Monday, December 30, 2019
Analysis Of William Byron s Lord Byron - 1281 Words
Everyone wants to experience love, but no one intends to deal with the heartbreak that comes with it. Lord Byron, an immensely popular English poet from the era of the 1700ââ¬â¢s, was a unique individual who converted his emotions on Romanticism and the common man into scriptures of poetry. Other than writing poetry about meaningless relationships and other conventional views, Byron was also known as a ladies man. He had many partners that he only lusted for but also had numerous that he fell in love with. Many of Byronââ¬â¢s poems express his ideal perspectives on a womanââ¬â¢s physical characteristics and a manââ¬â¢s humor. One could even say that the purpose of his poems was to objectify women. Lord Byron uses literary techniques to express his pointâ⬠¦show more contentâ⬠¦This was until he was then raped by his maid confusing him even more into what he was interested in sexually. Not only this but, despite her moments of weakness, the loss of his mother left hi m broken. His bond with his mother was a strong one as she cared and loved Byron very much and he considered her his only best friend in the world. Lord Byron later moved on to publicize his verses and continued to write about his relationships, lovers, and other perspectives that spoke not only for himself, but others as well. Lord Byron had a various amount of peculiar love interest, one of them being his cousin. A poem that Byron wrote, in particular, ââ¬Å"She Walks in Beauty,â⬠references his relationship with her. This poem illustrates numerous aspects of figurative language, imagery, and light to dark which expresses his emotions for this women. For example, when he writes the first line of She Walks in Beauty, he thinks about a lady s wonder to the night. Byron utilizes a simile to compare her excellence to that of cloudless climes and starry skies (Byron 1-2), stressing the lucidity and the splendor of her magnificence. Byron continues to open up his previous proposal that an immaculate mix of light and dark is the mystery of his subject s excellence. The second stanza starts with a clear explanation of this impact; he thinks he would have in any event to some degree impair dShow MoreRelatedByron3840 Words à |à 16 PagesShe Walks In Beauty By: Lord Byron (George Gordon) She walks in beauty, like the night Of cloudless climes and starry skies; And all thatââ¬â¢s best of dark and bright Meet in her aspect and her eyes; Thus mellowed to that tender light Which heaven to gaudy day denies. One shade the more, one ray the less, Had half impaired the nameless grace Which waves in every raven tress, Or softly lightens oââ¬â¢er her face; Where thoughts serenely sweet express, How pure, how dear their dwelling-placeRead MoreCharles Baudelaire And Victor Hugo976 Words à |à 4 Pageswith his poems. Often compared with Wordsworth, Baudelaire s French poems surfaced an ease of poetic elaboration. His poems including the L Ame du Vin and Mort des Artistes are popular for the thematic basis of defining the pursuits of life and art. The English romantic poetry is dense and divided into two eras; William Wordsworth, Samuel Taylor Coleridge and William Blake wrote in the first half of the romantic period and Lord Byron, Percy Bysshe Shelley and John Keats wrote in the second halfRead MoreRhetorical Devices3007 Words à |à 13 Pagesis part of classical rhetoric and a number of rhetorical devices are worth considering in any analysis of style. For the analysis of literature a knowledge of rhetorical devices is indispensable, since there is often a considerable density of rhetorical figures and tropes which are important generators and qualifiers of meaning and effect. This is particularly the case in poetry. Especially the analysis of the use of imagery is important for any kind of literary text. (For further details see AnalysingRead More The Composition and Publication History of Samuel T. Coleridges Kubla Khan2601 Words à |à 11 PagesInterestingly, although no original manuscript has been found, the Crewe Ma nuscript of Kubla Khan was discovered in 1934. Currently, the Crewe Manuscript is the earliest know version of Kubla Khan and is believed to have been written around 1810. After Lord Byronââ¬â¢s zealous response to Kubla Khan, Coleridge published the poem for the first time in May of 1816 under Byronââ¬â¢s publisher John Murray. While the poem was initially bound with two of his other poems: Christabel and Pains of Sleep, Kubla Khan wasRead MoreThe Evolution of the Hero1960 Words à |à 8 PagesMost of us have our own rough defnition of heroism ââ¬â we think we know a hero when we see one. But pinning down those attributes is a challenge; your hero may not look much like mine. So it s worth asking: Are there certain immutable characteristics that have defined heroism across the ages? The men and women on the following pages are individuals of extraordinary distinction, but how do they stack up against the legends of the past? Although there are some timeless, universal qu alities known asRead MoreThis Tournament Goes to Eleven4982 Words à |à 20 Pagessequences, while Mallivin is an infinite-dimensional one on the Wiener space and is also called the stochastic one of variations. Church and Kleene developed a formal logic known as the lambda one. In old literature it was known as infinitesimal analysis, due to the presence of quantities getting very small. For 10 points, Gottfried Wilhelm Leibniz and Sir Isaac Newton independently developed what branch of mathematics that utilizes limits, derivatives, and integrals? ANSWER: calculus [the dogRead MoreAbortion, Good or Bad for Society?3757 Words à |à 16 PagesCorporation. The Bendix Corporation was only part of what is now the Nurturing Network. Agee started the Nurturing Network in 1986, and then Agee realized that most of the abortion support groups were focused to teenage mothers. Agee completed an analysis of other abortion clinics and found that more women in their early twenties were seeking abortions because having a child would interfere with their college or career. Agee is not involved in any of the political protests and debates involving abortionRead More Whether Abortion is Good or Bad for Our Society Essay3719 Words à |à 15 PagesCorporation. The Bendix Corporation was only part of what is now the Nurturing Network. Agee started the Nurturing Network in 1986, and then Agee realized that most of the abortion support groups were focused to teenage mothers. Agee completed an analysis of other abortion clinics and found that more w omen in their early twenties were seeking abortions because having a child would interfere with their college or career. Agee is not involved in any of the political protests and debates involving abortionRead MoreRastafarian79520 Words à |à 319 PagesJamaicans regard as their cultural contribution to the world. Later I will return to these issues and will demonstrate how they contribute to the routinization of Rastafari in Jamaica. The nature of this book dictates a heavy reliance on documentary analysis. My focus is interpretation not ethnography. Therefore, I have not sought to generate primary data on the movement but to analyze and re-analyze the growing body of scholarly and popular literature on the movement, including sociological and anthropologicalRead MoreModernization of Ntuc Income Case Study14065 Words à |à 57 Pagesf history is any guide, SaskTel wonââ¬â¢t be laying off any employees for a long time. The Regina-based telecommunications company hasnââ¬â¢t laid off anyone since it was founded in 1908. ââ¬Å"[Layoffs] arenââ¬â¢t going to happen as long as we can help it,â⬠says Byron Pointer, SaskTelââ¬â¢s vice-president of human resources and industrial relations. By avoiding layoffs, SaskTel is building a more loyal work force. ââ¬Å"I have lots of friends who looked for greener grass and moved to Alberta, Toronto or Ottawa,â⬠explains
Sunday, December 22, 2019
A Short Note On Typhoid And Fiji Gender Analysis
3. Gender Analysis of Typhoid in Fiji 3.1 Gender Analysis in Fiji Due to the diverse population in Fiji, social, economic, legal, employment, educational aspects are different in both urban areas and rural areas. Population living in rural areas was less like to access to the same quality of education, health service and justice comparing with urban areas. However, Fiji government has already on the tract of equality improvement. (Asian Development Bank, 2014) Education. In terms of MDGs 4 and 5, 90% boys and girls accept primary education in Fiji. The amount of enrolment in secondary and tertiary education is higher for females than males (ADB, 2014 Fiji Islands Bureau of Statistics, 2006-2009). However, evidences showed that females are more likely to interrupt study because of financial problems. Meanwhile, the quality of education differs from rural areas and urban areas, as the result of poor education infrastructures, access to education and lack of materials and teachers. In addition, sexual and reproductive education shortage related to the low use of contraceptive and high teenager pregnancy rate. (ADB, 2014) Employment, participation and poverty. Despite females attend high level education than males; there is no relationship between education and employment. Females have less chance to be labour force, especially in rural areas. Furthermore, females are more likely to live with poverty because of less working time in formal sectors and more responsibility for
Friday, December 13, 2019
Racial Discrimination Free Essays
Seminar on Peace Education A Research Paper on Racial Discrimination Racism takes many forms. In general, it is a belief that a particular race or ethnicity is inferior or superior to others. Racial discrimination involves any act where a person is treated unfairly or vilified because of their race, color, descent, national or ethnic origin. We will write a custom essay sample on Racial Discrimination or any similar topic only for you Order Now Racism may take the form of stereotyping, name calling or insults, commentary in the media, speeches at public assemblies and abuse on the internet. It can include directly or indirectly excluding people from accessing services, employment, education or sporting activities. Racism can occur systemically, as the result of policies, conditions and practices that affect a broad group of people. For example, research shows that systemic racism can result in Aboriginal and Torres Strait Islander students experiencing poorer outcomes in education, or job applicants without Anglo-Saxon names finding it difficult to gain job interviews. Just as other forms of discrimination may relate to a number of attributes, so does the experience of racism. For example, racism may compound the experience of discrimination of a woman, who is treated less favorably on the basis of her religion and her gender, or an older person, who is discriminated against on the basis of their skin color and their age. In its most serious manifestation, racism is demonstrated in behaviors and activities that embody race hate, abuse and violence ââ¬â particularly experienced by groups who are visibly different because of their cultural or religious dress, their skin color or their physical appearance. Ultimately, racism is a tool to gain and maintain power. It is also inextricably linked with socio-economic factors, and frequently reflects underlying inequalities in a society. The impact or racism is becoming a major problem in our society today. Racism is a system in which a group of people practice violent acts and power over others on the foundation of their skin color and racial inheritance. Despite the consequences of who discriminates, why is it done and how it is practiced and defended, what has remained true is that racism promotes power, recognition, advantages, and opportunity for some people at the expense of others. Most people today have experienced racism in their lives. They may experience it while they are at school, in the neighborhood, shopping in the mall, dining in a restaurant, and at work. Racism takes place anywhere and everywhere. Racism may even change the way an individual may feel about themselves and marks a deep scar in their life and may take a while to heal. There are three types of racism in the workplace. First type of racism in the workplace is racial discrimination. Second type is color discrimination, and lastly the discrimination of language. The first type of racism in the workplace is racial discrimination. Racial discrimination is present when people are treated in a different way than others who are equally situated because they are part of a particular race and unchangeable characteristics, such as physical features, native to their race. In employment it can happen when employees are treated differently than other employees equally situated because of their interracial dating or marriages, culturally oriented expression of attitudes and beliefs, and members in racially oriented groups. An example of race discrimination is when you didnââ¬â¢t get a job because you were told you wouldnââ¬â¢t fit in to the workplace because of your race, youââ¬â¢ve been rejected service or treated incorrectly in a shop or hotel, or youââ¬â¢ve been separated out for filthy jobs because of your race. The next type of racism in workplace is color discrimination. Color discrimination is present when individuals are treated differently than others who are equally situated because of the color of their skin. This is a separately identifiable type of discrimination that can also occur in conjunction with race discrimination. Color discrimination can also occur in the absence of race discrimination