Treatment of Tb Essay Example for Free

Treatment of Tb Essay Tuberculosis, they say, is a disease of the poor and truly it is a disease that puts us high above other nations in the world. We are currently among the 22nd high TB burdened countries and are under the WHO TB watch list. Tuberculosis is such a problem for us. Imagine, 75 of our fellowmen die each day because of TB. Tuberculosis, however, is not a terminal disease. Before, people thought once you have TB you’ll just die not cured with the disease. But now, it is actually very curable. Our government, in addressing to this dreaded disease, formulated the National Tuberculosis Program or NTP. This program envisions our nation as a country where TB is no longer a public health problem. The goal therefore is to reduce the prevalence and mortality from TB by half by the year 2015. Now, this is where DOTS comes in. At first, I thought DOTS is just about making sure that the patient is really taking in his TB regimens – like literally swallowing the medicines on schedule. It, however, is not just as simple as that. DOTS or Direct Observed Treatment, Short-Course is the WHO-recommended strategy for diagnosis, treatment and management of TB. Since TB is curable, the WHO believes that the best way to cure TB is through DOTS. It is a health strategy made up of five important components: Political Commitment for TB Control; Facilities for Microscopic Diagnosis of Sputum Positive Smear Patient; Unlimited Supply of Good Quality Anti-TB Drugs; Direct Observation of Therapy; and, Good Record Keeping. Through these components, it is made sure that the program is managed properly and that the sputum microscopy is of good quality. The program is embraced by the government and made sure it is implemented. Health professionals are taught and trained well on the importance of the program, precautionary measures, how to deal with the TB patient, and, most importantly, on the proper identification and reporting of sputum microscopy results. There is therefore uniformity in the reporting of laboratory results. The government has also allotted a specific monetary budget for the services of the health professionals under this program. There is also the regular supply of drugs, not only just drugs but medications that are of good quality and recommended by the WHO. More importantly, these drugs are FREE! All the patient has to do is to comply with the treatment. But, there are still patients who are, well, â€Å"human† – remarkably wise, talented entrepreneur (because some sell their TB medicines to others who also present with TB symptoms as they have). They have a mind of their own; they have their own treatment strategy. These make TB treatment difficult and pose threat on the development of resistant organisms because the medications are not taken on proper dosage and duration. It is because of this that there is this 4th element of the DOTS strategy – the direct observation of the treatment partner (treatment partners could either be a Staff of the Health Center, Member of the Community , or Member of the patient’s family (last priority)) of the patient taking in the TB medications. With good record keeping, the patients are properly monitored and followed up wherever they may be in the country. With just one missed appearance on treatment appointments, the in-charge health partner is alerted. There’s no reason at all for non compliance. What is more wonderful with DOTS in our country is that we have this PPMD or the Private – Public Mixed DOTS. This is very important because even the private health institutions apply DOTS so that wherever may the patient consult he or she is directed to the same treatment strategy for TB which ensures patient receives proper treatment and program benefits. Upon enrollment with the DOTS program, there is an allotted box of medications both for the intensive phase and the maintenance phase – the Stop TB Kit. With those new pulmonary smear positive cases and new seriously ill pulmonary smear negative cases, the intensive treatment is made up of four regimens: Isoniazid, Rifampicin, Pyrazinamide and Ethambutol. The number of capsules taken will depend on the weight of the patient (since usually the four drugs mentioned are formulated on a single capsule). Like for example, a patient weighing between 38-54 kg will be taking 3 tablets each appointment time with the treatment partner. The intensive treatment lasts for 2 months then a sputum smear will be requested. If patient is still sputum AFB smear positive there will be a month extension for the intensive phase. Afterwhich is the 4 months of maintenance phase. The regimen usually is composed of Isoniazid and Rifampicin. The kind and number of treatment regimens for tuberculosis is such because the TB bacilli, although TB is curable, is very difficult to eradicate and are prone to resistance. This is also why compliance is very important to prevent further development of resistant organisms. Whenever there are MDR TB patients (Multi Drug Resistant TB), they are referred to a higher center in Manila. There, patients are housed for 24 months, still free treatment. I think each MDR patient is budgeted with 500 1 million pesos such a huge amount. It is important therefore for us to prevent the development of such resistant organisms if we want our taxes serve the majority and give us better lives. Through the exposures regarding the DOTS, I now have a great appreciation for this program of the government. Whenever I will have an encounter with a possible TB patient, I could confidently refer him to a DOTS facility. I am hoping that we will truly be able to achieve our vision with regards to tuberculosis control as a nation.

