of these costs were related to hip fracture care. (5) The annual cost of osteoporosis and fractures in the US elderly was estimated at $16 billion(6) Osteoporosis is diagnosed by a T-score, which is the number of standard deviation (SD) that patient’s bone mineral density (BMD), measured using dualX-ray absorptiometry, differs from the mean BMD of 30-years old premenopausal women. Patients with T-score of between -1 and -2.5 SD are said to have osteoporosis.7,8 Biphosphonates are medicaments which are chosen for their efficacy in reducing fracture incidence, increasing bone density and improving bone microarchitecture.9-15 Top of Form Methods: Retrospective. The patients were all female, in menopause or post menopause, 50 years old or elder, with T-score -1 to -6, diagnosed for the 1rst time in 2010 (the 1rst BMD measurement), who have received treatment (alendronate or ibandronate) for 12 months and in 2011 have performed a 2nd BMD measurement. The effectiveness is calculated as the average percentage of change in bone mineral density (av.% of change in BMD) of year 2011 vs. 2010 baseline. It was calculated the annual cost of the treatment of osteoporosis according to the protocols: with once monthly 150 mg oral ibandronate plus supplements (calcium, vitamine D) and once weekly 70 mg alendronate (4 times per month) plus supplements (calcium, vitamine D). There are also included other direct costs such as the examination with DXA scan (dual x-ray absorptiometry) to determine the diagnosis and the medical visits. Finally a comparison of the cost-effectiveness will be performed. Statistical Analysis Data were analyzed with SPSS 20 statistical package. It is used the non-parametric Man Whitney U test to compare the continuous variables, Fisher Exact test was used to compare proportions between variables and the the Odds Ratio OR for assessing the association between variables. Point estimations are accompanied with interval estimation by 95 % CI. For continuous variables is presented the average, the standard deviation and the minimum and maximum values. The level of statistical significance is defined at ÃŽ ± ≠¤ 005. Statistical tests are two-sided.duhet te shihet gjuha e perdorur, a qendron ne anglisht? Results of the study In our study were included 70 patients who fulfill the inclusion criteria. 24 patients were treated with once monthly 150 mg oral ibandronate and 46 patients with once weekly 70 mg alendronate.There were not case of fracture among our patients. Table 1 compares the frequency of pathologies (osteopenia and osteoporosis) in two groups of patients treated with alendronat or ibandronat. Osteoporosis Osteopenia Ibandronate 14 10 Alendronate 18 28 OR= 1.3 95%CI 0.5 4.2 p=0.4 Your contribution will be used to improve translation quality and may be shown to users anonymously Contribute Close Thank you for your submission. Number of patients treated with alendronate is 1.3 times higher than the number of patients treated with ibandronate in the case of osteoporosis. (OR = 1.3, 95% CI 0.5-4.2, p = 0.4). Chart 1 Calculation of efficiency We have to calculate the average percentage of change of BMD (2011) to baseline (2010): Table2. In the group of Alandronate (N=46) we have found this data: Osteoporosis n=18 Osteopeni n= 28 M (SD) min max M (SD) min max Mann-Whitney U p T Score 2010 -3.2 (0.7) -4.6 -2.5 -1.9 (0.4) -2.4 -1.1 507.0 T Score 2011 -3.1 (0.8) -4.7 -2.2 -1.8 (0.6) -2.4 -1.1 515.5 Age, yrs 61.2 (8.0) 51.0 – 79.0 59.1 (7.8) 51.0 – 81.0 223.5 0.3 Height, m 1.5 (0.05) 1.4 – 1.6 1.5 (0.07) 1.4 – 1.7 304.5 0.3 Weight, kg 58.8 (8.3) 46.0 – 73.0 68.6 (11.1) 51.0 – 95.0 376.5 0.01 *Age-Group, yrs n (%) n (%) OR (95% CI) 50 -59 yrs 8 (17) 19 (41) 60 -69 yrs 7 (15.2) 6 (13.0) 1.6 0.4 – 6.7 0.4 >70 yrs 3 (7) 3 (7) 2.8 0.4 – 25.2 0.3 *Fisher exact test p=0.3 There are 46 patients treated with alendronate. 