when members of the same race are treated differently because of their skin color. An example that relates to color discrimination in the workplace is the employer does not hire anyone darker but hires light-skinned or white persons of all races. Final type of racism in workplace is language discrimination. Language discrimination means treating someone in a different way only because of his or her native language or further characteristics of speech. An example of language discrimination on the job is when an employee may be subjected to language discrimination if the workplace has speak-English-only rule, especially if her primary language is not English. An employee may also be the victim of language discrimination if she is treated less favorably than other employees because she speaks English with an accent, or if she is told she does not qualify for a position because she does not speak English well enough. But language discrimination doesnââ¬â¢t only happen on the job, a person may be denied access to businesses or government services because he or she does not speak English. Racial discrimination is everywhere. In the Philippines, we can say that racial discrimination is evident, especially to those who belong to a tribal minority or ethnic groups. Even the media manifested racism, most of the advertisement that can be seen in the television could let us think about racism. Like for example, the commercial about a whitening soap or lotion, they used image models have dark complexion skin. And in order to promote the effectiveness of their products they have to show that their models are whitened by their products. So meaning having dark skin is not good to look at. Though it is just an advertisement but still it could be another form of racial discrimination among dark people. But not only those advertisements in television, but even also some of our local ââ¬Å"teleseryeâ⬠or ââ¬Å"telenobelaâ⬠. In that, I can say that racism is prevalent in the Philippines. Racial discrimination of Filipinos doesnââ¬â¢t exist only within the country but also to other countries. Why do most people from Western and other rich countries discriminate Filipinos? And why do they usually think of us as Gold diggers and stuff? How inferior it is to hear that thing if you were in our part either it is not easy to take that in your part knowing that people around the world describes Filipino as a Domestic Helpers. In theà Philippineà history, Spanish colony has made a bigà changeà in the country and has made contributed positive things and negative things. The friars (Spanish friars of the past settling in theà Philippines) is putting into the minds of theà studentsà and of the people that they are the Superiors since they are white and the Indios (Filipinoââ¬â¢s of before) are brown. In that thing you can already see that there is racial discrimination. One positive thing I can give upon their (the Spanish)à contributionà to theà Philippinesà is Christianity in the land. This has been the greatest thing Filipinoââ¬â¢s at this present is proud of and has made most us religious, God-fearing, prayerful and these things but in the other hand on the negative side, Spanish made us traumatize on the things they have done like being innocent, and idiots. They kept on punishing the people of before if they wonââ¬â¢t pay their debts. In fact, we Filipinoââ¬â¢s are the real owner of this land and there is no need for us to be demanded on the debts rather itââ¬â¢s in our whim toà demandà those things from them since they were foreign in the land. But look at what they did, because of power with so much guns, good swords and equipped soldiers, they controlled the land and called the Filipinoââ¬â¢s as squatters. Now at the present times, the effects of those traumas have occurred from the cause. We ought to be blameless if we canââ¬â¢t improve our economy that well, but time will come we will prosper since we have a kind of land that is much fertile and with lots of resources to cater the world. People would think we are poor, yes we are poor. Eventually, we are poor in terms of economy that is why most of us go to other lands just to be slaves and we donââ¬â¢t care for as long as we can feed our families after those wages and labors being given. Though the world describes Filipinaââ¬â¢s as DH or Domestic Helpers but in our land we call them as Heroes- heroes of our family. If you get to know our culture, I know you would understand everything why we come into certain things. For as long as we live happily, thatââ¬â¢s all it takes. The talks of the people wonââ¬â¢t stumble us down in fact we become stronger and stronger every day. It doesnââ¬â¢t mean we hate people the way they see us, well itââ¬â¢s normal and itââ¬â¢s there will and choice to hate us. We canââ¬â¢t stop them from it, but all I can say is that, respect is what we ask for. Respect us as humans and as a person. We cannot really avoid such discrimination, so many laws now implemented about anti-racial discrimination but still it is always there. Racism existed throughout human history. In the Philippines, last November 2011 the senate passed a bill that would prohibit and penalize racial discrimination in the workplace, educational institutions, and services. Senate Bill 2814 also known as the Anti-Discrimination Act of 2011, according to its sponsor Sen. Loren Legarda, would provide a lasting and effective solution to discrimination in the country. Legarda said that based on the 20th Periodic report submitted by the government to the Convention on the Elimination of all forms of Racial Discrimination (CERD) in 2008, the Philippines does not formally recognize the existence of racial discrimination in the country. She quoted the countryââ¬â¢s official stand in the report as saying ââ¬Å"racial discrimination is alien to the prevailing mores and culture of the Filipino Peopleâ⬠and that ââ¬Å"racial discrimination has never officially or factually existed in the Philippines, neither in a systemic nor formal nor intermittent nor isolated mannerâ⬠because ââ¬Å"Filipinos have essentially the same racial and ethnic origins. â⬠Legarda said the government has to formally recognize the existence of racial discrimination in the country. The bill stipulates penalties on acts of racial discrimination in employment, education, delivery of goods, facilities and services, accommodation, transportation, media, and in search and investigatory activities. Persons who ââ¬Å"request, induce, encourage and authorize or assist others to commit acts of discrimination or profilingâ⬠would also be held liable. We need to acknowledge that discrimination exists before we can eliminate it for we cannot eradicate something that is considered a ghost by others. We must strive to transform our society into an open-minded and sensitive community where no child is subjected to name-calling because of his distinct looks; we must build a nation where each individualââ¬â¢s beliefs and principles are respected and everyone is given equal opportunity to achieve his full potential as a person and as a Filipino citizen. Sources: http://www. senate. gov. ph/press_release/2011/0511_legarda2. asp http://www. philstar. com/Article. aspx? articleId=751133;publicationSubCategoryId=63 http://socyberty. com/ethnicity/racial-discrimination/#ixzz27l5k6GU6 How to cite Racial Discrimination, Essay examples
Thursday, December 5, 2019
Required Process and Documentation For Stakeholder Management Strategy
Question: Describe about the Required Process And Documentation For Stakeholder Management Strategy For An Organisation Change Program? Answer: Executive summary: The central topic of the project is the required process and the documentation for the stakeholder management strategy for an organizational change program. All the member of the project team can be regarded as the project stakeholder. The customers can also be denoted as a project stake holder as he gets involved on the project. In a particular project, there are three types of stakeholders, they are: Internal and external stakeholder Positive and Negative stakeholder Performing and advising stakeholder All of the above set of stakeholders possess different kinds of activities I the process of project. The project manager plays a very important role in shaping g, supporting, guiding and influencing the stakeholders in the projects to obtain successful and positive result. Business Stakeholders: Now let us focus on some types of business stakeholders:- The relationship of the firm with the stakeholder has various forms. For example, there are typically in two ways the firm establishes relationship with the stakeholders. Those that supply raw materials to the firm called the suppliers and those that participate in the process of consumption of the products of the firms called the customers or consumers. There are two other components of stakeholder, the employee and the owner. Employees are workers that participate in the process of project making and activities and the owner is the one that provides the necessary resources and financial support for the completion of the project. Business stakeholders are of two types: Primary- those that establishes connection directly with the firm and fortify the success of the firm are the primary stakeholders. For example, Employees and Suppliers Secondary- those that establishes connection indirectly with the firm and also bears the objective to ensure success of the firm are secondary stakeholder. For example, customers as they indirectly deals with the firm. Now let us understand some point s regarding the stakeholders group. The stakeholders groups can be categorized into three types, such as, Core stakeholders which are the crucial part of the survival of the firm. Strategic stakeholders are those that render solution for any new problem and opportunities for future success of the firm. Environmental stakeholders looks into the matter of environmental problems caused by the firms and provides solutions. Three attributes of the stakeholders are classified as: Legitimacy- this is the provision of suitable time limit to a stakeholders claim to stake. Power- this enables a stakeholder to exercise authority. Urgency- this enables the stakeholder to work effectively and reach the required deadline. There are three approaches for a stakeholder, they are: Strategic approach determines a stakeholder as a factor manager who manages and tracks the profits of the stakeholder. Fiduciary Approach determines the fiduciary powers and responsibility of the stakeholders group. Synthesis approach considers the stakeholders group to manage ethical responsibilities. Stakeholder model: The stakeholder model comprises of three values: 1. Descriptive values- it describes the features of an organization, assessing the behavior of the firm and ascertains the activities performed by the firm in the process of project making. It also depicts the corporate constituencies that the board of directors maintain while managing the firms. 2. Instrumental values- It recognizes the interrelation between the stakeholder group management and the achievements of the corporate objective by empirical data analysis maintain the effectiveness and the count of profitability. 3. Normative approach examines the function of the corporation and identifies the philosophical or moral guideline for the management and the corporation. These types of capabilities are needed for an effective Stakeholders management. Rational level includes the mapping of an organizations stakeholders group. It defines interest accurately in each and every operation which are included in the processing of the project. Transaction level includes the establishing and executing of a win-win transactional exchange with the stakeholder. There are some points about the organizational culture for a project which some people terms as Depart. It runs the activities of the project processing and conducts the project according to the organization culture and style. Culture and style are the group phenomena which can be denoted by cultural norms that develop over the time. It includes the establishing approach for initiating and planning a project and the acceptability of the work done. It also includes the recognized authority who will make and influences the decision. Further the discussion continues about the Projects stakeholders governance which includes the alignment of the project with stakeholders need and the objectives. These are critical for the successful management of the stakeholders engagement and the achievement of organizational change. Project governance enables organizations to consistently manage projects, maximize the value of project outcome and align the project with business strategy. Furthermore we can say that project governance provides a framework in which the project manager and the sponsor can make the decision. The decision satisfies both the stakeholders need and expectations and the organizational strategic objectives to address circumstances where they may not be in alignment. Relationship between project and stakeholder : A Stakeholder has various types of responsibility and authority in a project. It can change over the course of the project life cycle. Their involvement may range from occasional contribution in survey and focus group, to full project sponsorship. This includes providing financial, political, and other support. Some stakeholders may also detract from the project, actively or inactively. The project stakeholder requires the project managers attention throughout the project life cycle, and must plan to resolve any issue that may arise. Thus it can be stated that a stakeholder is hugely involved throughout the entire