Copd

COPD Chronic Obstructive Pulmonary Disease is treatable and can be prevented. It can greatly impact a patient’s lifestyle. The disease varies person to person and usually progresses. The two major components of COPD are inflammation and airflow limitation. Treatment and prevention of COPD is aimed at treating these. There are four stages of COPD; Mild, Moderate, Severe and Very Severe. Signs and symptoms for all types of severity are; possible cough, sputum and dyspnea, shortness of breath, wheezing, chest tightness and chronic cough. Diagnosing COPD and staging is predicted by the pulmonary function test results, and also again by possible symptoms. Treatment recommendations differ between the different stages of the disease. Treatment for COPD includes a new medication called roflumilast (Daliresp) which selectively inhibits Phosphodiesterase 4 a major AMP metabolizing enzyme in a lung tissue. The therapy goal with that rate of exacerbations improve ABG's pulmonary function tests and decrease the need for rescue medications. Also there is short and long acting inhaled beta antagonists. They are comprised of a cortiosteroid, bronchodilators and they reduce inflammation. Antibiotics can also be prescribed to reduce any increased sputum volume and dyspnea. Oxygen therapy also helps with COPD by improving breathlessness during exercise and daily living. Application to Nursing: COPD COPD has a dramatic impact on a patient’s lifestyle, it is preventable and treatable. Therapy treatments vary with the four stages of severity. Avoiding the risk factors for COPD and getting an influenza vaccine can help for all four of the stages. A short acting bronco-dilator can be used PRN for mild-moderate stages. Regular treatment with one or more long acting bronco-dilators can be used for moderate-very COPD. Rehab therapy is used for moderate COPD. Inhaled glucocorticosteroids are used for severe-very severe COPD. When the patient has very severe COPD they will be on long term oxygen, and also can or will be considered for surgical treatment. Patients with COPD will need support and possible motivation to participate in daily activities due to worry some behavior and or depression, fatigue and increased dyspnea Exercise and smoking cessation is the best intervention for people who have been diagnosed with COPD. This will possibly lessen the troubles that can arise from this disease.

