Practical Implementation Tips Type 2 Diabetes (T2Dm).

Practical Implementation Tips: Type 2 Diabetes (T2DM) 1. Identify those at high risk of T2DM on your practice register The State of the nation 2016 (England): time to take control of diabetes1 report from Diabetes UK warns us that 5 million people in England are at high risk of developing T2DM. We have high quality evidence from several international diabetes prevention studies2 that early lifestyle intervention can reduce both long-term progression to T2DM, and long-term incidence of cardiovascular all-cause mortality. Based on this evidence, the NHS Diabetes Prevention Programme3 was launched during 2016 to provide individualised lifestyle support for those at high risk of T2DM. NICE Public Health Guidance 38 â€Å"Prevention of T2DM†¦show more content†¦If repeat test is also 48mmol/mol, then a diagnosis of T2DM can be established o If HbA1c 42-47mmol/mol this suggests high risk of diabetes; follow flowchart above o If HbA1c 30kg/m2 †¢ Previous macrosomic baby weighing 4.5kg †¢ A family history of diabetes (1st degree relative with diabetes) †¢ A minority ethnic background with a high prevalence of diabetes (e.g. South or East Asian, Middle Eastern, Afro-Caribbean, Hispanic) †¢ Previous GDM †¢ 2+ glycosuria on antenatal screening (or 1+ on two or more occasions during pregnancy) NICE NG3 Diabetes in Pregnancy11 recommend we diagnose GDM as follows: †¢ A FBG ≠¥5.6mmol/l or a 2-hour blood glucose post 75g oral glucose tolerance test ≠¥7.8mmol/l †¢ As you can see, these thresholds are much lower than we would use to diagnose T2DM in the non-pregnant individual; we need to ensure that we do not miss this significant diagnosis GDM greatly increases the risk of future T2DM12, however, many women with GDM are unfortunately lost to follow-up after pregnancy, often understandably due to busy family lives13. NICE NG3 Diabetes in Pregnancy11 recommend we follow-up those with GDM as follows: †¢ Offer lifestyle advice and check a FBG at 6-13 weeks after birth in those women with GDM. Do not routinely offer an oral glucose tolerance test o Pragmatically, this could comprise part of the routine 6-week post-partum check †¢ If the FBG is ≠¥7mmol/l, a diagnosis of T2DM can be

The Day the Earth Stood Still †1951 vs 2008 Free Essays

â€Å"The Day the Earth Stood Still†, (1951) vs. â€Å"The Day the Earth Stood Still†, (2008) From the 19th to the 20th century there have been many changes in film. Movies went from silent features in black and white, to color with surround sound, and now to digital 3D. We will write a custom essay sample on The Day the Earth Stood Still – 1951 vs 2008 or any similar topic only for you Order Now One of the biggest changes occurred with special effects and the help of CGI (Computer Generated Images), which enhanced movie scenes and brought imagination to life. History has shown us that technology dictates where and how we watch movies, and it is continually evolving. In the 1950’s, television started drawing people away from the movie theatres, until the introduction of technical innovations such as â€Å"Cinerama, Cinemascope, and 3D, reversed the trend.† (Art Institute of Pittsburg Online) Since then, digital technology has brought movies back into the living room once again, delivered on DVD to our HDTV’s. These changes have had a huge impact on society, the way we view our lives, and the prospects of the future. â€Å"The Day the Earth Stood Still† compares two versions of the same movie made 57 years apart: the original was produced in 1951, and the remake was made in 2008. The original movie is one of the first alien invasion movies ever made and has become one of the classic sci-fi thrillers of our time. The alien in this movie, Klatuu, comes to Earth to issue a dire warning about its inhabitants’ aggressive nature. He states that man’s constant violent nature against one another has raised the attention of â€Å"an alien species, which is now threatening to exterminate all of mankind.† (â€Å"The Day the Earth Stood Still†) The premise of the 2008 movie is that humans are destroying earth at an escalating rate, so they have to die in order to save the planet. â€Å"If humans die, earth lives. If humans live, earth dies.† With the melting of the polar ice caps and the threat of global warming, there are real-life consequences that give plausibility to this modern plot. Klatuu requests a meeting with the leaders of all nations. In the older movie, this was redefined as â€Å"a meeting between the 2 super powers; the United States and Russia.