project life cycle. Identifying the role of a stakeholder is an essential work for the success of a project. Understanding the relative degree of influence of a stakeholder and the technique which balances the demand and need of a stakeholder must be verified in the process of the project. An organization should have the knowledge about the expectations of the stakeholders requirement in their product. Reasons for cancellation of a product: Delay in completion of a product. Low production Increased cost of production, and Poor quality of product. For example like a late realization of considering legal department as a significant stakeholder. It results in delay in time and increased expenditure due to legal requirements that are required to be met before the completion of the project. Stakeholder analysis Analyzing of stakeholder is systematically gathering technique and a product is analyzed. There are two types Quantitative Qualitative Quantitative is the process which is used only for calculating the quantity of a commodity more than quality. Qualitative is the process which is used only for calculating the quality of a commodity. There are three types of technique which is used to measure stakeholder analysis are as follows: Interests Expectation Influence Of stakeholder and relates with the purpose of the project. Moreover stakeholder analysis to help to identify relationship with the project that can be influence to: Build alliances and prospective partnership to increase the projects possibility of success. Construct stakeholder connections that need to be impact differently at various stages of the project or stage. Following are the steps of stakeholder analysis: Firstly need to identify the entire prospective project stakeholder and the applicable information which includes their roles, group of project team, interest, understanding and effect levels. Moreover key stakeholders are easily identified. Furthermore for the reasons of decision making or administration what footprint by the projects outcome is guided by the other person. Like it can be the sponsor, project manager and the primary costumer. Moreover by interview system other stakeholder can be identify or other various method depends on psychology. Some other methods used for identifying or analyze the stakeholder are as follows: First we have to assess the prospective impact or support of each stakeholder for the project which are generated by them. Moreover need to identify them so as to define an attitude. In a large stakeholder organization, it is important to prioritize the stakeholder to protect the efficient use of effort to communicate and manage expectation. It should also identify that in different situation how the stakeholder are reacted ,how they can hold the situation and what will be their plan to solve the problem. To analyze the power of the stakeholder three types of model can be used which are as follows: Power Influence Salience Power method In this method stakeholder are divided in the group according to their power level and then need to check their involvement in the success or processing of the project. Influence In this method people are divided into the group who involve in the project and need to check their involvement processing and their active or creative of the project. What they can do new for further processing of the project is also need to check. Salience This method narrate the grade of stakeholder which based on their power, urgency and the legitimacy. Stakeholder analysis: (analytical technique) The stakeholder needs to compare the planned engagement levels that are required for the successful completion of a project. The engagement of a Stakeholder throughout the life cycle of the project is critical to the project success. The engagement level of the stakeholder can be classified into the following:- Unaware: at this level the awareness about the project and its potential impacts of a project holder is categorized. Resistant: here, the project holder should be aware about the project and potential impacts and resistant to change. Neutral: at this level the project holder are neither supportive nor resistant. Supportive: in this level the project holders will be aware about the project and potential impacts and supportive to change. Leading: at this stage the project holders are aware of the project and its potential impacts, and they are actively engaged in ensuring that the project is a success. Communication with the stakeholders: It is necessary to meet every project stakeholder and document their ideas and views about the project in order to cover the specific goals of a project. The organization should ask what kind of changes they suggest and what alterations are necessary according to them. The stakeholder must suggest how the deliverables can be measured and verified. In order to perform these tasks a stakeholder should have a lot of knowledge about the project and they are expected to analyze the probability of success in the project. Introduction: As already mentioned, the important aspects and requirements on the process and documentation for an organizational change program is needed for proper decision making. Recommendation: Importance of stakeholder and roles have already mention above in the project. Primary and secondary stakeholders are combined with the base of a project. Who are supply the raw material and works in a group or department of an organization are primarily direct linked to the project and closely linked to project base. Who helps in the success of the project are secondary stakeholder are worked indirectly in the project. Like any costumer is a secondary stakeholder. Another example of a farmer can grow crop for any kind of food factory. So farmer comes in the list of secondary stockholder. A stakeholder should aware about his responsibilities when they will combine with a project and should also aware about all the plans of the project. According to the project life and during the process of the project, the responsibilities can be change of a stakeholder. Three values of the project also help to explain about the project model like descriptive its display all the characteristic of a project. Moreover it also shows how stakeholder can manage the team works for a project which also shows the behavior of the company. Moreover some instrumental approaches consider the actual data to explain the relationship between the stakeholder and the management. Analysis of stakeholders involves the evaluation of the stakeholder which can be two types such as qualitative and quantitative. Can check quality of a stakeholder in the first type and can check quantity of a stakeholder in the second type as it has been mention with the name of the both type. There are three methods to analyze the stakeholder such as power, influence and salience. Most of the methods are based on psychology such as stakeholder divided in a group according to their level and check their participation in the project. But in the second method which is influence, need to check involvement in the project. Conclusion: The importance of a stakeholder in the success of any project is relevant. It might be the case that the stakeholder may influence directly or indirectly. To transform the objective of any project into reality, a stakeholder plays a crucial role in achieving so. For a project to yield positive and successful results, not only stakeholders are important but other factors like ideas, innovation, finance, resources etc. are also equally important for its execution and end result. In the end, from this project we can well analyze some of the process and documentation for an organizational change program. References: Class work- SM 1 Class work- SM 2 Class work- SM 4 Some points include slides having the same title as the project.
Thursday, November 28, 2019
Power And Propoganda In Communist China Essays - Chinese Communists
Power and Propoganda in Communist China Propagand in China during the Cultural Revolution took on many forms; there were mass Red Guard demonstrations in Tianamen Square in support of Mao Zedong, pictures of Mao were put up in every conceivable location from restaurants to the wallpaper in nurseries, and pamphlets and books of Mao's teachings were distributed to every Chinese citizen. One of these propaganda publications Quotations from Chairman Mao which later became known as the Little Red Book contained quotes from Mao Zedong and was distributed to every Chinese citizen. The history of the Red Book provides one of the best ways in which to analyze Chinese propaganda during the Cultural Revolution and see the ways in which the Chinese government was able to produce and effectively indoctrinate the Chinese people with Mao Zedong Thought. Official Chinese magazines from the period of 1967 to 1970 are filled with many pictures of citizens holding, reading, and memorizing the Red Book. This proposal will trace the rise and fall of images of the Red Book in the official Chinese publication China Reconstructs. This proposal will use a graphical analysis of pictures in this publication from 1966 to 1973 to show that propaganda was not just a tool of the Communist party but also a reflection of internal power struggles within the party during the Cultural Revolution. The Red Book was written several years before it became the object of national adoration and a tool for the Cultivation of Mao's personality Cult. The history of the Red Book and its meteoric rise from a hand book for military recruits to compulsory reading for all Chinese citizens, is closely tied to its developer Lin Biao's rise to power. Lin Biao was born in 1907 and was fourteen years younger then Mao; he joined the communist party in 1925 and until the communists captured control of China was at various times in charge of resistance forces, and armies of communist soldiers. When the communists took control in 1949 Lin Biao was behind Mao Zedong, Liu Shaoqi, Zhou Enlai, Chen Yun, and Deng Xiaoping in rank (Yan and Gao, 1996: 179). But eighteen years later during the height of the Cultural Revolution Lin Biao by winning favor with Mao by publishing and championing the Red Book and the Cult of Mao became second only to the Chairman in power and position (Ming-Le, 1983: 80). In 1959 Peng Dehua was dismissed as minister of defense and Lin Biao was appointed in his place. At an armed forces meeting for high cadres during September of that year Lin Biao, energetically started promoting the Cult of Mao saying, "Learning the writings of comrade Mao Zedong is the shortcut to learning Marxism-Leninism. Chairman Mao's writings are easy to learn and can be put to use immediately. Diligent work will pay dividends many fold." (Yan and Gao, 1996: 182) His references to "shortcut" and "quick dividends" in his speech went unnoticed at the time as few foresaw the effects of creating a Cult around Mao. But looking back on the Cultural Revolution and Lin Biao, we can see his using the Cult of Mao was indeed a shortcut that produced huge dividends both for himself and for Mao. Mao to the Chinese people was a symbol sovereignty and the construction of socialism; to them praise for Mao was fitting with his symbolic role in society. Starting in 1959 Lin Biao in front of military audiences in order to help buildup support for the Cult of Mao used such phrases as, "the dire necessity of acquiring Mao Zedong's thought," "to study the writings of Mao Zedong with questions in mind is to shoot arrows with target in sight," "we must arm our minds with Mao Zedong's thought" (Yan an Gao, 1996: 181). Lin Biao's goal of building up both himself and the Cult of Mao lead him in September of 1960 to pass a resolution at the meeting of the Military Commission, which called for more political education among the armed forces (Yan and Gao, 1996: 181) "Mao Zedong Thought is the compass for the Chinese people's revolution and socialist construction, the powerful ideological weapon against imperialism, and the powerful ideological weapon against revisionism
Monday, November 25, 2019
Weldon v. Dunn essays
Weldon v. Dunn essays When reviewing the case file in question, I have found that one of the most important things to be taken into consideration when trying to decide injury cases is the fact of foreseeablilty. When Weldon seated the customer into the chair, she was well aware of the fact that the chair was not operating properly. In reference to the second allegation of the chair being to close to the manicure table, this as well is a foreseeable danger. When the inspector came to inspect the premises, the manicure table was in the same place and was not deemed unsafe. The third issue has a touch more credibility. The fact that Ms. Weldon injured her back during the course of her workday needed to be researched more in depth. Upon being accepted into the school of cosmetology, Weldon received an Admissions Information pamphlet. In this reading, it clearly states the following: Disadvantage of Cosmetology Careers Cosmetology is a physically and mentally demanding profession that requires dexterity and patience. There is always the possibility of chemical allergies, foot, leg and back problems After reading this statement, the possibility of any injury, including injury to the back, is imminently clear. This in turn disavows the third and final claim made by Weldon. Thus in conclusion I feel that all responsibilities of the accused should be waved. The injury to the employee was brought forth not due to the negligence of the company, but in turn by herself. She read the Admissions Information before signing on for the job, releasing Dunn of being held responsible on all accounts of work related injuries. ...
