Acute Myocardial Infarction and Periodontal Disease

Acute Myocardial Infarction and Periodontal Disease Research Findings The study examined the association between acute myocardial infarction and periodontal diseases using cross sectional design. The analysis was carried out using the SPSS/PC Windows version 21.0 software package (IBM, Inc.). The sample size taken for the study was 80 (Cases=40, Control=40). The bivariate association between the studied variables, acute MI and periodontitis (dichotomized) was analyzed with the appropriate test. A significance level of p≠¤0.05 was considered significant and the odds ratios with 95% confidence intervals were calculated. Further, conditional logistic regression analysis/cox regression analysis (1:1 matched pairs) was used to assess the independent contribution of periodontal diseases to the risk of acute myocardial infarction and also to find the relationship between AMI and other possible explanatory variables. The risk factors such as tobacco habit, smoking, dietary habits, family history of diabetes, were forced into the model. The following secti on presents the results. Descriptive Statistics and Preliminary Analyses Association between acute myocardial infarction and study variables. The table below presents the association between Acute Myocardial Infarction and study variables. The results showed that odds of outcome (AMI) were significantly higher in subjects with periodontitis, smoking habits, hypertension and mixed dietary habits. Out of the total 80 patients, the majority of the periodontitis patients (82.5%) were present within the case group (AMI patients) (p=0.026). Similarly, the prevalence of smoking (52.5% vs. 27.5%, p=0.031) and hypertension (52.5% vs. 47.9%, p Table 6:  Association between Acute Myocardial Infarction and study variables *p Association between periodontitis and study variables. The table below presents the association between Periodontitis and study variables. The results showed that odds of outcome (periodontitis) were significantly higher in subjects with smoking habits, hypertension and alcohol drinking (p Table 7:  Association between Periodontitis and study variables Conditional Logistic Regression Analysis Using Cox Proportional Hazard Model Following the preliminary analysis’ cox regression analyses were used to assess the independent contribution of periodontal diseases to the risk of acute myocardial infarction and also to find the relationship between an AMI event and possible explanatory variables. To control the effects of multiple potential confounders, multivariate model were also fitted by modeling periodontitis as a time varying covariant in a model. Cox proportional hazard analysis allowed the researcher to include the predictor variables (covariates) one by one into the subsequent models. This provided estimated coefficients for each of the covariates and allowed the researcher to assess the impact of multiple covariates in the same model. We can also use Cox regression to examine the effect of continuous covariates such as BMI. The following recoding was done to examine the association between AMI and periodontitis. Socio economic status=0 (Reference category): Lower; 1=Upper Lower; 2=Lower middle; 3=Upper middle; 4=Upper: Family history=0 (Reference category): No; 1=Yes; Exercise=0 (Reference category): Yes; 1=No ; Hyper tension=0 (Reference category): No; 1=Yes: Diabetes=0 (Reference category): No; 1=Yes: Dietary habit=0 (Reference category): Vegetarian; 1=Mixed: Smoking habit=0 (Reference category): Non-smoker; 1= Former smoker; 2=Smoker: Smokeless tobacco habit=0 (Reference category): Non-users; 1= Former user; 2=Current u ser: Alcohol drinking=0 (Reference category): Non-drinker; 1= Current drinker; 2=Irregular abstainer: Marital status=0 (Reference category): Unmarried; 1= Married; 2=Divorced. The conditional logistic regression estimates the odds ratio, and an exact 95% confidence interval. Table 3, below presents the association between AMI and Periodontitis using Cox regression. Table 8:  Cox Regression Dependent variable: Acute Myocardial Infarction Conditional logistic regression analysis outcomes indicated the presence of a significant association between AMI and periodontitis (Beta=1.358, p= .039 In all the stages, for regular exercise the beta value is negative which means it is a protective factor or is inversely related as acute myocardial events, however this association is not statistically significant to report. Statistical Analysis of Other Clinical Parameters (DMFT, CPI and LOA Scores) Test for normality. To test the assumption of normality, the study used the Kolmogorov-Smirnov and Shapiro-Wilks test. From this test, the Sig. (p) value was compared to the priori alpha level (level of significance for the statistic) – and a determination was made as to reject (p ÃŽ ±) the null hypothesis. The Table 1 below shows that where ÃŽ ± = 0.001, given that p Table 9:  Test for Normality Test for homogeneity of variance (equality of variances). Further, to test the assumption of homogeneity of variance, where the null hypothesis assumes no difference between the two group’s variances (H0: 2 ÏÆ' 1 = 2 ÏÆ' 2), a non-parametric Levene’s test for equality of variances is the most commonly used statistic to verify the equality of variances in the samples (homogeneity of variance) especially for non-normally distributed data. Therefore, Kruskal Wallis one-way analysis Leven’s test was applied. The Levene’s test uses the level of significance set a priori for the t test analysis (e.g., ÃŽ ± = .05) to test the assumption of homogeneity of variance. However, in SPSS it’s challenging to execute Leven’s test for non-normally distributed data in one step. Hence steps were applied to create three new variables such as ranked data, group mean ranks and deviation from mean ranks. Finally, the differences were computed using ANOVA and the p value was found to be Table 10:  Test Statistics Mann-Whitney U and Wilcoxon W test : comparing medians. As the data is non-homogenous and non-normally distributed, Mann-Whitney U and Wilcoxon W tests were used to compare the median scores of DMFT, CPI and LOA scores, and also to check the significance of differences. Null Hypothesis: Median score of DMFT, CPI and LOA is same for both case and control. Alternative hypothesis: Median score of DMFT, CPI and LOA differs between case and control. Table 11:  Test Statistics DMFT Score CPI Score LOA Score Mann-Whitney U 403.500 340.500 374.500 Wilcoxon W 1223.500 1160.500 1194

