The Concern of National Debt :: Argumentative Economy Economics Papers

The Concern of National DebtThe National Debt is large, and should be a major concern to the economy. and a even bigger concernis how our Government plans to balance the budget andpay off the Federal Deficit.I am not in kick upstairs of passing the National Debt on tofuture generations, nor am I in favor of passing theRepublicans Budget Plan either.The Republicans wantto sharply cut spending for Medicareand Medicaid health benefits for elderly and poor Americans in order to balance the budget by 2002 - while also providing $240 billion in tax cuts.I am in favor of balancing the budget but through manydifferent routes. 1) cut Social Security but haveAmericans set-up tax free IRAs for their future. 2) desex a politicians job not so glamourous. A mere $35,000 dollars per year and a suitable benefits planlike the majority of Americans have would be fine. perchance not so many greedy, power hungry indvidualswould want the job to make them richer and usthe American workers poorer. M aybe just maybe an average American would take the job to help the overall benefit of America as a whole and not justworry what is in it for them. 3) Cut several(prenominal) of theentitlements programs, but let the American peopledecide where to cut. The Government should haveon-line voting, so our voices are heard.The Republicans package is a tax cut for the rich, itsmuch more a tax cut for the middle class -- and a baddeal for the working poor. But I do understand, no matter where the cuts go, or who they hurt more, thedollars must come out.Take the dollars away from the rich and the greedy politicians who want more and more each year for their let benefit Most of these politicians areset for life with their million dollar benefits

The Sick Role and Application in the Nursing Practice :: Nursing Essays

IntroductionThe processes of life were being born, growing old, having illness, and death. In our life, we suffered from diametric sickness. It was a good reason for the off from school, work or other daily working activities. However, in the view of a sociologist, the people who were in the sick role, they were regarded as having committed a aversion and it was treated as deviant behavior (Peter & Meredith, 1998). In the structural functional model, people took various tasks and role in society or in different institutions. These were dependable with the structures and norms of the society. Did sickness have any effective elements in society? This paper would describe the concept of sick role and the application in the nursing practice (Parson, 1979). Concept of sick roleTalcott Parsons (1902 1979) was a famous American sociologist and a structural functionalist. He developed a general theoretical schema for analyzing the society. In his theoretical system, people hold their status and perform their role in the society, which was called social role. In his concept, the social roles were expected behaviors (including rights and obligations) of everyone with a given prepare in society (Diligio, 2005). This kind of social role maintained the structural and functional status of the society. I used Mr. Lee as an example to illustrate about the social roles. Mr. Lee was a registered nurse. He lived with his wife and his daughter. According to the Parsonss theoretical system, Mr. Lee has three social roles. At hospital, he took a role as a nurse. He vexationd his patients. At home, he took a role as husband to his wife and a role as spawn to his daughter.The sick role was first defined by Talcott Parsons (1951) in his seminal work which was describing a set of behaviors. These behaviors were associated with people who became acutely ill. As described by Parsons, the sick role was a process in which an individual experiences a change in ro le identity or role expectations. As a result, people were suffered from the illness. Base of the Parsons, there were some components in the sick role. Firstly, the illness was involuntary. Secondly, residents of the sick role were exempted from their usual work family, civic and permits to be take care of by health care professionals and others.

Duffy Little Red Cap poem :: Free Essay Writer

Duffy Little rose-cheeked Cap verse formIn Little Red Cap discuss the use of imagery, syntax and structure.PlanIntroduction to the collection of poemsSimilarities and differences between this poem and original fairytaleImagery how has Duffy employ the words used to stool pictures in the readers head?Syntax word order. Why has she written sentences the way she has? Emphasis on a particular word. social system length of stanzasLittle Red Cap is written by Carol Ann Duffy found in a collection of poems called The worlds wife, where she has devoted a voice to the women (fantasy characters and real people) who have generally been silent or their thoughts made clear through the voices of their husbands or partners.Firstly, the title of the poem grabs your attention and reminds you of Red Riding Hood, a childrens story. This is clever, as it sets the readers mind to thinking about the story, which means that the reader can plug into all of the similarities in the poem to the chil drens story, for example What big eyes he had What teethThe poem Little red cap is among others where Duffy has based this poem on a fairytale story, in this case, little red riding hood. However, this poem has a few differences to the original version of the story. For example, this poem uses imagery to create a very sexual feeling, where as the original fairytale was not in any way sexual, but had a more simplistic nous of good little red riding hood and bad the sly wolf.The wolf in this poem is portrayed to the reader as a good character, and Little Red Cap as the sly one who appears to know what she is doing in order to get what she wants.In the first stanza of the poem, Duffy starts off with the fable At childhoods end. This portrays that childhood is so powerful it has been described as a physical property. The reader can picture this place clearly because of they way she has continued to describe the houses petered out into playing fields till you came at last to the edg e of the woods. This makes the reader think that she is no longer an innocent child, she is independent and is now an adult. However, we find out in the second stanza that she is still only sweet sixteen which makes us wonder if she is real as grown-up as we first thought.