18 ( 39.1 %) (95% ; CI 29.7 52.1) of them suffer from osteoporosis and 28 ( 60.9 % ) (95 % CI 47.8 74.2) from osteopenia, with no statistically significant difference between them, p = 0.9 Grupmosha 60 – 69 vjeà § ka 1.6 herà « mà « tepà «r gjasa qà « tà « vuajnà « nga Osteoporoza sesa grupmosha 50-59 vjeà §, por pa ndryshim sinjifikant ndà «rmjet tyre (OR=1.6; 95%CI 0.4–6.7; p=0.4) Grupmosha >70 vjeà § ka 2.8 herà « mà « tepà «r gjasa qà « tà « vuajnà « nga osteoporoza sesa grupmosha 50-59 vjeà §, por pa ndryshim sinjifikant ndà «rmjet tyre (OR=2.8; 95%CI 0.4–25.2; p=0.3) Pacientet me Osteopeni kanà « peshà « mesatare mà « tà « lartà « krahasuar me pacientà «t me Osteoporozà «, me ndryshim statistikisht tà « rà «ndà «sishà «m ndà «rmjet tyre (Man Whitney U=376.5, p=0.01) Pacientà «t me Osteoporozà « kanà « tà « njà «jtà «n gjatà «si mesatare me pacientà «t me Osteopeni, pa ndryshim statistikisht tà « rà «ndesishà «m ndà «rmjet tyre (Man Whitney U=304.5, p=0.3). The change from baseline for Alendronate group The change from baseline is calculated: Table 3 Osteoporosis n=18 Osteopenia n= 28 M (SD) min max M (SD) min max Mann-Whitney U p The change from baseline 2.1 (4.5) -7.6 – 13.9 1.7 (6.2) -23 – 11.1 316.0 0.2 Patients with osteopenia have an average change from baseline higher compared with patients with osteoporosis, no statistically significant difference between them (Man Whitney U = 316.0, p = 0.2). Table 4. In the group of Ibandronate (N = 24) we have find this data: Osteoporosis n=14 Osteopeni n= 10 M (SD) min max M (SD) min max Mann-Whitney U p T Score 2010 -3.7 (0.7) -5.0 -2.7 -1.8 (0.3) -2.2 -1.4 140.0 T Score 2011 -3.2 (0.8) -4.4 -1.7 -1.5 (0.4) -2.1 -1.0 134.5 Age yrs 64.3 (7.3) 53.0 77.0 59.1 (5.0) 53.0 – 68.0 39.5 0.07 Height (m) 1.5 (0.05) 1.4 – 1.6 1.5 (0.06) 1.4 – 1.6 71.0 0.9 Weight 66.2 (10.9) 47.0 – 84.0 70.7 (7.1) 65.0 – 82.0 90.5 0.2 *Age-group, yrs n (%) n (%) OR (95% CI) 50 -59 yrs 3 (12.5) 6 (25.0) 60 -69 yrs 8 (33.3) 4 (16.7) 3.7 0.6 – 27.8 0.2 >70 yrs 3 (12.5) 0 13 0.5 – 33.0 0.03 *Fisher exact test p There are 24 patients treated with Ibandronate. 14 (58.3%), (95% CI 33.2-76.5) of them suffer from osteoporosis and 10 (43.7%), (95% CI 23.4-61.7) of osteopenia, no statistically significant difference between them, p = 0.9. Pacientà «t me Osteoporozà « kanà « njà « moshà « mesatare mà « tà « lartà « krahasuar me pacientà «t me Osteopeni, por pa ndryshim statistikisht tà « rà «ndà «sishà «m ndà «rmjet tyre (Man Whitney U=39.5, p=0.07). Pacientà «t me Osteoporozà « kanà « tà « njejtà «n gjatà «si mesatare me pacientet me Osteopeni, pa ndryshim statistikisht tà « rà «ndà «sishà «m ndermjet tyre (Man Whitney U=71.0, p=0.9) Grupmosha 60 – 69 vjeà § ka 3.7 herà « mà « tepà «r gjasa qà « tà « vuajà « nga Osteoporoza sesa grupmosha 50-59 vjeà §, por pa ndryshim sinjifikant ndà «rmjet tyre (OR=3.7; 95%CI 