Clinical epidemiology 2 Assignment Example | Topics and Well Written Essays - 1750 words

Clinical epidemiology 2 - Assignment Example Breast cancer cells may be hormone-dependent while some can lie dormant in tissues for a very long time, as long as thirty years, after removal of the primary tumor (Lipkus et al, 2001). Some illnesses may act as catalysts in the progression of the disease in the body (Gail & Rimer, 1998). Consequently, this implies that even with earlier detection and treatment, there can be a risk of recurrence during the entire life of the patient. However, with early screening, it is possible to detect these cells before they start causing symptoms (Schonberg   et al, 2014; Siegel et al, 2012). Once the disease symptoms start showing, the tumors are mostly larger and will have likely spread to other parts beyond the breast. In contrast, breast cancer cells found earlier through screening are likely smaller and their presence is still limited to the breasts thus their spread is much easier to curtail, for example, through prophylactic surgery (Freedman, 2010; Nelson,  2012). At the point of detection, it is easier to estimate the prognosis of breast cancer. The size of the tumor and how far it has spread are vital indicators of predicting prognosis and are almost entirely dependent on the time of detection of the cancer (Siegel et al, 2012). Screening enables detection of the disease in early stages and hence it is possible to reverse the spread of the disease. Consequently, screening improves survival rates among breast cancer patients. The proportion of the population affected by breast cancer is a pointer to the importance of screening the at-risk population. According to studies, breast cancer is the most common form of cancer and causes the second highest number of deaths in the US (Smith et al, 2013). Health statistics indicate that out of every 8 women, one will develop a severe form of breast cancer over the course of her lifetime. In 2014 alone, close to quarter million cases of new breast cancer cases were expected to

Anselm's Proslogion, Chapter II--The Ontological Proof of God Essay

Anselm's Proslogion, Chapter II--The Ontological Proof of God - Essay Example However, to maintain the position, the atheist would have to add another attribute, that of â€Å"existing in reality,† to supposedly make it the â€Å"greatest possible being†. It is just as if someone had claimed 7 to be the â€Å"largest possible number†; you could always add a number to make it greater. And when an atheist does add the attribute of existence, then he is no longer an atheist. This is a brief summary of the ontological argument. The immediate response this argument received was from Gaunilo of Marmoutiers, a Benedictine monk, who predictably flipped the tables and applied the same set of arguments to prove the existence of the Lost Island, in order to demonstrate how the argument is fundamentally flawed. However, the argument was critiqued on the grounds that the very concept of â€Å"the greatest conceivable being† does not apply to Islands, or any objects as such, and that it applies to God alone. One of the popular criticisms of St. Anselm’s argument is theological, proposed by St. Thomas Aquinas in Summa Theologica, who questioned the soundness of the initial premise of Anselm’s argument, stating one cannot possibly know the essence of God; ergo it is beyond humanly possible to adequately consider that premise. He also strikes a major blow to the first premise, pointing out that not everyone necessarily conceives God to be the ‘greatest possible being’, seeing that some have believed God to be a body. The criticism leveled by St. Thomas Aquinas was so strong, that it was said to have laid the argument dormant for centuries. David Hume also leveled a criticism against cosmological argument in his work Dialogues Concerning Natural Religion, which broadly applies to the Ontological Argument as well. Hume stated that existence of something cannott be established based on a priori reasoning. And whatever we

