Sociology written assignment Essay Example | Topics and Well Written Essays - 500 words

OfficeMax Corporate Description

Presentation The motivation behind this article is to portray the foundation of OfficeMax, Inc., fiscal summaries, authoritative structure, industry diagram, and in general execution of this company.Advertising We will compose a custom exposition test on OfficeMax Corporate Description explicitly for you for just $16.05 $11/page Learn More Company and Industry Description OfficeMax is an expanded organization and the pioneer of retail office items industry, which serves the pubic and private part for the workplace supplies, paper, print, archive administrations, and innovative arrangement with high honesty, responsibility, and corporate social obligation through 29,000 partners everywhere throughout the USA; also, it sets up a few auxiliaries with 1,000 stores in the US and Mexico (OMX, Inc. 1). The presentation of the workplace gracefully retail industry is exceptionally critical to the producers as they straightforwardly connected with the fast shaky interest, while the division cr eated benefit of US$ 151.5 million with deals income US$ 7.6 billion of every 2011, except the business has been experiencing a declining benefit from 2.6% to 2.0% during 2006 to 2011 (IBISWorld 4). History of firm OfficeMax began its excursion in 1931 for the sake of Boise Cascade Corporation; in 2003, it obtained OfficeMax, Inc. that gave the organization to twofold its office items flexibly chain in the US advertise and the organization bannered as OfficeMax; simultaneously, it enlisted in NYSE and built up headquarter in Naperville, Illinois (OMX, Inc. 1). In 2004, the organization expanded its business from assembling to autonomous office items conveyance channels for various innovation based office supplies; in 2006, it brought astounding changes at the administration and moved central command with key arrangement that safeguarded the organization from the genuine effect of worldwide money related emergency and the organization presented five-year development plan in 2010. Pos session and Stockholders of Company ZACKS (6) called attention to that OfficeMax Inc. has just recorded organization in the New York Stock Exchange, and it has lined up with 94% Institutional Ownership, 1 % Insider Ownership with US$ 696 million of market capitalization and 87 a large number of extraordinary offers while its Mexican outlets worked through 51% joint endeavor. The obligation value situation of the organization is as followsAdvertising Looking for paper on business financial matters? How about we check whether we can support you! Get your first paper with 15% OFF Learn More Figure 1: Equity and Debt Position of OMX Source: Modified from Morningstar, Inc. (1) The present value proprietors of the organization is as †Figure 2: Current Equity Owner Source: Modified from Morningstar, Inc. (1)Advertising We will compose a custom article test on OfficeMax Corporate Description explicitly for you for just $16.05 $11/page Learn More Morningstar, Inc. (1) revealed that the investors of the OfficeMax are Franklin Balance Sheet Investment Fund, Thornburg Value, CREF Stock, and Fidelity Value, etc while Countryman (1) called attention to that the portion of the organization is essentially underestimated and they think to separation or understand their full venture, such compromising pattern of financial specialists have produced tremendous difficulties. Monetary Condition: Past, Present, Trends According to the Yahoo Finance (1), share cost of OfficeMax experienced outrageous development in the securities exchange at the underlying stage, and the offer cost of this organization diminished in 2008 and it was beneath $2 around then however the position grew consistently; be that as it may, the accompanying figure shows the recorded stock cost of OfficeMax for three stock trades †Figure 3: Historical stock value execution of OfficeMax from 2008 to 2011 Source: Yahoo Finance (1) Key factors 1997 ($ million) 1998 ($ million) 1999 ($ million) Sales Revenu e 3.765.444 4,337.768 4,842.698 Gross benefit 870.36 973.23 1,111.543 Net Income 89.62 48.62 10.041 EPS 0.72 0.39 0.09 Table 1: Key money related factors of OfficeMax Source: Self produced from O’Malley (14)Advertising Searching for exposition on business financial matters? How about we check whether we can support you! Get your first paper with 15% OFF Find out More O’Malley (20) called attention to that the presentation of this organization decayed from the monetary 2000 and the procuring per share declined also; in any case, the current execution of the organization is palatable, yet it must need to think about worldwide money related emergency to hold stable situation later on. Investigation of budget reports and execution The working expenses of this organization had not expanded essentially, yet the net gain vacillated drastically, for example, total compensation owing to OfficeMax was $34.894 million, $71.155 million and $ 0.667 million for 2011, 2010 and 2009 in like manner; the accompanying tables show key money related insights and working costs for OfficeMax †Key factors 2011 ($ million) 2010 ($ million) 2009 ($ million) Sales Revenue 7,121.167 7,150.007 7,212.050 Gross benefit 1,809.18 1,849.652 1,737.598 Total Assets 4,069.275 4,078.93 4,069.531 Total Liabilities 3,468.359 3,428.918 3,566.335 Total incomes from contributi ng exercises (69.373) (87.338) 2.822 Table 2: Key Financial Variables of OfficeMax Source: self-created from OfficeMax (74-78) and Yahoo Finance (1) Variables 2011 ($ million) 2010 ($ million) 2009 ($ million) Cost of deals 5,311.99 5,300.36 5,474.45 Operating, selling, and general and regulatory costs 1,690.97 1,689.13 1,674.71 Asset weaknesses 11.20 10.98 17.612 Other working costs 20.53 3.077 49.30 Table 3: Total working costs of OfficeMax Source: Self produced from OfficeMax (78) and OMX, Inc. (1) Performance and Soundness in Comparison to Industry/Competitors The nearness of solid rivals in office-gracefully retail industry is one of the principle dangers for OfficeMax while the market position of the contenders is extraordinary and it has both immediate and circuitous contenders those offer comparative administrations, for instance, neighborhood and worldwide office merchandise markets are incredibly and progressively serious (Yahoo Finance and OfficeMax 35). As indicated by t he figure 2, the exhibition of this organization was insufficient sound considering the presentation of the contenders since it produced about $40 million benefits in 2011 while Office Depot earned around $80.95 million and Staples, Inc. produced more than $917 million; be that as it may, the accompanying figure exhibits direct contender examination among the significant contenders †Figure 4: Direct Competitor Comparison among Office Depot, Inc., Staples, Inc. WMT, and industry (Specialty Retail, Other) Source: Yahoo Finance (1) Figure 5: Comparison of stock value execution among OfficeMax and Staples, Inc. throughout the previous five years Source: Yahoo Finance (1) Figure 6: Comparison of stock value execution among OfficeMax and Office Depot, Inc. throughout the previous five years Source: Yahoo Finance (1) Many little organizations are offering comparable items and numerous others are attempting to create imaginative items utilizing current innovation, which can change the client conduct and increment advertise request; additionally, the current enormous organizations are by all account not the only compromising perspective for OfficeMax, however imminent new participants can likewise reason for serious difficulties in the free market economy. Industry Type: Manufacturing/Service In 2010, Sales income from assembling was US$ 3,634.2 million and from retailing US$ 3,515.8 million while the solidified deals income was US$ 7,150.0, this information showed that the commitment of Manufacturing was 51% and the rest 49% procuring from retailing; along these lines, the organization has the two qualities of assembling and administration; simultaneously, it is work concentrated (OMX, Inc. 6). Association and Structure The Chief Executive Officer named Ravichandra Saligram is capable to control all divisions; likewise, the VP and Chief Diversity Officer are responsible to keep up the OfficeMax Diversity Council to get ready different reports and improve operatio nal execution by actualizing vital arrangement. Figure 7: Organizational Structure 2012 of OfficeMax Source: Official Board (1) Diversification The organization is incredibly expanded organization, for example, it has retail fragment, contract area, etc †Figure 8: Sales from various section Source: OfficeMax (5) Centralization The top administration and board individuals are dependable to practice dynamic force, which exhibits that OfficeMax is following incorporated authoritative structure (Barney Hesterley 135). Remuneration Policies According to the yearly report 2011 of OfficeMax, Executive Vice-President Steve Parsons is liable for all angles related with pay and advantages; be that as it may, pay panel plans pay structure for the workers, chiefs and other board individuals. Then again, OfficeMax (1) revealed that pay of the executives is serious, non-worker chiefs get a type of long haul value repayment, yet non-representative board individuals simply get pay for their bo ard administration; in any case, it neglects to guarantee high pay and advantages to draw in and hold qualified partners. The accompanying figure shows data related with value pay plan †Figure 9: Equity Compensation Plan Information Source: OfficeMax (117) Management Controls The administration of OfficeMax is resolved to control the organization and audit the presentation of the Company by keeping up moral codes with honesty, the guidelines and behaviors for the board part, and legitimate arrangements of national and global markets; notwithstanding, Ethisphere Institute granted this organization for quality initiative in moral strategic approaches (OfficeMax 1). Kinds of Organizational Structure OfficeMax is following various leveled

Book Riots Deals of the Day for August 5th, 2019

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Healthcare Reform Essay - 894 Words

LEADER’S EFFECTIVENESS USING UTILITARIANISM AS THE ETHICAL DECISION-MAKING APPROACH IN REGARD TO THE HEALTHCARE CHALLENGES SET FORTH BY THE PROTECTION AND AFFORDABLE CARE ACT OF 2010 CECILIA AVEROS MBA IN HEALTHCARE MANAGEMENT , ABSTRACT Patient Protection and Affordable Care Act( PPACA) also known as Obama care is a healthcare reform signed in March 23, 2010 whose main goal is to conceptualizes the â€Å" Universal affordable Healthcare Coverage â€Å"making significant impacts in the healthcare system. The purpose of this board is to discuss the challenges that effective leaders at different levels in the society should face on regards to†¦show more content†¦Moreover, the office visit length will be shortened due to the high demand of customers making it harder to provide good quality of care to patients as well . On the other hand, from the physician point of view it is predictable that doctors will change practice patterns from private offices to hospital services because the facilities pay salaries with less expectations in the number of patients seen per day. Furthermore, due to the elevated number of patients, time left for clinical documentation and record keeping will be nulle. Expansion of the Medicaid coverage to all new eligible adults and increase fee for service and managed care by primary care physicians will be financed by federal funding. This will cause an outreageous increase in the Federal deficit from the historical 2.9% Gross Domestic Product to more than 20% by 2050. Employers should offer affordable( employee premium less than 9.5% of employee’s wages) and of minimum value( employers must pay at least 60% of insurance cost) healthcare benefits to their employees depending on factors like number of FTE, number of employees receiving premium tax credits and other complex measurements to calculate the amounts. Employers should also notify employees by written about State exchanges, and advise them that if an employee decides to purchase a health Plan through an exchange, they may lose the employers’Show MoreRelatedUs Healthcare Reform1639 Words   |  7 PagesUS Healthcare Reform and the Impact on Primary Care Physicians Laura Garcia ENG 122 English Composition II Dr. Paula Porter June 28, 2010 The new healthcare reform act recently passed will be fully implemented by 2014. Every person living legally in the United States will be guaranteed, under the Patient Protection and Affordable Care Act, (PPACA), healthcare insurance. Across the United States, primary care doctors are already preparing for the full impact this will have on their practicesRead MoreHealthcare reform Essay1289 Words   |  6 PagesEverybody concurs that healthcare must be accessible to all citizens, but the debate on whether the United States should adopt a universal health system still rages. According to the Institute of Medicine (2002), the U.S. is the only developed country that does not guarantee that its citizens have health care coverage. President Obama pledged to reform the country’s healthcare system by increasing health coverage and reducing expenses. Opponents of the universal healthcare law assert that the stateRead MoreThe Issue Of Healthcare Reform1570 Words   |  7 Pages Healthcare reform continues to be a topic of discussion among politicians, medical professionals, and many Americans who are struggling to pay for care in a system where costs are skyrocketing out of control. 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We have high rates of medical errors, millions without health insurance coverage, and lower utilization of advanced health information technology than most western European nations. It seems every time you turn on the evening news, you hear something about the healthcare system in American and how it is in shambles. WithoutRead MoreHealthcare Reform : Final Assignment1828 Words   |  8 Pages Healthcare Reform: Final Assignment By: Rachael Worley Community Care College â€Æ' Abstract Over 54% of Americans are against the Health Care Reform act and I am part of that percentage. This reform is asking Americans to give up some of their freedoms or risk getting a penalty. Many parties/groups are against this reform act as well and the following paper will show some of the arguments they have against Obamacare. â€Æ' Healthcare Reform Obamacare, officially called the Patient ProtectionRead MoreThe Healthcare Reform Act in Texas1954 Words   |  8 PagesPatient Protection and Affordable Healthcare Act in Texas On June 28, 2012, The Supreme Court ruled the Federal Government does not have the constitutional right to sanction an individual to buy health insurance, but declared that the states do have the right to place a tax on citizens that do not carry insurance. This ruling is in response to President Obama’s Patient Protection and Healthcare Act of 2010. Passed on March 23, 2010, President Obama’s Reform Act mandates Texas, as well as theRead MoreThe Massachusetts Model Of Healthcare Reform1887 Words   |  8 PagesTHE MASSACHUSETTS MODEL OF HEALTHCARE REFORM The Massachusetts model is considered by many to be the blueprint for the national health care reform. It was introduced in the year 2006 and was fully implemented by 2010. The state previously had a â€Å"free care† pool through which it funded the health care given to people who were uninsured and ineligible for Medicare, Medicaid and private health insurance. The then federal government insisted that either the state reduced this funding or it lost $385Read MoreHealthcare Reform Bill Essay613 Words   |  3 Pages2008. If it had not been for our family providing additional medical costs, she would not have been alive as long as she was. Unfortunately, not every American can afford to finance additional expensive procedures. If we do not have pass the Healthcare reform bill, millions of Americans will continue to die unnecessarily. There is a huge problem in our society. â€Å"Although nearly 250 million Americans have health insurance†, there are still a vast number of Americans who are without health care.