Sri Lanka Tourism

Tourists Return to Paradise Isle a Year After War’s End By Amantha Perera COLOMBO, May 17, 2010 (IPS) – A year since Sri Lanka’s bloody civil war ended on May 18 last year, tourists are returning in huge numbers to a popular beach destination located over 300 kilometres from where the last battles were fought. Nowhere is the relief at the end of fighting more tangible than on the beautiful beaches of Hikkaduwa, south of the capital Colombo.The war against the secessionist Liberation Tigers of Tamil Eelam, fighting for a separate state for the minority Tamils, cost over 70,000 lives in over two and half decades and sent over 280,000 fleeing for their lives in its final phase. Hikkaduwa, famous for its coral reef, sandy beaches and swanky hotels, is on the rebound. Visitors who abandoned the sun and the beach when bombs started going off have begun to return. The best days may be still ahead of this famous tourist destination south of the capital Colombo. Already, it is bracing itself for huge arrivals during the next European winter season.Arrivals grew by an impressive 50 percent or an increase to 160,000 from 106,000 in the first quarter of 2010, compared to 2009, according to the Sri Lanka Tourism Development Authority, the government agency that monitors tourist arrivals. This year, the island known for its scenic beauty expects over half a million tourist arrivals, making 2010 one of the best seasons in the last half a decade. â€Å"We saw very good arrival rates this season (between November 2009 and April 2010),† Siri Goonewardene, president of the Hikkaduwa Hoteliers’ Association, told IPS. With the war no more, travellers feel safer visiting here and there were no unexpected security-related incidents that would have driven them away. † The general manager of Coral Sands, a 75-room luxury hotel on the Hikkaduwa beach, expects better results later this year when the next winter season starts. â€Å"The bookings h ave been good. If the trend continues the next season will be definitely better than this one,† says Goonewardene.He adds that operators expect about a 50 percent growth in arrivals next season. The upbeat assessment is shared by operators who run smaller hotels and restaurants and others who depend on the tourist trade. This season was good. We had a high number of visitors,† says Dhammika Silva, who runs a small hotel at Mirissa, a cove-like beach south of Hikkaduwa. He depends on individual tourists who visit the Mirissa area as his business is too small to tie up with tour operators. â€Å"I needed more people on the beach having a good time to make ends meet. This time it happened. † The same is true of Nimal, who sells traditional woodcarvings from a small shop near the beach. â€Å"We had a very good season. I made some good sales,† adds Nimal, who simply identified himself by his first name.These hopes for a bumper tourist season are a far cry from the beach operators’ downcast mood less than 18 months back. With the war raging in the north, by the time the winter season began in November 2008, arrivals were sliding. With earnings going down, in 2008, tourism fell to number six in the country’s top foreign revenue earners from the fourth slot, accounting only for 2. 8 percent of the gross national product. The industry supports a large workforce, much of it informal. According to a labour survey conducted by the Sri Lanka Census and Statistics Department in 2007, over 100,000 were employed in the trade, 56 percent of whom were nformal employees. It was the informal employees that felt the pinch when arrivals kept going down without the security of at least a small wage packet. In early 2009, business operators like Nimal were complaining that they could not keep their shops open and at least pay the utilities.Some decided to close shop. The downturn in arrivals due to the war attracted low spenders to the island. Silva says that many tourists from Eastern Europe and Russia began arriving in Sri Lanka when the big spenders from Western Europe stayed away. I have nothing against them. But these were budget travellers who travel through the region. They don’t spend much,† he told IPS. Nimal concurs. â€Å"They are not the type who buy souvenirs, let alone expensive carvings, they will show up in the number of arrivals, but have no money. † Goonewardene from Coral Sands warned that the high numbers should not be an indication that the industry has fully recovered. â€Å"When the numbers are analysed, we will see that there will not be a 50 percent increase in earnings corresponding to the increase in arrivals. â€Å"He says the government should launch an aggressive public relations campaign to attract high-end spenders and give incentives like tax breaks to the industry. The new government that took office last month has brought tourism under the purview of the Economic D evelopment Ministry, which has been tasked with accelerating development. It is an indication that tourism is to be a vital component in the new economic plans. â€Å"It is good that the government is showing signs of making tourism part of the bigger national plans. Whoever invests in tourism now will be making a lot of money come next season if we make the right decisions,† Silva