James A. Naismith: Creator of Basketball :: Biography

Millions of players of basket eggs which was created by one man by the name of Dr. James A. Naismith. James Naismith was born around the 1860s. James Naismith created the biz of hoops in 1891. Dr. James A. Naismith was truly influential to the sports world through the institution of basketball, building Kansas University basketball tradition, and changing lives of millions of people through the game of basketball. onward the game of basketball James Naismith was truly influential to the sports world. According to James A. Naismith as a young man, Naismith studied Theology and excelled in various sports. Naismith was ever drawn to holiness because he k newfangled he wanted to help early(a)s, but his lifes mission became clear to him one day during a football game a football spouse began cursing after a blown play, but then stopped and apologized to Naismith, who was know for his morals. Naismith realized that there might be other ways of doing well up besides preaching and got the idea that he could practice his ministry through sports (1). James Naismith was always thought of as a man known for his morals. According to an obligate entitled James A. Naismith, Naismith also is credited with inventing the helmet for football players. Which gives better safety to football players(1). The football helmet is truly beneficial to football and sports world. The creation of basketball and sooner the creation of basketball was truly influential to the sports world. basketball game has a huge impact on the sports world. Naismith began to think about a new game that could be played indoors during the winter. In two weeks, hed come up with the basic concepts that would define the game basket ball to discourage tackling, players would not be able to run with the ball, but made the game of basketball would was made to pass it the players would have to loft the ball kinda of shoot it. In 1891, Naismith was appointed an instructor by Luther Halsey Gulick, Jr. Head of Physical Education at Springfield. Naismith put sports together such as soccer, American Football, Field hockey game and other sports. Naismith created the game of basket ball for players to play during football and baseball. The game started with two peach baskets, a soccer ball and 13 rules.(Original Rules of Basketball 1) Rains and carpenter said Naismith loved the idea that a minimum of a basketball, a basket, and a place to play (52).James A. Naismith Creator of Basketball BiographyMillions of players of basketball which was created by one man by the name of Dr. James A. Naismith. James Naismith was born around the 1860s. James Naismith created the game of basketball in 1891. Dr. James A. Naismith was truly influential to the sports world through the creation of basketball, building Kansas University basketball tradition, and changing lives of millions of people through the game of basketball.Before the game of basketball James Naismith was truly influential to the sports world. According to James A. Naismith as a young man, Naismith studied Theology and excelled in various sports. Naismith was always drawn to religion because he knew he wanted to help others, but his lifes mission became clear to him one day during a football game a football teammate began cursing after a blown play, but then stopped and apologized to Naismith, who was known for his morals. Naismith realized that there might be other ways of doing well besides preaching and got the idea that he could practice his ministry through sports (1). James Naismith was always thought of as a man known for his morals. According to an article entitled James A. Naismith, Naismith also is credited with inventing the helmet for football players. Which gives better safety to football players(1). The football helmet is truly beneficial to football and sports world. The creation of basketball and before the creation of basketball was truly influential to the sports world.Basketball has a huge impa ct on the sports world. Naismith began to think about a new game that could be played indoors during the winter. In two weeks, hed come up with the basic concepts that would define the game basket ball to discourage tackling, players would not be able to run with the ball, but made the game of basketball would was made to pass it the players would have to loft the ball instead of shoot it. In 1891, Naismith was appointed an instructor by Luther Halsey Gulick, Jr. Head of Physical Education at Springfield. Naismith put sports together such as soccer, American Football, Field Hockey and other sports. Naismith created the game of basket ball for players to play during football and baseball. The game started with two peach baskets, a soccer ball and 13 rules.(Original Rules of Basketball 1) Rains and Carpenter said Naismith loved the idea that a minimum of a basketball, a basket, and a place to play (52).