Thursday, November 21, 2019
Compair the thnen and christaller theory Essay Example | Topics and Well Written Essays - 1000 words
Compair the thnen and christaller theory - Essay Example The desire to make geography more scientific, or at least more intellectually acceptable as a discipline, led to the adoption of statistical methods as a primary research technique. Location (or spatial) analysis, as this new aspect of geography is called, seeks to analyze and explain the factors that control humankind's spatial organization, specifically by statistical methods and models. Mathematically constructed models became tools useful to the geographer in coping with rapidly accumulating knowledge, and they could also be used to predict future trends or spatial patterns. This was not the first time statistics had been used for geographic research. As early as the 1920s and '30s, Torsten Hgerstrand in Sweden and Walter Christaller in Germany had used statistical techniques. Only in the 1960s, however, did significant growth in statistical methodology occur. Johann Heinrich von Thnen was born on June 24, 1783, was a German agriculturist. In 1826 he wrote Der isolierte Staat (The Isolated State), in which he proposed his theoretical model showing concentric belts of agricultural production surrounding a market center and demonstrating the relationship of commodity transportation costs to production location. Thnen laid the foundations of contemporary spatial theory. (Larry, 2004) This non-linear reformulation of the von Thnen model... model explicitly allows for input substitution and provides for the rate of production intensities to be determines endogenously by the profit maximizing behavior of the individual farmers. If the transport rate is constant and production occurs with constant returns to scale, then the rent function, under bid rent tenancy, or owner occupied farming, is indeed nonlinear and strictly convex to the origin. It is also possible to determine the spatial distribution of labor density as well as levels of crop yield in accordance with this basic model. It is not surprising that these results confirm the Dunn-Isard conjecture as the bid rent functions so determined assume a strictly convex form, and the intensity of cultivation does, in fact, increase toward the market center. Now the nonlinear von Thnen model can be formulated to conform to the logistics of industrial production in order to derive a non-agricultural rent function, also based on constant-returns-to-scale technologies. Firms in the urban sector go to the market center to obtain their raw materials, which were previously delivered there from the agricultural sector. Some firms specialize in the production of various intermediate goods which are also delivered to the market, where other firms purchase them for incorporation in their own products. Final goods are then delivered to the market for sale to the general public. Capital is introduced as a production input, the amount of which is explicitly governed by the price ratio of labor and capital. This "augmented" model ultimately generates comparable results with regard to the shape of the resulting rent function as well as the spatial distribution of levels of production and employment and therefore the densities of capital and labor. Although based on
Wednesday, November 20, 2019
Create a research portrait of a well-known artist, explain how his or Essay
Create a research portrait of a well-known artist, explain how his or her work responds to particular social issues - Essay Example ject, requiring the artist to spend years painting in wet plaster rather than working on his sculpture or other projects, some might wonder what prompted Michelangelo to undertake this project rather than allowing some other artist the dubious honor. Just how much freedom Michelangelo had in this decision is an often discussed topic. It might also be wondered whether the subject of the painting was determined by Michelangelo himself or the Pope who commissioned him for the project. To more fully appreciate the process that contributed to the creation of the Sistine Ceiling, it is necessary to understand the details regarding the commission of the project, why it was commissioned, why Michelangelo accepted the commission given the difficulties involved, how he met these challenges given the media and subject involved as well as his final assessment of the results. It is widely accepted that Pope Julius II commissioned Michelangelo to paint the Sistine Chapel ceiling as none other had the power and authority to force the artist back to Rome. Michelangelo had fled the city only two years earlier after the Pope first commissioned him to create approximately 40 sculptures in the most lavish Papal tomb designed to date and then refused to honor his portion of the contract. In addition, the work being requested of Michelangelo was painting rather than sculpture which he preferred. Other accounts indicate the idea of having the ceiling completed by Michelangelo was the idea of Donato Bramante, who intended to discredit Michelangeloââ¬â¢s daunting reputation. ââ¬Å"In Michelangeloââ¬â¢s eyes, Bramante had persuaded the pope to abandon the project [of the tomb] by warning him that it was bad luck to have oneââ¬â¢s tomb carved during oneââ¬â¢s lifetime, and had then proposed an altogether different commission for the sculptor, a task at wh ich he knew Michelangelo could not possibly succeedâ⬠(King, 2003, p. 11). Work commenced on the project in 1536 under Pope Paul III and was
Monday, November 18, 2019
Negotiation Assignment Example | Topics and Well Written Essays - 750 words - 1
Negotiation - Assignment Example The two-day long correspondence with the client leads to us negotiating with a price that did not amount to my work but was not in their favor as well. I ended up withholding the rest of the series I had been working on for them and they paid me half price on a project that I had worked a lot on but the positive point is that I knew my walk away terms. It was established that poor communication was what lead to the break of the deal and a case was not filed from either of the party which I think is an achievement. I could have conducted the negotiating terms better if there had been a better communication system involved with information sharing from the start that would have helped in benefiting both parties. Another tactic that I could have applied in the negotiating terms is priorities because I left a pile of unfinished projects in lieu of this certain project and had to put double the time in other projects, so one important thing I learned from this failed project was to always get my priorities right and to give maximum time to things but do not forget that there are other tasks that need to be done as well.The two-day long correspondence with the client leads to us negotiating with a price that did not amount to my work but was not in their favor as well. I ended up withholding the rest of the series I had been working on for them and they paid me half price on a project that I had worked a lot on. It was established that poor communication was what lead to the break of the deal.