Bank of Credit and Commerce International

The Bank of Credit and Commerce International (BCCI) was the world’s largest Islamic bank which involved in many criminals activities due to which the bank was eventually shut down and was perceived as the worst bank operated ever in the history of world banking sectors.Introduction The Bank of Credit and Commerce International (BCCI) was established by a Pakistani banker Agha Hasan Abedi in 1972. BCCI was registered in Luxembourg. It reached at height within a decade. It has more than 400 branches which were operated in 78 countries.It was among the world's largest private bank ranking 7th position due to its excessive assets of US$20 billion (History Commons). BCCI's Involvement in Criminal Activities BCCI became the target in 1980 during which an undercover operation (extending two-years) was held through the Customer Service of United Sates. A fake wedding was concluded through the operation which was attended by the drug dealers and BCCI officers across the world. These v iolators built a working relationship and personal friendship with the Special Agent (undercover) Robert Mazur.The key bank officers were put in trial in Tampa for six months after which, they were seriously charged and imprisoned for lengthy period. Many other crimes were revealed during cooperation between bank officers and law enforcement authorities (American Patriot Friends Network). Major Tips of BCCI's Criminal Activities A Congressman Charles Schumer conducted a Congressional investigation between 1979 and 1991 which revealed around 700 tips regarding criminal activities of BCCI.The following are the major tips which were received by the federal law enforcement commissions and the same visualized the BCCI involvement in criminal activities: 1. Promotion of political unrest in Pakistan. 2. Financial supporting to terrorist groups. 3. Smuggling weapons to numerous countries such as Iran, Libya and Syria. 4. Organized criminal linking in Italy and United States. The above are o nly the major tips but indeed, around 700 tips were revealed through the Congressional investigation (History Commons). CIA's Illegal Involvement in BCCI BankFor the last ten years, CIA had been paying to its 500 British Informants through BCCI Bank. The information of illegal overseas business deals and sales of British arms were reported to the CIA by some informants. The spectrum of CIA informants involved in criminal activities include: 1. 124 people in politics or government 2. 53 in banking, industry and commerce 3. 24 scientists 4. 90 in the media 5. 75 in academia 6. 124 in communications Although, individuals were not specifically named but few of them were in senior positions (American Patriot Friends Network).Closure of BCCI Bank The Bank of England shut down the Bank of Credit and Commerce International (BCCI) on July 5, 1991 and the regulators shut down BCCI offices in dozens of countries and seize about $2 billion of the bank’s $20 billion in assets. Many milita nts including Bin Laden had operated accounts in BCCI. The President of UAE, Sheikh Zayed bin Sultan, owned 77% of BCCI shares and approx 1. 4 million accounts were operated by people who had likely lost their monies upon closure of the bank (History Commons).Conclusion Thus, the Bank of Credit and Commerce International (BCCI) financially supported many militant organizations through the money which was generated through illegal activities including illicit drug trafficking and arms trafficking, therefore, it is right to claim that BCCI worked viciously, violently and criminally in favor of deadly terrorist service across the world due to which the BCCI deserved to be shut down and the criminals operating BCCI will never ‘Rest-In-Peace' (Ambit ERisk).References Ambit ERisk, Case Study: Bank of Credit and Commerce International, Retrieved on May 4, 2010 from http://www. erisk. com/learning/CaseStudies/BankofCreditandCommerceIn. asp American Patriot Friends Network, Bank of Cre dit and Commerce International, Retrieved on May 4, 2010 from http://www. apfn. org/apfn/BCCI. htm History Commons, Bank of Credit & Commerce International, Retrieved on May 4, 2010 from http://www. historycommons. org/entity. jsp? entity=bank_of_credit_and_commerce_international

Property Investment Analysis Essay Example | Topics and Well Written Essays - 3000 words - 1

Property Investment Analysis - Essay Example In a series of cases, the wording of the lease agreements on rent review clauses was held to be upward only. In the case of Royal Insurance Property Services Ltd v Cliffway Ltd2 the lease agreement allowed the landlords to serve a notice on an increase in rent. One of the major questions that the Court had to address in this case was whether the lease allowed for a downwards review. The conclusion in this instance was that based upon the wording of the clause, provision existed only for upward revision, with only the landlord being able to initiate rent changes. Similarly, in the case of Standard Life Assurance v Unipath Ltd3a majority of the Court of Appeal ruled that the provision in the lease agreement pertaining to rent review was an upwards only clause. In this case the Court also observed that the purpose of a rent review clause cannot necessarily be assumed to be on the basis of anticipating changes in money; it might also represent the desire on the part of investors to protect themselves against risk and allow for the certainty of income contained in a rent review clause. Another problem that has been created in the sphere of rent reviews is that they provide for the landlord to initiate a rent review process by issuing a â€Å"trigger notice† and the validity of such notices has been an issue in the cases of Norwich Union Life Insurance Society v Sketchley plc.4 Letters from the tenants have been held to be valid counter notices in the cases of Nunes v Davies Laing and Dick Ltd5and British Rail Pension Trustee Co Ltd v Cardshops Ltd6 where the open market rental rate was the subject of dispute between the landlord and tenant. The underlying commercial purpose behind the inclusion of a rent review clause was spelt out by the Vice Chancellor in the case of British gas Corporation v Universities Superannuation Scheme Ltd7 who stated: â€Å"in the absence of special circumstances, it is proper to give