Julius Caesar: Synopsis Of Brutus :: essays research papers

Marcus Brutus, Caesars noble friend, joined the conspiracy to assassinate Julius Caesar because of his love for Rome. The Lives of the Greeks and Romans gives a very nigh description of Brutus it was not cold off what Shakespeare describes Brutus as. Plutarch described Brutus as A marvelous lowly and gentle person, noble minded, and would never be in any rage, nor carried away with pleasure and voraciousness but had ever an upright mind with him, and would never yield to any wrong or injustice. (p. 139) Brutus was a very respected and honest man. Casca, one of the conspirators, verbalize that he was very respected by the people by face O, he sits high in all the peoples hearts, And that which would appear disrespect in us, His countenance, like richest alchemy, Will change to virtue and to worthiness. (I, iii, l 157-160) Casca said this to Cassius. Marcus Brutus was very essential to the conspirators because this would have ensured that the people would listen to them. Brutus was also a legitimate Roman. When Cassius and all of the other conspirators met Brutus at his house and all of them decided to murder Caesar, Cassius said that all of them should swear. Brutus then said, No, not an oath if the face of men, The sufferance of our souls, the beats abuseIf these be motives weak, break off betimes, (II, i, l 114-116) and Than secret Romans, that have spoke the word And will not palter? (II, i, l 125-126) Here, Brutus is saying that if they are true and honest Romans they do not have to take an oath, their word should be good enough. Brutus was the only man in the conspiracy with good intentions. Brutus wants to assassinate Caesar for the good of Rome. The other conspirators are all doing it for their own selfish reasons. Brutus motives, for joining the conspirators, indicate that he was very public-minded and morally conscientious. When Brutus says But for the general. He would be crownd How that might change his nature, theres the question (II, i, l 1 2-14) He was stating that it will be for the good of Rome to assassinate Caesar. similarly he did not want their assassination to seem likewise gruesome, this shows he was morally conscientious. When Cassius said that they should also kill Antony, Brutus says Our course will seem too bloody, Caius Cassius.

Julius Caesar: Synopsis Of Brutus :: essays research papers

Marcus Brutus, Caesars noble friend, joined the conspiracy to assassinate Julius Caesar because of his love for Rome. The Lives of the Greeks and Romans gives a very easily description of Brutus it was not far off what Shakespeare describes Brutus as. Plutarch described Brutus as A marvelous lowly and gentle person, noble minded, and would never be in any rage, nor carried away with pleasure and greed but had ever an upright mind with him, and would never yield to any wrong or injustice. (p. 139) Brutus was a very respected and honest man. Casca, one of the conspirators, give tongue to that he was very respected by the people by utter O, he sits high in all the peoples hearts, And that which would appear offence in us, His countenance, like richest alchemy, Will change to virtue and to worthiness. (I, iii, l 157-160) Casca said this to Cassius. Marcus Brutus was very essential to the conspirators because this would have ensured that the people would listen to them. Brutus was a lso a uncoiled Roman. When Cassius and all of the other conspirators met Brutus at his house and all of them decided to murder Caesar, Cassius said that all of them should swear. Brutus then said, No, not an oath if the face of men, The sufferance of our souls, the judgment of convictions abuseIf these be motives weak, break off betimes, (II, i, l 114-116) and Than secret Romans, that have spoke the word And will not palter? (II, i, l 125-126) Here, Brutus is saying that if they are true and honest Romans they do not have to take an oath, their word should be good enough. Brutus was the only man in the conspiracy with good intentions. Brutus wants to assassinate Caesar for the good of Rome. The other conspirators are all doing it for their own selfish reasons. Brutus motives, for joining the conspirators, indicate that he was very public-minded and morally conscientious. When Brutus says But for the general. He would be crownd How that might change his nature, theres the question (II, i, l 12-14) He was stating that it will be for the good of Rome to assassinate Caesar. similarly he did not want their assassination to seem likewise gruesome, this shows he was morally conscientious. When Cassius said that they should also kill Antony, Brutus says Our course will seem too bloody, Caius Cassius.