The All-American Injury :: Essays Papers

The All-American Injury "Alright now, I want you to practice hard tonight, go full tilt, and, maybe tomorrow, our pregame practice will be short." The voice seemed a bit edgy, but then again, why wouldn't it? Coach was a little upset that we had lost our season home opener by three points. We were all disappointed by that. Practice had been deadly so far; we were pushed to the limit. Our conditioning warm-up had lasted almost twice what it usually was, and we were all dragging our feet. We were barely a half-hour into the usual Wednesday night ritual. "I want linemen down in the end zone," a husky voice cried out from behind the coach. The man who had hand-picked the Varsity players from the rag-tag group of civilians at the beginning of the season, and had turned them into a finely tuned, well-oiled piece of machinery, was expecting us to break into a full sprint for the end zone at that moment. When no one started running, he hollered. To underline his desire, hemade a few remarkable promise sof pain and suffering if his orders were not obeyed. Being one of the slowest members of the team, I was the third to the last man to the end zone. Naturally, I was the third one to be chosen for the endurance test. "Pits," the large man trumpeted, being drowned out in volume by the hoots of nearly twenty linemen. We loved pits, the mere mention of the word pumped overdosing amounts of adrenaline into the blood system. In this series of pits, however, there were two men threatening to invade my corner of the world, instead of the usual one man. This made the odds a little more interesting... for both corners. It gave one man a chance to prove how tough he was, and how weak the other two were, and it gave us our chance to earn respect among our peers. Taunting began almost immediately. One man's comment about another's sister quickly brought a retort about their mother. The battle was on. The teams were predetermined according to strength, size, and skill level. Having the chance to catch our breaths, and get our blood flowing to the appropriate parts of the brain, we faced off with abundant energy, and it proved to be rather competitive. "Walterick, Setcavage, Curtis, here now," the booming voice echoed in my helmet. Trotting over to the designated area, much as a warhorse into battle, I found myself at the end of a few selective comments about jelly doughnuts, and dead animals.

Impact of Terrorism and Violence on Global Tourism

Introduction According to World Travel and Tourism Council 1997, â€Å"Tourism Industry is the world’s prominent industries contributing $3. 6 trillion to the global gross domestic product (GDP) and employing 255 million people†. (Apostolopoulos, Sonmez &Tarlow 1999). It is also considered one of the most exciting and progressive industries which has a big impact on all other industries. Although tourism industry has shown tremendous growth in recent years providing incredible experiences to its consumers yet it remains highly prone to natural (e. g. Tsunami, Hurricane & volcanic eruptions) and human caused calamities (e. g. war, crime & terrorism). This essay therefore discusses about terrorism in relation to tourism. It focuses on the impacts of terrorism on global tourism and provides an understanding of the relationship between political instability, terrorism and tourism. Tourism, Political Instability and Violence Definition of terrorism† : ?† The US Department of State defines terrorism as â€Å". . . premeditated, politically motivated violence perpetrated against civilians and unarmed military personnel by sub national groups†¦ sually intended to influence an audience†Ã¢â‚¬  ? (Sihmez 1998)   Definition of political instability† : ?† Political instability describes the condition of a country where a government â€Å"has been toppled, or is controlled by factions following a coup, or where basic functional pre-requisites for social-order control and maintenance are unstable and periodica lly disrupted†Ã¢â‚¬  ? (Cook 1990, cited in Sihmez 1998). The study of D’Amore & Anuza 1986 states that, â€Å"Closer scrutiny of terrorism- for the purpose of understanding some of its underlying currents-begs a look at world conditions. As a new millennium is about to begin, nations wrestle with hunger, disease, and numerous other socioeconomic and environmental problems, which are further exacerbated by the alarming growth in the world’s population rate, the combination of which may nurture terrorism. It is suggested that terrorist organizations can easily recruit members by offering better conditions to people living in undesirable circumstances in undeveloped nations†. Therefore, in a situation where terrorism is on rise, safety and stability are the two factors that cannot be ignored while undertaking travel to other countries. Over the years, tourism industry has undergone tremendous changes wherein crime