Reaction Paper About Monetary Policy - 3087 Words

1. SOCIOLOGY is the ordered, logical study of human society and its origins, development, organizations, and institutions. It is a social science which uses various methods of empirical investigation and critical analysis to develop a body of knowledge about human social activity, structures, and functions. A goal for many sociologists is to conduct research which may be applied directly to social policy and welfare, while others focus primarily on refining the theoretical understanding of social processes. Subject matter ranges from the micro level of individual agency and interaction to the macro level of systems and the social structure. The traditional focuses of sociology include social stratification, social class, culture,†¦show more content†¦Both Auguste Comte and Karl Marx set out to develop scientifically justified systems in the wake of Europeanindustrialization and secularization, informed by various key movements in the philosophies of history and science. Marx rejected Comtean positivism but in attempting to develop a science of societynevertheless came to be recognized as a founder of sociology as the word gained wider meaning. For Isaiah Berlin, Marx may be regarded as the true father of modern sociology, in so far as anyone can claim the title. Herbert Spencer (27 April 1820 – 8 December 1903) was one of the most popular and influential 19th century sociologists. It is estimated that he sold one million books in his lifetime, far more than any other sociologist at the time. So strong was his influence that many other 19th century thinkers, including Émile Durkheim, defined their ideas in relation to his. Durkheim’s Division of Labour in Society is to a large extent an extended debate with Spencer from whose sociology, many commentators now agree, Durkheim borrowed extensively. Also a notable biologist, Spencer coined the term survival of the fittest. Whilst Marxian ideas defined one strand of sociology, Spencer was a critic of socialism as well as strong advocate for a laissez-faire style of government. His ideas were highly observed by conservative political circles, especially in the United States andShow MoreRelatedMonetary Policy Should Consider Asset Prices944 Words   |  4 PagesTo look into the is sue of whether monetary policy should consider asset prices in particular their appreciation, we lay out a model in which we corporate a role for asset prices in particular bubbles. To carry this forth, we lay the paper out into 3 sections, where in section one we summarize our model and findings, section two we look into the model in further detail. In section three we evaluate four scenarios in which a monetary policy maker could face in a given economy, and in the last partRead MoreRational Expectation Hypothesis Proposed By Lucas ( 1973 ) And Sargent1524 Words   |  7 Pagesmoney, considering hedge risk or make investment. As a result, the monetary supply become overabundance so that promote the rise of price level. Dotsey and King (1983) implied the aggregate supply and rational expectation theory to explore the monetary policy. Consequently, they suggest that the supply hypothesis and rational expectation are conducive to the draft of an activist monetary policy. Therefore, the implementation of the policy of the central bank should make the general price level changesRead MoreEvent Study Analysis1064 Words   |  5 Pagesstock return data respond to monetary policy shocks through an event study analysis, similar to Ekanayake and Sengupta (2009) . Thorbeke concludes, measured by the innovations in the federal funds rate, that explanatory monetary policy increases ex-post stock returns. Plus, using a multi-factor model also indicates that exposure to monetary policy boosts an asset’s ex-ante return. Gurkaynak, Sack and Swanson (2004) investigates the response of asset prices to monetary policy actions and statements, usingRead MoreThe Crisis Of The Bankruptcy Of Lehman Brothers1299 Words   |  6 Pagesbankruptcy of Lehman Brothers, the Fed took an exceptional measure and lowered the federal funds rate to a range of 0% to 0.25%, which is referred to as the â€Å"zero lower bound† because the Fed cannot provide any further stimulus through conventional policy. Since then, following from a Keynesian perspective the government took the responsibility to stimulate economy by increased spending and restoration of aggregate demand through supply of easy money. Quoting from www.investopedia.com, â€Å"Easy moneyRead MoreThe South American Country Economics Concerns Essay IP 4 Revised1404 Words   |  6 PagesTravis Eldridge Macroeconomics A.I.U Introduction This paper I am writing is concerned with the economic considerations of a South American country and shall analyze the impact of an economic concern as followed on this particular South American country that I have chosen and I will identify the trend of theRead MoreEssay On Options Budgets967 Words   |  4 PagesEmmons et al. utilizes options contracts on federal funds futures to derive probability forecasts regarding Federal Open Market Committee (FOMC) monetary policy decisions. In particular, they use this information to assess how market expectations evolve over time surrounding five key events from 2003-2006. Additionally, they provide a general overview of the mathematics behind futures and options contracts as well as pricing methodology. 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Eventually, the paper providesRead MoreFactors Affecting The Australian Financial Stocks1594 Words   |  7 Pagesfinancial stocks 2.1 A combination of three financial instruments: monetary policies, interest rate policies and foreign exchange rate In general, Australian financial policies can impact volatility of the local financial stocks. First of all, Faffa and Brailsfordb (1999) reprot that the Australian government is more likely to use the monetary policies, interest rate policies and foreign exchange rate policies as the financial policies to regulate the fluctuation of the financial stocks market. In

Malcolm X Views on Racism Free Essays

Malcolm X views on Racism† English II Ms. Taylor June 18, 2009 Malcolm Little (aka Malcolm X) viewed racism in America as dehumanizing to African Americans and that African Americans were treated with indifference and discrimination. During his lifetime, Malcolm X experienced firsthand how racism affected the lives of African Americans including himself, his family and friends. We will write a custom essay sample on Malcolm X Views on Racism or any similar topic only for you Order Now With some of his first encounters with whites being so terrifying and horrific the firsthand experience was the beginning of his views on how America allowed such treatment to exist. Malcolm X lived during a period in American history when racism and civil rights were at the forefront. This essay will explain what led to his views of racism in America and how his views changed. It will also explain why he embraced the Nation of Islam Muslim organization which works toward the change for the better of African Americans in an array of areas, including spiritual, financial, and social. I will argue why he left the Nation of Islam after he helped strengthen the Nation of Islam membership. Malcolm lost his father Earl Little when he was six years old. Earl Little was viciously beaten by a white mob and run over by a trolley in Lansing, Michigan (Bloom, 2008). The death of his father divided his family. After the father’s death, Malcolm’s mother, Louise Little, struggled to raise him and his seven siblings. The pressure of trying to raise eight children on welfare and the horrific death of her husband, Louise Little eventually had a nervous breakdown and was ultimately institutionalized. Malcolm and his siblings were then separated and placed in orphanages. For Malcolm, the role the state agency plays in breaking up his family became symbolic of how deeply racism is ingrained in society and its institutions. He stated â€Å"I truly believe that if ever a state social agency destroyed a family, it destroyed ours. We wanted and tried to stay together. Our home didn’t have to be destroyed. † (Bloom, 2008). From this point racist social barriers and Malcolm’s own sense of rebellion threw Malcolm into the criminal world as he became partially, broken by imperialism (Wood, 1992). The aforementioned encounters began molding Malcolm’s views on racism in America. As a youth Malcolm was sent to a detention home in Mason, Michigan the home was run by a white family the Swerlins. He had expected the worst due to his past experiences with whites but he was surprised to find that they were kind and generous. Malcolm then started feeling as though he was there mascot. The Swerlins and their friends would talk freely about â€Å"niggers,† using hurtful language, as though he wasn’t there. From here he went to another detention home. Once he was released he went to go live with his sister Ella where he continued to hang around people who were a bad influence on him. It wasn’t before long Malcolm was back in jail his one last hustle with two white women and a friend landed him back in jail for burglary. â€Å"His court appointed lawyer was appalled to see white women being lured into crime by black men and told him he had no business messing around with white girls! †(Helfer, 2006). While in prison Malcolm was introduced to the Nation of Islam (NOI) by his brother Reginald who visited him often. During his time in prison he recalled all the white people he’d encountered. â€Å"In one way or another he felt they all used blacks to better their own lives leaving blacks living under the same or worse conditions as before†(Helfer, 2006). Malcolm began to read a variety of books morning and night, he felt that knowledge was the ammuniton needed to fight the battle against the white devil whom he blamed for his wasted years. Malcolm also developed a relationship with the Honorable Elijah Muhammad through mail correspondence. After corresponding back and forth for a considerable length of time, Elijah Muhammad provided Malcolm with instructions of how he could enter into the Nation Of Islam. Malcolm commited himself whole heartedly to the Nation Of Islam and was welcomed into the brotherhood. â€Å"The teachings of the Nation of Islam that he receives in prison effect a further change in both Malcolm’s character and his view of white people. He simultaneously abandons his wild past and embraces a systematic hatred of whites† (Bloom, 2008). After his release from prison Malcolm continued to embrace the Nation of Islam which worked toward the improvement of African Americans in an array of areas including spiritual guidance, financial independence, and social skills. At this time Malcolm was given the X to replace his last name because Elijah Muhammad believed that Little was a slave name. Malcolm seen the Nation of Islam as a place that gave his life purpose and a sense of pride for African Americans. Soon after Malcolm’s last name changing he became a minister for the Nation of Islam. He would become very well known for his eloquent speeches and his ability to persuade others. During the time of his ministry, some of Malcolm’s close friends were murdered at mosques in Louisiana and New York that were apparently raided by white police officers for no reason. These unjust and tragic events angered Malcolm. This tragic act caused Malcolm’s first disagreement with the Nation Of Islam, because he felt that the Nation Of Islam should defend itself more aggressively over this tragedy. After this, Malcolm began to question the beliefs and philosophy of the Nation of Islam. His faith was soon crushed after he discovered that the Honorable Elijah Muhammad, whom he believed was a prophet, was secretly having relations with as many as six women whom were members of the Nation of Islam. Malcolm was so devastated by this deception and blatant hypocrisy he soon terminated his membership in the Nation Of Islam and founded the Muslim Mosque, Inc. After establishing his own Muslim organization, Malcolm took a pilgrimage to Mecca, Saudi Arabia which changed his opinion about whites. Malcolm greatly expanded his views on race in America by integrating the wisdom he gained from his travel to Mecca. The trip opened Malcolm’s eyes to see that Muslim’s come in all different races and genders. The trip proved life altering, as Malcolm met â€Å"blonde-haired, blued-eyed men I could call my brothers†(Wood, 1992). He returned to the United States with a new outlook on integration and a profound truth that all white people weren’t racist and evil people. After my research it validated my prior assumptions about Malcolm X himself being racist while under the teachings of Elijah Muhammad. His views changed about racism in America that he could also call a white man his brother as well as a black man. He realized you should judge the individual not an entire race of people as a whole but only the individuals that display or encourage acts of racism. References Alkalimat, A. (1999). ed. , Malcolm X: A Research Site: University of Toledo and Twenty-first Century Books) http://www. brothermalcolm. net Bloom, H. (2008). Bloom’s Guides Comprehensive Research Study Guides: Alex Haley’s The Autobiography of Malcolm X Hefler, A. (2006). A Graphic Biography Malcolm X Wood, J. (1992). Malcolm X In Our own Image How to cite Malcolm X Views on Racism, Papers