Julius Nyerere & African Socialism Essay

Socialism as quoted by Julius Nyerere as â€Å"the attitude of the mind† and often defined as a system of social organizations producing and distributing goods that are owned collectively or by a centralized government that often plans and controls the economy. In a socialistic society it is the attitude of mind, and not the rigid adherence to a standard political pattern, which is needed to ensure that the people care for each other’s welfare. In order to understand African socialism better we need to clearly understand how a society operates. In a socialist society the means of production are owned by the workers rather than by a rich minority of capitalists or functionaries. Such a system of ownership is both collective and individual in nature. Socialism will not be a utopia simply created in people’s minds. It will be the product of economic and social development. Now African socialism is a belief in sharing economic resources in the â€Å"traditional† African way. Many African politicians supported the â€Å"traditional† African way that is often referred as African Socialism. Julius K. Nyerere who was one of them who later became the President of Tanganyika (East Africa) in 1962 and was President of Tanzania (Tanganyika and Zanzibar) from 1964 to 1985. A Socialist and Pan-Africanist, was a force for moderation and racial harmony. He worked in close cooperation with the British authorities in his homeland. However, advocates of African socialism claimed that it was not the opposite of capitalism or a response to it, but something completely different. They claimed their socialism was merely recapturing the spirit of what it was to be African. Many believed that Africa was far behind capitalist states in terms of economic development and to compete fairly with them they needed a different appeal to unite them. German economist Werner Sombart in 1906, in his definition of American Capitalism stated, â€Å"America is the Canaan of capitalism, its promised land. † Capitalism is regarded as an economic system distinguished by private ownership of the means of production and the production of commodities for sale. The modern business corporation is an original creation of the American imagination. It was first fashioned to extend local markets, then, it became an indispensable means to create a national market. Both American industrialization and capitalism were crucially dependent upon the corporate form of organization. Thus arising a political process whereby economic power can become translated into governmental policy. American capitalists had almost a free hand in gaining control of a country unimaginably rich in natural resources. In straight-out contests of strength with both organized and unorganized workers American capitalists usually triumphed. The very philosophy of individualism facilitated the adoption of slavery in the American history. President, Nyerere had to steer a difficult course by the late 1960s Tanzania was one of the world’s poorest countries. Like many others it was suffering from a severe foreign debt burden, a decrease in foreign aid, and a fall in the price of commodities. The objective of socialism in the United Republic of Tanzania is to build a society in which all members have equal rights and equal opportunities, in which all can live in peace with their neighbors without suffering or imposing injustice, being exploited, or exploiting. The nature of Tanzanian society was on rural development. People were encouraged (sometimes forced) to live and work on a co-operative basis in organized villages or ujamaa (meaning ‘family hood’ in Kishwahili). It is important to realize that the policy of ujamaa Vijijini is not intended to be merely a revival of the old settlement schemes under another name. The Ujamaa village is a new conception; â€Å"Understanding that what we need to develop is people, not things, and that people can only develop themselves. † Ujamaa villages are intended to be socialist organizations created by the people, and governed by those who live and work in them. They cannot be created from outside, nor governed from outside. No one can be forced into an Ujamaa village, and no official at any level can go and tell the members of an Ujamaa village what they should do together, and what they should continue to do as individual farmers. According to Julius Kambarage Nyerere â€Å"I have said that a millionaire can be a good socialist. But a socialist millionaire is a rare phenomenon. Indeed he is almost a contradiction in terms. The appearance of millionaires in any society is no proof of its affluence; they can be produced by very poor countries like Tanganyika just as well as by rich countries like the United States of America. † He also goes on to say that a millionaire can be a socialist; he may value his wealth only because it can be used in the service of his fellow men. But the man who uses wealth for the purpose of dominating any of his fellows is a capitalist. On the other hand the white population of the U. S. A. descended from European immigrants who, most energetic and independent elements of their peoples, crossed the ocean to escape oppression, persecution and poverty. From the first settlements on the Eastern coast, with its commercial towns, they gradually expanded over the entire continent, exterminating in continuous fight the Indian natives, clearing the forests, subduing the wilderness, and converting it into cultivated land. American capital soon played the chief role in opening up the Western wilds by digging canals and building railways. Through its friends in Congress it was rewarded for this service to the nation with big allotments for exploitation, paying not more than the bribes, the form by which the politicians got their share of the profits. Founded on the principles of individual liberty and self-determination the nascent United States provided fertile ground for the seeds of Capitalism. Conditions such as slavery, explosive growth in the number of banks, America’s powerful drive to expand its territory, neutral trade during the war between Great Britain and France, and ultimately, the Industrial Revolution enabled American Capitalism to grow into a thriving jungle. Ayn Rand, a Russian-born, American novelist and philosopher says,† America’s abundance was created not by public sacrifices to the common good, but by the productive genius of free men who pursued their own personal interests and the making of their own private fortunes. â€Å"

