Statement of purpose for undergrad in business studies Essay Example for Free

Statement of purpose for undergrad in business studies Essay â€Å"Take up one idea. Make that idea your life- think of it, dream of it, live on that idea. Let the brain, muscles, nerves, every part of your body be full of that idea, and just leave every other idea alone. This is the way to success†. I read this quote by Swami Vivekananda in 2011 when I was deciding my career choice in 2011 when I was in Grade 11. Initially I was inclined towards science as that’s the preferred career option for most in India. However a deeper analysis, introspection and influence of my parents made me realize my strengths and interests make me more suited for Economics and Business Studies. My family has been a major influence – my father and maternal uncle are both engineers with an MBA from top business schools and have made a great career for themselves. My father is into international business development and marketing and has made a successful career. After deciding on Commerce and Business Studies, I scored 91. 2 % (top 10 % in the CBSE across in grade 12 and made it to the top 10 % of candidates who took the board exam nationwide. After 12th grade, I took an entrance exam and qualified for the interview and group discussion round by securing a national rank of 143. I made it to the top 80 students to get admission to the coveted College of business studies, Delhi University (voted as Asias best undergraduate management college by the Commonwealth of Nations). Good academic performance in my school and college, active participation in academic as well as extra-curricular activities in several marketing activity groups and several part time and full time internships during college have helped me to develop analytical, communication and social interaction skills. I now feel strongly that I would like to pursue this career further. During the one and a half years of my undergraduate studies, I interacted with students from different cultural and social backgrounds. The college has a strong culture of developing practical skills and nurturing entrepreneurship. Most students got campus placements and more than 60 % students chose management consulting and marketing as career options. I used to visit NGO’s and teach students on weekends but I wanted to do something bigger. I got through Kartavya ( The social service club of my college) and here, I organized blood donation camps and collection drives in college, visited slums , organized movie screenings and talent shows for the unprivileged children living in orphanages and the happiness I got by seeing them happy is inexpressible. I was a part of MIC (The Management Interaction Cell) wherein my team co-hosted an event with FICCI ( Federation of Indian chambers of commerce and Industry ). I was given the role of Director, Human resources at DUMUN (Delhi University Model United Nations) where my key roles involved raising funds for our national level event, managing and ensuring co-ordination in the team and representing my team to the college authorities. While organizing and hosting these events, I led teams and was appreciated for my leadership skills and dedication towards my clubs. I started enjoying the whole process of recruiting new members, leading them, pitching to prospective sponsors to raise funds and managing the working of the team . This was the time I realized that I enjoy leading people and it is something I can do well. Academically, I balanced my studies well with my co-curriculars and always scored 80% and above in my semesters. I enjoyed every bit of my course and thoroughly researched on all my projects. Business Research, Organizational Behavior and Marketing management have been my favorite subjects in college. The project I enjoyed the most was a live project in Public Relations for which I studied the Cadbury worm crisis and took interviews of employees there to gain first hand knowledge over their crisis. CBS has made me confident about my choice of stream and made me realize my ambitions in life. To quench my thirst for practical management knowledge, I went on to join Vodafone as an HR intern where my assignment was to check employee satisfaction by conducting surveys, suggest better schemes and analyze the areas where improvement was required. Later, I also joined Brand Hawkers as a Marketing trainee. My job assignment involved creating a prospect list of advertising partners for our ‘SmartBooks’ product, qualifying and pitching to them and facilitating their engagement with Brand Hawkers. During this assignment I realized that marketing was the forte I wanted to excel in since this is what I enjoyed the most. It didn’t seem like work to me but it was simply fun. I am confident of my abilities to carve a niche for myself in this field of Business Management. I am ready to take the desired steps to achieve my ultimate goal.

Statistics in Business Essay Example for Free

Statistics in Business Essay Statistics is the science of learning from data, and of measuring, controlling, and communicating uncertainty; and it thereby provides the navigation essential for controlling the course of scientific and societal advances. Statisticians apply statistical thinking and methods to a wide variety of scientific, social, and business endeavors in such areas as astronomy, biology, education, economics, engineering, genetics, marketing, medicine, psychology, public health, sports, among many. Statisticians provide crucial guidance in determining what information is reliable and which predictions can be trusted. They often help search for clues to the solution of a scientific mystery and sometimes keep investigators from being misled by false impressions. Some examples that statistics are used are Statistics also provide the reasoning and methods for producing and understanding data. Statisticians are specialists, but statistics demands they be generalists, too. One advantage of working in statistics is that you can combine your interest with almost any other field in science, technology, or business. Another is Studies of the environment require data on the abundance and location of plants and animals, on the spread of pollution from its sources, and on the possible effects of changes in human activities. The data are often incomplete or uncertain, but statisticians can help uncover their meaning. One last example is the future of many industries and their employees depends on improvement in the quality of goods and services and the efficiency with which they are produced and delivered. Improvement should be based on data, rather than guesswork. More companies are installing elaborate systems to collect and act on data to better serve their customers. Statisticians must know more than statistics. A statistician who works in medicine or in a manufacturing plant or in market research must learn enough medicine or engineering or marketing to understand the data in their setting. Statisticians need the ability to work with other people, to listen, and to communicate. References; http://www.amstat.org/careers/whatisstatistics.cfm

Smoking and Coronary Heart Disease Impact