Solubility of potassium chlorate Essay Example

Solubility of potassium chlorate Essay My plan is to find the determination of solubility curve of potassium chlorate.PredictionMy prediction is to find that the solubility of potassium chlorate (kClO3) increases as the temperature increases.ApparatusThe apparatus that I used during the experiment were* Bunsen burner* Tripod* Gauze* Safety goggles* Heat resistance mat* A boiling tube* A test tube rack* Thermometer* Burette* Two glass beakers* Two grams of potassium chlorateSafety measuresWear safety goggles and lab coat.When do the experiment stand up dont sit down.Use caution when dealing with chemicals.Hot boiling tubes and beakers can cause burns.Do not move around the lab during the experiment (stay at your work station)Scientific information on solubilityThe solubility of a solute in a solvent at a given temperature is the number of gram of that solute which can dissolve in 100g of solvent to produce a saturated solution at that temperature. In this experiment I will see how the solubility of potassium chlorate (KClO 3) changes as the temperatures changes.ProcedureI will explain my procedure in bullet points* Set up the Bunsen burner, tripod, gauze and the rest etc. as shown on the diagram sheet.* Put 2 grams of potassium chlorate into a boiling tube.* Add 4ccm of distilled water from the burette. ( the burette is more accurate to use)* Place the boiling tube in boiling water and allow the solid to dissolve.* Remove the tube from the boiling water when the KClO3 is dissolved.* Stir the contents with a thermometer record the temperature at which the KClO3 crystals first reappear.* Add another 4ccm distilled water from the burette to the boiling tube and stir the contents with the thermometer and record the temperature at which the first KClO3 crystals reappear.* Repeat this step another three times using the same boiling tube.* Then take another boiling tube and add 2 grams of potassium chlorate and repeat the whole experiment in same way to obtain a second set of results.DiagramCalculationsSolub ility (g/100g of water) = mass of solute (g) x 100Mass of water2/4 x 100 = 502/8 x 100 = 252/12 x 100 = 16.672/16 x 100 = 12.52/20 x 100 = 10 average temp = (temp1 + temp2)Results and also see my graphMass of KClOVolume of water ccmSolubility g/100 ccm waterTemperature(`c) at whichcrystals reappearTemperature(`c) at which crystals reappearAverage temperature(`c)2g4ccm50g/100ccm91 `c92 `c91.5 `c2g8ccm25g/100ccm59 `c55 `c57 `c2g12ccm16.67g/100ccm45 `c42 `c43.5 `c2g16ccm12.5g/100ccm33`c31 `c32 `c2g20ccm10g/100ccm25 `c27 `c26 `cConclusionFrom performing this experiment I have found that the solubility of potassium chlorate (KClO3) increases as temperature increases. Every thing happened as I predicted it.I also concluded that most solids that dissolve in water behave like potassium chlorate, although the amount that dissolves will be different.EvaluationAfter doing the experiment and concluding that the solubility of potassium chlorate increases when temperature increases and also findi ng that other solids behave like this I feel that the experiment was successful. By using accurate apparatus like the burette and thermometer I believe that I have obtained reliable results. By also repeating to get a second set of results and finding the averages has also made my results reliable. From the graph I can clearly see it is a solubility curve as is should have drawn a line of best fit to suit my results.There are also other experiments that could be done to obtain results for the solubility of potassium chlorate and surely the same conclusion would be drawn up. But I think that the experiment I did was not so accurate but reliable enough.

USA World Bank Paper

USA World Bank Paper In recent years, the banking industry has experienced tremendous pressure to expand its market share globally. As a result, USA World Bank (UWB) is introducing more effective products and services to its customers. Competition has made selecting a successful product considerably more difficult than previous years; therefore, creating an exceptional and profitable product has become very challenging. UWB is a global organization that must create products to improve profitability and increase its market share. This analysis will identify challenges and opportunities, business goals, and potential problems preventing the successful launch of UWB's strategic goals.Scenario Background USA World Bank is a major player in the banking industry. Boasting both a large consumer and small business customer base, UWB has experienced marginal success on recent initiatives. UWB's President of New Product Development feels the pressure to present a product to the Board of Directors that will have si gnificant impact on the firm's earnings (University of Phoenix [UOP], 2007).Product Development TechnologiesBased upon the decision to introduce a new product, UWB's leadership team is now in the midst of deciding whether it would be more beneficial to focus on the consumer or small business market. As a result, the executive team has come up with two options: offer an instant reward credit card for consumers. Similar to a frequent flier program, an instant reward consumer credit card would collaborate with airlines, hotels, and retailers enticing the cardholder to make purchases with UWB credit card. The second option is the small business credit card with a $200,000 credit limit for capital purchases, offering discounted interest rates and incentive rewards.Mary Monroe, Vice President of New Product Development, and Jim Wilson, the Vice President of Marketing Development presented their products to the executive staff. The executive staff supported both Mary's Instant Rewards and Brian's Small...

List of Obama Gun Control Measures and Executive Orders

List of Obama Gun Control Measures and Executive Orders President Barack Obamas record on gun control is a fairly weak one, even though he was often portrayed  as the most anti-gun president in American history and called for more regulations in the wake of the numerous mass shootings that occurred during his two terms in office. We do not have to accept this carnage as the price of freedom, Obama said in 2016. The National Rifle Association once claimed Obamas obsession with gun control knows no boundaries. Did You Know? Only two gun laws made it through Congress during Obamas two terms in office, and neither placed additional restrictions on gun owners.   In fact, the two gun laws signed by Obama actually expanded the rights of gun owners in the United States. Attempts to limit the size of gun magazines, expand background checks of gun buyers and ban gun sales to buyers on terrorism watch lists all failed to pass under Obama. Perhaps the most significant Obama gun control measure was not a law but a rule that required the Social Security Administration to report disability-benefit recipients with mental health conditions to the FBI’s background check system, which is used to screen firearm buyers. Obamas successor, Republican President Donald Trump, rescinded the rule in 2017. Obama Gun ControlProposals Had No Teeth That is not to say Obama was not critical of the use of guns to commit the numerous mass shootings and acts of terrorism during his tenure in the White House. Quite the opposite. Obama sharply criticized the gun lobby and the easy access to firearms. President Barack Obama pauses during a meeting to observe a moment of silence for Sandy Hook Victims. Pete Souza/Wikimedia Commons Obama also made curtailing gun violence a central theme of his  second-term agenda  after the  mass shooting at Sandy Hook Elementary School  in Newtown, Conn., in December 2012. The president signed  executive orders  calling for mandatory  criminal background checks on gun-buyers  and several other measures that were unpopular in Congress including  a ban on assault weapons  and high-capacity magazines. But he was unable to win passage of  new laws and insisted authorities do more to enforce measures already on the books. Executive Actions Not Executive Orders Critics, however, point to Obamas issuance of 23 executive actions on gun violence in January 2016 as proof that the Democratic president was anti-gun. What most fail to point out is that those executive actions contained no new laws or regulations; and they were not executive orders, which are different than executive actions.   For all the pomp and ceremony, nothing in the president’s proposals is going to put a dent in U.S. gun crime or even substantially change the federal legal landscape.  In that sense, apoplectic opponents and overjoyed supporters are both probably overreacting, wrote  Adam Bates, a  policy analyst with the libertarian Cato Institutes Project on Criminal Justice. Gun Laws Signed by Obama Expanded Rights During his first term, Obama didnt call for any major new restriction on guns or gun owners. Instead, he urged authorities to enforce the state and federal laws already on the books.  In fact, Obama signed only two major laws that address how guns are carried in America, and both actually expand the rights of gun owners. One of the laws allows gun owners to carry weapons in national parks; that law took effect in February 2012 and replaced President Ronald Reagans policy of required guns be locked in glove compartments of trunks of cars that enter national parks. Another gun law signed by Obama allows Amtrak passengers to carry guns in checked baggage, a move that reversed a measure put in place after the terrorist attacks of Sept. 11, 2001. A Strong Tradition of Gun Ownership Obama often mentions the expansion of gun rights under those two laws. He wrote in 2011: In this country, we have a strong tradition of gun ownership thats handed from generation to generation. Hunting and shooting are part of our national heritage. And, in fact, my administration has not curtailed the rights of gun owners- it has expanded them, including allowing people to carry their guns in national parks and Obama repeatedly expressed support for the Second Amendment, explaining that If you’ve got a rifle, you’ve got a shotgun, you’ve got a gun in your house, I’m not taking it away. National Rifle Association HammersObama During the 2008 presidential campaign, the NRA Political Victory Fund mailed out tens of thousands of brochures to gun owners and like-minded voters that accused Obama of lying about his position on gun control. The brochure read: Barack Obama would be the most anti-gun president in American history. Senator Obama says words matter. But when it comes to your Even though the president didnt sign a single bill into law limiting the use or purchase of guns the NRA Political Victory Fund continued to warn its members and like-minded voters during the 2012 election that Obama would make weapons a target in a second term. If Barack Obama wins a The NRA Political Victory Fund also falsely claimed that Obama had agreed to give the United Nations authority over the guns owned by Americans, saying: Obama has already endorsed moving ahead toward a U.N. gun ban treaty and will likely sign it after it’s negotiated.