The relationship between a Toucans beak and new materials Essay

The relationship between a Toucans beak and new materials - Essay Example An example of such natural inspirations is the toucan’s beak. This is a great natural phenomenon that has attracted much attention from material engineers as they try to study its properties and understand the factors behind its unique features. The toucan’s beak is long and thick, and is perceived to be heavy for the bird though it is relatively light despite its size (Seki, Kad Benson & Meyers, 2006). The toucan’s beak is a third of the bird’s length, about 1/20 it’s mass, and has been proven to possess great stiffness (Seki, Schneider & Meyers, 2005). A study of the bird’s beak found it to be made of a sandwich composite with keratin on its outside and close calcium cells rich proteins making a fibrous network (Seki, Schneider & Meyers, 2005). Moreover, the closed cell making the bird’s beak has fibers with a young modulus of more than twice as high as the keratin shell on the outside due to the calcium content. Therefore, such biological materials when well-studied inspires engineers to come up with materials that correspond to the beak, which incidentally would offer similar characteristics and qualities in engineering materials , resulting to superior materials for specific us age. For example the length of a toucan’s beak and its size in relation to its light weight inspire engineers to come up with martials with a keratin coating on the outside, fibrous networks on the inside, plus an added calcium layer to achieve the strength and flexibility portrayed by a toucan bird, but still meet the need to have such a large component with light weight. In the construction industry where flexible materials are essential, such toucan’s beak offers a great inspiration for engineers to come up with similar materials, which will offer more flexibility, will be much light compared to its size, will possess great strength, and which will absorb high impacts (Biomimicry Institute 2013). Such materials