and violence have increased to a great extent. Such exertions have had a big impact on tourists altering their travel. Political instability can be categorised into various forms such as: international war, riots, social unrest, civil war, terrorism etc. â€Å"Most of the evidence on tourist motivations points to fear and insecurity as a major barrier to travel and thus a limitation on the growth of the industry. In addition to the openly stated fear there is often an expression of lack of interest in travel, which can mask an underlying fear. In these circumstances, the possibility of terrorism, however remote, will have an effect on the tourism demand of a large number of potential tourists. † (eds Mansfeld & Pizam1996) Political instability and tourism can be best explained with an example of crackdown by Chinese government on students who protested in Beijing’s Tiananmen Square In a volume edited by Mansfeld & Pizam (1996), â€Å"The sight of tanks rolling into the Square; the violent battles between students and troops; the steadfastly uncompromising attitude of Chinese authorities; it was all watched by the world on prime-time television. And most people living in free societies felt revulsion and anger; those planning holidays to China cancelled, while those with a vague notion of visiting the country put it on hold for the distant future- if ever† General impacts of terrorism and political disturbances upon the tourism industry Even its demonstrated economic success does not shield international tourism from the sinister power of terrorism† (Sonmez, Sevil F. , 1998). No country is safe from the threat of terrorism and research has shown that no part of the world has been spared by it. The fear of a totally unexpected terrorist attack grips the mind of today’s tourist, irrespective of region he is travelling to. Terrorism started to t ake its toll on tourism from mid 80’s, when international tourism was at its peak (Sonmez, Sevil F. 1998), and it became a major concern for many countries. Its impacts vary from direct to indirect and individual to global. Usually, after a terrorist attack or violence erupted due to political clashes, a destination recovers back to its normal inflow of tourists in about a quarter, but some major incidents can also affect tourist visitation for a longer period of time, the reason being over popularity by the media (Sihmez, 1998). For example, India was overexposed in the media after the Mumbai attacks in November 2008 which has had a negative effect on inbound tourism to India during the first quarter of 2009 (Tourism Forecasting Committee, 2008). Political disturbance, on the other hand, has long-term and deeper effects on a destination as it threatens the economy, the law and the society as a whole, thus jeopardizing the potential of a country as a tourism destination (Sihmez 1998). Economic impacts Terrorism and political turmoil mainly affect the economy of a country or a region. Worst hit are the countries, which are majorly dependent on the tourism industry. A good example can be given from 1986, when 54% of Americans who planned to go to Europe, cancelled their bookings because of the risks implied by the rise of terrorist activities during that period (D’Amore and Anuza 1986, cited in Sihmez 1998). Furthermore, countries located nearby a politically agitated country may suffer from a perceived lack of safety by tourists who associate the neighbouring countries due to geographical proximity, although travelling in the former may be without any risk. Countries often have to bear the costs of terrorism, in terms of investments in security, terrorism risk insurance premium, airport screening opportunity costs and consumer welfare losses to ensure safety and security for their people (Keefer P. , 2008). Psychological impacts Impacts of terrorism on tourist behaviour and decision-making process (Sihmez, 1998 pg. 13) however, depend on the type of tourists: business travellers and leisure travellers will not react the same way in regards to risk, as they do not have the same motivations and needs for travel. Image deterioration / Negative images Natural events such as floods, tsunami or earthquakes do not have the same impact on a country’s image as a terrorist attack has. Natural calamities may draw sympathy, and may affect inflow of tourists for a short period, but people know that natural disasters are unavoidable, so the image they form of a destination is different. Fall in tourist arrivals in these destinations may recover earlier because these destinations are not perceived as ‘unsafe’, as in case of a destination, where terrorist activity is prominent. Politically unstable environment of a destination usually has a negative and a much stronger impact on people’s mind over a longer period of time because human action is deliberate and physical injury is most of the time the aim of these actions. Examples and focus on