Eco Essay Example | Topics and Well Written Essays - 2500 words

Eco - Essay Example A customer relation is one primary feature of business that can allow a small company to outshine large business competitors without spending much money or time. Truthfully, customer relations will build a concrete reputation for an organization and earn repeat clientele. This paper will address customer relations as a congruent economic issue in an organization. In order for any organization to succeed, it must bear in mind that the ultimate goal of all customer relations programs is to establish and build long-term relationships- those in which customers keeps buying the product or service and recommending it to others- with customers. For an organization to achieve this objective, it may need to go to greater lengths to build strong reputation for lavishing their customers with special services, gifts, discounts or other benefits (Schulz, 2008). Nowadays, customer relations has become such a vital paradigm in modern business that people commonly refer to relations with an organiza tion’s internal and external customers. ... Nevertheless, acquiring clients and maintaining them is yet another challenge facing many organizations worldwide. The main aim for all businesses is to gain the most out of their activities. Therefore, customers and customer relations are essential factors that contribute to achievement of this goal (Bliss, 2006). Cognitively, it becomes vital to focus on customer loyalty in order to achieve an organization’s objectives. The main purpose of most well developed customer relations is to turn one time or occasional clients into loyal buyers. Customer relations specialists distinguish loyalty from satisfaction, putting across that, it is possible for an organization to satisfy customers but have no particular loyalty. Some customers claim to draw satisfaction from one company’s products but still buy competitor’s products as well. Indeed, what mostly drives the emphasis on loyalty is the bottom line (Kollin, 2011). Customer relations analysts assert that, by estimat es, an organization can spend much higher amount of money in attracting new customers compared to that required in bringing back loyal customers. In addition, repeat customers are more likely to recommend the company to others and try to out the company’s latest products and services. The financial results are that a small percentage increase in customer loyalty can translate into significant rise in profits. Nonetheless, the opposite of customer loyalty- customer turnover- can deplete an organization’s marketing resources and signal weaknesses in the firm’s brand image or its competition position. However, it is worth noting that, high turnover does not necessarily depict that the company’s underlying products or services are at fault. Rather, it may be the negativity or

Computer Sciences and Information Technology Research Paper

Computer Sciences and Information Technology - Research Paper Example Computer science focuses on creating new concepts around the implementation and design of computing systems. Computer science incorporates mathematical concepts of computation as well as information. Further, Clark French (1) mentioned science can be described as the systematic study of the feasibility, expression, structure, and mechanization of the methodical procedures, also known as algorithms. These serve as the foundations for the gathering, processing, representation, communication, storage, and access to relevant data, irrespective of such gathered data is encoded in bytes or bits within the computer’s memories or just transcribed in the proteins and genes structure of the Human cellular structure. The main goal of computer science is to determine the best data processing systems computers can be efficiently and effectively automated and set into motion. Clark French (44) mentions computer science creates programs that improve the computer users’ output. With th e use of accounting software, the accountant’s prior tedious pencil and paper job is reduced by simply encoding the daily transactions. The accounting software will automatically perform all the other steps in the accounting cycle. The accounting software presents a balance sheet, income statement, statement of cash flows as well as breakdowns of receivables, breakdowns of payable amounts, and other accounting information, with just the click of a mouse. The picture development shop can use computer software such as Adobe Photoshop to enhance the output of the camera pictures. The researcher can use the Adobe reader to read pdf files uploaded on the internet. Computer science focuses on how the computer works. The focus includes determining which computer programs will work and which computer programs should be discarded. The computer scientists study which algorithms will produce an end product that is logical, realistic, and saves the computer usage time and money. The comp uter scientists implement the best algorithms that will offer a true as well as an efficient answer to a concrete or real-life problem. The computer scientists create computer program languages such as FoxPro, database III, word, and excel, photoshop, adobe reader, to ensure the specification as well as expression of the established algorithms (Toledo 47). The computer scientists design, build, as well as evaluate current and future computer operating software that can both effectively and efficiently perform prescribed program specifications. The computer scientists implement the preferred algorithm structures to significant software application domains. Michael Huth (259) insists the computer science student creates programs that will lessen the professional’s job. The medical doctor can trust the encoded computer report of the medical transcriptionist. The architect can use AutoCAD architect software to draw the minute details of a house or building. The car driver can use the computer system of the car to determine whether step on the gas or step on the brakes. Michael Huth (213) Computer scientists enter rewarding careers in many fields. One of the fields is software engineering. Another field of specialization is system administration. Another influential field is system management. A favorite field is a research and development to help the government in its drive to improve the lives of the constituents. Some of the computer scientists work in other related areas.  

Sexism in Our Society Essay -- Sexism Gender Women Men Essays

Sexism in Our Society Sexism has always been a major issue for women. It seems that today, everyone has to be careful of what they say and do so as to avoid offending someone. While everyone is busy worrying about extinguishing sexism towards women - which still is an issue that needs to be taken care of, who is concerned with sexism towards men? Sexism is just as much of an issue to men as it is to women. Many people believe that men have advantages over women when comes to a topic such as occupation. Although this may be true, in some cases it is in fact exactly the opposite. Today?s society is so concerned with political correctness and equal rights to women that it has almost completely forgotten about equal rights to men as well. If, in a hypothetical example, a man and a woman go into the same job interview for a company that was involved in a sexual harassment suit with a female employee some years before, and has since had trouble keeping its female employees, there is a very good chance that the woman applicant will get the job, even if the man may be better qualified for the position. If instead, a company was deciding between a man and a woman candidate for a promotion, and was worried about its image as a sexist industry? Not to say that men are always better-qualified than women, or always passed-over for a position or promotion because the company wants to save-face, but unfortunately it does happen in our culture. Granted, women are still often the unfortunate victims of sexism in today?s society, being denied a job opportunity or equal pay because of their gender or because they are thought to be for example too fragile or too emotional for the applied position. Women ... ...ough name-calling and sexist actions. Men and women are also both stereotyped and judged by their looks. A small, attractive woman is less likely to get a job in a warehouse or packing-plant than a larger, more rough-looking woman, regardless of skills or qualifications. The same goes for men in such a situation; an attractive man is assumed to be better suited for an office or sales job, whereas a less-attractive man would be assumed to be better at a job such as truck driving or something with manual labor. Although the issue of sexism has gotten better over the years, and continues to do so, we as a culture must not neglect to realize that women are not the only sufferers of this offense. The more society focuses solely on sexism as an issue toward its women, the less it will recognize that sexism is just as much of an issue to its men.

Boony Doon Case Essay

CASE FORMATTING RULES AND CONTENT GUIDELINES/ CASE QUESTIONS FOR BONNY DOON VINEYARD I Formatting rules The case write-ups should be typed and double spaced, 12 point font (Times New Roman), normal margins with a maximum length of 5 pages which you can split between text, numerical tabulations or appendices as you see fit. You should have a cover page with your names, student numbers, title and course section. You can add the table of contents page and 1 page with the appendices. I expect that it will take you about 3.5 pages to do the analysis (points 1to 4) and about 1.5 pages for points 4 to 7. II Content guidelines The structure of your report should follow the following template: 1. Brief statement of current position/outlook of Bonny Doon (about 1 paragraph) 2. Firm Analysis (This part should include: – business model, business-level strategy and position, – value chain model analysis – analysis of the firm’s resources, capabilities and competitive advantage, – organizational analysis (management, ownership) – profitability analysis (please make sure to include relevant numbers). 3. Industry analysis This part should include: – basic descriptors (size of the market, key players, demand) – Porter’s 5 forces model, – life-cycle model, – key success factors (what it takes to be successful in this industry) – economics of the industry (profitability, costs and revenues) – industry’s overall attractiveness (including the past performance and projected growth) 4. Strategic problem/issue identification and definition 5. Generation of alternatives 6. Recommendation(s) 7. Brief implementation schedule III Case Guidelines/major points for â€Å"Bonny Doon Vineyardsâ€Å" Reference point: You are writing a report as consultants to Bonny Doon. Your report will be presented to their senior management. Here are the main points for your report. 1Describe the current environment for Bonny Doon, including competition and the market trends in the California wine industry at the time of the case. 2.Outline the main features of Bonny Doon’s business strategy. What are its benefits and drawbacks in the light of current situation? Why has Bonny Doon been so successful? 3What are the main challenges and strategic problems facing Bonny Doon? 4.In light of the problems that Bonny Doon is facing, what would you recommend to their management? You should attach a statement to this write-up, which should be signed by all members of the group, indicating that this is entirely the group’s own work, is based exclusively on the information provided in the case, and that each group member contributed their best.