Marthas Vineyard Essay Example for Free

Marthas Vineyard Essay Abstract I chose Martha’s Vineyard as the subject of my School Context Paper. Martha’s Vineyard is New England’s largest resort island and lies seven miles off the coast of Cape Cod in the Commonwealth of Massachusetts. It is accessible by ferry or plane only. The island is roughly one hundred square miles with 124.6 miles of tidal shoreline. Martha’s Vineyard has a year-round population of about twenty thousand residents that grows to one hundred thousand in the summer with an additional twenty five thousand visitors coming and going on the ferries every day. There are six towns that makeup the island; Aquinnah, Chilmark, Edgartown, Oak Bluffs, West Tisbury and Vineyard Haven (also known as Tisbury). The island is best known for its miles of beautiful beaches, quaint villages and natural beauty. On the vineyard there is only one regional high school which offers a vocational program for its students along with five public elementary schools, one public charter school, several private pre- schools and an active home schooling network. The school system also provides for children with special needs from ages three to twenty two. Assignment 2: School Context Paper I chose Chilmark, a village located on Martha’s Vineyard to write my paper on. Martha’s Vineyard is located about seven miles off the coast of Cape Cod. It is a triangular shaped island that is nine miles wide and twenty three miles long with a total land area of approximately one hundred square miles and 124.6 miles of tidal shoreline. You can travel by ferry to reach the island, which takes about forty five minutes from the mainland, or you can take a plane that will fly you to the only airport on the island located in its center. It is New England’s largest resort island. There are six towns (or villages) on the island; Aquinnah, Chilmark, Edgar Town, Oak Bluff, West Tisbury and Vineyard Haven. There is one regional high school, one public charter school and five public elementary schools serving the Vineyard. These are administered through the office of the Superintendent of Schools. The All-Island School Committee is composed of members from all of the towns. The Up-Island Regional District committee hires the superintendent and oversees shared programs that serve all Island schools. These resources are available through Central Administration: Superintendent of Schools, Assistant Supt. for Curriculum Instruction, Director of Student Support Services, Assistant to the Superintendent for Business Affairs, Financial Administrative Assistants, Administrative Secretary, Business Secretaries, Treasurer, Grant Administrator, Receptionist/Clerk and Special Education Secretary. Special Services are available such as: Title 1 Coordinator, Early Childhood Coordinator/Consultant, Occupational Therapists, School Psychologists, Speech Pathologists, Autism Specialist and ELL Director. Chapter 766 provides for the educational needs of children with special needs. The school system provides for every child, regardless of handicap, between the ages of 3 and 22. The law requires parental involvement and a network of services including that of a school psychologist, occupational therapist, and psychiatric and nursing services under the direction of a special education administrator. The school system also operates a special needs preschool, called Project Headway (http://www.mvy.com/Vineyard_Community/Public_School.aspx August 2012). I chose Chilmark’s school system and the Up-island Regional District as my area of focus. The Population of Chilmark was eight hundred and ninety four as of July 2009 with the estimated median household income of fifty seven thousand, one hundred and eight dollars. The major business of Chilmark is construction with Carpentry being the most popular occupation. The Chilmark School serves students in grades K-5. Chilmark students in grades 6-8 attend the West Tisbury School and Martha’s Vineyard Regional High School serves grades 9-12 for the whole island. Students can also apply to The Vineyard Public Charter School. The enrollment indicators for these schools are as follows; Chilmark Elementary School enrolled fifty two students, W. Tisbury enrolled three hundred and twenty five students for grades pre k thru 8, Martha’s Vineyard Regional High School enrolled six hundred and sixty nine students and The Vineyard Public Charter School enrolled one hundred and eighty one students for the 2011-2012 school year. Chilmark’s