Friday, November 15, 2019
Anti-cataract Activity of Abies Pindrow Luffa Cylindrica
Anti-cataract Activity of Abies Pindrow Luffa Cylindrica ââ¬Å"Evaluation of in-vitro anti-cataract activity of Abies pindrow Luffa cylindricaâ⬠: A Comparative study Suchita Dubey, Sudipta Saha, Shubhini A Saraf* Abstract- Context- Cataract is the opacification of lenses resulting in blurring of vision.Oxidative stress is the major cause of many diseases including cataract. Objective- The study was designed to evaluate and compare the in-vitro anti-cataract activity of aqueous extracts of Abiespindrowleaves (APE) and Luffacylindrica fruits (LCE) against hydrogen peroxide induced cataractogenesis, using isolated goat lenses. Materials and Methods-Standardized extracts of APE and LCE were compared for their anti-cataract activity against marketed eye drops. Hydrogen peroxide (0.05M) was used to induce cataract in goat eye lenses. Photographic evaluation confirmed the clarity of lenses incubated in APE and LCE respectively. Result-.MeanGSH Value in normal lenses was found to be 2.9765à ±0.17à µg/mg of fresh weight of the lens.In the presence of APE and LCE respectively, a significant restoration of the levels of GSH as compared to the toxic control was observed. An increase in MDA level was found in the control opposed to the normal lenses (1.57à ±0.04à ¼mol/g of fresh weight of lens; P Discussion -SOD, GSH, TPC and copper-induced lipoprotein diene formation was found to increase, whereas MDA levels significantly decreased, as the concentration of APE and LCE increased. Conclusion: The study demonstrated that monotherapy of APE and LCE respectively, has the potential to prevent cataract because of the strong antioxidant potential of each. Keywords- Antioxidant, Cataract, Hydrogen Peroxide, Abies pindrow, Luffa cylindrica Introduction- Oxidative stress has been the major cause of many diseases including cataract. The free radicals that are produced as the result of daily stress borne by the human body are scavenged by a range of antioxidant enzymes and small molecule antioxidants. Cataract is the opacification of lenses resulting in the blurring of vision. Since ancient times, Indiaââ¬â¢s conventional medicinal knowledge has been extraordinarily useful in treating rarest of the rare diseases. The term cataract describes lenticular opacities that may be congenital or acquired. Systemic diseases (such as galactosemia, diabetes mellitus, Wilson disease atopic dermatitis), drugs (especially corticosteroids), radiation, trauma, and many intraocular disorders are associated with cataract. Traditional medicines have proved to be effective to an extent in curing cataract. Plants such as Embellica Officinalis (Amla) and those which are rich in gallic acid, digallic acid, ellagic acid, and tannins respectively serve as g ood anticataract options.[1] The development of the disease depends on many factors.The lens Na+- K+-ATPase activity plays an important role in maintaining lens transparency, and its impairment causes accumulation of Na+ and loss of K+ with hydration and swelling of the lens fibres leading to cataractogenesis[2] . In conjunction, aldose reductase is a lens enzyme probably involved in the development of cataract [3]. It acts on the sugars like glucose, galactose, and xylose and converts them into their respective alcohols. These alcohols, also known as polyols: accumulate within the lens thereby producing osmotic effects. Since polyols are not capable of either diffusing out easily nor are metabolizes rapidly, they may cause hyper tonicity responsible for the formation of cataract [4]. Oxidative mechanism plays an important role in biological phenomena including cataract formation. The formation of superoxide radicals in the aqueous humor and in lens and its derivatization to other potent oxidants may be responsible for initiating various toxic biochemical reactions leading to the formation of cataract. Catlin is the marketed drug with considerable anticataract activity hence was taken as standard and various parameters measured, including total proteins and malondialdehyde (MDA) in vitro on goat lenses. Materials and Methods- Plants- Standardized extracts of ââ¬Å"Abies pindrow leafâ⬠and ââ¬Å"Luffa cylindrica fruitâ⬠were obtained from Navchetna Kendra, New Delhi (A registered manufacturer, exporter and supplier of herbal products in India) along with the certificate of analysis of both the extracts confirming that extract complies with all the morphological specification of colour, odour, taste along with LOD, Ash value and microbial load (Total Plate Count, yeast and mould and E.coli). Drug- Catlin eye drop available in the market were purchased from medical store in Lucknow, UP. Eye Balls-Goat eye balls were used in the present study. They were obtained from the slaughterhouse and immediately transferred to laboratory at 0-4 degree Celsius in physiological salt solution containing 1% solution of antibiotic to prevent microbial contamination. Preparation of Lens Culture- The lenses were removed by extracapsular extraction and incubated in artificial aqueous humor (NaCl 140 mM, KCl 5 mM, MgCl2 2 mM, NaHCO3 0.5 mM, NaH (PO4)2 0.5 mM, CaCl2 0.4 mM) at room temperature and pH 7.8 for 72 h. Penicillin 32 mg% and streptomycin 250 mg% were added to the culture media to prevent bacterial contamination [6]. H2O2 (0.05M) was used to induce cataract. Preparation of Lens Homogenate-After incubation, lenses were homogenized in 10 volumes of 0.1M potassium phosphate buffer, pH 7.0. The homogenate was centrifuged at 10,000 rpm for 1 hour and the supernatant was used for estimation of biochemical parameters. Drug Concentration and Groups- The standard drug Catlin was taken in the concentration of 1% v/v and the Goatââ¬â¢s eye lenses were incubated with Abies pindrow extract (APE) (5mg/ml, 10mg/ml, 15mg/ml 20mg/ml) andLuffa cylindrica extract (LCE) (5mg/ml, 10mg/ml, 15mg/ml, 20mg/ml, 25mg/ml 30mg/ml) concentrations as mono therapy. A total of 65 lenses were divided into 13 groups of n=5. Group 1- PSS + Ab 250 mg (1%) + lens Group 2- PSS + Ab 250 mg (1%) + H2O2(0.05 M) 0.5ml+ lens Group 3- PSS + Ab 250 mg (1%) + Catlin (KI-3.3%, NaCl-0.83%, CaCl2-1%w/v) 1ml Group 4- PSS + Ab 250 mg (1%) + APE (5%) Group 5-PSS + Ab 250 mg (1%) + APE (10%) Group 6-PSS + Ab 250 mg (1%) + APE (15%) Group 7-PSS + Ab 250 mg (1%) + APE (20%) Group 8-PSS + Ab 250 mg (1%) + LCE (5%) Group 9-PSS + Ab 250 mg (1%) + LCE (10%) Group 10-PSS + Ab 250 mg (1%) + LCE (15%) Group 11-PSS + Ab 250 mg (1%) + LCE (20%) Group 12-PSS + Ab 250 mg (1%) + LCE (25%) Group 13-PSS + Ab 250 mg (1%) + LCE (30%) Homogenate preparation- After incubation, lenses were homogenized in 10 volumes of 0.1M potassium phosphate buffer, pH 7.0. The homogenate was centrifuged at 10,000 rpm for 1 hour and the supernatant was used for estimation of biochemical parameters. Biochemical estimation- SOD and GSH levels were measured using Ellmanââ¬â¢s method[6]. Protein estimation was done by Lowryââ¬â¢s method [7]. The degree of oxidative stress was assessed by measuring the MDA levels by using TCA-TBA-HCl reagent. [8] (Table-2,3). The mean GSH Value in normal lenses was found to be 2.9765à ±0.17 à µg/mg of fresh weight of the lens (Fig-5) . A significant decrease was observed in presence of in GSH value in presence of hydrogen peroxide in control. In the presence of APE and LCE, there was a significant restoration of the levels of GSH as compared to the toxic control. A significant increase in MDA level was found in the control opposed to the normal lenses (1.57à ±0.04à ¼mol/g of fresh weight of lens; P APE and LCE significantly protected the test group lenses from lipid peroxidation; Hydrogen peroxide treated lenses showed significantly low concentrations of proteins (total and water soluble proteins) in the lens homogenate (P SOD levels as compared to the toxic control were found to be significantly more in normal lens group (1.76à ±0.10unit/mg of protein) which was far less than that of the toxic group (0.23à ±0.01unit/mg of protein). APE and LCE were found to increase the level of SOD in presence of hydrogen peroxide as well (Fig-4). Result- Photographic evaluation confirmed the clearance of vision when the lenses were incubated in APE and LCE (Figure 6). Photographic Evaluation: Scale of opacity- Absence of opacitySlightly opaquePresence of diffuse opacityPresence of extensive thick opacityResults of biochemical parameters are reported as Meanà ±SD. (Table-2,3). Comparisons were made on the basis of one-way ANOVA and Bonferroni test was performed between test samples and data was considered to be statistically significant when p Discussion-Cataract is mostly brought about by age. It is common to older people. Inflammatory reactions to the lens material may develop as a result of the exposure of intact lens cortex by rupture of the lens capsule. In cataractogenesis, the parameters commonly considered are malondialdehyde (MDA) and proteins (total proteins and water soluble proteins). Oxidative stress is the main marker of cataract and is responsible for its pathogenesis.The study demonstrated that AP and LC are effective against H2O2 induced cataractogenesis in goat eye lens, used as in-vitro model. Significant prevention of cataract was observed during the study. SOD, GSH, TPC and copper induced lipoprotein diene formation was found to increase proportionally with the concentration whereas MDA levels significantly decreased as the concentration increased and reached its saturation level at the concentration 20% and 30% respectively for AP and LC (Table 2, 3). The photographic evaluation based on the opacity scale (Table-1) showed that highest concentrations of both the plants i.e. AP (20%) LC (30%) maintained the vision for 39.5 42 hours respectively. It was also observed that the lens incubated in Hydrogen peroxide swelled imbibed more solution which can be a possible outcome of inflammation while the lenses incubated in plant groups were less swollen which further potentiates the anti-inflammatory activities of both the plants. In conclusion, the study demonstrated that monotherapy of AP and LC had potential to prevent cataract due to their strong antioxidant potential. However, AP in lower concentration was more effective in treating cataract than LC according to results of the photographic evaluation. There is no literature available for anticataract activity of AP and LC. This is the first study which reports that the monotherapy of both the plants can afford significant prevention of cataract. Further studies can be performed with different routes and doses to evaluate the anti-cataract effect of these two drugs as future scope of the work. Conclusion- The herbal extract of both the plants were found to significantly reduce the free radical generation in isolated goat lenses. The extracts can be further developed into a polyherbal formulation or characterisation and isolation of phenolics in the extract can prove to be a good herbal remedy for treatment and prevention of cataract because of potent antioxidant action of plant. Acknowledgement- Suchita Dubey is thankful to University Grant Commission for providing research grant during M.Pharm Project. References- Gupta SK, Kalaiselvan V, Srivastava S, Agrawal SS, Saxena R (2010): Evaluation of anticataract potential of Triphala in selenite-induced cataract: In vitro and in vivo studies. J Ayurveda Integr Med 1: 6 Unakar NJ, Tsui JY. (1983) Inhibition of galactose induced alteration in ocular lens with sorbinil. Exp Eye Res 36: 685-694. Guzmà ¡n à , Guerrero O R (2005) ââ¬Å"Inhibition of aldose reductase by herbs extracts and natural substances and their role in prevention of cataractsâ⬠Rev cubana plant med 10 :3-4 Kinoshita JH, Merola LU, Dikmak E. (1962) The accumulation of dulcitol and water in rabbit lens incubated with galactose. Biochem BiophysActa; 62:176-178. Harding JJ, Rixon KC. Carbamylation of lens proteins: (1980) A possible factor in cataractogenesis in some tropical countries. Exp eye res; 31:567-571. Ellman GL. (1959) Tissue sulfhydryl groups. Arch Biochem Biophys. 82: 70-77. Lowry OH., Rosenberg NJ., Farr AL., Randall RJ (1951) Protein measurement with the Folin phenol reagent. J. Biochem. 193: 65. Bar-Or D., Rael LT., Lau EP., Rao NK., Thomas GW.,Winkler JV., Yukl RL., Kingston RG. and Curtis CG. (2001) An analog of the human albumin N-terminus (Asp-Ala-His-Lys) prevents formation of copper-induced reactive oxygen species. Biochem. Biophys. Res. Commun. 284 , 856-862
Wednesday, November 13, 2019
Comparing Society in The Dharma Bums and The New American Poetry Essay
Mass Society in The Dharma Bums and The New American Poetry à à à à One of the best ways to fully understand an era is to study its literature. The printed word has the incredible capacity to both reflect and shape the hopes, fears, and ideologies of the time. This is very evident when reading literature from 1960's America, a turbulent period in the history of our country. While the authors' styles are very different, there are definite thematic patterns and characteristics evident in many of their works. For one, there is a prevalent concept of the unenlightened masses. This concept serves as a foil for the enlightened few often represented as the main characters and more specifically as the authors themselves. There also seems to be a general questioning of the "American Dream" as well as a clear conflict between nature and technology. By looking at these common thematic elements, not only can we better understand the literature of the time, but we can also get a fuller picture of the era itself. à One of the most interesting concepts in 60's literature is that of mass society. And while this notion is evident in many of the writings, the treatment of it is different from author to author. Richard Brautigan chooses to show the poor masses in his piece "Trout Fishing in America". He writes, "...people gather in the park across the street from the church and they are hungry.//It's sandwich time for the poor."(280,Streets) Donald Berthelme in his work "The Glass Mountain" calls the masses, "acquaintances"(284, Streets). He shows them to be a drunk and unruly lot who shout profanities at him as he tries to climb the building. Lawrence Ferlinghetti mentions an "unlonely crowd"(130,Poetry) in his po... ...erature from 1960's America is full of recurring themes and images, which help to shed some light on the society of the time. There is a portrayal of a mass society that is questing for the American dream. There is also a call for enlightenment which many of the authors seem to say comes from a rejection of technological glitter and a return to simple, awe inspiring nature. These themes are shown in many different ways and with various slants. By placing these works in the larger context of a social era, we can see that the 60's was a very tumultuous time of great conflict and great change. à Works Cited: Allen, Donald ed. The New American Poetry. U of California Press:Berkeley, 1999. Bloom, Alexander and Wini Breines Takin It To The Streets. Oxford University Press: Oxford, 1995. Kerouac, Jack The Dharma Bums. Penguin Books: N.Y., 1986.