DOTS Programme Nigeria

Sample details Pages: 31 Words: 9166 Downloads: 6 Date added: 2017/06/26 Category Health Essay Type Analytical essay Did you like this example? Chapter One 1.0  Introduction to TB: Characteristics of Tuberculosis: Tuberculosis is a disease caused by the bacteria known as Mycobacterium tuberculosis.[1] Mycobacterium tuberculosis was identified in 1882 by Robert Koch.[2] It is an acid-fast bacillus and obligate aerobe which grows in about 15 to 30 days at a  temperature of 35 to 37 degrees centigrade in an enriched media with a moderately acid base medium. It has no natural reservoir and its antigenic properties are similar to the leprosy bacillus, the Bacille Calmette-Guerin (BCG) and other typical types of mycobacterium[3]. M. Don’t waste time! Our writers will create an original "DOTS Programme Nigeria | Health Dissertation" essay for you Create order tuberculosis is pathogenic and virulent in nature. Its ability to cause disease depends on the susceptibility of the host as well as the aggressiveness of the invading organism[4] . An electron scan of the bacterium is highlighted below[5]: Considered one of the most dreaded diseases of the 19th and 20th centuries, TB was the 8th leading cause of death in children between the ages of 1 to 4 years old during the early 1920’s especially in the developed countries of the world like the United States and Britain.  As the general standards of living improved in the industrialised nations of the world so too did the decline in TB related incidences. TB is often classed by the â€Å"infection of one of the two variants of the tubercle bacillus which is known to commonly affect man. They are Mycobacerium tuberculosis and bovis†[6]. In Nigeria, majority of the TB related disease is due largely to the M. tuberculosis variant of the tubercle bacillus. The TB infections caused by Mycobacterium bovis which is associated with milk are rare and few and far between[7]. TB can take an â€Å"active and an inactive† state of infection. The Word Health Organisation (WHO) describes an active case of TB as â€Å"a symptomatic disease due to infection with Mycobacterium tuberculosis†[8].  TB cases are generally classified as either pulmonary or extra-pulmonary. Patients with pulmonary TB are further sub-divided into â€Å"smear-positive† and smear-negative cases[9]. Smear-positive cases are the most important sub-groups for control programmes as they are the source of infection.  The WHO has defined a smear-positive patient as: A patient with at least two sputum specimens positive for acid-fast bacilli (AFB) by microscopy A patient with at least one sputum specimen positive for AFB and radiographic abnormalities consistent with active pulmonary TB. A patient with at least one sputum specimen positive for AFB, which is c ulture-positive for M. tuberculosis. A smear-negative patient; on the other hand is also defined by the WHO as:  ·Ã‚  A patient with at least two sputum specimens negative for AFB by microscopy, radiographic abnormalities consistent with active pulmonary tuberculosis and a decision by a physician to treat with a full curative course of anti-TB chemotherapy  ·Ã‚  A patient with a least one sputum specimen negative for AFB, which is culture-positive for M. Tuberculosis; and finally Extra-pulmonary tuberculosis is defined by the WHO as:  ·Ã‚  A patient with a histological and (or) clinical evidence consistent with active extra-pulmonary TB and a decision by a physician to treat with full curative course of anti-TB chemotherapy[10] 1.10  Mode of Transmission: The transmission of Tuberculosis is done mainly through â€Å"droplet infection and droplet nuclei† which is said to be generated when a patient with tuberculosis coughs[11].  For the infection to be transmitted the droplet particles must be fresh in its constituency to carry a viable organism. The spread and transmission of tuberculosis is heightened even further depending on the vigorous nature of the cough and the ventilation provisions in the environment concerned. 1.11  Signs Symptoms: The element of signs and symptoms in Tuberculosis is often misleading in the sense that the human body may harbour the bacterium that causes tuberculosis, and the immune system in the body suppresses the resultant effect and prevents the host from becoming sick. It is as a result of this scenario that the medical profession and doctors make a distinction between what is referred to as â€Å"Latent TB and Active TB† Latent TB is a condition where the patient has a TB infection but the bacteria (†¦) remains in the body in an â€Å"inactive state† and therefore causes no symptoms to be shown.  Latent TB which is often referred to as â€Å"inactive TB† is not known to be infectious. Active TB on the other hand is the contagious wing of tuberculosis and can make its hosts sick.[12] The state of active TB develops some clear signs and symptoms in its diagnosis and they include: Chills and cold spells Fatigue Fever Loss of Appetite Night Sweats Unexplained weight loss[13] Medical evidence has shown that there are varying degrees of Tuberculosis depending on which part of the human body it affects. Tuberculosis often attacks the lungs and its signs and symptoms include:  ·Ã‚  Coughing that laughs for three weeks or more  ·Ã‚  Coughing up blood  ·Ã‚  Chest pain or pain resulting from breathing or coughing[14] Tuberculosis is known to affect other parts of the body of which include the brain, spine or kidneys. The symptoms depend on the organs that are affected. Tuberculosis of the kidney tends to show signs symptoms of bleeding in the patient’s urine whilst Tuberculosis of the spine shows cases of back pain. 1.12  Incubation Periods source https://www.aarogya.com/index.php?option=com_contenttask=viewid=834Itemid=853 1.2  Public Health Importance Standard of Living State of Health In Nigeria The United Nations Human Development (UNDP) programme has through the early 1990s paid greater emphasis in human development, welfare and poverty research.  Through its Human Development Report, it has published the Human Development Index (HDI) which looks beyond GDP to a broader definition of a nation’s well-being. The link in welfare is a determinant index to health conditions, well being of persons and an insight onto their susceptibility and immunity to disease infection[15]. The economic condition of a nation is a guiding factor to growth, development and living standards of a nation’s citizen. The assumption that a citizen who is paid more per capita has his or her standard of living higher than those who are paid less is not often the case.  Levels of livelihood and poverty are not necessary elevated through higher income. Nigeria has seen a steady rise in its income per capita over the years.  However, a sharp incline in its inflation rate to the economy, poor standard of governance coupled with a dilapidated health care system has seen a decline in its overall standard of living.[16] The graph below shows this comparison when we see the income per capita of a nation like Madagascar over Nigeria whose citizens receive a higher pay package but have poorer living standards which trigger health concerns[17]. The Human Development Index (HDI) provides a composite measure of three dimensions of human development. These areas include:  ·Ã‚  Living a long and healthy life which is measured through life expectancy  ·Ã‚  The level and degree of education and literacy of nation’s citizens.  This is measured by adult literacy and enrolment at the primary, secondary and tertiary levels; and finally,  ·Ã‚  Levels of a decent standard of living which is measured by an individuals level of purchasing power parity (PPP) and income base analysis.[18] Critics of the process have adhered to the fact that the in dex is not in any sense a comprehensive measure of human development and a way of monitoring standard of living. It does not, for example, include important indicators such as gender or income inequality or other indicators such as respect for human rights and political freedoms. However, what it does provide is a broadened prism for viewing human progress and the complex relationship between income and well-being. In Nigerias context, this index measures the countrys standard of living and state of health by comparing certain key sectors such as life expectancy rates and adult literacy rates.  The chart below gives a unique view to Nigerias position. In this chart, Nigeria has been ranked 158th out of 177 amongst the developing nations of the world with an HDI rating of 0.470.[19] The evaluation of a standard of living is relative, depending upon the judgment of the observer as to what constitutes a high or a low scale. Another relative index to the standard of living of a certain economic group can be gathered from a comparison of the cost of living and the wage scale or personal income. Factors such as discretionary income are important, but standard of living includes not only the material articles of consumption but also the number of dependents in a family, the environment, the educational opportunities, and the amount spent for health, recreation, and social services. Nigeria as a nation has a GDP range of 6.4 as at 2008[20] and the number of dependants vary within the populations in the Northern Southern part of the country. A key example on health grounds are the lifestyles of community citizens in Kano, Kaduna, Zamfara, Sokoto and Bauchi States.  The cultural and religious trends of having a male occupant look after both siblings and relatives within a nuclear family as well as the extended family puts a large burden on cost of living, health standards and living quarters. The research conducted by International medical associatio ns and bodies such as CDC, UNICEF, WHO, Rotary International through the Polio vaccination programme in Kano State are key resources showed a dilapidated and sub-standard level of livelihood amongst the locals in urban regions[21]. Unemployment, low wages, crowded living conditions, and physical calamities, such as drought, flood, political instability, malnutrition etc has brought a drop in the standard of living within such regions in Nigeria. While standard of living may vary greatly among various groups within the country, it also varies from nation to nation, and international comparisons are sometimes made by analyzing gross national products, per capita incomes, or any number of other indicators from life expectancy to clean water. Overall, industrialized nations tend to have a higher standard of living than developing countries. Nigeria is no exception to this theory. Records have shown that since the mid-1970s almost all regions have been progressively increasing thei r HDI score.  A key region that has seen a tremendous rise in their standard of living since the early 1990s are East South Asia.  Central and Eastern Europe and the Commonwealth of Independent States (CIS); especially Russia and its former Soviet colonies initially had a catastrophic decline in the first half of the 1990s but have recovered and improved their standard of living.[22] The major exception is sub-Saharan Africa in areas such as Niger, Togo, Cameroon and Nigeria. Records have shown that since 1990 standard of living has not improved but stagnated.  Experts believe that this is partly due to economic reversal but principally because of the catastrophic effect of HIV/AIDS on life expectancy.[23] Poverty is the major consequence of the dilapidated and chronic failure in Nigeria’s healthcare and social service system.[24] The access to standard resources such as good education, improved water supply, good nutritional standards and adequate shelter provis ions has rendered Nigeria being ranked 80th amongst 108 developing countries with an HPI-1 value of 37.3 as evident in the chart below.[25] These key trends in life expectancy, standard of living and health conditions explains why the 22 nations targeted and responsible for 80% of the world’s TB infections are found in impoverished and developing nations with a poor level of standard of living and health concerns. 1.3  Housing and Poor Sanitation Nigeria; especially Lagos State has had the in-dignified commercial label of being the most expensive slum in the world. This gives a clear insight into the high magnitude of housing inadequacy in both urban rural centres in Nigeria. The dilapidated state of infrastructure and a poor maintenance culture has aggravated the spread of disease and risk in healthy living standards of the vulnerable masses especially in impoverished regions within the country. This can be proven and manifested in both quantitative and qualitative terms. In developed societies such as the United Kingdom (UK), the local authorities are responsible for things like planning permission needed before erecting structures. Nigerias UDB (Urban Development Board) commissions do have rules and regulations in place for buildings, drainage facilities and proper infrastructural displacement but the problem is one of implementation, corruption and share disregard for social, health and economic concerns. This ha s over the decades given rise to poor sanitary conditions which can be seen through the severe overcrowding and unsanitary environment characterized by housing in the urban centres. The only resultant factor are the culminating effect and growth of slum areas. The deficiency in housing quality, building materials and the design and spacing of buildings is a key aspect of why the spread of diseases such as Meningitis, Cholera, Malaria and Tuberculosis are rampant in the region. Take for example the Northern city of Kano State. A city known for its ancient history and strict adherence to Islamic principles, is also known for its vast close knit network of shanty mud houses that lie in close proximity to one another with barely no room for cross ventilation, proper drainage or sewage facility[26]. Sewage is surface borne with the refuse and excreta of humans and livestock being displayed in the open. The health hazards this poses are many. The question of housing and poor sanitat ion is nothing new to the African continent and is indeed a key feature in its rural regions which has spread into the urban developed areas of the countries within Africa. The United Nations in 1969 confirmed that the average annual growth rates were 4.7% and 4.6% between the period 1960 and 1980, and 1980 and 2000 respectively. A confirmation of this can be found in the table annexed below.