† In the early 1950’s when this movie was produced, a meeting between the U.S. and Russia would be unthinkable. World War II had just ended and we were in the middle of the Cold War. McCarthyism was at its height and the paranoid fear of Soviet domination was an obsessive national past-time. The movie was influenced by the use of the atomic bomb and our wars against each other. In that time period, there was a test of the atomic bomb of out in the Yucca Flats in New Mexico. It was believed that if one day these bombs could be strapped to rockets, it would destroy the earth. Unfortunately, there are still wars going on around the world and in our own back yard. In the 2008 movie, the U.S. government sends a woman to represent the president and gives her full authority to act on his behalf. She immediately orders the use of restraints and with the aid of a lie-detector test attempts to extract information from the alien. In another over excessive show of force, she orders all military forces to attack and destroy the alien ship. Klatuu manages to escape through the use of mind control and a lengthy visual display of electrical forces – alien style. In this part of the movie I found the special effects to be less than convincing. Special effects were a very important part of the film remake, so the original story was modified in part to accommodate them. I noticed some of the differences in content are in the language and scenes. The 1951 version had more dialog and placed more emphasis on the meaning and lesson to be learned. Early era movies were more idealistic, with little to no objectionable content or language. They may have implied a situation, but didn’t show anything explicit. The 1951 version had the clean-cut charm of an old â€Å"Leave it to Beaver† episode. The 2008 version had more violence and scenes that were highly graphic in nature. The close-up surgical procedures in this film are not atypical of many of today’s shows and with the use of high density graphics, we get every gory detail. Klatuu, comes to earth in human form in the 1951 movie, along with a robot that was obviously just a tall man in a rubber suit. In the newer movie, with the aid of special effects, he morphs from alien into human form right before our eyes. The robot in the newer movie is several stories high and much more compelling as an enforcer of peace for an entire planet. The acting in the original movie seemed overly dramatized, which was a characteristic that was often used in the earlier films of this genre. Early attempts to simulate believable alien creatures and moving spaceships were crude at best. The first movie comes with a long list of revealing mistakes; wrinkles in metal and zippers in alien attire, while the space ship moving through the sky looked crude at best. The most obvious errors were in the scenes that show the â€Å"crowds running away in panic,† obviously created by speeding up the film. (Janson) In contrast, by 2008 special effects are widely used, portraying realistic action without the overdramatic characterization. Because special effects were not available during the earlier version, actors were much more athletic, usually performing their own stunts. Another industry change that cannot be overlooked is budget. For example, the 1951 movie had an estimated budget of $1,200,000, while the cost of the 2008 movie soared to $80,000,000. This can be attributed in part to the cost of special effects, but we also have to consider that most of the earlier films were usually shorter in length than their modern counterparts. Another consideration for the rising cost in some of today’s movies is found in epic films which have crowd scenes that employ a very large number of actors at union wages. In the final scene of both movies, Klatuu recognizes that the human race is worth saving after witnessing the heartfelt interactions between a woman and her young son. The story ends with Klatuu sacrificing himself to stop the planet’s destruction process and save the human race. This part of the story gives a human quality to the film. In some ways, the old classic movies and today’s movies are the same. They all have a story line and are aimed at a select audience, whether it’s a particular age bracket, ethnicity, social status other special group. Some of the content in movies can also be related to one’s life, such as the relationship between mother and child, fear of the unknown, and the struggles between good and evil or the strong and the weak. Movies often share a common theme about human nature and bring a message home to the audience that is relative to its time. Since the making of silent films to the movies of today, the emphasis has been on entertainment, making it a favorite family pastime throughout the years. It has created a multi-billion dollar industry that serves its creators as well as the public, because it does more than just entertain. It also educates and informs, gives hope, happiness and inspiration, raises awareness in individuals and creates a higher consciousness among people of all origins. As the movie industry gets older and wiser, it gets better at its craft. As it harnesses technology on all levels, we can look forward to future remakes of today’s movies and the possibilities of tomorrow. How to cite The Day the Earth Stood Still – 1951 vs 2008, Essay examples