Monday, November 11, 2019
Knowledge, Attitude and Breast Cancer Screening Practices in Ghana Essay
INTRODUCTION à à Breast cancer in its simplest definition is the cancer of breast tissue. It is the most common nonskin cancer that affects women in the United States and the highest fatality rates of cancer deaths among women in low-resource countries (Anderson et al 2006). Severity of breast cancer differs based on its level of tissue invasion. Ductal carcinoma in situ is the most common noninvasive breast cancer while infiltrating or invasive ductal carcinoma is the most common breast cancer that accounts for about 80% of invasive breast cancer. Breast lumps presentation is the commonest form of presentation regardless of the breast cancer type (ACS 2005). Epidemiologic factors are attributed to dietary and environmental risk factors, although association of diet and breast cancer had varied results. Environmental risk factors involve the exposure to several toxic elements which accounts for the increased incidence of breast cancer in Western countries. Alcohol intake is also considered to effect in the increase of the number of cases in the US population. Age is also considered as cancer risk factor and can be attributed to hormonal change. Genetic variation and ethnicity are not out of scope for the investigation of breast cancer risk factors (Barton 2005). Diagnosis and Pathology of Breast Cancer: In 2002, Breast Health Global Initiative (BHGI) together with panel of breast cancer experts and patient advocates develop a consensus of recommendations for the diagnosis of breast cancer in limited-resource countries (Shyyan 2006). Histopathologic diagnosis included fine-needle aspiration biopsy which was recognized as the least expensive, core needle biopsy and surgical biopsy and had a consensus of choosing the method based on the availability of tools and expertise. They gave emphasis on the correlation of histopathology, clinical and imaging findings. They agreed on the need of histopathologic diagnosis before breast cancer treatment. In 2005, BHGI panel recommended an additional strategy of breast cancer management. They stratify diagnostic procedure and histopathology methods into ââ¬â ââ¬Å"basic, limited, enhanced, and maximalââ¬âfrom lowest to highest resourcesâ⬠. Basic level includes medical history of the patient, clinical breast examination, tissue diagnosis and medical record keeping. Limited level includes the increasing resources that enable diagnostic imaging utilization such as ultrasound with or without mammography, tests that can evaluate metastasis, use of image-guided sampling and hormone receptor sampling. Enhanced level includes diagnostic mammography, bone scanning and an onsite cytologist. Maximal level includes mass screening mammography (Shyyan 2006). Treatment of Breast Cancer: Treatment includes surgery, radiotherapy or chemotherapy or combinations of these three treatment modalities. According to American Cancer Society (2005), treatment can be local or systemic. Local treatment of the tumor is done without affecting the rest of the body. Surgery and radiation are examples of this treatment. On the other hand, systemic treatment which includes chemotherapy, hormone therapy and immunotherapy, is given into the bloodstream or by mouth to reach the cancer cells that may have spread the beyond the breast. à Radiotherapy is a treatment of breast cancer with high-energy rays to help shrink the cancer cells. It can be given outside of the body (external radiation) or can be placed directly into the tumor as radioactive materials (ACS 2005). It may be given external to the body.à Radiotherapy requires safe and effective application requiring appropriate facilities, staff and equipment. Radiotherapy should be applied without delay, should be accessible to all but without prolongation of the overall treatment time exposure. It is part of an integral part of breast-conserving treatment. It is required in almost all women with the breast cancer, and therefore should be available (Bese 2006). à à Chemotherapy is the use of anticancer drugs that are administered through injection in the vein or taken orally as a pill. It may be given before breast cancer surgery to reduce the size of the tumor or may be given after the surgery to reduce the chance ofà recurrence (ACS 2005). This treatment is done in cycle the most common of which is 3-6 months. Most common side effects of these drugs usually stopà once the treatment is over such as in hair falling. Some ofà drugs used as chemotherapyà à are tamoxifen, cyclophosphamide, methotrexate, 5-fluorouracil doxorubicin, epirubicin, taxane and aromatase . These are usually prescribed in combination, and treatment is done with adjuvant therapy such as radiotherapy and pre- and post operation ( Eniu 2006). à à à à à à à à à à à Surgical management in breast cancer is very common. This is done to remove as much as the cancer as possible and to find out whether the cancer has spread to the lymph nodes under the arm. Surgery can also restore the appearance of the breast and relieve the symptoms of advanced cancer. ACS (2005) released some of the common surgical procedures in breast cancer. These are lumpectomy, partial or segmental mastectomy, simple or total mastectomy, modified radical mastectomy and radical mastectomy. RESULTS à Breast cancer patients in Ghana. The present study which included women with mean age population of 48 yearsà revealed an almost consistent perception with regards to breast cancer.à à They were aware that breast cancer is highly increasing in their place but not informed of the cause of disease. All of the responders were not aware of family breast cancer history except one. Information about breast cancer was acquired through television and radio programs. Only afterà consultation with doctors due to lumps orà pains in their breast and some due to liquid coming out of their breast, that they were informed that they have breast cancer. Most of them underwent breast tissue exam for confirmation of the disease. Afterwards, they were advised to undergo surgery with medical treatment. The responders were ignorant of the breast cancer screening and prevention. In fact, out of 10 responders, only 2 (20%) of them were aware of breast self examination and clinical breast examination and admitted that they occasionally practice BSE. None of the responders knew about mammogram except for one (10%) of them who has heard of it but never had tried one. The feeling towards the knowledge of acquiring the disease was also the same; the feeling of being a burden in the family was common. They were afraid to face the reality but have realized that they have to fight the disease through the encouragement and support of family members andà help of medical professionals. The sample population was aware of the herbalist and faith healers but they did not submit themselves into that kind of treatment because herbalist have notà proven cure for breast cancer.à The most common complaint of the responders was the high cost of therapies, hospitalization and doctor fees. The treatment cost ranged toà à ¢250,000-à ¢24 million except to one of them who received a free treatment for being enrolled to a clinical trial. Sentiments of the participants were the same. Delay of treatment was attributed to their distant place from the health clinics; some facilities like x-ray were not available in the clinics andà high cost of treatment. These people asked for the betterment of breast cancer management through education dissemination to the community by health care providers and a help from the government to provide financial support to those who cannot afford to submit themselves for treatment. Patients in breast cancer clinic. In this part of the study, women with mean age of 42 years who were in breast cancer clinic were included. Most common medical complaint was lump and pain in the breast while others submit themselves for screening because they have just heard it from the radio/TV. à The study revealed that women who were attending the clinic were not actually informed of the cause breast cancer but aware of its increasing rate of mortality. Misconception about the cause of breast cancer such as exposure to coins was not common but did not exclude the form of trauma due to manipulation of the breast. Others correlate breast cancer with smoking and taking alcoholic beverages. They were not aware of their family history of breast cancer. à Information regarding breast cancer was acquired through television and radio programs and others were through their friends and family members. Most of the respondents believed that early detection and prompt treatment of the disease can prevent the unfavorable outcome of breast cancer such as removal of their breast or the worst would be cancer death. Only one out ofà 10 participants (10%) actually practice breast self examination (BSE). Most of them were informed of BSE but not actually practicing it. They were also aware of healers and herbalist but they did not believe that they can cure breast cancer but did not disagree of the possibility that herbalist and healers could treat other diseases or illnesses like hypertension. The participants suggested that it would be better if the government would provide or establish more health care clinics for breast cancer screening and provide free screening programs especially to those who cannot afford toà pay for high cost of treatment of the disease and for an open-easy access to all especially to those in rural areas. One of the participants suggestedà that doctors should study further about the treatment of breast cancer instead of resorting to breast surgery. Healers involved in breast cancer management. Many of the population of Ghana are still patronizing healers and herbalist as a resortà of treatment. Two healers from Ghana were interviewed regarding their management of breast cancer. The healers have been into this practice for about 20-50 years. According to them, breast cancer is very common in Ghana and they are aware of the increasing incidence ofà the disease. They described breast cancer as an ââ¬Å"obosamâ⬠disease and the other was a supernatural disease. Healers believed that their ability to cureà the disease inherited from their forefathers who taught them how to prepare herbs and provide them with dwarfs. They believed that doctors have no right treatment towards breast cancer because according to them they just remove the breasts of womenà and subsequently die. According to the healers they do not promote breastà examinations to their patients because these are useless and cannot stop women from getting the disease. Despite the big machines available in the hospitals, women with breast cancer still die, according to them. Healers charge their patients with as much as à ¢200,000-à ¢1(à £15-60) million depending on the patientsââ¬â¢ condition. The healers admitted that there were cases of recurrence of the disease due to lost to follow up and missed spiritual sessions. Healers do not refer patients to hospitals rather, they encourage hospital doctors to refer their patients to healers because they are more capable of treating breast cancer. Breast cancer consultants.