[27] Average Annual Growth Rate Population (Millions) 1960-1980 1980-2000 1960 1980 2000 % % Africa 31 77 190 4.7 4.6 Studies have shown that the rapid rate of urbanisation in Nigeria and the consequential explosion of urban population have not been matched by a corresponding commensurate change in social, economic and technological development[28] The economic down town in the early 1980s saw a break in the level of growth and development with the nation’s economy to that of its population boom[29]. The lack of proper adequate public infrastructure and social services has suffered tremendously and this has affected the process and level of urban planning and zoning in many cases.  A practical example of this can be seen in the newly created Nigerian capital the Federal Capital territory, Abuja. The capital was built by foreign contractors; Julius Berger, with the idea and layout of a suburban aristocratic society with well spaced buildings proper social and infrastructural amenities and health concerns taking into consideration.  But the key problem lay with accommodation and transportation of the work force and working class within the city. No provisions were made which forced locals to build shanty accommodations unaided by proper planning authorities with little or no regard for health safety issues, sanitary considerations or even building regulations. This idea coupled with the population growth had outpaced the rate of housing provision and created a dilemma in the housing standards and sanitary conditions of millions of its inhabitants.  The spread of diseases both air water borne became eminent and this has been a key problem and contributory factor to disease control in Nigeria. 1.4  Housing and Poverty: The spread of disease can be said to be the resultant consequence of a number of socio-economic factors as well as the action and inaction of government over the years.  Rural areas and indeed some urban regions in Nigerian States, generally lack vital social services and infrastructure services such as clean water, electricity, and good roads. The absence of these amenities constitutes push factors which can be said to have facilitated the migration of rural dwellers into urban centres. It is note a surprise that the rate of urbanisation in Nigeria far outpaces the rate of economic development.  Despite the enormous amount of money proposed for urban investment in the National Development Plan, very limited investment is made in urban infrastructure.  An increasing shortage of urban services and infrastructure characterize the urban areas, and these are only accessible to a diminishing share of the population. The existing urban services are overstrained which often ti mes lead to total collapse.  A large proportion of the population does not have reasonable access to safe and ample water supply, and neither do they have the means for hygienic waste disposal. It is eminent that these two services are essential for a healthy and productive life and the lack of it are a key contributory factor to the causes of Tuberculosis. The quality of the environment in most urban centres in Nigeria is deplorable.  This is not so much dependent on the material characteristics of the buildings but on their organization as spatial units.  The slow process of urban planning and zoning, in the face of rapid urbanisation in most urban centres, has resulted in poor layout of buildings with inadequate roads between them and inadequate drainage and provision for refuse evacuation.  Thus there is a high incidence of pollution through water, solid waste, air and noise and inadequacy of open spaces for other land uses[30]. Studies over the years have shown th e deplorable conditions of urban housing in Nigeria. They affirm that 75% of the dwelling units in Nigeria’s urban centres are substandard and the dwellings are sited in slums[31].  This is attributed to the combined effects of natural ageing of the buildings, lack of maintenance and neglect, wrong use of the buildings, poor sanitation in the disposal of sewage and solid waste, wrong development of land, and increasing deterioration of the natural landscape. There are moderate building facilities in Nigeria but the high level of poverty of most urban households places the available housing stock out of their economic reach.  Many of the households resort to constructing make shift dwellings with all sorts of refuse materials in illegally occupied land.  This has led to the growth of squatter settlements in many urban centres.  The buildings therein are badly maintained and lack sanitary facilities with little access to light, air and good water.[32] The United N ations Standard for Nigeria’s room occupancy is 2.20. The World Health Organization (WHO) stipulates the average rating to be between 1.8 and 3.1, whilst the Nigerian Government prescribed a standard of 2.0 per room.[33] However, the reality is different as overcrowding is thus a visible feature of urban housing in Nigeria.  It is symptomatic of housing poverty and consequential of poor economic circumstances. 1.5  Prevalence of TB: The term â€Å"prevalence† of Tuberculosis usually refers to the estimated population of people who are managing Tuberculosis at any given time.  Prevalence and mortality are considered by the WHO as direct indicators of the burden of Tuberculosis which indicate the number of people suffering from the disease at a given point in time and subsequently those dying each year.[34] A balance and understanding of these terms aids the improvement of the level of control and effectiveness in treatment thereby reducing the average duration of the disease.  The Stop TB Partnership link spearheaded by the WHO is aimed at reducing by 2015, the per capita prevalence and mortality rates by 50% in comparison to records in 1990.[35] The optimism is reassuring in most regions of the world with the exception of the African continent. The key factors derailing the efforts will be highlighted in the next chapter. In order to determine prevalence levels within a region, resort to stati stic by way of a â€Å"population based survey† is often adopted. These surveys are used to estimate prevalence for those countries with proper census records. Another option is to adopt the method of â€Å"estimated incidence† ratings. Estimates of this nature on TB incidences, prevalence and mortality rates are based on a consultative and analytical process proscribed by the WHO and published on an annual basis. Records vary from country to country, however the general formulae used is derived from the following key factors: Estimates of incidence combined with assumptions about the duration of the disease. The duration of the disease is assumed to vary in accordance with whether or not the disease is â€Å"smear-positive and whether or not the individual receives treatment in a DOTS programme or in a non DOTS programme or is not treated all; and finally Whether or not the individual is infected with HIV[36] According to the WHO, nearly two billion people; about one-third of the world’s population, are infected with TB.[37] In developed regions of the world such as the United Kingdom (UK) and the United States of America (USA), the prevalence levels are much lower than those recorded in high risk regions of the developing world. Statistic records rendered in 2003 from the Department of Health within the UK suggests the following:  ·Ã‚  42 years was the mean age of patients hospitalised with Tuberculosis in England between 2002-2003  ·Ã‚  69% of hospitalisations for Tuberculosis was for 15-59 year olds in England between 2002-2003  ·Ã‚  10% of hospitalisations for Tuberculosis was for over 75 year olds in England between 2002-2003.[38] The goal for Tuberculosis elimination in the United States of America (USA) is a TB disease incidence of less than 1 per million US population by 2010. This requires that the Latent TB Infection (LTBI) prevalence level should be less than 1% and decreasing by 2010. Current prevalence rate levels of Tuberculosis in the United States are between 10 and 15 million people. In 1998, a total of 18,371 active TB cases were recorded in all 50 states and the District of Columbia[39] A comparison level of statistical studies in the prevalence levels of patients between 1999-2000 was compared to those of patient’s way back in 1971-1972 and the results were as follows: LTBI prevalence was 4.2% with an estimated 11,213,000 individuals diagnosed with LTBI Amongst 25 – 74 year olds, prevalence decreased from 14.3% in 1971-1972 to 5.7% in 1999-2000 Higher prevalence’s were seen in the foreign borns which accounting for 18.7%, non Hispanic blacks and African Americans accounted for 7.0%, Mexican Americans accounted for 9.4% and individuals living in poverty accounted for 6.1% A total of 63% of LTBI was among the foreign born A total of 25.5% of persons with LTBI had previously been diagnosed as having LTBI or TB; and Only 13.2% had been prescribed treatment[40] The chart below; as well as that in â€Å"the annex†, shows the level of new TB cases per 100,000 population and that of prevalence levels in HIV+ people worldwide for the year 2007.[41] 1.6  How Rapid Does TB Spread In Nigeria?: Part of the Federal Governments programme in curbing the spread has been initiated through the National TB and Leprosy Control Programme (NTBLCP) which is seeking to achieve a 70% TB detection rate and an 85% cure rate by the end of 2010 The programme also aims to ensure that TB patients receive adequate drugs and comply with the slated 8 months period of treatment. Mr Omoniyi Fadare; an NTBLCP Programme Officer is quoted to have said in 2005 that the DOTS programme was being implemented in 584 out of 774 local government areas with the country recording between 700,000 to 1 million TB cases annually out of which 105,000 are TB related deaths.[42] Ideally, the spread of TB should be less bearing in mind that the Nigerian Government has implemented the DOTS strategy in all antiretroviral treatment centres nationwide in an effort to control the spread of Tuberculosis.. However, this is not the case as in 2009 the rate of prevalence had risen to over 1.2 million with an an nual mortality rate of 150,000. These statistics question the reasons behind the spread of TB in Nigeria. The spread of TB is made rampant through factors such as poverty and outdated testing equipment which contribute to Nigeria’s high TB prevalence. The lack of awareness, early detection and failure to render immediate treatment are also key factors to the spread of TB in Nigeria as corroborated by Dan Onwujekwe; a Senior Fellow of the Lagos based Nigerian Institute of Medical Research.[43] A recent study carried out by the Nigerian Institute of Medical Research (NIMR) in 2007 found out that of the 620 HIV/AIDS patients surveyed in June and July, 2006, about 160 had TB without knowing they did have the disease.[44]  Other factors which contribute to the growing spread of the disease include: The lack of sufficient drugs and clinics within close proximity of affected regions has heightens the spread of the disease as infected persons and those willing to undergo m edical check ups are discouraged from seeking help. Poor laboratory infrastructure needed for testing as well as insufficient man power also plague the success and undermine the effective implementation of the TB control activities. Also worthy of note is limited funding for TB control efforts from the Federal and Sate government authorities. The failure on the part of the authorities stalls the programmes ability to execute necessary activities when due.  The issue of funding is a paradoxical point as it points also to issues of embezzlement and corruption that has plagued the country over several decades of mismanagement. The DOTS programme and TB drugs are relatively cheap and free to the public and yet with adequate funding from NGO’s and governments like the EU and the United States; as indicated in the diagram below[45], the problem of funding still remains a key factor that continues to fuel the spread of the disease. 1.7  Aim: The aim of this study (dissertation) is:  ·Ã‚  To provide an insight into the terminal disease of Tuberculosis on an International and national level  ·Ã‚  To evaluate DOTS implementation in Nigeria using a series of case detection and treatment outcomes as indicators  ·Ã‚  To analyse and evaluate the resulting consequences of the DOTS programme in Nigeria within the 21st century and see if its adoption has favoured a positive control of TB over the years 1.8  Obejetive: The following are the objectives of this study (dissertation):  ·Ã‚  To evaluate case detection rates of smear-positive TB cases in selected areas implementing the DOTS programme within Nigeria  ·Ã‚  To evaluate case detection rates of all TB cases notified in Nigeria within the 21st century  ·Ã‚  To compare Nigerian experiences, failures and progresses to other developing nations and developed countries of the world affected by TB  ·Ã‚  To identify potential weaknesses, strengths and developments in the DOTS programme in Nigeria  ·Ã‚  To create, deliver and analyse a survey on the Nigerian public on the implementation of DOTS in Nigeria within selective states and compare the resulting outcomes with available data 1.9  Research Question: Research questions will be focussed on whether or not the DOTS programme has achieved its object and mandate of reducing the rate of TB infection in Nigeria. Whether or not the target of 2015 by the WHO is a realistic target that can be met by Nigeria? Whether or not Nigeria has made progress over the years with the amount of funding hey have had and the exposure the healthcare system has had to curb the growing threat of TB in the country Whether factors such as cultural, religious, economic and social elements are the cause of the drawback in the successful implementation of the DOTS programme in Nigeria? Chapter Two 2.0  The Federal Republic of Nigeria: Nigeria is located in Western Africa on the Gulf of Guinea and occupies a total area of 923,768 km ² making it the 32nd largest country in the world.[46] It is comparable in size to the South American country of Venezuela and is about twice the size of the State of California in the United States of America.[47] It is bordered by Benin in the West, Niger in the North, Chad in the North West, Cameroon in the East and has a coastline of at least 853  km with the Atlantic ocean.[48] The countrys climatic regions are broken down into three categories – the far south which is defined by tropical rainforest climate with annual rainfall of between 60 to 80 inches per annum, the far north where majority of the TB epidemics and polio incidences have been recorded is defined by its almost desert-like climate where rain fall records are set at less than 20 inches per annum and finally the rest of the countrys region between the far south and far north is characteristic of the sa vanah grove land with annual rainfalls of between 20 to 60 inches.[49] The country has over 250 ethnic group divisions.