Business Strategy Report External Issue Affection

Question: Discuss about the Report for Business Strategy Report of External Issue Affection. Answer: Introduction: The aim of the report is to analyze the various factors that lead a company to adopt strategies to move parts of its business activities offshore resulting in the loss of a number of local jobs. In order to achieve this aim, analysis of both internal and external factors that affect the business operation of an organization. In this report, Telstra has been selected for the case study. Report suggested that Telstra has confirmed its off shore shift that resulted in shifting of 670 Australian jobs (ABC News. 2014). A detail analysis of the internal and external issues that has forced the company to take initiative to shift their business offshore will be done in the report. In addition to this, discussion of the impact on the stakeholders of the organization will also be made. Following this, an explanation shall be made to find the reason that helps to continue a number of jobs in Australia. Telstra Corporation or Telstra is Australias largest telecommunication and Media Company which operates with telecommunication networks, mobile, internet, television and other entertainment products and services. With total revenue of A$ 27.1 Billion, the company is head quartered at Melbourne, Australia (telstra.com.au, 2016). When business outsourcing transgresses the national boundaries of a country, outsourcing takes the form of off sourcing. Both internal and external factors are equally responsible for a company to take strategic decision to undertake off shore expansion of business. Evaluation of the external issues affecting the company that have driven it to employ a strategy that has resulted in moving off-shore As pointed out by Wjcik (2013), that a company can find out strategies to improve the internal business of their company but it becomes challenging for the company to fight against the external changes that results in the loss of the business of the company. Therefore, external factors are highly responsible for the company to move off shore. Some of the external factors for Telstra that compelled the company to move off shore are: Increase in competitors: Top competitors like Vodafone Group Public Limited, Optus Systems Pty Limited and Spark New Zealand Limited supported the regulations proposed by the Government. It was found that of 499 base stations located at different regions, 427 belonged to Telstra. Keeping this particular factor in mind, it can be easily said that this situation created greater impact on the business of the particular company (The Sydney Morning Herald. 2016). Therefore, sharing network shall put negative impact on the profitability of the company. Political factors: Roaming regulations: Government has launched a number of competitive laws to detect the misuse of the market power of the telecommunication companies. Australian Competition and Consumer Commission has also declared their intention of asking the domestic telecom service providers to keep a check on the roaming services to the competitors network to operate on the Telstra network in major regional and rural areas (telstra.com.au, 2016). In this matter, Tony Warren, Executive of Telstra group commented that a declaration of the mobile roaming coverage would stop the Company to remain a differentiator in the Australian market. This made the management to remove their rationale for investment in the regions of Australia. Decreasing market share: With the advent of several telecom regulations, it was found that the share of the Company considerable declined. The Vice President of Victorian Farmers Federation also welcomed the regulation set by ACCC on the roaming regulations to open up to a competitive market. It has been found that several other companies from other countries as well use the option of outsourcing or off shoring their service when they find that there is less opportunity of growth in their own country (telstra.com.au, 2016). This was exactly undertaken by Telstra when its market share found to decrease. Emphasis on perfect processes: Many Companies focus to strengthen their business operation by improving their standardization in the internal processes of the business. In order to save time and managements involvement in a particular business project, major companies often take the help of other companies in other countries to carry out their business operations (telstra.com.au, 2016). For Telstra as well, this point is equally valid. In order to think of expansion and bigger