0.6–27.8; p=0.2). Grupmosha >70 vjeà § ka 13 herà « mà « tepà «r gjasa qà « tà « vuajà « nga osteoporoza sesa grupmosha 50-59 vjeà § me ndryshim sinjifikant ndà «rmjet tyre (OR=13; 95%CI 0.5–33.0; p=0.03). Pacientà «t me Osteopeni kanà « peshà « mesatare mà « tà « lartà « krahasuar me pacientà «t me Osteoporozà «, por pa ndryshim statistikisht tà « rà «ndà «sishà «m ndà «rmjet tyre (Man Whitney U=90.5, p=0.2) The change from baseline for Ibandronate group (N=24) The change from baseline is calculated: Table5 Osteoporosis n=14 Osteopenia n= 10 M (SD) min max M (SD) min max Mann-Whitney U p The change from baseline 7.3 (6.1) -0.5 – 17.3 3.3 (2.2) -1.3 – 6.3 43.0 0.1 Patients with osteoporosis have an average change from baseline higher compared with patients with osteopenia, no statistically significant difference between them (Man Whitney U = 43.0, p = 0.1) Comparison of change from baseline for patients with osteoporosis referring the two drugs. Table 6. Alendronate n=18 Ibandronate n= 14 M (SD) min max M (SD) min max Mann-Whitney U p The change from baseline 2.1 (4.5) -7.6 – 13.9 7.3 (6.1) -0.5 – 17.3 66.0 Chart 2. The change from baseline for patients with osteoporosis Pacientà «t me Osteoporozà « tà « mjekuar me medikamentin Ibandronat kanà « njà « ndryshim mesatar nga baseline mà « tà « lartà « krahasuar me pacientet e mjekuar me Alendronat, me ndryshim statistikisht tà « rà «ndesishà «m ndà «rmjet tyre (Man Whitney U=66.0, p Table 7. Percentages of the average change of BMD from baseline Total Osteoporosis Ostopenia Alendronate 1.83564848 2.081694 1.677476 Ibandronate 5.635355 7.27025 3.346503 Chart 3. Nga figura rezulton se efikasiteti i medikamentit ibandronat (5.6) à «shtà « dukshà «m mà « i lartà « se efikasiteti i medikamentit alendronat (1.8). Efikasiteti i medikamentit ibandronat tek pacientà «t me osteoporozà « (7.3) à «shtà « dukshà «m mà « i lartà « se efikasiteti i medikamentit alendronat (2.1). Efikasiteti i medikamentit ibandronat tek pacientà «t me osteoponi (3.3) à «shtà « mà « i lartà « se efikasiteti i medikamentit alendronat (1.7). Cost analysis We consider only direct costs such as: DXA scanner examinations, medical visits and medications costs (drugs and the supplements), according to a well-defined treatment protocol. In Albania, there is only one kind of ibandronate (only one brand) 150 mg / once a month, while there are lots of alendronate (different brands) 70 mg / 4 times per month, which we have called A1,A2,A3, A4,A5. We have calculated the costs of the only ibandronate and the costs of five types of alendronate, including the alendronate produced by a pharmaceuticals firm in the country, which has the lowest price in the market. In both cases the basic treatment is associated with calcium and vitamin D. Table 8 Annual Cost of treatment and cost of examination Nr Currency Quantity Cost Month Annual Costs 1 Diagnostics skaner DXA Lek1 1 4,000 4,000 Medical examination 1 1,000 1,000 2 Type of Alendronat 70mg A1 lek 4 3,410 12 40,920 A2 lek 4 2,093 12 25,116 A3 lek 4 3,301 12 39,612 A4 lek 4 4,102 12 49,224 A.5 (Albanian Product) lek 4 1,200 12 14,400 3 Ibandronat 150 mg lek 1 4,873 12 58,476 4 Calcium Carbonat 1000 mg + Colecalciferol 880 UI lek 30 1,019 12 12,228 Table 9 Cost of illness according the type of medications Type of Alendronat 1+2+4 Annual costs A1 lek 58,148 A2 lek 42,344 A3 lek 56,840 A4 