[50] The main tribes are the Hausa’s in the Nothern part of the country where majoriy of the TB pandemic is recorded, the Yoruba’s in the Southern part of the country known for is thick mangrove swambs and malaria manifestation and the Igbo’s in the Eastern part of the country where majority of the nations oil explorations and severe environmental degredation oil spilllages are found.[51] In a country ranked as the 8th most populous country in the world, the United Nations (UN) estimated Nigeria’s population at 131,530,000 in 2004.[52] The latest censors in Nigeria in 2006 put the countrys population at 150 million; that is almost 3 times the population of the United Kingdom in an area mass of about less than half the size of Nigeria. It is estimated that by 2050, Nigeria will be one of those countries in the world; like China, Ind ia and Brazil, that account for majority of the world’s population.[53] It is indeed a statistical nightmare when one considers that most of the world’s current populous nations are amongs the 22 nations in the DOTS programme. Nigeria as a confederation of states is divided into thirty six (36) states and one Federal Capital Territory (Abuja) which are further divided into 774 LGA’s.[54]  This gives you an idea of the logistical difficulties and task ahead of the DOTS programme in curbing a disease that is catalysed by such vices as poor sanitary conditions and tightly spaced housing plans. Nigeria has six major cities with a population of over 1 million people. They are the cities of Lagos, Kano, Ibadan, Kaduna, Port Harcourt and Benin City.[55]  The city of Lagos alone accounts for 8 million people[56]; a region of about the size of Cardiff. This demography and health hazards surrounding a region in comparision to the capital of Wales which accounts for only 2.9 milion citizens.  A map of the region showing its states and geographical location is higligted below[57]. Another key segment worth mentioning is the health sector in Nigeria.  It is a known fact corroborated by the UN’s list of disfunctional national heathcare systems that over the past 4 decades Nigeria’s healthcare and general living conditions are poor, delapidated, ill funded and neglected since its  independence from the British government in 1960. This is not categorically due to inability or lack of financing in a nation that is ranked as the 7th largest oil producing country in the world[58], but merely as a result of lack of proper planning execution, misrule, mismanagement and corruption over the past 40 years. The life expectancy rate in Nigeria is put at 47 years for both males and females and just half the population has access to potable and appropriate sanitation.  Infant mortality rate is set at 97.1 deaths per 1000 living births with the only plausable progress being the HIV/AIDS rate in Nigeria which is recorded as being lower compared to other African nations such as Kenya, Zimbabwe and South Africa which are in double digits.[59] In 1995 the estimated TB cases was put at 220,000 cases. Today the figure is put at over 449,558 as at a 2006 survey done by USAID.[60] This just adds to the evidence of the growing problem in disease malcontrol highligted by poor hygiene, poor medical facilities and lack of good awareness and educational strategic policies which has seen the steady rise in other infectious outbreaks such as polio, cholera, malaria and sleeping sickness. The Nigerian healthcare system is continuously faced with shortages of doctors due to the simple fact that many highly skilled Nigerian doctors have quiet understandably opted for better standards of living and opportunities in the developed world. It is estimated that in 1995 alone, over 21,000 Nigerian doctors were practicing in t he United States of America (USA) alone.[61]  This figure accounts for the current volume of qualified medical doctors in the whole country. On average this is just over 700 doctors per state and approximately one doctor to each LGA. This figures are a ridicule to a developing countries basic fundamental right and a case sudy to disaster and intrigue in the fight adopted by the DOTS programme in curbing the TB saga. There is still a long way to go in curbing such health hazards and improving the chances of an exceedingly significant TB programme which needs political, economic and social will-power from the government of Nigeria to see through this disease which is currently ill-understood and not respected. So what really is Tuberculosis and what is its impact in Nigeria? 2.1  TB In Nigeria: Nigeria as a nation has had its own spell of disease epidemics and pandemics.  With a well documented spell of malaria, cholera, meningitis and polio, its efforts in combating, curbing and procuring vaccination strategies and control measures have been mediocre to say the least. The first TB clinic in Nigeria was opened in 1942 during the colonial period in Lagos.[62]  WHO records confirm that during the period of 1955 to 1958 in Ibadan, Oyo State, the prevalence rate of TB was showing a level of increase from 0.03 to 0.12 per 1000 population.[63] Estimates published by the World Bank’s WDR (World Development Report) 40 years on showed an alarming increase in its incidence ratings to 222 cases per 100,000 population.[64] The DOTS strategy for TB control was formally adopted by the Nigerian Federal Ministry of Health (FMOH) in 1993[65] and has seen a keen improvement in the resultant effects from donor support and National subsidy encouraged through free treatments, support with anti-TB drugs, laboratory reagents and awareness programmes. By the early 90’s, the National Tuberculosis and Leprosy Control Programme; otherwise known as (NTBLCP) was established by the Federal Ministry of Health (FMOH) in 1988 and formerly kicked of with the execution of its mandate in 1991. The programme cleverly adopts the governments 3 tier system and drafts in National, State and Local Government Co-ordinators, Health officers and Support Staffs to cover all of the 744 LGA’s.[66] Apart from the DOTS programme currently in force in Nigeria, the Stop TB Partnership strategy instigated by the WHO, drafts in the idea of tackling special problems like multi drug resistant TB; otherwise known as MDR TB.[67] It also involves the integration of HIV related services with TB, engaging all stakeholders involved in the development and execution of this programme and carrying out relevant research to ensure that tuberculosis is tackled decisively within t he Nigerian communities.  But has this worked over time? By the turn of the century, Nigeria was heavily involved with UN, WHO, CDC and every other internationally backed healthcare programme sponsored by governments of the developed world. In April 2009, Nigeria’s current Health Minister; Mr Babatunde Osotimehin was reported to have confirmed that Nigeria is ranked 5th on the WHO’s list of the 22 countries with the highest TB burdens worldwide.[68] These 22 countries collectively account for 80% of the global TB burden with the disease seeing an increase in Nigeria from 31,264 cases in 2004 to an outstanding 90,307 cases in 2008.[69] The problem according to Wale Akeredolu; a Lagos Island Government Medical Officer, lies in two categories: Inadequate awareness of the disease; and Reluctance by citizens affected by TB to seek treatment even where there is an awareness in sight.[70] The failure and low trend of success in attributed to government bureaucra cy coupled with the slow drive of awareness and initiative that is hampered by cultural, social and taboo related vices. These factors have made the average citizen either too frightened to come up and receive free treatment or too ill informed to carry out the basic health and sanitary culture needed to maintain clean environments and a healthier lifestyle. 2.11  Rates and Number of Cases: The exact burden of TB in Nigeria is generally unknown due to the inadequacy and non-reliance of disease surveillance in the country. The burden of TB is therefore estimated indirectly using â€Å"epidemiological parameters† such as the Annual Risk of Tuberculosis Infection (ARTI), estimated incidence of smear-positive pulmonary TB, case notifications and notification rates[71].  The other parameters used include estimated coverage of the population with Nigeria’s healthcare services, the estimated case-fatality rates for smear positives and other forms and trends of Tuberculosis. In 2004 for example, the WHO estimated Nigeria’s TB incidence rate in all forms of TB at 290 per 100,000 population within that year. The trend in incidence ratio was fixed at 2.6% per annum and the prevalence ratio was put at 531 cases per 100,000 population.[72] These figures compare with countries like Pakistan and Bangladesh and put Nigeria amongst the countries with the high est â€Å"incidence ratio† of TB in the world. Within the same year, the mortality ratio was recorded at 82 deaths per 100,000 population. The heightened degree in mortality rate can be linked to the synergy between TB and HIV levels in Nigeria. This is evident in the statistics recorded again in 2004 which put the prevalence of HIV in adult TB patients at 27% for those aged 15 to 49 years.[73] New cases recorded in 2004 as a result of MDR-TB was recorded at 1.7% with a sharp increase prior to this on previously treated TB cases of multi drug resistant TB (MDR-TB) put at 7.6%.[74] Nigeria has since 1995 been recording a steady increase in notification rates. Due to insufficient and unreliable statistics it is yet unclear whether this level of increase is due to the awareness and publicity of the DOTS programme in Nigeria or simply due to the increase in incidence ratio to HIV.  In a period of 10 years since 1995, Nigeria has seen an increase of over 120% in the not ification rates of TB related syndromes. The increase is also evident in age demographics.  For instance, the highest levels of SS+ cases are recorded in both men and women between the age brackets of 25-35 years and astonishingly a sharp increase of similar magnitude in patients aged 65 and above.  The figure below provided by the WHO and IUATLD programmes gives a graphical representation of the above statistics.[75] Nigeria’s current Health Minister; Prof. Babatunde Osotimehin revealed that the number of TB cases notified in the country increased from 31,264 in 2002 to 90,307 in 2008. Within this period more than 450,000 TB cases have been successfully treated free of charge in the past 5 years in Nigeria. According to the Minister, the rates and numbers of TB burden in Nigeria is compounded by the high HIV/AIDS prevalence of 4.6% recorded in 2007. Consequently, the FMOH has developed a strategy to maximise collaboration between HIV and TB programmes in Nigeria and has instituted a policy that all TB suspects and patients should be screened for HIV while all HIV positive patients should also be screened for TB. As a result of this policy, about 58, 942 TB patients (65.2% of the registered TB patients in 2008) were screened for HIV last year, out of which 14,698(24.94%) were found to be HIV positive.[76] 2.12  TB Centres and Influence of Who on TB in Nigeria Nigeria, being the most populous nation in Africa does have a great burden on itself regarding the amount of TB centres needed for its 772 local government regions. Prior to 1988 only a few states had a relatively well organised TB unit[77] The centres were plagued with problems such as untrained personnel in charge of clinics and rendered healthcare services. The methodology adopted was one of â€Å"isolation of the infected patient† from the community for a long period[78]. The methods of case finding adopted by health workers and the administration of anti-TB drugs were not up to standard or the recommendation of the WHO and IUATLD. The risks therefore were that doctors were prescribing wrong medication based on wrong diagnostic methods and in some other cases due to the unavailability of drugs in certain centres, patients were either turned back or given alternative medicine. It wasn’t until after 1988 that the government with the aid of WHO and the DOTS pro gramme did healthcare in this sector began taking on a positive start. In 1991 the Federal Ministry of Health (FMOH); then in Lagos, formulated an official TB control policy consisting of a programme manual with goals and objectives, a fully kitted training programme, a plan for supervision and a development plan. This development plan has over the years seen hospitals, facilities and TB centres move from just 3 centres in the mid 70’s to several hundreds in the early 90’s. The Nigerian Health Minister confirmed that TB incidences were treated in all 36 states of he Federation with an average of 25 centres per state.  An example of this can be seen in Zamfara State in Northern Nigeria which has 66 TB centres in the region. The state representative; Dr Ibrahim Bature confirmed that in 2008 it averaged 25 reports per month of TB related infections[79]. The government’s subsequent health policies backed by NGO’s, WHO and key stakeholders saw the c hange and redevelopment of Infectious Disease Hospitals (IDH) and TB clinics being built into society.  The General Hospitals in the country such as â€Å"Murtala Mohammed Hospital† in Kano State, The University Hospital’s in Ife and Ibadan and he Lagos State University Teaching Hospital in Lagos have all been equipped with necessary facilities either donated by international donors, independent sponsors, NGO’s or government intervention. A recent visit by the Global Alliance for TB Drug Development (TB Alliance) was made to the University College Hospital of Ibadan in September, 2007. The association gave a â€Å"satisfactory favourable site rating† to what it saw as adequate clinical sites and associated Mycobacteriology laboratories needed to conduct clinical studies on anti TB drugs in human subjects.[80] This is seen as a positive step Nigeria’s TB programme since it is a known fact that TB related research activity is very low in the region. Where funding is available, majority of it comes from individual grants from local research institutions; which includes Nigerian universities and also foreign donors and NGO’s.  For example, the recently awarded â€Å"Round 5 Global Funds† for ATM was used in Nigeria to scale-up DOTS expansion but this left very little funding for research.  Despite this, Nigeria has seen research on TB in such institutes as: NIMR, Lagos The TB training school in Zaria, Kaduna State, University College Hospital, Ibadan, Oyo State. The National Institute for Pharmaceutical Research Development (NIPRD) in Abuja in conjunction with Dr Clifton E Barry of National Institute of Allergy and Infectious Diseases, National Institute of Health, USA. The challenges of TB related research in Nigeria can be summarised in these words. Availability of standard research facilities such as proper infrastructure to house equipments, high grade standard equipments, hardwar e, kits etc. Capacity to train health personnel, physicians, researches, lab scientists, nurses etc Continued Financial backing of the programme and adequate support in maintaining facilities, remuneration of staff and recognition of work done Implementation and maintenance of good clinical practice, good laboratory practice and respect on ethics of research in human subjects.