Is costumer behavior a quantitative science or qualitativ

United International Business School Main Campus Brussels Prof. uncontaminating Individual Assignment Student Martinotta Lara Introduction All of us are consumers. We consume good everyday, we consume and buy products and services according to our needs, preferences and buying power. What we buy, how we buy, where and when we buy, in how much quantity we buy depends on our social and cultural background and our age and family but also on our perception, attitudes, beliefs and values, motivation, personality, and many other factors that are both(prenominal) internal and outer to us.All this process is what we call in economics term consumer behaviour. It is key to say that we also consider before buying whether to buy or not to buy and, from which source or sellers. The marketers try to understand the needs of different consumers and having understood different behaviours require they study in their internal and external environment, they formulate their plans for marketing.I wil l try to develop an interdisciplinary approach of consumer behaviour starting from defining the concept moving to microeconomics methodological study and passing done the behavioural economics highly mphasizing on factors that influence the decision-making process of consumers behaviour I think two summarize more the concepts Customer behaviour reflects the solely of consumer decision with respect to the acquisition, consumption and disposing of goods, services, activities experiences, people and ideas by (human) decision-makingl . Customer behaviour means more than Just the way that a person buys concrete product such as cars.It also included peoples use of services, experiences and activities such as going to the doctor. Microeconomics and Behaviour economics I start with a sketch overview of to microeconomics theory, which represents a starting point for examining costumer behaviour. The microeconomics theory makes the supposal that Consumer behave rationally and given the ch ance they will choose the best alternative of with their take aim of income and preference2 Neoclassical economic coincided with the dominance of the positivist methodological position that judges a theory by its ability to make predictions that are supported by the evidence.In Microeconomics the individual firm rationally maximizes profit through purchase decision3. n sum the microeconomics theory balances tour elements tn consumers available income, the price of the goods, the consumers tastes or preferences, and the surmise of utility maximization. In such models, utility can best be thought of as levels of satisfaction, happiness or personal benefit. By using the assumption that individuals act in order to maximize personal subjective benefits, economists make costumer behaviour analyse quite simple as they apply right on mathematical techniques for modelling behaviour outcomes4.The Microeconomics model of costumer behaviour often correspond to how costumer ehave however cle ar and voluminous evidence from psychology has shown that the intellect assumption of standards economics are wrong. Evidence from psychology has shown that we often are irrational. This selfish maximization principle of Homo economicus limits the application of neoclassical economics to other areas5 Recognition of these difficulties had led to a series of newfound approaches to modelling the individual behaviour, mostly based on challenges to the assumption of neoclassical economics.At the end of the twentieth century the strict neoclassical position came under attack from many different directions. Some of these merely suggested more complex objectives and constraints, while others took economics is new directions by putting an emphasis on uncertainty and risk6. Simon argued that human behaviour is best modelled as aspiration-based, rather than as optimizing behaviour. In his view is important to achieve aspiration levels with satisfactory outcomes indicating that satisfy behavi our is normal and optimizing behaviour is abnormal.