à Medical health professionals play a significant role in the awareness of breast cancer. They have the power to influence their patients toward right management of the disease. In the present study, surgeon/breast cancer consultants were interviewed. Consultants as expected were aware of the increasing incidence of breast cancer but they cannot give an exact figure due to absence of cancer registry in the place however they were able to attend to 200-300 new cases of breast cancer annually with age range starting from 20 years and above. They revealed that women in Ghana associate breast cancer to death because after undergoing breast caner surgery they usually die. People in Ghana link medical intervention and death which made the women in this place afraid ofà the disease and lead them to negative attitude towards the disease. Consultants believed that there were several misconceptions about the disease. They were also aware that healers and herbalist delay theà presentation of patients toà hospital which accounted for the late stage of diagnosis. National Screening Program would benefit the people in Ghana for early detection of breast cancer and prompt treatment, however, they did not deny the fact it would be difficult to establish such program due to lack of funds by the government at present time. Consultants were aware of the limited resources of the needed for the implementation of the program. They believe that it is much easier and feasible to educate the women on simple screening methods such as regular breast self examination and encourage practitioners to take advantage of examining the breasts of their patients. There are also NGOs who are engaged in some activities like providing health care assistance. Consultants revealed that they receive referrals from district regions and from private practitioners. All patients with breast cancer are candidates for surgery. There are just some procedures that lead to untoward incident which cause the people to blame the doctors. According to consultants, one big problem that they encounter is the delay of the result of tissue exam from the pathologists which sometimes lead them to acquire the high cost of private laboratory. According to consultants the 5-year survival rate in Ghan is 25% which is disappointing. According to radiology consultant, patients present themselves to treatment once they are already in advanced stage, most at stage 3 and 4. They revealed the common factors that influence the delay of treatment among Ghana women. Most of the patients were scared of the procedure ofà breast cancer treatment like in breast surgery which have many social and marriage implications. The high cost of the procedure hinders the patient to go to the doctors. Consultants revealed that surgical procedure may costà à ¢2-3millionà (à £ 150-200), radiotherapy is aboutà à ¢3-4 million ( à £ 200-300) and chemotherapy is around à ¢6 million (à £400). Although surgical treatment cost is covered in National Health Insurance, the cost of radiotherapy and chemotherapy are excluded. Mammography which is an effective tool in breast cancer screening costs à ¢400,000 (à £30) in private health institution and around à ¢250,000 (à £20). DISCUSSION WITH REVIEW OF RELATED LITERATURES à à à à à à à à à à à The present study aimed to increase the awareness of the women in Ghana to breast cancer and the benefits that can be gained from breast cancer screening. The knowledge, attitude, behavior and practices of the women regarding early detection of breast cancer were analyzed. The ultimate aim of the study was to reduce the mortality rate ofà breast cancer. à à à à à à à à à à à The study revealed that there were still misconceptions about breast cancer despite the information gathered from televisions and radio programs. Attendance of Ghanaian women in breast clinic did not mean that they were informed of the nature of their disease. Only few of them were also aware of preventive procedure in detecting breast cancer. Local healers and spiritualists also delayed the presentation of the patients to the hospital which contributed to the late diagnosis of the disease. Difference in the disease management of health professionals can be attributed to the location of practice and availability of resources. Several factorsà thought to affect the breast cancer screening program were the poor education of the Ghanaian towards prevention awareness against breast cancer; lack of initiative of the people to spread the knowledge ofà breast cancer screening such as simple breast self examination and clinical breast examination; the inaccessibility of the of primary health care and the organizers; the unavailability of the appropriate screening tools like x-ray and mammography in the community and its high costà and the lack of support from the government. à The followingà review of related literatures will help in the understanding of breast cancer and breast cancer screening. Because of the continuous increasing prevalence of breast cancer and high cost of treatment, breast cancer screening remains the most cost effective way of cancer management (Parkin and Fernandez 2006). à Most of the world faces resource constraints that hinder the capacity to improve early detection, prompt diagnosis and sufficient treatment of the breast cancer. Every country finds its way to develop evidenced based, economically feasible and culturally appropriate guidelines that can be utilized by countries of limited health care resources to improve breast cancer outcomes (Anderson 2006). Adaptive strategies should be applied to ease the growing burden of breast cancer. In 2005, according to Smith and his colleagues (2006), the Breast Health Global Initiative (BHGI) held its second summit in Bethesda, MD with the intention of reaffirming the principle of requiring all women of all resource levels to support in seeking health care and assuring the access to affordable and appropriate diagnostic tests and treatment intervention against breast cancer. They recommended breast health awareness to all women including the basic resources. They enhanced the basic facilities for effective training of relevant staff in clinical breast examination (CBE) or breast self examination and even the feasibility of mammography. MRI: Magnetic resonance imaging is one of the breast cancer screening procedures. It has been increasingly used as tool for early diagnosis of breast cancer. This screening tool has shown to detect cancers even they are small and potentially proven to be more curable than mammography alone. However, MRI is more costly than mammography and can lead to unnecessary breast biopsies, thus causing anxiety and discomfort to patient. On the other hand, a research study about the cost-effectiveness of breast MRI screening by cancer risk where they included the cancer detection ability of MRI, characteristics of women with dense breast tissue and women with high inherited breast cancer risk, revealed mortality reduction and cost effectiveness of breast MRI screening added to mammography in BRCA1 and BRCA2 mutation carriers (Kurian 2006). à The hallmark of morality and morbidity of breast cancer can be attributed to the late presentation of the patients at an advanced stage of breast cancer. It is when there is no or little benefit that can be derived from any treatment modality. In a study conducted by Okobia and colleagues (2006), the knowledge, attitude and practice of community dwellers of Nigeria towards breast cancer were analyzed. They recruited urban-dwelling women with conducted an interviewer-administered questionnaires to elicit sociodemographic information regarding knowledge, attitude and practice towards breast cancer. It was found out that the participants had poor knowledge of breast cancer. Only 214 out of 1000 participants knew that breast cancer is presented initially with breast lumps. Breast cancer examination practices were low. Only 432 participants were able carry out breast self examination while only 91 participants had clinical breast examination. This study revealed that participants with higher level of education were significantly more knowledgeable about breast cancer. Ethnicity or race-related culture and beliefs are factors that affect the increase in prevalence of breast cancer mortality. Paterniti (2006) investigated how ethnically diverse women who are eligible for tamoxifen prophylaxis because of their breast cancer risk decide about tamoxifen use for risk reduction. Prior to the study, there was discussion of the benefits and risks of tamoxifen as prophylaxis. The study which included African-American, White, and Latina women, of 61ââ¬â78 years, revealed that fear of breast cancer was not prominent and they were not inclined to take tamoxifen as preventive therapy after receiving the information. Participants showed limited unwillingness to take the medication with potential adverse effects. This study revealed that women felt that they had other options other than taking the risk of tamoxifen to reduce their risk of breast cancer, including early detection, diet, faith and other alternative therapies. à à à à à à à à à à à Graham (2002) conducted a research aboutà the relationship between beliefs and practice of breast self examination (BSE in a black women population of 20-49 years of age. It was found out that health beliefs were much stronger in determining BSE performance for a given individual than were demographic characteristics. Breast self examination was related to increased perceived seriousness of breast cancer, benefit of the procedure and health motivation and was noted to have inverse relationship with perceived barriers. A related study was reported by Mitchell and colleagues (2002), about the effects of religious beliefs with other variables on breast cancer screening and the intended presentation of self-discovered breast lump. This study included women aging 40 years and above and were interviewed in their homes. Most of the interviewees believed that doctors cure breast cancer with Godââ¬â¢s intervention which was labeled as ââ¬Å"religious intervention with treatmentâ⬠. This dimension was found out to be correlated with self-reported mammography but no clinical breast examination or intention to delay presentation of self-discovered breast lump. Minority of them believed treatment of breast cancer was unnecessary because only God could cure the disease which was labeled as ââ¬Å"religious intervention in place of treatmentâ⬠, and was significantly more common among African-American women whoà are less educated and older. This was correlated with the strong intention of delaying the presentation of self-discovered breast lump. It was concluded thatà religious intervention in place of treatment contributes significantly the delay presentation of breast cancer among African-American that contribute largely to the advanced-stage cancer diagnosis. The cause of breast cancer is still unclear. Adjei (2006) who grew up in Ghan and had some work about breast cancer. In his letter, he revealed his sentiments about the genetic differences in breast cancer. He had been aware of the incidence of breast cancer in Ghana since 1974 to 1999. He noted that the peak incidence of breast cancer in Ghana is in younger women with age range of 40-45 years while in United States and Caucasians, the peak incidence is in older age groups. Adjei (2006) pointed out that women of different places and environments, with different diets have similar epidemiology of breast cancer. In an argument which revealed number of breast cancer in African-Americans but rare in native African has been used to suggest that ethnicity is one factor of acquiring the disease, however, according to Adjei (2006), this information is leading because cancer has not been well-studied in Africa. Researchers are still finding their ways to fully disclose the correlation of genetic signature in breast tumors that are presently notedà to be a powerful predictor of cancer spread and cancer death. In a limited study conducted by Kolata (2002), she included few patients who are relatively. As she stated in her report, scientists said that the activity of a collection of 70 genes appear to predict cancer mortalityà better than traditional measures like tumor size, cancer stage or lymph node spread to the axilla of women. She