Literary Analysis of Schindler’s List Essay

The Holocaust was a colossal extermination of about six million Jews in Eastern Europe under the criminal hands of Nazis and SS troops during World War II. It started in 1933 and ended in 1945 when the war in Europe finally ended. The whole genocide was organized methodically Germany’s leader, Adolf Hitler. At first Jews are persecuted, then robbed of their citizenship, then moved into ghettos, and quickly into concentration camps. The evil plot developed and grew and what started out as hatred turned into a scheme of mass murder. Steven Spielberg uses color, shadows, and juxtaposition of scenes to display the inhumanity of the Nazi Germans and the hopelessness of the Jewish people during the Holocaust of World War II. Spielberg uses shadows to symbolize the archetype of good and evil in Oskar Schindler. The shadow on Schindler’s face is used to represent the evil and the selfishness in him. The shadow on Schindler’s face in the beginning is dark and prominent. T he dark shadow becomes less and less prevalent as Schindler’s point of view of the Jews begins to change. As the film goes on and Schindler’s emotions change Spielberg uses less shadow, and eventually ends up using none at all. Schindler begins to care about the well-being of the Jews. When Schindler gives his speech to the Jews before they all leave the camp, no shadow is seen on his face, displaying his true emotions and his complete empathy for the Jews. Spielberg uses shadows for Schindler as he makes the transformation from a selfish Nazi to the savior of hundreds of Jews. Spielberg’s use of color indicates hope in the film. In the beginning, the film’s color changes from all color to black and white, except for one candle. The switch to black and white gives the film a more realistic feel by relating to film from World War II. The color of the candles both at the beginning and at the end of the movie represent the loss and redemption of hope for the Jews. While the Germans are clearing out the slums where the Jews are being held, Schindler is seen looking at an apparently lost girl wearing a spot-lit red coat. The girl is confused about where to go and what to do. After seeing this girl Schindler begins to feel  the same, he’s confused about how the Germans can be so cruel to the Jews and he begins to wonder what he can do to help. The little girl pushes against the crowd, and Schindler, when he sees this, begins to do the same by pushing against the German attacks to help the Jews be free once again. Spielberg uses black-and-white and spot color to display the theme of hope throughout the film. Juxtaposition from scenes places a Nazi party, a Jewish wedding celebration, and a servant being brutally beaten parallel to each other to contrast the differences between them. In the first scene, a party is shown filled with many Nazi soldiers and officials. Schindler is seen at this extravagant party drinking, laughing, and kissing many women. He is happy and shows no kind of remorse for his action or any of the actions going on at the concentration camp. As Schindler’s scene closes, the camera goes to the Jewish barracks where a sec ret wedding is taking place. The barrack is filled with singing and happiness as the couple is united. This symbolizes the Jews’ choice to be happy even as the world around them is so harsh and brutal to them. The scene once again circulates to show Amon Goeth in the basement intimidating, yelling at, and eventually beating his Jewish servant