lek 66,452 A5 lek 31,628 Type of Ibandronat 1+3+4 Annual costs I1 lek 75,704 The annual cost of the disease when treated with ibandronate is 2.4 times higher than the annual cost of treatment with alendronate the alendronate produced by a pharmaceuticals firm in the country, which has the lowest price in the market, respectivly 537[1] euro versus 226 euro per patient in alendronate group. Having all the annual costs and the efficiency for each drug, we can compare: Table 10 Name (Changes by baseline in %) Efficiency of alendronate 1.83565 Efficiency of ibandronate 5.63536 Table11 Type of treatment C/E Alendronate A1 31,677 A2 23,068 A3 30,965 A4 36,201 A5 17,230 Ibandronate 13,434 The analyse of cost per efficiency unit (Table 10) shows that in the case of ibandronate the value obtained is 13.434 units and in alendronate A1 case is 31.677 units. Discussion of results Patients with osteoporosis treated with Ibandronate, at our clinic in Tirana, have an average change from baseline higher compared with patients treated with Alendronate, with statistically significant difference between them (Man Whitney U = 66.0, p 16 The annual cost of the disease when treated with ibandronate is 1.3 times higher than the annual cost of treatment with alendronate A1 and 2.4 times higher than the annual cost of treatment with the alendronate produced by a pharmaceuticals firm in the country, which has the lowest price in the market. So as claimed, the cost for effectiveness unit is lower (about 2.3 times) in the case of ibandronate compared to alendronate A1. Well ibandronate results the most cost- effective. Ibandronate turns more cost effective than all other alendronate including the alendronate produced by a pharmaceuticals firm in the country, which has the lowest price in the market Literature Christiansen, C. (1993). Consensus development conference: diagnosis, prophylaxis,and treatment of osteoporosis. Am J Med 94:646–50. Kanis, J.A. (1994). Assessment of Fracture Risk and its Application to Screening forPostmenopausal Osteoporosis. Report of a WHO Study Group. Geneva: World HealthOrganization. Johnell O, Kanis JA (2006) An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporosis International 17: 1726–33. Dorina Ruco,(Dhjetor 2011): Osteoporoza nà « qytetin e Tiranà «s British Orthopaedic Association (2007).The care of patients with fragility fracture. Burge RT, Worley D, Johansen A, et al. The cost of osteoporotic fractures in the UK: projections for 2000–2020. Journal of Medical Economics 4: 51–52. Blume SW,Curtis JR Osteoporos Int.2011 Jun;22(6):1835-44. doi: 10.1007/s00198-010-1419-7. Epub 2010 Dec 17. Medical costs of osteoporosis in the elderly Medicare population. BMJ Group. Annual zoledronic acid for osteoporosis. Drug Ther Bull. 2008 Dec;46(12):93-6. Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002;359:1761e7. Delmas PD. Treatment of postmenopausal osteoporosis. Lancet 2002;359:2018e26. Hochberg MC, Ross PD, Black D, et al. Larger increases in bone mineral density during alendronate therapy are associated with a lower risk of new vertebral fractures in women with postmenopausal osteoporosis.Fracture Intervention Trial Research Group. Arthritis Rheum 1999;42:1246e54. Hochberg MC, Greenspan S, Wasnich RD, et al. Changes in bone density and turnover explain the reductions in incidence of nonvertebral fractures that