Public Elementary/Middle School Mission Statement states that,  Ã¢â‚¬Å"Chilmark Elementary School is committed to equipping students with the tools they need for academic, personal and social achievement. Chilmark Elementary School enables every student to reach their highest potential by establishing a curriculum that meets or exceeds government standards for education; providing extracurricular programs that develop children’s’ mental, physical and social skills; and partnering with parents and the community to create an environment geared to the success of all students†( http://massachusetts.webschoolpro.com/chilmark-elementary-school_MA00707740010/mission.htmlAugust 2012). West Tisbury’s School Mission Statement states that â€Å"The West Tisbury School staff strives to provide a solid academic foundation, to inspire a love of learning for the sake of learning, to foster an understanding of basic human values with a working knowledge of the rights and responsibilities associated with those values, and to promote independent thinking through cooperative and inclusive learning while maintaining the unique values of our diverse, rural island community. We strive: To teach solid academic skills, to instill a love of learning and to promote an understanding of human values† (http://wtisburyschool.org/modules/cms/pages.phtml?pageid=225325SID August 2012). Martha’s Vineyard Regional High School’s Mission Statement states that â€Å"Martha’s Vineyard Regional High School will provide a safe, active teaching and learning environment where students strive for academic excellence and endeavor to achieve the high level of intellectual and interpersonal skills needed for success in a culturally diverse society. Each student’s educational experience will prepare him/her to be a self-confident lifelong learner, able to set and achieve individual goals, and to become a contributing member of a humane and democratic society (http://www.mvrhs.org/pos/POS-2011-2-Eng.pdf1August 2012). The Martha’s Vineyard Public Charter School is a K-12 public school. Families do not pay tuition. An application is filled out and then the student body is drawn from a lottery. The mission statement of the Martha’s Vineyard Public Charter School states that â€Å"It is the mission of The Martha’s Vineyard Public Carter School to create a public school that will  cultivate life-long learners in a multi-aged, project-based setting. To this  end, each student in the K-12 school works from a personal education plan that sets specific obtainable and challenging goals. In addition to meeting the state mandated curriculum frameworks, students experience a rich array of other educational arenas outside of the academic classroom. The entire Island serves as campus where an educational alliance of parents, educators, businesses, artisans and community services is formed† (http://www.mvy.com/Vineyard_Community/Marthas_Vineyard_Public_Charter_School.aspx August 2012). The chart below shows some of the MCAS ratings for the school year 2010-2011: Massachusetts Elementary School Rankings 3rd, 4th Grades Combined MCAS English Language Arts MCAS Mathematics 2010-2011 Rank* (of 895) School District City Tisbury Elementary Tisbury Vineyard Haven HighGrade Total students (2010) Student/ Teacher Ratio (2010) MCAS, avg Mathematics** (2011) 8 305 8.2 88.5 MCAS, avg English Language Arts** (2011) MCAS Combined Rank Change from 2011) 86.5 175.0 up 23 School District City W. Tisbury ElementaryUp island Regional West Tisbury HighGrade Total students (2010) Student/ Teacher Ratio (2010) MCAS, avg Mathematics** (2011) 8 276 7.8 79.5 MCAS, avg English Language Arts** (2011 MCAS Combined Rank Change from 2010 82.0 165.9 down 19 (http://www.schooldigger.com/go/MA/schoolrank.aspx August 2012 Reference List http://www.mvy.com/Vineyard_Community/Town_Information.aspx http://www.mvy.com/Vineyard_Community/Public_Schools.aspx http://www.mvy.com/Vineyard_Community/Education.aspx http://www.mvrhs.org/pos/POS-2011-2-Eng.pdf http://profiles.doe.mass.edu/state_report/enrollmentbygrade.aspx http://www.city –data.cim/city/Chilmark-Massachusetts.html http://massachusetts.webschoolpro.com/chilmark-elementary-school_MA00707740010/mission.html http://profiles.doe.mass.edu/mcas/performance_level.aspx?linkid=32orgcode=07740010orgtypecode=6 http://www.schooldigger.com/go/MA/schoolrank.aspx http://wtisburyschool.org/modules/cms/pages.phtml?pageid=225325SID http://www.mvy.com/Vineyard_Community/Marthas_Vineyard_Public_Charter_School.aspx