Man and a Woman: A Yin and Yang

Its still fresh in my memory the answer of 2008 Miss Universe Dayana Mendoza in her question Does a populace or a cleaning lady live and easier life? - actually in that respects not much digression about how a muliebrity or adult male lives but rather they differ on the way they think. Man thinks the easiest way to corroborate to the point is to go straight. Woman, not exactly, they go through and through many curves and fixed it. This answer is just one among the many answers on how to differentiate a man between women. In the field of hard sciences, the difference between a man and a muliebrity is far way varied.It is usually differentiated through sex or the possession of certain variety meat and hormones that make them unique. Man or male is characterized by possessing the male genitalia which composed of the testicles, the penile gland and of course Adams apple. Women or female is otherwise characterized by the possession of uterus, ovary, and vagina. In terms of the Hi ppocratic eye, there atomic number 18 different hormones and chromosomes that discriminates both sexes- chromosome XY for male and XX for female (York 2008).In the society, one laughingstock easily differentiate a man from a woman by the way they act, they dress and they appear in public. A man usually is short haired contented with t-shirts and pant or tuxedo for the elite while women are oft long haired, fond of having fancy dresses with playful colors and distinguished by their high sky voices as contrast to male with a distinguishable baritone voice. During the olden snips, in terms of gender and socialization, a masculine is usually viewed to be brave, aggressive, and ice lolly winner while a feminine is usually calm, conservative, and responsible in child rearing.Tracing the history, women in the olden days are considered as one among the level society wherein they are not allowed to vote and their only profession is to become a plain housewife. In the ancient times in Asia and Europe, women are often the subjects of slavery. In Japan, once a woman has been married to a man, she no longer free. Her work is just centered on family rearing and farewell helper to the husband. The only way to escape from the marriage is to commit hara-kiri or the virtue of killing themselves.In the Philippines during the sultanate period, only the son of the king or sultan can inherit the land and women are just for marriage rites and are just means to procreate through pregnancy. The worst thing is that they are not allowed to approach pattern the land. In contrast, Egypt is known to have women rulers before man became the ruler. One good example is Cleopatra who ruled the ancient Egypt and who have man as subordinates (timemagazine. com 1972). But with the renegade of industrial revolution, feminists became more gender sensitive and gender equality had been on the rise.Now, there had been widespread gender stereotyping such as female police enforcers, pilots, so ldiers, and the being of working moms and even female engineers. In addition, there is an increase of women politicians and rulers and believe it or not that the Philippines being a democratic republic had some assort of girl power because they had already to female presidents whom actually won through people power revolution. Tracing the history is likewise one way of differentiating man between women based on their family roles and social responsibility. The existence of pluralism in nature allowed varied responsibilities of a man and a woman.Delving deeper in differentiating man and women is through their event of feelings. Men are thought to be pride and full of ego. Women are the exact opposite as they are more patient and unruffled. Usually in a family a woman/wife is usually the mother of all chores in the house doing all the laundry, cleaning, and preparing food except if a there is a hired nanny, but still a nanny is a woman. On the other hand, those of the man usually s ips coffee while reading the daily give-and-take and eats the breakfast and then go to work. Going back to the answer of Miss Universe 2008, it would be nice if we cite some examples.Man thinks that the easiest way to get through a point is to go straight. I might as well agree on that. When a man goes to off a extra thing in the department store, he goes exactly to the rack or place where it is located, grabs it and pays it over the counter immediately. Women dont, they actually took many more time visiting every lane of the shop and fit all things that she thinks its nice for her and grabs unnecessary things forgetting what to buy. This only means that man is more straightforward on everything. When he wants an answer, he wants it immediately. When he takes orders in a restaurant, he wants it in a brisk.Women are more patient and complicated, they are the ones who usually start the husband-wife get by because of their hasty tongue who usually nags and nags until both of them ge ts pissed off. Among all of these opposite characters, I still view man as being a yin and a yang, a perfect opposite but a perfect combination. Every imperfection of a man can be complemented by a woman and every womans flaw is complemented by a man. That is why there is the existence of marriage, to unite both the ideals of a man and a woman and to live together as one body and being separate entities.A man and a woman are created complementary to work and help severally other. Each sex/gender represents a function in a society. There has been a saying that No man is an island. Truly no man is alone because there is the existence of a woman. Every human beings life is like a puzzle, it will only be completed when the remaining pieces are there. A woman therefore is never complete without a man, which maybe her father or her lover. Likewise a man is never complete without there woman, which is his mother and his lover.

Acc 490 Week 4 Individual Assignment

The trends show a significant increase in the inventory turn days, an increase in the gross margin for the best result for the quaternary year period, and an improved collection time. c. 7. 84 days Tolerable misstatement ? cogs x 365 = 45 ? 1859 x 365 = 7. 84 d. 205 has significant changes with the combined precipitate to purchases with an increase in the gross margin which increased by 52. 4%. Inventory turn days increased to 199 days from 183 days. When you combine this result with the hope range of 7. 4 days, the result is significant and shows what could be a potential overstatement of inventory from a possible error in calculations or double-faced financial reporting. 10-32 a. a. run across Environment. b. Control activities Controls over management discretion in financial reporting. c. Control activities Information touch controls Computer general controls. d. Monitoring. e. Risk Assessment. f. Control Environment. g. Control activities Information processing controls Com puter general controls. h.Control activities Information processing controls Computer application controls. i. Control activities Performance reviews. j. Control activities Information processing controls Computer application controls. k. Monitoring. l. Information and communication. m. Risk assessment. n. Control activities Information processing controls Controls over the financial reporting process. b. a. Common impact. b. Valuation or totallyocation c. All assertions d. Completeness, Existence or occurrence. e. Common impact f. All assertions g. All any assertion . Completeness i. Valuation or Allocation, Completeness, Existence or occurrence j. Existence or occurrence k. Existence or occurrence l. All assertions m. All assertions n. All assertions 11-21 a. The reasons an attender may assess control luck at the maximum train for one or more assertions embodied in an account balance include controls that are unlikely to relate to an assertion, controls are unlikely to be effec tive, and it would not be efficient for the auditor to evaluate the metier of the controls of the entity. b.In order for an auditor to support assessing control risk at less than the maximum take when the auditor has determined that the controls have been placed into operation include a few issues. One is that the auditor needs to identify the specific controls that will pertain specific financial statement assertions. Another involves the auditor performing tests of controls in order to evaluate the effectiveness of the plan and operation of said controls that prevent or detect any misstatements of material of financial statement assertions.The final issue is that the auditor needs to determine the assessed level of control risk. c. There are things that an auditor needs to consider when seeking a further reduction in the planned assessed level of control risk including if special tests of controls will give additional needed evidence, and if it will be effective to the additio nal tests of controls. d.The auditors documentation requirements concerning an entitys system of internal controls on with assessing the level of control risk include having the auditor document the basic requirements involving the systems of internal controls of the entity and assessing their levels of control risks. An auditor also needs to document the basic understanding of the risk assessment along with the control environment, monitoring, and information and communication.An auditor is also required to document the assessment of the level of control risk for all significant financial statement assertions along with the control risk that is assessed at the maximum level. Documentation of the workplace needs to include a description of the tests of controls that the auditor has completed, the results obtained from those findings with the deficiencies noted, the evaluation of the auditor as to the effectiveness of the controls, and the effect on the timing, nature, and extent of the substantive audit procedures.