occur during treatment with antiresorptive agents. J Clin Endocrinol Metab 2002;87:1586e92. Epstein S. The roles of bone mineral density, bone turnover, and other properties in reducing fracture risk during antiresorptive therapy. Mayo Clin Proc 2005;80:379e88. McClung MR, Wasnich RD, Recker R, et al. Oral daily ibandronateprevents bone loss in early postmenopausal women with osteoporosis.J Bone Miner Res 2004;19:11e8. Rosen CJ. Postmenopausal osteoporosis. N Engl J Med 2005;353: Miller PD,Epstein S,Sedarati F,Reginster JY Once-monthly oral ibandronate compared with weekly oral alendronate in postmenopausal osteoporosis: results from the head-to-head MOTION study. http://www.ncbi.nlm.nih.gov/pubmed/18042311

Ravenna Essays -- Art History Papers

Located in northeast Italy in the Emilia-Romagna region and the capital of the province bearing its name, Ravenna is internationally celebrated for its stunning ancient mosaics and rich history. Ravenna's prosperous past is evident in its wealth of still-standing examples of Byzantine art and architecture. Positioned near the Adriatic Sea on a marshy plain, Ravenna has served as a strategic ?capital three times: of the western Roman Empire, of Theodoric King of the Goths, and of the Byzantine Empire in Europe? (History, par. 1). By delving into Ravenna?s history, as well as its remarkable artistic achievements, the reasoning behind its popularity in tourism becomes clear. Ravenna was formed by the buildup of centuries of silt deposits from the annual flooding of the Po River branches. The floods repeatedly pushed back the waterline of the Adriatic Sea to the point where Ravenna now lies, about five miles from the coast (Benigni, par. 1). The exact origin of this ancient city is uncertain as a multitude of legends lay claim to its beginnings. The Greek historian Dionysius of Hilicarnassus stated that the city was founded seven generations prior to the Trojan War; however, a fellow Grecian, Strabo, claimed that the Thessalonians were the founders. Tradition, according to Bovini, grants the title of earliest inhabitants to the Etruscans due to the typically Etruscan suffix,enna, as well as the discovery of Etruscan artifacts while historiographers insist that the Umbrians were the first established people (7). Little is known about Ravenna's history until the end of the third century BC when it fell completely under the influence of Rome. Though the city lacked the agricultural strength that normally drew the attention of th... ... by the Roman fleet in Classe, the earth has shifted in a way that it now lies two to three kilometers from the ocean Theodoric?s sixth century Basilica of Sant'Apollinare Nuovo was originally intended for Arians as their own palatinate church.? With a 16th century portico made of marble, a cylindrical bell tower from the 9th or 10th century, and mosaics with an astounding surface area, this edifice is a remarkable glimpse into Ravenna?s history.? The mosaics representing the processions Virgins and Martyrs are typical examples of Byzantine style.? In 520, Theodoric built this structure as his tomb.? The Mausoleum of Theodoric most likely held his remains in the upper floor until their removal during Byzantine rule.? The structure is made of Istria stone, the roof being one single block, and is ?divided in two decagonal orders one above the other (par. 52).?