Organizational Structure And The Relationship To The Mission

Organizational Structure And The Relationship To The Mission Nowadays, with the increase of living quality, more high standard health organizations or facilities are required to meet the population demand of health care. According to the change of the plan of New South Wales Health, the Childrens hospital at Westmead (CHW) determines future developmental direction and formulates its own strategies, vision and mission (The Childrens Hospital at Westmead 2007). In a word, the CHW sticks to respect both children and their families in spite of the change of hospital strategies, mission and vision (The Childrens Hospital at Westmead 2008). Actually, the organizational structure of hospital has relevant relationship that can not be neglected and obliterated with mission and vision. Thus, it is considered that the establishment of hospital structure can help to complete the mission and vision that are designed by organization (University of Western Sydney 2009); meanwhile, mission and vision can impact the hospital structure that is set up (Madden et al. 2006). The purpose of this article is to critically analyse the structure, mission, vision and goals of the CWH, and analyse interaction between organizational structure and mission or vision. Initially, according to the Childrens Hospital at Westmead (2008), the CHW adopts line structure to administer the whole operation of hospital. The mission, vision and goals impacts organizational structure of CHW designed; meanwhile, the aim of the structure is to complete the mission, vision and goals (University of Western Sydney 2010). For instance, workforce development which is involved in organizational structure is designed to offer high skill practitioners of tertiary and quaternary care (CHW annual report 2008), so that it can meet the demand of mission to complete the promise of hospital. The relationship between clinical operations and department of nursing shows the influence of mission statement which mentions to set up good consociation. In addition, it can be seen from the organizational chart (The Childrens Hospital at Westmead 2008) that there are many departments found for economics, treatment, health care and training and education. All of them established a susta inable foundation for the achievement of hospital vision, which shows that healthy children for healthy future (The Childrens Hospital at Westmead 2008). At last, the CHW goals direct the development of finance, emergency, health care and other services; it also requires the high quality of staffs. Secondly, line structure has both negative and positive impacts on the development of hospital. Admittedly, the line structure of CHW is clear and simple. It shows the clear relationship between each department. Moreover, the organizational chart shows distinct superior-subordinate relationship. For example, according to the organizational chart, clinical operation directly administers allied health, diagnostics, medical, critical care and emergency services; at the same time, clinical operation hands in summary of annual work and feedback from lower levels to the highest level named chief executive(The Childrens Health at Westmead 2008). Another advantage of CHW structure is that not only one authority to judge all things. It is shown by the Childrens Hospital at Westmead (2008) that internal audit has right to supervise the action of chief executive. Even so, there are also some disadvantages of this line structure. Less communication of parallel departments which may decrease the quality of health service is demonstrated obviously. For instance, it is hypothesised that one child is sent immediately into critical care because of emergency situation, but he has renal disease that has not been checked out. If there is no contact with medical and critical care, this child would have life risk. What is worse, sometimes, highest authority can not receive the feedback immediately or receive untruthful information due to the incautiously negligence or deliberately concealing of middle or lower departments (Marquis Huston 2009). Therefore, the problems of line structure will result in medical issues and descend the health care level of children. Thirdly, according to the CHW goals (The Childrens Hospital at Westmead 2008), one main line of authority and responsibility is combined by finance and corporate services, community relations and marketing and information services and planning. It is believed that excellent staffs are an important foundation of the high quality health care. It is considered that appropriate incentives can retain the health professionals in different environment, especially in rural and remote areas (Dassault and Franceschini 2006). In addition, high standard of meals and accommodation promote the health care condition. Internet service can help families to solve problems at home; as well as, it can help to book the services, which saves time if it is not emergency problem but some small health issue. Furthermore, fundraising from companies or individuals creates equal chance for every child to accept treatment. It is shown by The Childrens Hospital at Westmead (2008), clinical operation and its subor dinate departments combined into another main line push hospital to realize the goals. For example, hospital strengthens the infrastructures (such as advanced equipments) of emergency services, so that patients can accept efficient cure in time. The increase of whole level of clinical services improves the clinical safety and helps to practice good quality health care. Moreover, some parts of the CHW structure can help to achieve the hospital mission to a certain extent. For example, Allied health in the structure provides the service to meet the requirement of chronic and complex care which is mentioned in hospital mission (The Childrens Hospital at Westmead 2008). There is a relationship between clinical operation and nursing. Nurses and clinical staffs keep in touch and share working experience with each other to establish good partnership described in mission (The Childrens Hospital at Westmead 2008). Nurses also can express the requirement or complain of patients to clinical practitioners, so that hospital could ensure the profits of children. Whats more, training and education bring up professionals to keep the high quality services. Admittedly, the organizational structure helps to reach the goals. For instance, internet service provides a link to save time of patients or their families to book services. Allied health service offer various h ealth services to detective health issues in the early stage of children. Finally, some aspects of the CHW structure could assist the development of hospital and solve some problems. It has been mentioned that there is an internal audit existing with chief executive, so it enhances hospitals monitoring, which may avoid the appearance of bureaucracy to a certain degree (Withey Gellatly 2007). The good cohesion and cooperation between different services can make sure the high quality health service and medical safety of patient. One exact situation is that nurses and clinical operations have built a good relationship, which could be useful to operate clinically and solve problems such as conflict between patients and doctors (The Childrens Hospital at Westmead 2008). However, some aspects of this structure also can have negative impacts on the development of hospital and the solution of problems. In spite of the relationship between nursing and clinical operations, it is not enough partnerships for the hospital to promote its health care quality. For exampl e, the lack of linkage between the department of workforce development and clinical operations is one important issue. It is stressed that the method of training workforce is changing with the change of clinical demand (Withey Gellatly 2007). As a result, the lacking communication between these two departments may lead to the waste of resources including human resources and material resources. Thus, to sum up, the line structure of the CHW is designed to reach the hospital mission, vision and goals; meanwhile, organizational structure is impacted by mission, vision and goals. Moreover, line structure has both merits and demerits in supply of health care services. In addition, there are two main lines of authority and responsibility which boost the completeness of hospital goals. Furthermore, some functions of hospital structure are useful for hospital to achieve its mission and goals. At last, the aspects of line structure both assist and descend the development of the CHW. Consequently, mission, vision and goals impact the establishment of organizational structure; and organizational structure can help to achieve them. It is recommended that the hospital should change the settled mode of line structure into the informal mode that is more flexible; and hospital might increase the chances of lateral communication as vertical communication (University of Western Sydney 2010) .