[81] 2.13  What is DOTS? The term â€Å"DOTS† stands for Directly-Observed Treatment Short course.  It is a comprehensive and internationally recommended strategy endorsed by the World Health Organization (WHO) and International Union Against Tuberculosis and Lung Diseases (IUATLD) to detect and cure TB patients.[82] 2.14  Origin of DOTS and why it is adhered to: The DOTS programme has been identified by the World Bank as one of the most cost effective health strategies available.  The economic realities of a killer disease in Tuberculosis signifies the unique position the DOTS programme has to play especially in the developing economies of the world when the questions of affordability, reliability and effectiveness all play a part in the realities of life and the survival of the human race and those in desperate need of a cure. 2.15  Aims and Objectives of DOTS: The aims and objectives of the DOTS strategy are designed to decrease the risk of infection, reduce morbidity and the transmission of the infection and prevent TB deaths.  The achievements of these objectives are initiated through: (a)  identifying TB related cases in communities around the world; especially in developing countries; and (b)  treating TB cases by directly observing the medication intake of the patient over a relative period of between six to eight months. This is essential in order to ensure that medication is taken in he right combination and appropriate dosage in an effort to prevent the development of MDR-TB (Multi drug resistant Tuberculosis)[83] The DOTS operational goals are geared towards detecting at least 70% of the new smear-positive TB cases and curing at least 85% of these detected cases. The end goal is that through these detection methods about 80% of deaths attributed to TB worldwide will have been successfully prevented.[84] The WHO has always advocated that for the DOTS strategy to be effective and successful, five key elements are essential in its implementation. They are: (1)  Sustained Political and Financial Commitment: TB can be cured and the epidemic reversed if adequate resources and administrative support for TB control are provided. Invariably this would enhance the opportunity for countries with a higher level of TB occurrences to make the TB policies part of their national health system. (2)  Diagnosis by Quality Ensured Sputum-Spear Microscopy: This entails aspects such as detection amongst patients found to have symptoms of TB especially those with prolonged cough. An even heightened concern is given to case detection among HIV infected people or other similar high risk scenarios. (3)  Standardised Short-course Anti-TB Treatment (SCC) Given Under Direct and Supportive Observation (DOT): This is a case management strategy that involves the direct observation of treatment. This segment helps to ensure that the right drugs are administered at the right time and for the full duration of the treatment. (4)  A Regular, Uninterrupted Supply of High Quality Anti-TB Drugs: This segment ensures that there is a credible national TB programme in place that satisfies demand with the supply of high quality drugs secured through a satisfactory drug procurement and distribution system. (5)  Standardised Recording and Reporting: This final segment enables the assessment of each and every patient as well as the assessment of the overall programme performance[85] 2.16  Search Strategies To be filed in once research work and thesis write up is completed 2.17 Literature Review  ·Ã‚  Data Extraction  ·Ã‚  Appraisal of Study  ·Ã‚  Baseline Data Extraction  ·Ã‚  Findings Extracted To be filed in once research work and thesis write up is completed [1] Walton J., Barondess J.A. and Lock S., The Oxford Medical Companion, Oxford University Press, London, 1994. [2] See Nobelprice.org via website link entitled â€Å"Robert Koch and Tuberculosis† at https://nobelprize.org/educational_games/medicine/tuberculosis/readmore.html [3] Pagel W., Simmonds F.A.H., MacDonald N., â€Å"Pulmonary Tuberculosis†, Oxford University Press, London 1994. [4] Grange J.M., Macobacteria and Human Disease, 2nd Edition, Arnold, London, 1996. [5] Diagram on TB can be found at Todar’s  Online Textbook on Bacteriology available online at: https://www.textbookofbacteriology.net/tuberculosis.html [6] For further reading see Walton J., Barondess J.A. and Lock S., The Oxford Medical Companion, Oxford University Press, London, 1994. [7] NTBLCP (1991), Workers Manual. Federal Ministry of Health Lagos. [8] See World Health Organisation (1993). Treatment of Tuberculosis. Guidelines for National Programme, Geneva. [9] Ibid. [10] For further research see S.K. Sharma A Mohan,  Indian Journal on Medical Research, 120 on October 2004 also available online at: https://icmr.nic.in/ijmr/2004/1008.pdf [11] See Australia’s Victorian Health Information Centre on Tuberculosis available online at: https://www.health.vic.gov.au/ideas/bluebook/myco_tb [12] See Article from CDC entitled: TB Elimination – The Difference Between Latent TB Infection and Active TB Disease, February 2005 also available online at: https://www.temple.edu/ovpr/ehrs/docs/LatentTBandActiveTBFactSheet.pdf [13] For further reading see link on MedTV available online at: https://tuberculosis.emedtv.com/latent-tuberculosis/latent-versus-active-tuberculosis.html [14] Ibid. [15] See Human Development Reports on the UNDP website available online at: https://hdr.undp.org/en/countries/ [16] For further reference see A. Abba, The Nigerian Economic Crisis; Causes and Solutions, Published by The Academic Staff Union of the Universities of Nigeria, 2005 [17] See UNDP: Nigeria – 2007/2008 Human Development Report, The HDI – Going Beyond Income available online at https://hdrstats.undp.org/countries/country_fact_sheets/cty_fs_NGA.html [18] Ibid. [19] Ibid. [20] For further analysis of the countries GDP values see Mundi Index: Nigeria GDP – Real Growth Rate available online at: https://www.indexmundi.com/nigeria/gdp_real_growth_rate.html [21] See further research on â€Å"Health Workers Renewing Fight Against Polio† available online at: https://www.pbs.org/newshour/bb/africa/jan-june09/nigeria_04-13.html [22] See Russian Demographics; Wikipedia Analysis, available online at: https://en.wikipedia.org/wiki/Demographics_of_Russia [23] See Medical Article by Ma rk Cichocki R.N., â€Å"The Deadly Intersection Between TB HIV†, 2007 also available online at https://aids.about.com/od/opportunisticinfections/a/tbhiv.htm [24] For further reference see text authority by Sofo C.A., Ali-Akpajiak and Tony Pyke, â€Å"Measuring Poverty in Nigeria† Oxfam Publ at pg. 8/65, 2003 also available online at: https://books.google.co.uk/books?id=4scgLlqWHWECsource=gbs_navlinks_s [25] See UNDP: Nigeria – 2007/2008 Human Development Report, The HDI – Going Beyond Income available online at https://hdrstats.undp.org/countries/country_fact_sheets/cty_fs_NGA.html [26] See Rotary International Journal Publication entitled â€Å"Fulfilling Our Promise† by Norman R Veliquette, 2004 [27] See Article by Olotuah A.O. and Adesiji O.S., â€Å"Housing Poverty, Slum Formation and Deviant Behaviour†, 2005. Article is also available online at: https://209.85.229.132/search?q=cache:5DqImlRIWlQJ:www.york.ac.uk/inst/chp/hsa/ autumn05/papers/OLOTUAH1.doc+salau,+1992cd=3hl=enct=clnkgl=uk [28] See text authority by: Mabogunje, Akin L., â€Å"Urbanisation in Nigeria†, University of London Publ., 1968 [29] See Text Authority by Salau A.T., â€Å"Urbanisation, Urban Poverty and Housing Inadequacy†, 1992 [30] Full insight on this point can be seen at Journal article presentation made by Professor Akin L Mabogunje, â€Å"Global Poverty Research Agenda – The African Case†, Abuja, Nigeria, 2005. [31] Ibid. [32] Ibid. [33] Article by Olotuah A.O. and Adesiji O.S., â€Å"Housing Poverty, Slum Formation and Deviant Behaviour†, 2005 [34] See WHO Website on â€Å"Prevalence on TB† also available online at: https://www.who.int/whosis/indicators/compendium/2008/2ptt/en/index.html [35] Article on â€Å"The STOP TB Strategy – Building on and Enhancing DOTS to Meet the TB-Related Millennium Development Goals† hosted by the WHO and presented in 2006. Available online at: https://www.stoptb.org/resource_center/assets/documents/The_Stop_TB_Strategy_Final.pdf [36] See WHO: Prevalence of Tuberculosis (Per 100000 Population) available online at: https://www.who.int/whosis/indicators/compendium/2008/2ptt/en/index.html [37]  See NIAID (National Institute of Allergy and Infectious Disease) on Tuberculosis available online at: https://www3.niaid.nih.gov/topics/tuberculosis/Understanding/overview.htm [38] Department of Heath Statistic records for the United Kingdom available online at: https://www.dh.gov.uk/en/Publichealth/Communicablediseases/Tuberculosis/DH_278 [39] See statistic records available online at cureresearch.com at: https://www.cureresearch.com/t/tuberculosis/prevalence.htm [40] See American Journal on Respiratory and Critical Care Medicine, Vol. 177 pp. 344-355, 2008 also available online at: https://ajrccm.atsjournals.org/cgi/content/short/177/3/348 [41] See Henry J. Kaiser Family Foundation webs ite on US Global Health Policy available online at: https://www.globalhealthfacts.org/topic.jsp?i=12 [42] See Kaiser Network.org – The Henry J Kaiser Network Foundation on Tuberculosis  Ã‚  Nigeria Implements DOS at Antiretroviral Treatment Centres Nationwide, 11th July, 2006 also available online at: https://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=38419 [43] See Article written by Ogechi Eronini entitled â€Å"TB – A Leading Cause of Death Amongst People Leaving With AIDS†, 2007 aso available online at: https://www.panosaids.org/Left_read.asp?leftStoryId=123leftSectionId=2 [44] Xinhua News Agency – Nigeria: Poverty, Obsolete Equipment Responsible for TB Spread in Nigeria, March, 2007 also available online at: https://www.aegis.com/news/ads/2007/AD070632.html [46] See analysis of the Geography, Subdivision and Demographics of Nigeria in the Wikipedia printout available online at: https://en.wikipedia.org/wiki/Nigeria  See a lso publication and Broadcast of the BBC on â€Å"What do you think about Nigeria†, BBC. 2006-06-16. https://news.bbc.co.uk/2/hi/africa/5072244.stm. Retrieved on 2008-08-05 [47] Ibid. [48]Ibid [49] Ibid [50] Ibid. For further reference on this see Geographica: The complete Atlas of the world, Nigeria, (Random House, 2002). [51] Ibid. For further reference on Nigeria and Oil Spillage and Environmental Degradation see National Geographic, Nigerian Oil, Publication made in August 2009 and available online at: https://ngm.nationalgeographic.com/2007/02/nigerian-oil/oneill-text [52] See analysis of the Geography, Subdivision and Demographics of Nigeria in the Wikipedia printout available online at: https://en.wikipedia.org/wiki/Nigeria [53] Ibid [54] Ibid [55] Ibid [56] Ibid [57] See Wikipedia search on Nigeria available online at: https://en.wikipedia.org/wiki/Nigeria [58] See List of TOP 10 Oil Producing Countries of the World at https://inter nationaltrade.suite101.com/article.cfm/top_ten_oil_countries  For further reading see The Economist, Shutting the Stable Door – OPEC and Oil Prices, September, 1990 [59] See International Journal of Tuberculosis and Lung Disease, IUATLD Article on â€Å"Treatment Regimens in HIV-Infected Tuberculosis Patients – An Official Statement from the IUATLD, 2: 175-8 of 1998.  See also WHO Website on Nigeria and HIV at https://www.who.int/countries/nga/areas/hiv/en/index.html [60] See Global Tuberculosis Control: Surveillance, planning, financing: WHO Report 2008. For figurative analysis and survey see USAID Website on Nigeria and Infectious Diseases available online at https://www.usaid.gov/our_work/global_health/id/tuberculosis/countries/africa/nigeria_profile.html [61] See Buse K, Walt G, and Mays N., Making Health Policy, Published by Open University Press, 2008 at pg. 140. See Also Wikipedia Printout on Healthcare in Nigeria available online at:  https://en .wikipedia.org/wiki/Health_care_in_Nigeria [62] For further reference see Unpublished reports by the NTBLCP on â€Å"TB in Nigeria†, 1998 and see also NTBLCP Workers Manual in he Ministry of Health, Lagos, 1991. For further reading see the USAID link on TB in Nigeria at: https://www.usaid.gov/ng/hiv_aids_r.htm and Arukwe E., Nigeria Newsday, TB and Its Scourge on Nigeria’s Population, 2007 available online at: https://www.nasarawastate.org/newsday/news/nasara07/NewArticle207.html [63]  Kochi A.,  Tuberculosis Control – Is DOTS the Health Breakthrough of the 1990’s?,  World Health Forum, 18:225-47 , 1997 [64] Ibid. [65] Kochi A.,  Tuberculosis Control – Is DOTS the Health Breakthrough of the 1990’s?,  World Health Forum, 18:225-47 , 1997 [66] For further reference see Federal Ministry of Health Lagos, Workers Manual by the NTBLCP, 1991 [67] For further research on this see Wikipedia Printout on Multi Drug Resistant TB available online at: https://en.wikipedia.org/wiki/Multi-drug-resistant_tuberculosis [68] See WHO Webpage on TB in Nigeria available online at: https://www.who.int/countries/nga/en/ [69] Ibid. [70] See Global Health Reporting.Org, Weekly TB/Malaria Report, April, 2009 available online at: https://www.globalhealthreporting.org/article.asp?DR_ID=58098 [71] See WHO official website at: https://www.who.int/whosis/indicators/compendium/2008/3itt/en/index.html [72] Ibid. [73] Ibid. [74] See Country Profile available online at: https://www.afro.who.int/tb/country-profiles/nig.pdf [75] Ibid. [76] Ibid. [77] NTBLCP, 1991 [78] Ibid. [79] See This Day Newspaper, â€Å"Nigeria 220 Tuberculosis Cases†, September 2008 available online at: https://allafrica.com/stories/200809090344.html [80] See Presentation by Dr Aderemi O Kehinde, â€Å"Tuberculosis Drug Research in Nigeria – Challenges and Prospects†, 2005 [82] See Indian Journa l of Tuberculosis, A Report on the 34th IUATLD World Conference on World Health, Paris, 2003 at 51:97-98. Also available online at https://medind.nic.in/ibr/t04/i2/ibrt04i2p97.pdf [83] See article on STOP TB Working Group on DOTS – Plus for MDR-TB Strategy Plan 2006 to 2015 available online at https://www.finddiagnostics.org/export/sites/default/media/news/pdf/Stop_TB_Working_Group_on_DOTS_Final.pdf [85] See World Health Organisation – Regional Office for the Western Pacific, â€Å"What is DOTS?†, available on the WHO website at: https://www.wpro.who.int/sites/stb/dots_definition.htm