a particular region or destination There are a lot of tourist destinations which suffer from terrorist attacks. Egypt which had almost 4 billion dollars in tourist receipts in 1999 depended a lot on the tourism revenue. However, the revenue from this sector of economy decreased due to the terrorist attacks by al-Gama’a al-Islamiya. The first attack occurred on October 1, 1992. One British tourist was killed and two others were wounded. During the five year period about 100 tourists were killed in the attacks including the tourists from Germany, Greece, Switzerland, Japan and Great Britain. One year after the first attack tourism revenue in Egypt felt by 11 percent. However, it increased by four percent in 1994 and by 34 percent in 1995. Moreover, net increase in tourist receipts between 1993 and 1997 was 93 percent (Essner, 2003). The Egyptian government managed to sustain its tourism sector and contribute to the GSP by 5% (Weaver). The factors of this success are the huge historic and cultural heritage of Egypt that keeps drawing international visitors, but also incentive measures taken by the industry in order to sustain inbound tourism. For instance, the national airline, EgyptAir, cut its airfares by 50% after the 1997 Luxor massacre of 58 tourists (Weaver). â€Å"Event in New York City and Washington D. C. on September 11, 2001 was one of the most significant terrorism attacks which occurred recently. This event influenced the economies of states which depended on the tourism industry a lot. Furthermore, the whole economy of the USA was demolished which led to the global economic slump† (Pizam, 2002). Certain sectors of the tourism industry suffered from the terrorist attack. Hotel occupancy rates decreased dramatically. It â€Å"plummeted to 41. 8 percent the week following the attacks, a 52-percent decrease from the same period in 2000† (Stafford et al, 2002). In total, 3016 people died including passengers and crew on the planes, people within or beneath the Twin Towers and on the ground at the Pentagon. This attack has certain impacts on travel and tourism industry in the USA. Security measures at the places where large number of people including tourists are likely to gather were reconsidered. The number of US National guards in the airports increased and other security measures in the airports such as better screening and checking of passengers and baggage technologies were introduced. Security measures were improved in seaports, bus stations and train station as well. It included increasing of the surveillance cameras and checkpoints. The number of security guards in these places grew up as well. Moreover, the Federal Aviation Administration set up the program of increasing the number of bomb-sniffing dogs. The FAA trained 175 dogs for 39 airports (Goodrich, 2002). Many other countries which have high rates in tourism receipts also suffered from the terrorist attacks. Establishing of an Islamic Palestinian State in place of Israel resulted in the attacks initiated by both Israelis and Palestinians. This disturbance led to dramatic drop in 1996 in the number of tourists which grew steadily between 1970 and 1994 (Sihmez Sevil F. 1998). Another example of suffering from terrorism attack is Peru. Attacks by the Sendero Luminoso (Shining Path), a Maoist terrorist group caused the decrease in number of tourists from 350,000 in 1989 to 33,000 in 1991 (Sihmez Sevil F. 1998). Word of mouth and previous experience Media Reporting & Image making Intergovernmental relationsGovernment policies and interests Figure 1: Political instability, violence and the imaging process Hall &O’Sullivan study (cited in Mansfeld & Pizam 1996) The above figure is a model of various factors that lead to image creation of the political stability of the destination region. Three factors: word of mouth, media and the government lead to the images creation of destination, in the tourist generating regions. Domestic tourism is equally affected by the occurrence of any kind of violence or terrorist activity. Many factors such as: promotion, tourist attractions, development, new routes, travel prices contribute in to reasonable changes in domestic as well as international tourism. As per the study of Bar-on (cited in Mansfeld and Pizam 1996), act of violence can affect tourism in following ways: â€Å"Tourists may fear being killed or injured. † Security checks, especially at airports, may take a long time and even be unpleasant for some tourists. † â€Å"Tour operators, travel agents and airlines may not want to risk organizing trips to specific regions. † â€Å"Travel insurance of tourists and airlines may be difficult, limited or expensive. † â€Å"Friends or relatives at the destination may advice against the proposed trip. à ¢â‚¬  This is also supported by Hall and O’ Sullivan study (cited in Mansfeld & Pizam 1996) which states that, â€Å". . . tourism may decline precipitously when political