operational facility, going off shore is the best process to implement in the business. As pointed out by Wjcik (2013), when a company takes the opportunity of moving off-shore, it becomes one of the steps that they undertake to increase their profit margin. The issues that Telstra faced were not new to the Company but in 1998 as well as in 2005, Telstra released similar discussions in their paper. Network sharing agreement was also ended in the year 2012 and since then the Company do not have any kind of domestic roaming agreements till today. The management has pointed out that network coverage is clearly an important feature for a telecom company and any kind of changes in such plans definitely impact the business operation of a company. Analyses of the internal issues that are making the company consider moving jobs offshore as part of its strategy As pointed out by Fratocchi et al. (2014), that a company undertakes the opportunity to go off shore due to a number of internal factors as well. These factors might range from internal business decisions to the incapability of the labor force in action. Reading Kotlarsky, Scarbrough and Oshri (2014), it has been found that in recent perspective, companies are moving in a sophisticated and more mission-critical function. Moving to countries like China, India and other such countries can provide highly skilled labor with scientific and engineering intelligence. It is for the same reason that many companies of United States and Europe to grab the strategies of moving off shore. The need of skilled and low waged labor makes a Company to take strategic decisions regarding their out sourcing (Dawley, 2014). A number of internal factors that compel a Company to take decision to take outsourcing are: Absence of specialists or experts: In many cases, the sole driver that forces a company to go off shore is the inability or incompetency of the leaders of the Company to manage the operation of the business. In a competitive world, it is important to understand the needs and demand of the dynamic environment (France and Pope 2016). Failing to cope with such situations, some companies grab the option of going offshore. Irregular risk factors: Australia faced sudden risk factors at regular interval of time in situations related to the telecom industry. With regular up downs in the rules and regulatory of the telecom business, it was challenging for Telstra to operate in the competitive market scenario. In case of outsourcing or off shoring a business project, the responsibility of the business gets distributed and is narrowed down (Vitasek, Ledyard and Manrodt 2013). As a result a Company gets prone to the risk factors that arise at any point of time in a market. In case of Telstra, it can be said that lack of skilled labor is one of the main issue that the company has been facing since a long time. In Asian countries like India or China, availability of skilled and low paid workers is easily available. There is great provision for call centers in these countries and many companies from around the Globe are grabbing this opportunity to outsource their business and gain more net profit. Telstra also wanted to grab the same opportunity and access to the qualified personnel of the particular country. Customers of the Company also had complaints regarding the quality of network that the Company served. These complaints against the Company created a negative image of the Company in the market (Gerbl, McIvor and Loane 2014). This was another vital factor for Telstra to move off shore for creating greater reach of their business to people around the world. Identification of the stakeholders in this company and discussion on how the shift of offshore activities will affect these Stakeholders Stakeholders of Telstra include internal stakeholders like the employees, team of management, owners and directors of the Company. External stakeholders include shareholders, customers, dealers and other business partners as well. Primary stakeholders are the group of people who are directly affected either positively or negatively by any kind of action of the agency or the organization. Primary stakeholders of Telstra are all Australians ranging from customers, shareholders and other publics who show greater interest on the matters of the telecom company (Gerbl et al. 2016). It has to be understood that Telstra operates in a community of metropolitan, regional as well as remote areas of Australia. Telstra operates with great responsibility in terms of designing, operating and managing the products and services of the company. These primary stakeholders have been found to get engaged with the community organization of Telstra. Therefore, it can be easily assumed that any kind of business move is bound to affect this group of primary stakeholders of the Company. Customers