Helen. The entirety of Goeth’s hate and wrath are taken out on Helen. Spielberg’s use of parallel editing helps display the effects of the Holocaust between three different groups of people at the same time. In the film Schindler’s List, Schindler stands up for the Jews by buying their freedom and shipping them to his own factory where they are treated well with good food, water, and the company of what family still remained. The Nazi party wanted the extinction of the Jews, so they made a valiant effort to do so. In 1933 approximately nine million Jews lived in the 21 countries of Europe. By 1945 two out of every three European Jews had been killed. The Holocaust was one of the darkest periods of history, filled with madness and murder, and Spielberg displays the effects of the Holocaust by using color, shadows, and juxtaposition in his film, Schindler’s List.

Assessment Pl Risk Management Framework And The New Lakes...

ELIZABETH MEMAN ID: 1115196 BSBRSK501 TASK 1 DETAILED PERFORMANCE PLAN Risk Review Report # 2. A. Introduction- Coffeeville’s Risk Management Framework Risks are probabilities that could render a business to have lower than anticipated profits. This could be due to various and numerous factors. The identification, acknowledgement and acceptance of these risks are fundamental to every business, Coffeeville in particular. This report will outline CoffeeVille’s exisiting Risk Management Policy. It will also determine its effectiveness with regards to risk identification, management and control. The main purpose of this report is to be able to identify all the possible risks that could occur in the new Lakes Entrance Store before new management assumes position. It will determine defective and ineffective rules, guidelines, employee conduct and management approach, thus, modifying actions to be able to live up to the company goals. B. Scope This report will measure the efficiency of CoffeeVIlle’s existing Risk Management, framework and policies. This performance measurement will be done through the identification of specific Key Performance Indicators (KPI) using the Risk-based approach which will be applied to measure progress towards reductions of risks Responsibilities As the newly appointed Manager for Lakes Entrance CoffeeVille cafe, it is my primary responsibility to be able to determine risks as early as possible to be able to create and modify the existingShow MoreRelatedQuality Improvement328284 Words   |  1314 PagesEditor: Sandra Dumas Senior Designer: Kevin Murphy New Media Editor: Lauren Sapira Editorial Assistant: Mark Owens Production Management Services: Elm Street Publishing Services Composition Services: Aptara, Inc. This book was typeset in 10/12 Times by Aptara, Inc., and printed and bound by R. R. Donnelley (Jefferson City). The cover was printed by R. R. Donnelley (Jefferson City). The paper in this book was manufactured by a mill whose forest management programs include sustained yield harvesting ofRead MoreBhopal Gas Disaster84210 Words   |  337 Pagesand soil contamination. As a result a whole new generation continues to get sick, from cancer and birth defects to everyday impacts o aches and pains, f rashes, fevers, eruptions of boils, headaches, nausea, lack of appetite, dizziness, and constant exhaustion. During the last four years survivors’ organizations have renewed their campaign to both get justice for the survivors as well as cleaning up of the hazardous waste. This compilation of selected news stories covering the last four years is a