Bhagavad Gita Critique

Well I would first like to start collide with by saying that after I let go of my psycheal beliefs for a moment, and actu wholey let myself be open to the ideas of the Bhagavad-Gita I rather enjoyed it and I feel like I actually can see how the modes of life (for loss of a better term) that argon expressed in this shamble a lot of sense. I can actually sit and weigh about what kind of people today would possibly be categorized as Tamasic, Rajasic and Sattvic. I also can see some very similar concepts in the account book that follow modern Christian beliefs and values which made it a lot more interesting.For example from the time I wake up to the time I go to bed I thank God and deliveryman for the blessings and positive moments in my life. I pray throughout the day when things ar well(p) or bad. I also try to live a good Christian life as well as conscionable trying to be a good person. I guess my ideas of a good person stem from my influences and morals, as well as my new found belief in God and deliveryman. I try to worship, pray and give thanks everyday. I try to read my bible as often as I can, seeing Im so busy all the time it has been rocky to even find the time to pick it up, but I do try to think before I act, speak and think.I think what would Jesus and God and all my loved ones think of the thing I am about to do or what would Jesus say if I completed that non nice thought about that person. Seeing how I believe every one of us is a child of Gods and that God knows everything we do, say, think and so on I try to keep my life to a pure as I can standard. I think about all that I realize been given and the least I can do is try my best to be my best for Jesus, God and all that I am connected to in this lifetime. This brings me to my topic, spiritual beliefs. There are so many different types of religion. Catholicism, Hinduism, Christianity, etc.They all have various ways of being when it comes to being a member of the church or religion. No two parties are alike that is why no two peoples beliefs are the same completely. Yet when you read the Bhagavad-Gita it puts it so simple. Do your life this way you are worthy of finally passing on into the next life for eternity. Do your life that way you come cover charge and suffer a circle of never ending lives. Try but not quit there you come back to life but in a higher level of caste so you can start off close to where you left off. It is all pretty simple. In the book it is essentially Arjuna asking guidance from Krishna.At first it is whether he should fight or not fight, then it turns into a how do I live my life for you in your way topic. Krishna basically starts out very slow in explaining that all life is connected and is stemmed from his existence. That life is here in the body year but continues into the spirit world with him, and that life is a never ending circle until you reach the highest point of understanding and are worthy of being with him in the spirit world forever. That when you realize that life never truly ends, that it is just the body that dies you cannot feel sad for such things as fighting wars and killing men. whence he explains such things as the importance of ceremony and living a pure life, then about the Brahmas and literally tells him the secrets of life. Krishna reveals his true great form to Arjuna and covers all the possible topics you could think of when it comes to being Hindu. The story is so filling that you literally wonder how it could possibly have an end to it. The main point I got from the book was that it is important to live your life according to first what you think is right and then second to what you believe Krishna and the other Gods (which are Krishna and they are him) say is the way to live.In the book it speaks of how to perform ceremonies and the importance of not just performing them but to perform them with heart. You are to serve good foods and give great offerings to your God. You yourself are to eat good foods and take care of your body for the Gods as well. You are to drink and perform the ceremonies the way the scriptures say and to keep your heart and mind on God (Krishna). Then it sort of ends weird It says that you are to live your life well and good and pure but that you have to follow the path you think is the right one.And that when you think you have reached that level of true knowledge you are to try to share that with others. So I guess what I got out of it is just that live your life to the best you think you can. Dont be a selfish, greedy, rude, etc. person. Dont have false beliefs even if that sum you have none. And to try to give your heart over to the beliefs you do have. If they were the right ones then you win the ultimate prize, eternity with Krishna. If it was the wrong one you just have to keep trying until you get it right.I read this book and I pretty much decided that it is great to help guide you no matter what religion you believe in. Jus t the base principles and sort of guide it lays out for the individual, so you can clearly see the different ways and the different options is so clear and simple it cant not make sense. And I love the fact that the idea is that everything comes from one God initially even if there are other gods now everything is God and he is everything, even if you are not in god, he is in you. I am so happy I had the opportunity to be exposed to such a great experience. It will stay with me forever.