Compare and contrast the republican forms of democracy Essay

Compare and contrast the republican forms of democracy - Essay Example Concerning this need, the personalities wanted for the American citizens’ access to better services in all the spheres of life. The common belief and the aspiration in this regard were that the achievement of the dream was only possible through the establishment of a representative democracy. Therefore, the bottom line is that all the three individuals championed for representative democracy. Another similarity is that despite John Adams being a former monarchist with Alexander Hamilton, he together with T. Jefferson and T. Paine were during the duration 1770-1780 strongly opposed to the hereditary monarchical rule. They all argued that the monarchical and aristocratic rule established a basis of power independent of the people. In this regard, all the three were indeed in agreement that the people must be the center of focus of the constitution. In the spirit of fighting to eliminate every element of monarchy, all the three were in agreement and indeed despised the idea of seeking the royal and the republican loans. They argued this was a vital ingredient toward the establishment of the monarchical and the aristocratic rule in America. The three argued that, in the height of a popular corrupt, some very desperate persons would be tempted to re-establish and initiate some hereditary offices in the land. The three were also in agreement concerning the rule of law. There was no doubt as to their commitment to have a nation governed by a system of rules that govern everyday life of the people. They derived this understanding from the literal and ever true meaning of a republic, now that they were republicans. The meaning as espoused then was that; â€Å" Republic being an empire of laws and not men, must establish a government in which all men, rich and poor, magistrates and subjects, the officers and people, masters and serva nts, the first citizen and the last one are equally subject to the

HISTORY Essay Example | Topics and Well Written Essays - 750 words - 5

HISTORY - Essay Example The aim of Grady was to develop a dynamic and prosperous country. After the fire accident in the year 1864, the city of Atlanta raised to a much beautiful and bold city. Since then, leaders like Grady wanted America to be one among the best countries in the world. He wished the New South to be a united and democratic place. The main aim of Grady was to bring a nation where people had the freedom to express their views. He wanted to bring about a change in the history of America. This was made possible since southern nation changed to a nation with more freedom. Grady aspired to make New South a place with diversity. Since agriculture was the only form of occupation, it did not yield much of an income. Then Grady wanted the people to work in all the fields like the people of Northern nations. (Grady 1890).He wanted to indulge people in all sorts of industries and improve their standard of living. Grady encouraged the public to invest in capital funds which will improve the financial status of the country. Another aim of Grady was to improve the industries so that job opportunities would increase. Grady wished to abolish labor unions and slavery. This was ruining the people of America. Another major aim of Grady was to remove racism and treat everyone as same. He strived hard to put an end to racism. Due to racism, many Americans and African-Americans found it difficult to work in the industries. A high rate of difference was prevailing in the industries which led Grady to abolish racism. African-Americans were not given opportunity to work in the industries were Americans were working. After a struggle Grady managed to change this situation. Blacks were also treated as other Americans. His dream of bringing blacks into â€Å"New South† came true. This gradually led to the improvement in the lives of slaves. Many people were living in the South as slaves’ pre and post war. (Grady 1890).Grady freed the slaves from the Southern job market. He initiated a

How airlines have been effected by the economic recession and how they Essay

How airlines have been effected by the economic recession and how they adapted - Essay Example ironment of cutthroat business, the company must adapt dynamic strategies within the broader paradigm of ethical consideration which would meet the shrinking pocket of the customer. At the same time, the strategic plans must also ensure comfortable margin of profit for the companies. Hence, airlines are being creative in the following ways: Dynamic pricing as per the demands of the customers have become the most common strategy of the airlines. Low fare strategy and giving fringe benefits with higher fare has become popular as it attracts not only those customers who work within the defined budgets but also the premium class who an afford extra. Interesting some airlines have also started offering different classes like business class, executive, economic and premium economic depending on the legroom and extra facilities like free drink, enclosed cabin, etc. Customers are being offered innovative packages and arrangement within flights. While some airlines like Virgin offer personal space by allotting front row for business class, others like British Airways is giving its premium economy class more privacy, space and comfort in a secluded cabin. Kay (1995) says that business relationships are linkages that promote organizational growth. Airlines are evolving new ways of earning and seasonal tickets for defined tourist places are being offered at flexible prices. Thus, airlines are also forging alliances with leisure market, corporate world etc. to boost their revenue. In the current times, food and drinks that were taken for granted on long routes have now become charged items. The local airlines and some international airlines have started charging for the food and drinks from the customers. The airlines compensate the financial loss on low fare by charging exorbitantly on eatables on flight. Space allocation or leg room has become a scarce item. The airlines have increasingly been charging customers for extra legroom and for preferred seat like window or