conditions appear unsettled. Tourists simply choose alternative destinations. Unfortunately, many national leaders and planners either do not understand or will not accept the fact that political serenity, not scenic or cultural attractions, constitute the first and central requirement of tourism. † Although, political violence may not last for a longer period yet it has the tendency to leave a formidable impact on the tourism industry for many years which further can affect the confidence of the tourists and also the investors in tourism industry. Crisis management and recovery methods employed by the tourism industry Tourism has been a way for under-developed and developing countries to get more revenue. Therefore tourists are a potential target for terrorist groups looking to destabilise and undermine these countries by cutting the revenue they get from tourism activities. Recent events such as 9/11, the Southeast Asian tsunami and the Bali bombings have had devastating consequences upon the tourism industry and have shown crisis management and recovery measures have become critical in managing a destination (Robson 2008). According to Santana (cited in Weber 1998), crisis management comprehends five steps: signal detection, preparation/prevention, containment/damage limitation, recovery and learning. Planning and training before, during and after the crisis have also been highlighted (Santana, cited in Weber 1998). On the one hand, research has shown the tourism industry was able to fully recover from terrorist assaults in a period of six to twelve months, at the condition these events were not repeated in the future (Pizam and Fleischer, cited in Arana 2008). However, appropriate management methods must be employed and applied by destination managers in order to ensure image destination rehabilitation. To this end, the management and coordination of human and financial resources as well as public relations through the media for example are critical when it comes to managing terrorist events at a destination (Stafford et al 2002). For instance, a set of recommendations compiling crisis management, preventive management and recovery methods through marketing could be useful for the tourism industry to restore a destination’s image (Sonmez 1998) and prevent any negative publicity from spreading (Stafford et al 2002). Furthermore, collaboration between tourism industry actors and government organisations can often be preventive and mitigate the impacts of the crisis (Stafford et al. 2002). In terms of preventive and recovery methods, tourism destinations should promote the use of information for locals and visitors (Weber 1998) in order to ensure their own safety, for example by signalling any suspicious piece of luggage in a public space through the use of official signs posted in public areas such as airports, railway stations and stadiums. The role of advertising and education as recovery methods is also of importance. For example, the ‘Vigipirate Plan’ was put in place by the French government in 1991 after several terrorist attacks took place in Europe in the nineties. It is made up of 4 levels of emergency (yellow, orange, red and purple) and has been greatly promoted in France at the local administration levels as well as to the general public, especially after massive terrorist attacks such as the March 2004 Madrid attacks and the July 2005 London bombings. Furthermore, government initiatives such as the Australian travel advisory (smartraveller. gov. au) which issues travel recommendations to destinations presenting a certain degree of risk is a preventive way to avoid any accidental or dangerous event. For example, the Australian Government gives tips about Cyprus in terms of safety and security in both the Cypriot and Turkish part of the island, as well as details about local laws, entry and exit requirements and health issues (Department of Foreign Affairs and Trade 2009). On the other hand, tourism may be a way to enhance peace, mitigate tensions between countries and recover from any negative effects of terrorism. An example of this is given by the situation between North and South Korea (Kim 2007). Research was conducted in order to evaluate the reactions of South Koreans after visiting a natural site, Mt Gumgang, an emerging tourist destination located in North Korea. The findings suggested that South Korean visitors to North Korea had a better image of the country and the people after their tourist trip, although both countries have technically been at war for decades (Kim 2007). To conclude, tourist destinations have the possibility to prevent terrorism actions from happening or mitigate their effects through combined policies of crisis management involving different participants such as governments and private/public tourism bodies. Nevertheless, although tourism is often a victim of terrorism and political disturbances, it can also