of Telstra include residents of Australia, small and medium size enterprises and other governmental heads as well. These customers are largely depended on the quality, accessibility and affordability of the product (Lacity and Willcocks 2013). In case if the company goes off shore their might arise certain issues regarding the personal information and services provided to these customers. It has been found that Telstra works with a diverse range of employees including 29,000 employees. The employees get ample opportunity to involve in the business operation of the Company. The employees are always asked to express their views on the business of the Company. Therefore, off shoring the business is a big issue that definitely put impact on the business operation. Another important stakeholder of the company is the Governmental bodies. The local, state and national level Ministers and leaders to other department staffs are depended on the service of this telecommunication department (Duan et al. 2014). Telstras corporate and relationship management team always focus on keeping a good relation with these people. However, in case the Company goes off shore, the company has to be more focused on delivering their information to a world-class information solution. Telstra is a member of the Mobile Carriers Forum that deals with the social and environmental issues. It is also a member of Australian Industry Group and Business Council of Australia. Other stakeholders of Telstra include major companies and organizations which are greatly depended on information communication technology (telstra.com.au 2016). These industries are also interested in any kind of issues that impact the business of a telecommunication industry. Therefore, in case moving off shore becomes one of the strategies of the Company, it is going to affect these federal bodies of Australia as well. Explanation of why a number of jobs will continue to be based in Australia and the associated implications As pointed out by Lacity and Willcocks (2013), a company cannot completely shift its business to other country. In case a company has to undertake the option of shifting its operation to other country or countries, a part of the business operation always remains in the base country. It has been identified that moving off shore shall result in a net loss of 116 jobs from Telstra who are citizens of Australia. However, there shall remain 128 existing job in the country and 12 new ones shall be created. It has also been commented that initiatives have been undertaken by the management of the team to operate in other country by sending a number of important officials to the target country. However, their specification of the role has not been defined yet. Moving a business completely to another country is not feasible for a company. It has to be understood that a company take the opportunity to move its business operation to other country just to grab the opportunities of skilled or low waged laborer or the market opportunity of that particular country. In this situation, it has to be mention that an Australia based company cannot take the risk of completely shifting its operation to another country. In such case, the complete identity of the company might get lost (Duan et al. 2014). The company has tom leave its mark on the home country to maintain a personal identity. It is usually happen that the main operations and higher designated posts job remained in the home country and only the business operation that are depend on a large number of labor support shift to the other country where off shoring has been decided to take place. If the case of Telstra is taken into consideration, it has to be said that the company planned only to shift the customer support channel to the Asian countries like India, China, whereas the important decision making process that requires the involvement of the higher authorities like the managing director or the CEO remain in Australia (Baltzan 2012). The management commented on this initiative that only a part of their operation shall be shifted to Asian countries to grab the opportunity of the skilled and low waged laborer who are available in these countries in abundance (Kim et al. 2013). However, all kind of business decision shall be based completely on the decision making procedure that the management shall decide operating from Australia only. The shifting handover is done only to maximize the profit of the country and not to shift its business operation. Off shoring can be considered as one of the reasons that fulfill the objective of expansion of the business (Stanger 2014). Therefore, it can be said that off shoring is not the process of shifting the business entirely on another country but to use the resources of the other country and make best utilization of it. The same approach