Smoking and Coronary Heart Disease Impact Introduction Medical innovations and rapidly evolving technology has led to a decrease in the rate of mortality from diseases. However, the fast and constantly changing hectic lifestyle of today has led to the introduction of new diseases, unhealthy lifestyle and early, premature deaths. Todays technology has provided us with the benefits of early detection and preventive treatments and answers to some of the previously incurable diseases. But it has brought in increased stress and unhealthy eating and other habits that have in some ways caused more harm than benefit. This report titled Smoking: The Heart Breaker is a look at the current situation of coronary heart diseases caused by smoking, relevant legislations, policies and practices, strategies to deal with the situation and future of the disease at local, national and global levels. The report will start by discussing the smoking and coronary heart disease as a public health issue and the reasons for concern. It will provide a background to help better understand the present situation along with an epidemiology of the disease and its causes, with special reference to smoking. It will then go on to report about the legislative policies and strategies that are being currently undertaken in the region of Burnley, East Lancashire to counter this particular health issue. The report will also discuss the policies and initiatives and the status of the health issue at national and global level, so as to provide a complete and holistic picture of the seriousness of the health issue. Finally the report will discuss the current strategies being employed by the government as well as non-government agencies to tackle the health issue. Recommendations will also be made to help make an improvement in the current situation. Public Health Issue: Coronary Heart Disease due to Smoking The term Coronary heart disease is used to describe a condition of blockage or interruption of blood supply to the heart due to build-up of fatty substances in the coronary arteries (NHS, 2009). This build-up (called atheroma) can lead to insufficient supply of blood to the heart causing pain in the chest known as angina. A completely blocked artery can lead to a heart attack (called myocardial infarction) (NHS, 2009). There are various mild to critical impacts of this condition that even result in death. According to the British Heart Foundation Statistics (2009), diseases related to the heart and circulatory issues are the biggest cause of deaths in the UK, resulting in over 90,000 deaths in the UK in a year. This has resulted in not only raised concerns about the disease but also growing efforts to increase the awareness about the disease, its causes, and preventive as well as precautionary measures that can help to avoid the disease. The situation isn t any brighter in other par ts of the world. According to the World Health Organisation (WHO), the majority of countries around the world are affected by coronary heart disease and the disease is a major killer, especially in developing and transitional countries of the world. In a WHO report, cardiovascular diseases including coronary heart disease is considered to be the leading cause of death and is projected to increase from 17.1 million in 2004 to 23.4 million in 2030 (WHO, 2004). Among the various causes of coronary heart disease, smoking is regarded to be one of the primary causes. According to the WHO report, tobacco-related deaths are expected to rise from 5.4 million in 2004 to 8.3 million in 2030, representing 10% of all global deaths; and smoking has been associated to cardiovascular diseases and subsequent deaths (WHO, 2004). According to a study conducted in 2008, smoking is the leading cause of cardiovascular diseases including coronary heart disease (Bullen, 2008). Though increasing age has been thought as a cau se of coronary heart disease, two studies have found that improper lifestyle, stress, etc are increasing the mortality rates due to coronary heart disease among the young population in the UK, USA and Australia (Nemetz, Roger Ransom, 2008) (Ford Capewell, 2007). Therefore, the growing concern for this disease and its preventable yet common cause is the choice of topic for this report. Background and Epidemiology Cardiovascular diseases including coronary heart disease have been found to be an unbiased killer that can create havoc in any society irrespective of its economic, political, cultural, religious, regional or racial identity. Similarly, tobacco smoking (either active or passive) is known to be a major cause of many diseases including the coronary heart disease. Given the stressful lifestyle in today s world, many people take up smoking to tackle the stress levels and in the process get addicted. They not only harm themselves but also people around them. The region of Burnley in East Lancashire, is no exception to this trend. Being witness to many friends and family members taking up smoking in the name of relieving stress and then getting addicted and finally ending up suffering from diseases, especially coronary heart disease inspired the choice of topic for this report. There are several causes that can result in coronary heart disease. The NHS lists smoking as the major cause of the disease (NHS, 2009). The various other causes of coronary heart disease have been listed as high blood pressure, high level of cholesterol in blood, presence of thrombosis and / or diabetes unhealthy lifestyle with no regular exercise, obesity and a family history of angina and / or heart attack (which are hereditary) (Nemetz et al, 2008). The risk factors associated with coronary heart diseases which cannot be treated, modified or changed include age, gender and heredity (or race). Increasing age increases the risks of coronary heart disease and fatality from it. Men are found to be at a greater risk of suffering from coronary heart disease in comparison to women (Wells, 1999). Heredity of coronary disease or its causes such as diabetes, high blood pressure, and cholesterol are also known to create risks of coronary heart conditions. The causes such as smoking, high le vel of cholesterol in blood, high blood pressure, physical inactivity, being overweight and / or obesity and diabetes (diabetes mellitus) are some of the risk factors of coronary heart disease that can be modified, changed and controlled by taking medication and / or by adopting a healthy lifestyle. Other risk factors and causes of the disease include stress and alcohol addiction and can in certain circumstances prove to be fatal causes of the coronary heart disease (Ewles Simnet, 2003). Comparative data of the effects of coronary heart disease in different countries do not provide a very positive picture (see appendix 1). According to a World Health Organisation survey report, the mortality from cardiovascular diseases in 2002 for the developed nations like the United Kingdom and the United States was higher than many other developing nations like China, India, even Nigeria (WHO, 2002). It is clear from the data, that developing countries have a much higher mortality rate from cardiovascular and consequently coronary heart diseases in the developed countries like UK, USA, Germany; and an important fact to notice is that the death rate is higher in the European region in comparison to other