revealed in her study that 5.5% of women with good genetic signature died within the next decade while 45% of women are those of with bad genetic signatures. Adherence to the treatment regimen of breast cancer plays a big role in the improvement of disease outcome. There are no much literature about the factors associated to the behavior that influence the patient to delay or cause an incomplete adherence to the recommended follow up in patients with breast cancer. In a study conducted by Kaplan (2006), race/ethnicity, country of birth, financial issues fear of pain and difficulty of communicating with the healthcare providers are the barriers to seek follow up consultation Breast Cancer Screening: There was decline in breast cancer mortality rate of 0.9% in African American women while 2.1% was the decline in breast cancer mortality rate in non-Hispanic White women (Stewart et al 2004 as stated by Settersten , Dopp, and Tjoe, (2005). à On the contrary, De Koning (2000), questioned in his study the cost effectiveness of breast cancer screening. His idea came out when he analyzed his expectations of the reduction of breast cancer mortality after breast cancer screening. He stated in his study that the Dutch program of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. As stated in his research paper, the actual benefit that can be achieved from breast cancer screening programs is overstated. According to him breast cancer screening need to be carefully balanced against the burden to women and health care system. De Koning (2000) stated that ââ¬Å"effects of breast cancer screening program depend on many factors such as epidemiology of the disease, the health care system, costs of health care, quality of the screening program and the attendance rateâ⬠. Groot, M. T. et al (2006) estimated the costs and health effects of breast cancer interventions in epidemiologically different regions of Africa, North America and Asia. They developed a mathematical simulation model of breast cancer using the different stages of cancer, its distribution and case fatality rates in the absence and presence of treatment as predictors of survival. The study resulted to a conclusion that untreated patients were the most sensitive to case fatality rates. This study suggest that treating breast cancer at stage 1 and introduction of an extensive breast cancer program are the most cost effective breast cancer interventions. à à This study is supported by the research done by Aylin and colleagues (2005). They recruited women at the mammography clinic to evaluate the knowledge about breast cancer and mammography as breast cancer screening procedure. The striking result of this study is that most of the participants (95.3% of the total participants) were aware that women should have mammography screening periodically. They were informed of the fact that breast cancer screening such as mammography could help in the early detection of breast cancer. However, less than 50% of them admitted that they had never had mammography screening. Majority of the respondents (71.1%) were practicing breast self-examination. Another related study was conducted by Dundar and colleagues (2006), since breast cancer is the second leading cause of cancer deaths in Turkey , they determined the t the knowledge and attitudes of women in a rural area in western Turkey about breast self examination and mammography. They recruited women with age ranging from 20-64 years. Although majority of the participants have heard or read about breast cancer only 56.1% of them had sufficient knowledge about breast cancer and some admitted that they acquired the information from their health care professionals. Those with information of beast cancer were also those who practice breast self examination. This study revealed that health care professionals play a big role in information dissemination about breast cancer. Table 1. Recommendations for routine mammographic screening in North American women aged 40 years or older who are at average risk for breast cancer* Group (date of recommendations) Frequency of screening (yr) Included ages (yr) à à 40-49 50-69 >70 Government-sponsored and private groups US Preventive Services Task Force (2002)** 1-2 Yes Yes Yes*** Canadian Task Force on Preventive Health Care (1998, 1999, 2001) 1-2 No Yes No National Institutes of Health consensus conference (1997) à No+ ââ¬â ââ¬â American Cancer Society (1997) 1 Yes Yes Yes National Cancer Institute (2002) 1-2 Yes Yes Yes Medical societies American College of Obstetricians and Gynecologists (2000) 1-2 if aged 40-49 yr 1 if aged >50 yr Yes Yes Yes American Medical Association (1999) 1 Yes Yes Yes American College of Radiology (1998) 1 Yes Yes Yes American College of Preventive Medicine (1996) 1-2 No|| Yes Yes American Academy of Family Physicians (2001) 1-2 No+|| Yes No American Geriatrics Society (1999) 1-2 ââ¬â ââ¬â Yes*** Advocacy groups National Breast Cancer Coalition (2000) à No ââ¬â+ No National Alliance of Breast Cancer Organizations (2002) 1 Yes Yes Yes Susan B. Komen Foundation (2002) 1 Yes Yes Yes The above tableà was taken from the study conducted by Barton (2005) There are several ways presented and studied for breast cancer screening. Its concern is to reduce the prevalence of cancer mortality and to improve the quality of life as a result of early detection, however, there are still people that are not aware of breast cancer screening In response to increase the worldwide awareness of breast cancer, breast cancer advocacy movement has been analyzing the common experiences of women with breast cancer around the world especially those with limited resources. They found out that although there are language barriers, sentiments were consistent across cultures; cancer survivors have the same experiences and fears. The beliefs and taboos about breast cancer hinder the awareness programs and treatment. There are also limited resources for public education and awareness. Difficulty in understanding and translating the concept of the disease into English also hinders them in the public awareness of breast cancer (Errico and Rowden 2006). In accordance with this, sociological review of the barriers experienced by the women from different traditional cultures is essential not just to understand patterns of late breast cancer diagnosis but also the importance of interventions and programs. This is necessary for them to understand the preventive health care, specifically in breast cancer. This is because many are still ignorant of the breast cancer. According to Remennick (2006), health care providers and policymakers should try to understand and influence women especially those who are cancer risk to be aware of the disease to detect and treat breast cancer early. There are many structural barriers that hinder women especially those living in rural areas. Socioeconomic factors include poor health insurance, distance to medical facilities and inability to take time off work. Organizational barriers include difficulty in navigating complex health care systems and interacting with medical staff. Psychological and sociocultural barriers are poor health motivation, denial of personal risk, fatalism mistrust of cancer treatments and fear of becoming a burden on the family members. Still in other cultural behavior, especially in Muslims, women are strongly controlled by men and therefore may prohibit women in breast cancer screening. Remennick (2006) includes in his study the different approaches that lower the mentioned barriers, including implementation of uplifting the educational programs that would enlighten people regarding cancer myths and fallacies. He suggests that health care professional must outreach to their co ethnics. Primary health care providers play a critical role inà determining the compliance with treatment and preventive practices through direct recommendations to their patients. Family physicians and general internists showed that 70% of women who received a provider referral completed a screening mammography within one year versus only 18% of self-referred women (Gradyà et al 1997 as stated by Santora 2003). However, Over 90% of rural women report that a doctorââ¬â¢s recommendation to have breast cancer screening is ââ¬Å"importantâ⬠(Sparks et al 1996 as stated by Santora 2003). It should be noted that clinician compliance is contributed by several factors such as relation with provider, guideline of the treatment, patientââ¬â¢s behavior and environmental factors. Several studies have been conducted to report theà differences of health services in rural, urban and suburban areas with regards to theirà health care services in the family practice clinics. It has been pointed out that lower utilization has been a significant factor. Those rural health practitioners have less access to health care services.à In a study done byà Pol and his colleagues (2001), suggested that rural health services do not lag for patients with access after revealing that 9 out of 16 services examined were as high or higher in rural areas. Another à study to examine the variations in breast cancer screening among primary care clinicians by geographic location ofà clinical practice was done by Santora (2003). Physicians, nurse practitioners and physician assistants were included in the study and were classified into urban, rural and suburban categories based upon practice location. The study revealed that although there was no significant difference in the practice location, there was evident variation in the practice ofà breast screening. It was reported that urban and suburban health practitioners were less compliant with the use of breast cancer guidelines as compared to clinicians in rural areas.à Primary care clinicians, including physicians, nurse practitioners and physicianââ¬â¢s assistants lack a consistent. This study revealedà that geographical location is not the main factor of inconsistent medical approach to breast cancer screening. Although the difference in the approaches to the procedure is uncertain in this study. A related study about General Practitionersââ¬â¢ (GPââ¬â¢s) knowledge, beliefs and attitudes toward breast screening, and their association with practice based-organizations of breast cancer screening, was conducted by Bekker, Morrisona and Marteau (1999). This study revealed that womenââ¬â¢s attendance for breast cancer screening may be increased due to raising GPââ¬â¢s perceptions of theà threat of breast cancer. General practitioners addressed their concerns about the procedure and enhanced their views on the importance of primary health care in breast cancer screening programs. REFERENCE Adjei, A. A., 2006, ââ¬Å"A final word about genetic differencesâ⬠, American Association for Cancer Research, Available at http://www.aacr.org/page4444.aspx. American Cancer Society 2005, Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_What_is_breast_cancer_5.asp Anderson, B. O. et al, 2006, ââ¬Å"BREAST HEALTH GLOBAL INITIATIVE Breast Cancer in Limited-Resource Countries: An Overview of the Breast Health Global Initiative 2005 Guidelinesâ⬠, The Breast Journal, vol 12 no. 1, pp. S3ââ¬âS15. 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S. and Gupta, R. 2003, ââ¬Å"Predictors of Screening for Breast and Colorectal Cancer among Middle-aged Womenâ⬠, Family Medicine Journal, vol 35 no 5, pp. 349-354 â⬠Weight Gain a Big Factor in Postmenopausal Breast Cancerâ⬠, 2006, Journal of the American Medical Association, Available at http://www.aphroditewomenshealth.com/news/20060612001144_health_news.shtml Yip, C. H. et al, 2006, ââ¬Å"BREAST HEALTH GLOBAL INITIATIVE: Breast Cancer in Limited-Resource Countries: Health Care Systems and Public Policyâ⬠, The Breast Journal, vol 12 no. 1, pp. S54ââ¬âS69.
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