Review of BPR methodologies

This paper presents the advantages and disadvantages of development a methodological analysis in the context of BPR. It also provides a critique of existing BPR methodologies which erved as a basis for the development of the CONDOR BPR methodology. The paper also presents the main points of the implementation of this methodology to three European construction companies. What can a methodology offer to the BPR dramatics? According to Preece and Peppard (1996), a methodology is simply theory put into practice aiming at dealing with real world situations.According to Valiris and Glykas (1999) a BPR methodology should provide a consistent set of techniques and guidelines which will enable the business process redesigner to reorganise business ctivities and processes in an organisation. The use of a methodology is essential for a number of reasons. First, a methodology provides a means of codifying experience, knowledge and ideas, in a form that not only can be easily applied, unless also can be evaluated and tested. Second, a methodology offers a certain level of organisation, and facilitates planning and monitoring.In BPR initiatives, a methodology enables the organisation, on the one hand, to have a clear picture of its current processes along with their associated problems and, on the other, to design the new state of these processes. In addition, by following a certain methodology, BPR re-engineers have the chance to monitor and evaluate the progress of the re-engineering effort. Third, a methodology enables those who are involved or affected by the BPR to recognise their tasks and clarify their roles.A BPR methodology which is clearly define and explained to those who are leading the BPR work can facilitate the communication between them, and serve as a kind of contract in which all the parties understand their responsibilities and are, therefore, able to monitor the overall process re-engineering progress. Finally, adoption of a methodology allows a s tandard set of mandatory skills to be identified and developed. Key skills required for BPR include process modelling, organisational development techniques, and skills to deal with resistance to change.There are, however, a number of problems related to the use of a methodology. One important reason which explains the reluctance of growth and using methodologies or models in the BPR context is that the widely accepted methodologies are based on how the business processes should change and how the organisation should adapt itself in this change, quite an than on the evaluation of urrent practices and on the codification of successful practical experiences (Simsion, 1994).Moreover, the BPR literature search reveals that there are an increasing number of successful re-engineering implementations and case studies using BPR methodologies. Although each business situation has some unique characteristics, an appropriate methodology will need to allow tor assessment and re-use ot existin g successful approaches and practical experiences. In addition, a methodology hides the danger of restraining creativity and innovation. The latter are crucial elements in he radical thinking during the re-engineering process.By encouraging those who are involved in the reengineering process to comply with the requirements of a given methodology, there is a potential risk of restricting the opportunity of optimising the results according to the level required by the methodology (Simsion,1994). Critique of existing BPR 239 240 In conclusion, there are many advantages and disadvantages regarding the use of a specific methodology or model in the re-engineering initiative. Each perspective demonstrates equally important arguments that affect the organisation.The lternative to using a methodology in an attempt to minimise the negative consequences is not anarchy but a hazard approach tailored to suit the objectives and needs of every organisation or business sector, building on basic p rinciples of planning and monitoring as swell as on previous successful working practices. Critique of existing BPR methodologies and models The are many BPR methodologies and models available, and most of them pursue a similar path and border commonalities in key areas (Butler, 1994).Today, an increasing number of methodologies, models and tools taken from other disciplines re available in the market, claiming that they are suitable for BPR initiatives. Ruessmann et al. (1994) reported the results of their research, claiming that BPR methodologies are based on a synthesis of techniques drawn from other disciplines and methodologies such as soft systems, total quality management (TQM), benchmarking, and organisational development. According to a I-JK BPR methodology survey analysis findings (Archer, 1996), the number of stages involved in BPR approaches varies greatly, despite the fact that they do present key similarities.