regions of the world. This most probably can be attributed to the excessive use of tobacco, alcohol, improper lifestyle that increases stress levels, improper eating habits that leads to blood sugar and cholesterol in the blood. The tobacco usage in different countries around the world also points towards the grimness and enormity of the situation, through which one can appreciate the risk of tobacco causing further deaths due to coronary heart disease (WHO, 2008). The WHO report on tobacco consumption in different countries show that despite government initiatives and regulations, the tobacco consumption has mostly increased and has led to increased mortality especially in the age groups between 25-45 years. Though coronary heart disease is of global nature without any kind of boundary, various specific groups of people are in greater risk of having the disease in comparison to others. The affinity to having coronary heart disease is dependent on factors such as geography, heredity, age and gender. Men are at an increased risk of suffering from coronary heart conditions as compared to women (Wells, 1999). Increase in age increases the chances of suffering from coronary heart disease (DoH, 2004). Coronary heart conditions are also known to be prevalent among Mexican Americans, some Asian Americans, American Indians, and Native Hawaiians (American Heart Association, 2010). England is one of the most vulnerable nations in Europe when it comes to coronary heart diseases (NHS, 2009). Populations in developing and underdeveloped nations of the world too are at a higher risk of suffering from coronary heart disease and related fatalities (American Heart Association, 2010). Smokers, obese people and people with high blood cholesterol are also included in the high risk group for coronary heart disease. Female smokers are more susceptible to the disease especially with increased age since females are more susceptible to the dangers of smoking in comparison to men (WHO, 2002). With increased impact of aggressive and unhealthy lifestyle and stress, the young population across the developed nations of the world too are increasingly coming under the risk of coronary heart disease (NHS, 2008). Therefore, these risk factors result in the coronary heart disease taking on a pandemic nature if certain precautionary and preventive measures are not taken to control the risk factors that can be influenced. Strategies, Policies and Initiatives Given the growing concern about coronary heart diseases, deaths due to the disease and the impact on the younger population, government agencies around the world are taking steps to combat the growing menace. Non-governmental and private agencies too are joining the efforts to promote a healthy lifestyle and awareness about preventive techniques that can help to bring down the risks associated with the disease and the rising cases of fatalities. This section of the report looks at the strategies, agenda, policies, that are being undertaken at the local (NHS East Lancashire, 2010), national and global levels to combat coronary heart disease. Local Public Health In East Lancashire, several workshops and other programmes have been undertaken to increase awareness, educate and help the residents of the area give up smoking and adopt a healthy lifestyle that will help prevent and fight coronary heart disease. The MPs in the region are encouraging antismoking legislations and policies being adopted by the authorities. The NHS has introduced the concept of smoke free zones. The SMYL programme is promoting healthy lifestyle and eating habits (NHS East Lancashire, 2010). Another campaign called Could it be you was also started in 2008 to help people fight coronary heart disease and adopt healthy and preventive lifestyle (Chime Communications Plc, 2008). The authorities in East Lancashire have also collaborated with different agencies to start networks that can promote anti tobacco campaign and raise awareness on coronary heart disease (NHS Networks, 2010). This involvement of the government as well as non-government agencies in the area, one can b e hopeful that headway will be made into the matter. However, it is important that the public realise the criticality of the situation and take advantages of the programmes being undertaken to have a long, healthy and disease free life. Implications at the National Level The National Heart Forum (2006) indicated that heart diseases cost the UK around  £29 billion per year and was termed as economic burden . There are several programmes that have been taken up by the health care authorities and the government in collaboration with non-government agencies to promote anti smoking habits in the country. Several regional programmes such as Bolsover Teenage Smoking Programme, Corby Smoking Cessation Programme, Halton Smoke-Free Programme, London Borough of Tower Hamlets Tobacco Control Alliance, Pendle Smoke-free Council, Heartbeat Awards, the GO Smokefree Campaign, etc have been launched in an earnest to curb the growing effect of smoking in the country (IDeA, 2009). Several governmental legislations have also been put into place (IDeA, 2007). The Department of Health has also started programmes such as Start4Life, 5 A Day, National Support Teams and Let s Get Moving to promote healthy lifestyle that can help to prevent coronary heart disease (DoH, 201 0). Therefore the various government and nongovernment agencies in UK are making effort to control smoking habit and improve lifestyle of the citizens of the country thereby ensuring a brighter future free from smoking and coronary heart disease. Global Health The fight against smoking and coronary heart disease has taken enormous proportions with the growing realisation that these are two of the most important killers in the world today. Especially, the understanding that smoking causes diseases such as the coronary heart disease not only in the smoker but also in non-smokers who have been in the presence of smokers, has led major organisations and developed nations of the world to taking a stand against smoking. The Work with Heart project by WHO is helping to spread the message of preventive actions that can help in prohibiting coronary heart disease and other cardiovascular diseases (WHO, 2010a). WHO has also taken up research and global partnership initiatives to help the developing countries of the world fight cardiovascular diseases (WHO, 2010b). Furthermore, WHO has aligned with several countries in the world to promote regional activities under the global strategy to counter cardiovascular diseases which includes America, Eastern Mediterranean, Africa, South-East Asia, European region and Western Pacific (WHO, 2010c). To help fight the smoking addiction growing among countries, WHO has set up the Global Tobacco Surveillance System (GTSS) (WHO, 2010d) and is also collaborating with different international organisations such as the United Nations and the governments of various countries to help campaign against sale and use of tobacco among different nations (WHO, 2010e). Recommendations and Conclusion Upon analysing the current situation on a local, national and global basis, the following recommendations can be made: Initiatives to prevent coronary heart disease and promote anti smoking