has been taken by Telstra in its recent business operation to overcome the issues that the company was facing in operating in Australia. Conclusion: The report based on the analysis of the opportunities that an organization gains when it opt for shifting a part of its business operation over sea. In case of Telstra, a number of internal and external factors have resulted in adoption of the strategies that ultimately resulted in the factor that the company has to off shore its business in other countries like India and China. It has been found that by undertaking the strategies for off shoring, the company tend to improve its business function to a great extent that resulted in improving the condition and fight against the odds that Telstra had to face in its home country. However, it has also been found that it is never feasible to transfer the entire business off shore because it might result in loss of identity of the business or disturb the business strategies and operations undertaken by the company. Therefore, it is likely to use the resources of the other country that might include both human resource and physical resources like land or climate, and the main part of the business still remained in the home country. References: ABC News. 2014. Telstra confirms 670 Australian jobs to go offshore. [online] Available at: https://www.abc.net.au/news/2014-07-23/telstra-to-move-almost-700-australia-jobs-offshore/5619102https://www.abc.net.au/news/2014-07-23/telstra-to-move-almost-700-australia-jobs-offshore/5619102 [Accessed 8 Sep. 2016]. Baltzan, P., 2012.Business driven technology. McGraw-Hill/Irwin. Dawley, S., 2014. Creating new paths? Offshore wind, policy activism, and peripheral region development.Economic Geography,90(1), pp.91-112. Dhar, S., 2012. From outsourcing to Cloud computing: evolution of IT services.Management Research Review,35(8), pp.664-675. Duan, C., Grover, V., Roberts, N. and Balakrishnan, N., 2014. Firm valuation effects of the decision to adopt relationally governed business process outsourcing arrangements.International Journal of Production Research,52(15), pp.4673-4694. France, C. and Pope, N., 2016. The Effect of Offshore Shifts on Brand Attitude and Corporate Image. InLooking Forward, Looking Back: Drawing on the Past to Shape the Future of Marketing(pp. 305-308). Springer International Publishing. Fratocchi, L., Di Mauro, C., Barbieri, P., Nassimbeni, G. and Zanoni, A., 2014. When manufacturing moves back: Concepts and questions.Journal of Purchasing and Supply Management,20(1), pp.54-59. Gerbl, M., Gerbl, M., McIvor, R., McIvor, R., Humphreys, P. and Humphreys, P., 2016. Making the business process outsourcing decision: why distance matters.International Journal of Operations Production Management,36(9), pp.1037-1064. Gerbl, M., McIvor, R. and Loane, S., 2014. Near or Far: A Multi theory lens to examine the business process outsourcing decision. Kim, Y.J., Song, J., Baker, J. and Kim, J., 2013. An examination of the importance of core competencies and relationship management in IT outsourcing agreements: empirical evidence from an eastern cultural context.Journal of Global Information Management (JGIM),21(3), pp.21-41. Kotlarsky, J., Scarbrough, H., and Oshri, I. 2014. Coordinating expertise across knowledge boundaries in offshore-outsourcing projects: The role of codification.Management Information Systems Quarterly,38(2), 607-627. Lacity, M.C. and Willcocks, L.P., 2013. Outsourcing business processes for innovation.MIT Sloan management review,54(3), p.63. Stanger, A., 2014.One nation under contract: The outsourcing of American power and the future of foreign policy. Yale University Press. telstra.com.au, 2016. About Telstra [online] Available at: https://www.telstra.com.au/abouttelstra/download/document/telstra-how-we-engage.pdf [Accessed 8 Sep. 2016]. telstra.com.au, 2016. Annual Report 2016 [online] Available at: https://www.telstra.com.au/content/dam/tcom/about-us/investors/pdf%20D/2015-ANNUAL-REPORT.pdf [Accessed 8 Sep. 2016]. telstra.com.au, 2016. Telstra [online] Available at: https://www.telstra.com.au/ [Accessed 8 Sep. 2016]. telstra.com.au, Financial report 2016. [online] Available at: https://www.telstra.com.au/aboutus/investors/financial-information/financial-results [Accessed 8 Sep. 2016]. The Sydney Morning Herald. 2016. Telstra may be forced to open up regional mobile networks. [online] Available at: https://www.smh.com.au/business/consumer-affairs/telstra-may-be-forced-to-open-up-mobile-networks-in-regional-and-remote-areas-20160905-gr8qeh.html [Accessed 8 Sep. 2016]. Vitasek, K., Ledyard, M. and Manrodt, K., 2013. An Outsourcing Primer. InVested Outsourcing(pp. 17-25). Palgrave Macmillan US. Wjcik, D., 2013. Where governance fails Advanced business services and the offshore world.Progress in Human Geography,37(3), pp.330-347.