Marketing and Company Culture Essay -- Analysis, Deshpande and Webste

This paper explores the various aspects of marketing and company culture and how both are interrelated within a functioning organization. Specifically, focus will be placed on the definition of company culture, the definition of marketing, how company culture and marketing are related, implementing both effectively, and finally a discussion of companies with excellent cultures. First, in order to have a complete understanding the relationship between marketing and company culture, one must know how company culture is defined. According to Leo Sin and Alan Tse, â€Å"Corporate culture has been defined as patterns of shared values and beliefs over time which produce behavioral norms that are adopted in solving problems† (295). Additionally, Debra Nelson and James Quick define organizational (corporate) culture as, â€Å"A pattern of basic assumptions that are considered valid and that are taught to new members as the way to perceive, think, and feel in the organization† (556). Furthermore, company culture is important because it facilitates higher efficiency, communication and collaboration between employees (Sathe, 9). In summary, the culture of an organization describes and determines how an organization and its employees will function in various situations. Beyond a definition of corporate culture, one also needs to look at how a company functions from a marketing perspective. According to the American Marketing Association, â€Å"Marketing is the activity, set of institutions, and processes for creating, communicating, delivering, and exchanging offerings that have value for customers, clients, partners, and society at large† (1). It can be seen clearly from this definition that marketing cannot be contained to merely advertising or a str... ...appos is another company recognized for a great culture and customer service. They have concentrated on maintaining the customer-centric view by pushing their marketing budget into developing customer service oriented culture and employees (Mickiewicz, 1). Both organizations have an understanding of the necessity of employee development and taking the viewpoint of the customer as Richard Drucker suggests. Through this research it can concluded that company culture not only affects and defines the company and the employees but marketing strategy as well. Furthermore, it would be beneficial to marketers and company executives alike for additional research to be conducted about how marketing can drive company culture and vice versa. However the empirical evidence of the numerous companies that already demonstrate excellent corporate culture and strategic marketing.

Discuss Research Into Effects of Workplace Stress Essay

A research for workplace stress was conducted by both Marmot and Johnson and Hall. Marmot researched effects for low control and whether it was linked to more stress. Johnson and Hall researched high workload to stress. Marmot conducted an investigation with participants from London – based government civil servants, and the studies are therefore referred to as the Whitehall studies. Civil employees in London were asked to volunteer to take part in the study. High grade employees were compared to Low grade civil servants. Marmot found that workers with less control were four times likely to die of heart attack than their colleagues with more control. In addition they were more likely to suffer from other stress related illnesses such as cancers, ulcers, stomach disorders and strokes. The conclusion was obvious, that lack of control seemed to be associated with illness and they recommended that employers gave their staff more autonomy and control. The study showed to be correlational. This is because it can only be said that there appears to be an association with low control and stress-related illness. It cannot be assumed that law control is causing illness. It could be that workers with poor health are likely to achieve the higher grade jobs with more control. For all the more reasons to weaken the findings. Also the research is said to be self-reported. This is because workers filled in their own questionnaire which is inaccurate and eligible for participant reactivity. Also if the workers found out what the researchers are looking to find then the results would be biased and so they may answer the questions accordingly. For this reason the findings of the research may be inaccurate and so will not be reliable. The investigation that Johnson and Hall did was done on a large scale and they investigated with 14000 male and female Swedish workers. They used self-report questionnaires. They compared sawmill workers high job demand and low control with maintenance workers who had low job demand and high control. Sawyers in Swedish sawmill had more illnesses and higher levels of adrenaline in urine than lower risks groups. This shows that high demand and workload is associated with stress related illness. The study relies heavily on self-report techniques making them less reliable. A person perception of their workload may not be entirely accurate or unbiased. Also cause and effect is hard to establish and high demand/low control jobs may be linked to social class. Furthermore the study doesn’t take into account of individual differences. Lazarus, another psychologist, claims that it is the perception of work overload that is the important factor rather than the number of hours/the actual amount of work. In this sense, work overload is a perception held by a worker that they are required to work too long and/or too hard. Those who have high hardiness may see demand as a challenge rather than a threat; this therefore weakens Johnsons’ overall assumption of workplace stress affecting individuals in the same way. The research on workplace stress has a good significance on its stressors as it affects productivity, motivation and time off work with health problems. Therefore occupational psychologists are brought into the workplace to reduce the workplace stress. The study also has practical applications and so many employers now take stress in the workplace very seriously. Stress is bad for business as it is seen to cause ill health, absenteeism, high staff turnover and low job performance all of which costs the company money. The research also has extraneous variables. This is because despite the link between lack of job control and stress related illness found in many studies.