habits need to be undertaken at the grass root level, i.e. at local level. This will make the initiatives and campaigns more effective. The developing nations such as India, Brazil and China need to be targeted with confidence. Further researches into preventive and curative medicines and technologies for coronary heart diseases need to be promoted. Healthy lifestyle needs to be promoted at every level since preventive practices are more beneficial than curative ones. It is important to realise that despite several initiatives being taken by local, national and global agencies and governments, smoking trends are increasing around the world and has started to affect the young population. Coronary heart disease too has started to take its toll on the population around the world due to the hectic and unhealthy lifestyles that have come to permeate people s lives. It is highly essential that for the success of the initiatives and programmes, people must be involved in them and everyone across the globe has to realise that simple changes to their lifestyle, eating habits and anti smoking measures will help to fight and prevent coronary heart disease. The changes in lifestyle will also bring down coronary heart disease caused due to other factors such as stress, alcohol, blood sugar and cholesterol. To conclude, it can be stated that prevention is better than cure and quitting smoking and leading a healthy lifestyle can protect everyone from the silent killer, the coronary heart disease (Ewles Simnet, 2003). References American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2008) Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 Bibliography American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Hill, S. Blakely, T., Kawachi, I., Woodward, A. (2004) Mortality Among Never Smokers Living with Smokers: Two Cohort Studies British Medical Journal Vol. 328, No. 7446, pp. 988-989. Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Jiang, H.E., Vupputuri, S., Allen, K., Prerost, M. R., Hughes, J., Whelton, P. K. (1999) Passive Smoking and the Risk of Coronary Heart Disease A Meta Analysis of Epidemiological Studies New England Journal of Medicine Vol. 340, No. 12, pp. 920-926. Kaur, S., Cohen, A., Dolor, R., Coffman, C.J., Bastian, L.A. (2004) The Impact of Environmental Tobacco Smoke on Women s Risk of Dying from Heart Disease: A Meta Analysis Journal of Women s Health Vol. 13, No. 8, pp. 888-897. National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. Whincup, P. H., Gilg, J. A., Emberson, J. R., Jarvis, M. J., Feyerabend, C., Bryant, A., Wakler, M., Cook, D. G. ( 2004) Passive Smoking and Risk of Coronary Disease and Stroke: Prospective Study with Cotinine Measurement British Medical Journal Vol. 329, No. 7459, pp. 200-205. World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2008)Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/ Smoking and Coronary Heart Disease Impact Smoking and Coronary Heart Disease Impact Introduction Medical innovations and rapidly evolving technology has led to a decrease in the rate of mortality from diseases. However, the fast and constantly changing hectic lifestyle of today has led to the introduction of new diseases, unhealthy lifestyle and early, premature deaths. Todays technology has provided us with the benefits of early detection and preventive treatments and answers to some of the previously incurable diseases. But it has brought in increased stress and unhealthy eating and other habits that have in some ways caused more harm than benefit. This report titled Smoking: The Heart Breaker is a look at the current situation of coronary heart diseases caused by smoking, relevant legislations, policies and practices, strategies to deal with the situation and future of the disease at local, national and global levels. The report will start by discussing the smoking and coronary heart disease as a public health issue and the reasons for concern. It will provide a background to help better understand the present situation along with an epidemiology of the disease and its causes, with special reference to smoking. It will then go on to report about the legislative policies and strategies that are being currently undertaken in the region of Burnley, East Lancashire to counter this particular health issue. The report will also discuss the policies and initiatives and the status of the health issue at national and global level, so as to provide a complete and holistic picture of the seriousness of the health issue. Finally the report will discuss the current strategies being employed by the government as well as non-government agencies to tackle the health issue. Recommendations will also be made to help make an improvement in the current situation. Public Health Issue: Coronary Heart Disease due to Smoking The term Coronary heart disease is used to describe a condition of blockage or interruption of blood supply to the heart due to build-up of fatty substances in the coronary arteries (NHS, 2009). This build-up (called atheroma) can lead to insufficient supply of blood to the heart causing pain in the chest known as angina. A completely blocked artery can lead to a heart attack (called myocardial infarction) (NHS, 2009). There are various mild to critical impacts of this condition that even result in death. According to the British Heart Foundation Statistics (2009), diseases related to the heart and circulatory issues are the biggest cause of deaths in the UK, resulting in over 90,000 deaths in the UK in a year. This has resulted in not only raised concerns about the disease but also growing efforts to increase the awareness about the disease, its causes, and preventive as well as precautionary measures that can help to avoid the disease. The situation isn t any brighter in other par ts of the world. According to the World Health Organisation (WHO), the majority of countries around the world are affected by coronary heart disease and the disease is a major killer, especially in developing and transitional countries of the world. In a WHO report, cardiovascular diseases including coronary heart disease is considered to be the leading cause of death and is projected to increase from 17.1 million in 2004 to 23.4 million in 2030 (WHO, 2004). Among the various causes of coronary heart disease, smoking is regarded to be one of the primary causes. According to the WHO report, tobacco-related deaths are expected to rise from 5.4 million in 2004 to 8.3 million in 2030, representing 10% of all global deaths; and smoking has been associated to cardiovascular diseases and subsequent deaths (WHO, 2004). According to a study conducted in 2008, smoking is the leading cause of cardiovascular diseases including coronary heart disease (Bullen, 2008). Though increasing age has been thought as a cau se of coronary heart disease, two studies have found that improper lifestyle, stress, etc are increasing the mortality rates due to coronary heart disease among the young population in the UK, USA and Australia (Nemetz, Roger Ransom, 2008) (Ford Capewell, 2007). Therefore, the growing concern for this disease and its preventable yet common cause is the choice of topic for this report. Background and Epidemiology Cardiovascular diseases including coronary heart