be used as a tool to promote and enhance peace between countries affected by political tensions. References Adams, S. 2004, All the Troubles: Terrorism, War and the World after 9/11, Simon Adams, Australia Arana J. , 2008, The impact of terrorism on tourism demand, Annals of Tourism Research, Vol. 35, No. 2, pp. 299–315. Apostolopolous Y. , Sonmez S. & Tarlow P. 1999, Tourism In Crisis: Managing the Effects of Tourism, Journal of Travel Research, Vol. 38, No. 1, viewed 17 May, http://jtr. sagepub. com. ezproxy. lib. uts. edu. au/cgi/content/abstract/38/1/13 Bar-On R. , ‘Measuring the effects on tourism of violence and of promotion following violent acts’, in Mansfeld Y. & Pizam A (eds), Tourism, Crime and International Security Issues, John Wiley & Sons Ltd. , pp. 159-160 Department of Foreign Affairs and Trade 2009, last viewed May 17th 2009, http://www. smartraveller. gov. au/ Essner J. 2003, Terrorism’s Impact on Tourism: What the Industry May Learn from Egypt’s Struggle with al-Gama’a al-Islamiya, viewed on May 15,2009, http://sand. miis. edu/research/student_research/Essner_Tourist%20Terrorism. pdf Hall C. & O’ Sullivan V. , ‘Tourism, political instability and violence’, in Mansfeld Y. & Pizam A (eds), Tourism, Crime and International Security Issues, John Wiley & Sons Ltd. , pp. 105-114 Kim S. , 2007, Using tourism to promote peace on the Korean peninsula, Annals of Tourism Research, Vol. 34, No. 2, pp. 291–309. Mansfeld Y. & Pizam A. , ‘Conclusions and Recommendations’, Tourism, Crime and International Security Issues, John Wiley & Sons Ltd. , pp. 311-312 Mueller J. 2007, Reacting to Terrorism: Probabilities, Consequences and the persistence of Fear, Ohio State University, viewed 17 May, http://scholar. google. com. ezproxy. lib. uts. edu. au/scholar? hl=en&lr=&q=REACTING+TO+TERRORISM%3A+PROBABILITIES%2C+CONSEQUENCES%2C+AND+THE+PERSISTENCE+OF+FEAR&btnG=Search Pizam A. 2002, Tourism and Terrorism, Hospitality Management, Vol. 21, No 1–3 Robson, L. , 2008, Crisis Management in Tourism, Annals of Tourism Research, Vol. 35, No. 2, pp. 600–601. Sihmez Sevil F. 1998, Tourism, Terrorism and Political Instability, Annals of Tourism Research, Vol. 25, No. 2. Sonmez, S. F. 1998, Tourism, Terrorism and Political Instability, Annals of Tourism Research, Vol. 25, No. 2. Stafford, G. Et al, 2002, Crisis Management and Recovery, Cornell Hotel and Restaurant Administration Quarterly 27, Cornell University Tourism Forecasting Committee, 2008, Forecast 2008, Issue 2, Tourism Forecasting Committee, Canberra, pp 91-92 Weaver D. , Tourism Management, 2000 Weber, S. 1998, War, Terrorism and Tourism, Annals of Tourism Research, Volume 25, Issue 3, Pages 760-763 ———————– Tourists Destination Region Generating Region Media Government

Data Security Cloud Computing - 1693 Words

DATA SECURITY IN CLOUD COMPUTING Introduction: Cloud computing has prompted a movement in how individuals consider IT frameworks structural engineering. Numerous associations today are either executing cloud-based services, or assessing which cloud-based measures they will be portraying later on. As indicated by Gartner Inc. distributed computing is no less compelling than e-business. This sprocess in building design from an undertaking normal server-based framework to a cloud-based framework will have related expenses of passage and dangers, yet it can bring about inconceivable advantages in reserve funds and in IT and business deftness. Review of literature: Bhadauria, R., Chaki, R., Chaki, N., and Sanyal, S Web has been a main thrust†¦show more content†¦This coordinates elements supporting high adaptability and multi-occupancy. In addition, distributed computing minimizes the capital consumption. This methodology is gadget and client area free. As indicated by the not at all like sorts of administrations offered, distributed computing can be considered to comprise of three layers. IaaS or Infrastructure as a Service (IaaS) is the most minimal layer that gives fundamental base bolster administration. PaaS - the Platform as a Service (PaaS) layer is the center layer, which offers stage arranged administrations, other than giving the earth to facilitating client s applications. SaaS - Software as a Service (SaaS) is the highest layer which includes a complete application offered as administration on interest. SaaS guarantees that the complete applications are facilitated on the web and clients use them. The installment is being m ade on a pay-per-use model. It takes out the need to introduce and run the application on the client s nearby PC, in this manner mitigating the client s weight for programming consideration. In SaaS, there is the Divided Cloud and Convergence intelligibility instrument whereby each information thing has either the Read Lock or Compose Lock. Two sorts of servers are utilized by SaaS: the Main Consistence Server (MCS) and Domain Consistence Server (DCS). Reserve rationality is