Essay on Male Prejudices in Susan Glaspells Trifles :: Trifles Essays

Male Prejudices in Trifles Susan Glaspell's Trifles explores male-female relationships through the murder investigation of the character of Mr. Wright. The play takes place in Wright's country farmhouse as the men of the play, the county attorney, the sheriff, and Mr. Hale, search for evidence as to the identity and, most importantly, the motive of the murderer. However, the clues which would lead them to such are never found by the men. Instead it is their female counterparts who discover the evidence needed, and who are able to do so because of their gender. The male investigators need to find, as Mrs. Peters puts it, "'a motive; something to show anger, or--sudden feeling'" (357). Yet the men never see the uneven sewing on a quilt Minnie Wright was working on before the murder. The quilt is a symbol of Minnie's agitation--her anger. The men, though, laugh at the women's wonderings about the quilt. To them it is of little importance. Likewise, the bird and its cage are easily dismissed. In fact, the men just as easily believe a lie about this bird and cage. When the cage is noticed, its broken door overlooked, the county attorney asks, "'Has the bird flown?'" Mrs. Peters replies that the "'cat got it'" (360). There is actually no such cat, but the men do not know that and never question the existence of it. The bird, however, is vital to the case. Mr. Wright killed the bird, Minnie's bird, which may have provoked her to then kill him. In addition, the strangling of Mr. Wright, a form of murder which perplexes all when a gun was handy, is reminiscent of the strangling of that bird. It is another answer to the men's questions, but an answer they never find. The women, on the other hand, take note of all they see. They notice not only the bird, the cage, and the quilt but other things that the men call "trifles," like Minnie's frozen preserves and her request for her apron and shawl. These women are united, it seems, not only as country wives or as neighbors but on the basic level of womanhood. This is apparent from the start of the play. Mrs. Hale and Mrs. Peters "stand close together near the door," emotionally bonded throughout the play and, here, physically, in a way, too. Mrs.

Chaucer’s Humor

Chaucer has been acclaimed as the first realist, the first humorist, the first narrative artist, the first great character-painter, and the first great metrical artist in English literature. But it is powerful and ubiquitous presence of Chaucer’s humour that makes him distinct among others writers and poets of English Literature hitherto. Chaucer perpetually observes or perceives the humorous side of any facade of human life. His humor is not constrained to his emotions but it encircles all of his interests, his beliefs, his whole being and his everything.If he manifests his knowledge and information about a wide variety of things, he also mocks, creates caricatures, parodies with the help of same knowledge. It seems that manifestation of knowledge in this way, he tries to relieve himself. For example, he shows his interest in astronomy and manifests its knowledge here and there in Canterbury Tales; he also utilizes his extensive and intensive knowledge of astrology as satiric al and mocking frequently. He has an unparalleled sense of humor.The main reason for this outstanding achievement is that his use of humor has an outstanding multiplicity and variety. Unlike most humorists, he does employ the tone of hyperbole and fantasy. He concentrates on the traits and aims at providing the real mirror images. Additionally, his least-cynical observation of realities of life and traits of human beings enables him to produced unparalleled humor. When this effort mingles with his in-depth knowledge of things and his witticism, humorist effect is created.He achieves humor through a variety of elements including plot, characterization, language, pace, and timing,. Fir example in ‘The Merchants Tale’, he does juxtaposes genre of courtly love and religion against each other and mocks them. Different precepts of courtly love are satirized by characterization and are undermined to an extent by effective utilization of images, descriptions and tone that it se ems comical and illogical.So there is no reason to deny the fact that a great deal of liveliness and reality in Chaucer’s poetry is due to his all-pervasive humor and he is unsurpassable in this art of creating humorous sketches and verbal renderings that represent a probably every facet of the contemporary life. Kemp Malone and Albert Croll Baugh observation that ‘Chaucer is sometimes denied the rank of a great poet, on the ground that he lacked higher seriousness, that his poetry is without great themes nobly conceived’ is true to some extent but not utterly.The assumption that his poetry is devoid of great themes is based on misconception. His major contribution towards the content of poetry is in his advocacy of and strict adherence to realism. His Canterbury Tales embodies a new effort in the history of literature, as it strictly deals with real men, manners, and life. He realized, to adopt Pope’s famous couplet (with a little change): Know then thyse lf: presume not dreams to scan, The proper study of mankind is man. And the product of this realization was The Canterbury Tales.This poem, as it were, holds a mirror to the life of Chaucer’s age and shows it manners and morals completely, â€Å"not in fragments†. Chaucer replaces effectively the shadowy delineations of the old romantic and allegorical school with the vivid and pulsating pictures of contemporary life. ( Brewer, 1978) Chaucer’s tone as a poet is wonderfully instinct with geniality, tolerance, humor, and freshness which are absent from that of his contemporaries and predecessors who are too dreamy or too serious to be interesting. References Brewer, Derek. Chaucer and his world. New York: Dodd, Mead, 1978.