disease have been found to be an unbiased killer that can create havoc in any society irrespective of its economic, political, cultural, religious, regional or racial identity. Similarly, tobacco smoking (either active or passive) is known to be a major cause of many diseases including the coronary heart disease. Given the stressful lifestyle in today s world, many people take up smoking to tackle the stress levels and in the process get addicted. They not only harm themselves but also people around them. The region of Burnley in East Lancashire, is no exception to this trend. Being witness to many friends and family members taking up smoking in the name of relieving stress and then getting addicted and finally ending up suffering from diseases, especially coronary heart disease inspired the choice of topic for this report. There are several causes that can result in coronary heart disease. The NHS lists smoking as the major cause of the disease (NHS, 2009). The various other causes of coronary heart disease have been listed as high blood pressure, high level of cholesterol in blood, presence of thrombosis and / or diabetes unhealthy lifestyle with no regular exercise, obesity and a family history of angina and / or heart attack (which are hereditary) (Nemetz et al, 2008). The risk factors associated with coronary heart diseases which cannot be treated, modified or changed include age, gender and heredity (or race). Increasing age increases the risks of coronary heart disease and fatality from it. Men are found to be at a greater risk of suffering from coronary heart disease in comparison to women (Wells, 1999). Heredity of coronary disease or its causes such as diabetes, high blood pressure, and cholesterol are also known to create risks of coronary heart conditions. The causes such as smoking, high le vel of cholesterol in blood, high blood pressure, physical inactivity, being overweight and / or obesity and diabetes (diabetes mellitus) are some of the risk factors of coronary heart disease that can be modified, changed and controlled by taking medication and / or by adopting a healthy lifestyle. Other risk factors and causes of the disease include stress and alcohol addiction and can in certain circumstances prove to be fatal causes of the coronary heart disease (Ewles Simnet, 2003). Comparative data of the effects of coronary heart disease in different countries do not provide a very positive picture (see appendix 1). According to a World Health Organisation survey report, the mortality from cardiovascular diseases in 2002 for the developed nations like the United Kingdom and the United States was higher than many other developing nations like China, India, even Nigeria (WHO, 2002). It is clear from the data, that developing countries have a much higher mortality rate from cardiovascular and consequently coronary heart diseases in the developed countries like UK, USA, Germany; and an important fact to notice is that the death rate is higher in the European region in comparison to other regions of the world. This most probably can be attributed to the excessive use of tobacco, alcohol, improper lifestyle that increases stress levels, improper eating habits that leads to blood sugar and cholesterol in the blood. The tobacco usage in different countries around the world also points towards the grimness and enormity of the situation, through which one can appreciate the risk of tobacco causing further deaths due to coronary heart disease (WHO, 2008). The WHO report on tobacco consumption in different countries show that despite government initiatives and regulations, the tobacco consumption has mostly increased and has led to increased mortality especially in the age groups between 25-45 years. Though coronary heart disease is of global nature without any kind of boundary, various specific groups of people are in greater risk of having the disease in comparison to others. The affinity to having coronary heart disease is dependent on factors such as geography, heredity, age and gender. Men are at an increased risk of suffering from coronary heart conditions as compared to women (Wells, 1999). Increase in age increases the chances of suffering from coronary heart disease (DoH, 2004). Coronary heart conditions are also known to be prevalent among Mexican Americans, some Asian Americans, American Indians, and Native Hawaiians (American Heart Association, 2010). England is one of the most vulnerable nations in Europe when it comes to coronary heart diseases (NHS, 2009). Populations in developing and underdeveloped nations of the world too are at a higher risk of suffering from coronary heart disease and related fatalities (American Heart Association, 2010). Smokers, obese people and people with high blood cholesterol are also included in the high risk group for coronary heart disease. Female smokers are more susceptible to the disease especially with increased age since females are more susceptible to the dangers of smoking in comparison to men (WHO, 2002). With increased impact of aggressive and unhealthy lifestyle and stress, the young population across the developed nations of the world too are increasingly coming under the risk of coronary heart disease (NHS, 2008). Therefore, these risk factors result in the coronary heart disease taking on a pandemic nature if certain precautionary and preventive measures are not taken to control the risk factors that can be influenced. Strategies, Policies and Initiatives Given the growing concern about coronary heart diseases, deaths due to the disease and the impact on the younger population, government agencies around the world are taking steps to combat the growing menace. Non-governmental and private agencies too are joining the efforts to promote a healthy lifestyle and awareness about preventive techniques that can help to bring down the risks associated with the disease and the rising cases of fatalities. This section of the report looks at the strategies, agenda, policies, that are being undertaken at the local (NHS East Lancashire, 2010), national and global levels to combat coronary heart disease. Local Public Health In East Lancashire, several workshops and other programmes have been undertaken to increase awareness, educate and help the residents of the area give up smoking and adopt a healthy lifestyle that will help prevent and fight coronary heart disease. The MPs in the region are encouraging antismoking legislations and policies being adopted by the authorities. The NHS has introduced the concept of smoke free zones. The SMYL programme is promoting healthy lifestyle and eating habits (NHS East Lancashire, 2010). Another campaign called Could it be you was also started in 2008 to help people fight coronary heart disease and adopt healthy and preventive lifestyle (Chime Communications Plc, 2008). The authorities in East Lancashire have also collaborated with different agencies to start networks that can promote anti tobacco campaign and raise awareness on coronary heart disease (NHS Networks, 2010). This involvement of the government as well as non-government agencies in the area, one can b e hopeful that headway will be made into the matter. However, it is important that the public realise the criticality of the situation and take advantages of the programmes being undertaken to have a long, healthy and disease free life. Implications at the National Level The National Heart Forum (2006) indicated that heart diseases cost the UK around  £29 billion per year and was termed as economic burden . There are several programmes that have been taken up by the health care authorities and the government in collaboration with non-government agencies to promote anti smoking habits in the country. Several regional programmes such as Bolsover Teenage Smoking Programme, Corby Smoking Cessation Programme, Halton Smoke-Free Programme, London Borough of Tower Hamlets Tobacco Control Alliance, Pendle Smoke-free Council, Heartbeat Awards, the GO Smokefree Campaign, etc have been launched in an earnest to curb the growing effect of smoking in the country (IDeA, 2009). Several governmental legislations have also been put into place (IDeA, 2007). The Department of Health has also started programmes such as Start4Life, 5 A Day, National Support Teams and Let s Get Moving to promote healthy lifestyle that can help to prevent coronary heart disease (DoH, 201 0). Therefore the various government and nongovernment agencies in UK are making effort to control smoking habit and improve lifestyle of the citizens of the country thereby ensuring a brighter future free from smoking and coronary heart disease. Global Health The fight against smoking and coronary heart disease has taken enormous proportions with the growing realisation that these are two of the most important killers in the world today. Especially, the understanding that smoking causes diseases such as the coronary heart disease not only in the smoker but also in non-smokers who have been in the presence of smokers, has led major organisations and developed nations of the world to taking a stand against smoking. The Work with Heart project by WHO is helping to spread the message of preventive actions that can help in prohibiting coronary heart disease and other cardiovascular diseases (WHO, 2010a). WHO has also taken up research and global partnership initiatives to help the developing countries of the world fight cardiovascular diseases (WHO, 2010b). Furthermore, WHO has aligned with several countries in the world to promote regional activities under the global strategy to counter cardiovascular diseases which includes America, Eastern Mediterranean, Africa, South-East Asia, European region and Western Pacific (WHO, 2010c). To help fight the smoking addiction growing among countries, WHO has set up the Global Tobacco Surveillance System (GTSS) (WHO, 2010d) and is also collaborating with different international organisations such as the United Nations and the governments of various countries to help campaign against sale and use of tobacco among different nations (WHO, 2010e). Recommendations and Conclusion Upon analysing the current situation on a local, national and global basis, the following recommendations can be made: Initiatives to prevent coronary heart disease and promote anti smoking habits need to be undertaken at the grass root level, i.e. at local level. This will make the initiatives and campaigns more effective. The developing nations such as India, Brazil and China need to be targeted with confidence. Further researches into preventive and curative medicines and technologies for coronary heart diseases need to be promoted. Healthy lifestyle needs to be promoted at every level since preventive practices are more beneficial than curative ones. It is important to realise that despite several initiatives being taken by local, national and global agencies and governments, smoking trends are increasing around the world and has started to affect the young population. Coronary heart disease too has started to take its toll on the population around the world due to the hectic and unhealthy lifestyles that have come to permeate people s lives. It is highly essential that for the success of the initiatives and programmes, people must be involved in them and everyone across the globe has to realise that simple changes to their lifestyle, eating habits and anti smoking measures will help to fight and prevent coronary heart disease. The changes in lifestyle will also bring down coronary heart disease caused due to other factors such as stress, alcohol, blood sugar and cholesterol. To conclude, it can be stated that prevention is better than cure and quitting smoking and leading a healthy lifestyle can protect everyone from the silent killer, the coronary heart disease (Ewles Simnet, 2003). References American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2008) Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 Bibliography American Heart Association (2010) Risk Factors and Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.americanheart.org/presenter.jhtml?identifier=4726 Ash (2007) Ash facts at a glance: Smoking and Diseases [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_94.pdf ASH (2009) Ash facts at a glance: Implementation of the Smoke-free Law in England, Wales and Northern Ireland [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_594.pdf Ash (2009) Ash facts at a glance: Tobacco Regulations [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_96.pdf Ash (2010) Ash facts at a glance: Smoking Statistics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_93.pdf Ash (2010) Ash facts at a glance: Tobacco Economics [Online] last accessed 2nd December 2009 at http://www.ash.org.uk/files/documents/ASH_95.pdf British Heart Foundation Statistics Website (2009) Mortality [Online] last accessed 2nd December 2009 at http://www.heartstats.org/topic.asp?id=17 Bullen, C. (July, 2008). Impact of Tobacco Smoking and Smoking Cessation on Cardiovascular Risk and Disease. Expert Review of Cardiovascular Therapy, Vol. 6, No. 6, pp. 883-895. Chime Communications Plc (2008) East Lancashire PCT Enlists BMT to Develop a Campaign to Tackle the Region s Biggest Killer [Online] last accessed 2nd December 2009 at http://www.chime.plc.uk/press-releases/bmt-launches-east-lancashire-pct-campaign-could-it-be-you Department of Health (DoH) (2004) The National Service Framework for Coronary Heart Disease: Wining the War on Heart Disease [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4077154 Department of Health (DoH) (2010) Public Health [Online] last accessed 2nd December 2009 at http://www.dh.gov.uk/en/Publichealth/index.htm Ewles L, Simnett I. (2003). Promoting Health: A Practical Guide. London: Balliere Tindall. Ford, E. S. Capewell, S. (2007) Coronary Heart Disease Mortality Among Young Adults in the U.S. from 1980 Through 2002. Concealed Levelling of Mortality Rates Journal of the American College of Cardiology Vol. 50, pp. 2128-2132. Hill, S. Blakely, T., Kawachi, I., Woodward, A. (2004) Mortality Among Never Smokers Living with Smokers: Two Cohort Studies British Medical Journal Vol. 328, No. 7446, pp. 988-989. Improvement and Development Agency (IDeA) (2007) Smoke-free Legislation [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=6166044 Improvement and Development Agency (IDeA) (2009) Smoking [Online] last accessed 2nd December 2009 at http://www.idea.gov.uk/idk/core/page.do?pageId=5889940 Jiang, H.E., Vupputuri, S., Allen, K., Prerost, M. R., Hughes, J., Whelton, P. K. (1999) Passive Smoking and the Risk of Coronary Heart Disease A Meta Analysis of Epidemiological Studies New England Journal of Medicine Vol. 340, No. 12, pp. 920-926. Kaur, S., Cohen, A., Dolor, R., Coffman, C.J., Bastian, L.A. (2004) The Impact of Environmental Tobacco Smoke on Women s Risk of Dying from Heart Disease: A Meta Analysis Journal of Women s Health Vol. 13, No. 8, pp. 888-897. National Health Service (NHS) (2008) Rates of Heart Disease in the Young [Online] last accessed 2nd December 2009 at http://www.nhs.uk/news/2007/January08/Pages/Ratesofheartdiseaseintheyoung.asp National Health Service (NHS) (2009) Health A-Z: Coronary Heart Disease [Online] last accessed 2nd December 2009 at http://www.nhs.uk/conditions/Coronary-heart-disease/Pages/Introduction.aspx National Heart Forum (2006) Economic Cost of Heart Disease [Online] last accessed 2nd December 2009 at http://www.heartforum.org.uk/AboutCHD_Economicburden.aspx Nemetz, P. N., Roger, V. L., Ransom, J. E., Bailer, K. R., Edwards, W. D., Leibson, C. L. (2008) Recent Trends in the Prevalence of Coronary Disease: A Population-Based Autopsy Study of Non-natural Deaths Archival of Internal Medicine Vol. 168, No. 3, pp. 264-270. NHS East Lancashire (2010) SMYL If you want to live longer [Online] last accessed 2nd December 2009 at http://www.smyl.eastlancspct.nhs.uk/welcome/ NHS Networks (2010) East Lancashire Public Health Network [Online] last accessed 2nd December 2009 at http://www.networks.nhs.uk/networks.php?pid=727 Smoke Free (2007) Smoke-free Legislation Compliance Data [Online] last accessed 2nd December 2009 at http://www.smokefreeengland.co.uk/files/dhs01_03-smokefree_report_final.pdf Wells, A. J. (1999) Passive Smoking and Coronary Heart Disease New England Journal of Medicine Vol. 341, No. 9, pp.697-698. Whincup, P. H., Gilg, J. A., Emberson, J. R., Jarvis, M. J., Feyerabend, C., Bryant, A., Wakler, M., Cook, D. G. ( 2004) Passive Smoking and Risk of Coronary Disease and Stroke: Prospective Study with Cotinine Measurement British Medical Journal Vol. 329, No. 7459, pp. 200-205. World Health Organisation (WHO) (2002) Global Burden of Disease in 2002: Data Sources, Methods and Results [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/compare.aspx?dm=10countries=818%2c250%2c414%2c484%2c554%2c566%2c643%2c710%2c826%2c840year=2002sf1=mo.cg.059sex=all World Health Organisation (WHO) (2004) Causes of Death (part 2). The Global Burden of Disease: 2004 Update [Online] last accessed 2nd December 2009 at http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_part2.pdf World Health Organisation (WHO) (2008)Tobacco Use: Infobase [Online] last accessed 2nd December 2009 at https://apps.who.int/infobase/report.aspx?rid=116dm=8 World Health Organisation (WHO) (2010a) Cardiovascular Diseases: Key messages to protect heart health [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/en/ World Health Organisation (WHO) (2010b) Research and Global Partnership Initiatives [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/research/en/ World Health Organisation (WHO) (2010c) Regional Activities to the Global CVD Strategy [Online] last accessed 2nd December 2009 at http://www.who.int/cardiovascular_diseases/region/en/ World Health Organisation (WHO) (2010d) Global Information System on Tobacco Control [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_data/en/index.html World Health Organisation (WHO) (2010e) Global Network [Online] last accessed 2nd December 2009 at http://www.who.int/tobacco/global_interaction/en/

A CHRISTMAS CAROL (BY CHARLES DICKENS) :: English Literature

A CHRISTMAS CAROL (BY CHARLES DICKENS) â€Å"By Close Analysis of Staves One and Five Show How Dickens Portrays the Transformation of Scrooge and To What Effect† In December 1843, Charles Dickens wrote and published â€Å"A Christmas Carol.† He published this book when he needed money; he needed money badly because he was in debt. He decided to link it to things that are happening; that Christmas was not taken seriously, it was fading out and ghost traditional Christmas tales. Dickens used the genre of ghost stories, but Dickens did something unusual, he changed the fact that ghost stories are meant to be frightening, in this book, the ghost stories were scary. In 1843 (ancient times), there were no security, pensions, national health nor compulsory education. You were expected to work six days a week and on Sunday, you go to church (only if you had a job). Those who had no job couldn’t go to church, because they were probably in prison or workhouse. There were no holidays, you had to work on Boxing Day, and if you ended up in debt, you would be put in debt prison. Dickens grew up in this prison with his dad, he started work at the age of 12 (it was a terrible work). Looking at the Book, it was about ghosts, and ghost stories were always told during Christmas. Books were always in chapters, but Dickens wrote his in staves; musical notes. Dickens starts to compare, first, looking at the full title, â€Å"A Christmas Carol in prose,† to have a carol in prose means a contradiction (to speak against). The book written in staves, which is a music stave, is already contradicting the title. In the preface, he uses another contradiction (repetition); we will also be looking at jokes and humours. Stave1: Marley’s Ghost â€Å"Marley was dead; to begin with† this is a contradiction; we already begin to make assumptions about the story. Stave1, beginning with a negative statement; â€Å"Marley was dead..........† (A quick reference to stave 5), and stave 5; a positive statement; â€Å"Yes!† with an exclamation mark, showing that there is an excitement there, even in the first paragraph. Dickens uses repetition in the first paragraph of stave 1; clergyman and clerk, undertaker and chief mourner, and Scrooge was also emphasised twice. He uses a simile; â€Å"Old Marley was dead as a door nail†, he was being humorous; in the book he explains why he used it, but we figured out that Dickens uses these to slow down the â€Å"pace† and change the â€Å"atmosphere†, this was meant to be funny (in1843), he used this to divert people’s attention from the

Stanhope from Journeys End by RC Sheriff Essay -- Journeys End Hero

Stanhope from Journey's End Stanhope provides the most obvious candidate for the accolade of â€Å"hero† in Journey’s End: R.C.Sherriff has included many themes in Journey’s End; a play portraying the reality of trench warfare. Some of these include Comradeship, The horrors of war, Heroism and Relationships. My essay will be focusing mainly on the theme of heroism. The audience relate the word â€Å"hero† with mainly one character in the play. But the word hero has many positive connotations. A hero could be a person who â€Å"saves the day† or is a hero in somebody else’s eyes or maybe even his personality and how he interacts with other characters could also give him the status of being a hero. There are many aspects of Stanhope which rightfully award him the status of being a hero. The audience is first introduced to the possibility of Stanhope being a hero when we first meet Raleigh. A keen and un-experienced officer, Raleigh forces himself into Stanhope’s battalion. Stanhope was Raleigh’s hero ever since high school, and when he joins the company he expects to some e...

The Internet, Technology, and Privacy Essay -- privacy on the web, grow

Privacy on the Web has become a growing concern among Americans' due to tracking and social profiling of users' and their online habits. Government, businesses, web platforms and their advertisers are collecting users' online data on a daily basis through various techniques which could be used for study, security, and economic advantage. According to â€Å"The Danger of Big Data: Social Media as Computational Social Science,† smaller bits of user shared data can potentially be combined together to reveal information that could be damaging to a group or individual in which they may view as an invasion of their privacy. The capacity to collect and analyze such data can become a concern when that information is made available to businesses and government. With a lack of disclosure on how the users' data is being gathered and analyzed with a difficulty in knowing which pieces of the data shared could later prove damaging, many users' may not be aware of the potential adverse effects of the information they share online. [1][2] Social media networks gather and analyze large amounts of data on their users' to build a detailed social graph to better target advertisements, which can create an ethical dilemma in what constitutes as sensitive user information and how that could vary between different users'. In one case that called for class-action lawsuits in the U.S was how Facebook would keep track of its users and the websites they visited via the â€Å"Like,† and â€Å"Recommendations,† buttons that many web sites include for social and sharing purposes. Facebook was notified every time a user would access a website that had a â€Å"Like† button, even if the button wasn't clicked or the user logged into their Facebook account. [3] Due to the accuracy... ...glass-begins-and-they-arent-even-available-yet/ [9] The Day The World Fought Back https://www.eff.org/deeplinks/2014/02/day-world-fought-back [10] Information Commissioner's Office: Cookies http://ico.org.uk/for_organisations/privacy_and_electronic_communications/the_guide/cookies [11] All About Cookies http://www.allaboutcookies.org/ad-serving/ [12] Target retail http://www.forbes.com/sites/kashmirhill/2012/02/16/how-target-figured-out-a-teen-girl-was-pregnant-before-her-father-did/ Additional references used in study. The Future of Big Data http://www.pewinternet.org/2012/07/20/the-future-of-big-data/ Younger Generation Embracing A New View of Privacy http://singularityhub.com/2012/05/12/younger-generation-embracing-a-new-view-of-privacy/ How Companies Learn Your Secrets http://www.nytimes.com/2012/02/19/magazine/shopping-habits.html?pagewanted=1&_r=2&hp

Peace on Earth

This place known so well to me never fails to uplift my spirits after the annual visit my family and I take over summer. The crisp wind and the scent of nature seem to cast a spell on campers, relaxing and relieving them of stress. Tellico Plains, Tennessee might very well be my peace on Earth. I love escaping from the malicious grasp of modern day technology and taking a leap into the wild, with a breath of fresh air to clear my head. It is absolutely rejuvenating to come to this town and live with no connections to the World for a week.Two hours up the narrow, winding, gravel path spiraling the mountain, we veer to the right at Big Oak Campsite. The popping of the tire treads on the gravel sends warm waves through my body; I know we have arrived. Immediately I venture to the freshwater stream crafted from the melting ice off the higher altitude mountains. Due to how inviting it looks, I hop across the slippery stones to the infamous â€Å"Old Faithful† rock, which is just a good trout fishing spot. Standing here I scan my surroundings, which blow my mind. The lush forest filled with oak, pine, maple, and evergreen trees is so dominant over me; and I know it, but I am ok with it.The stream is relatively narrow, only spanning about 20 ft in width. Rocks of all sizes poke out the surface of the water and electric green moss grows thick on each one. They serve as my stepping stones back to the bank. The Coleman camper we pull behind the car is old and smells musty every year, but it doesn’t phase me at all. We wench the pop top up and pull out the beds, make them up and sweep the linoleum floor before we go any further in setting up camp, the last touch to the camper being a floor mat just inside the door.By this time, the sun is setting and the fireflies are flourishing. Everywhere you look you see a spark of yellow-green light on the move. It’s almost impossible to refrain from getting up to attempt to catch one, so I get up every time. Cre eping up slowly with a jar in one hand, lid in the other, I zoom my vision to the vicinity around me, wait for the bud of the insect to light up, and snatch him up inside the jar. It is likely, too, that I move on to the next nearest light I see and try again to catch a critter, and in the process lose the first one I caught, leaving me with none.The creaking of the Coleman coolers filled with ice, cold cokes, sweet tea, bacon, eggs, and the most delicious chocolate milk in the World makes my eyes light up. It just gives me that feeling of lightness; like there are no worries here. It has nothing to do with the fact that it is a cooler, but more so the amount of times I have heard the sound, only here. As the temperature drops low at night, a fire is needed to keep warm. Mom usually takes the initiative to get the fire going. The teepee of logs under stuffed with newspapers and twigs burns slow and hot, and makes a mean s’more.Appetite satisfied, exhausted from the trip, the pull out mattress looks ever so inviting. I grab my toothbrush and walk to the water cooler to brush my teeth and wash my face. After cleaned up, it’s PJ time. Then I lay myself down, pull the covers up to my chin and tuck myself in. As I lie here, I can honestly say I feel numb to the World. The rushing of the stream plays in my head like music and puts me in a trance; a trance that no other place could ever measure up to doing. There really is peace on Earth, unfortunately you have to find it.