Ph Balance in Human Body

As we all know ein truth solution is either savage or alkaline. alkaline is often called base. These solutions poop be anything from body fluids, to fruits, vegetables, saltwater, beverages you name it. Acid and alkaline is measured in pH. It starts as low as zero being very acidic and works its way up to fourteen being the most basic. The pH of our stomach is 2, obviously to digest food, wine is 3. 5,water is 7(neutral), arterial blood is 7. , and seawater is 8. 5. Baking soda is 12. Virtually all-degenerative disease including cancer, heart disease, arthritis, osteoporosis, kidney and gall stones and tooth decay are associated with excess acidity in the body. The amazing self-healing body will continuously work to neutralize the pH in the body by withdrawing acid and alkaline minerals from other locations including bones, soft tissues. The pH of saliva offers a window with which you can see the overall pH balance in your body.Acid rain, which is rain or any other form of preci pitation that is unusually acidic and can destroy an entire forest, so you can only imagine how much acid solution can destroy our delicate internal organs of the muscles and tissues. When we drunkenness and feed in alkalized foods we are making deposits in our bodies that work as antioxidants. When we eat or drink acidic food we are making withdrawals from the body. The goal is to eat 80% alkalized foods verse 20% acidic food, which is the reverse of the standard American today.Point being you can see where the problem lies here in our country. Its bend a lifestyle to eat highly fat, high sugar diet, also including unlimited amounts of prescription and non prescription drugs which are one of the most highly ototoxic substances you can put in your system. Another one of the leading causes to acidity in the body is emotional stress. Negative emotions cause so much acid in the body that its one of the leading causes to illness.Not to mention all sorts of meats that are highly proc essed with growth hormones and antibiotics, to milk that is pasteurized and homogenized being extremely acidic causing inflammation in the colon to not enough exercise, to not getting the proper amount of daily sunlight that provides you with the highest level of essential vitamin D. The list can go on forever. What is the only food that has the ability to absorb light and null from the sun and transmit this energy to our bodies?If you were to observe the molecular structure of the human blood and chlorophyll you would see that they are almost exactly the said(prenominal), just the chlorophyll has magnesium in the center, and the hemoglobin is iron. When the sun hits the plants, the energy is captured into the chlorophyll in to green food energy. That brings us to natures simple formula, when we eat green food and drink green drinks this becomes a part of our blood. Its so step forward of our habit to go and eat the necessary amounts of fruits and vegetables today due to how co nvenient fast food has become for us.Its more difficult to eat healthier now, and thats why when you see people around the world who come to America instantly start to gain weight, even though they were eating the exact same diet back in their home country. My goal is to try and influence as many people as I can to try and fool care of their bodies, for thats our way of showing thanks to our existence to this beautiful life we have. To be able to live life in freedom of health to have the ability to experience the wide rage of opportunities that is out there for us.

Approaches to Management

APPROACHES TO MANAGEMENT Dr. M. and somozhi Professor Department of Management Studies Indian Institute of Technology Madras Chennai 600 036 E-mail emailprotected ac. in APPROACHES TO MANAGEMENT 1) 2) 3) 4) 5) 6) 7) 8) 9) Empirical Approach military mans Behaviour Approach Social System Approach close Theory Approach Mathematical Approach Socio- technical Systems Approach Systems Approach Contingency Approach running(a) Approach REASONS & PROBLEMS 1) Semantic problems in management literature. 2) Contributions from different disciplines. 3) Misunderstanding of principles. EMPIRICAL APPROACH Study of managerial determines and cases(mgt) Contributors Earnest Dale, Mooney & Reiley, urwick. Features Study of passenger carial Experiences Managerial experience passed from participationer to students for continuity in knowledge management. Study of Successful & failure cases help practicising managers. Theoretical research combined with practical experiences. Uses Learning th rough experience of others boundarys No Contribution for the development of management as a discipline Situations of past not the same as present. HUMAN conduct APPROACH Organisation as people ) Interpersonal Behaviour Approach Individual Psychology b) Group Behaviour Approach Organisation Behaviour Features Draws heavily from psychology & sociology. Understand human being relations.Emphasis on greater productivity through motivation & good human relations Motivation, leadership, participative management & group dynamics argon shopping mall of this approach. HUMAN BEHAVIOUR APPROACH Contd.. Uses Demonstrates how management can be effective by applying knowledge of organisation behaviour. Contributors Maslow, Herzberg, Vroom, Mc Cleland, Argyris, Likert, Lewin, Mc Gregor, etc. Limitations Treating management as equivalent to human behaviour. Talks about organisation & organisation behaviour in vague terms. SOCIAL SYSTEM APPROACH Understanding the behaviour of groups & individuals. Features 1. 2. 3. 4. 5. Social System, a dodge of cultural relationship Relationship exist between external and internal environment of the organisation. Formal Organisation Cultural relationships of well-disposed groups working within the organisation. Co-operation incumbent Efforts directed harmony between goals of organisation & goals of groups.SOCIAL SYSTEM APPROACH Contd Contributors Pareto, Chester Barnard Uses Organisational decisions should not be based on desires of one group alone but should glint the interests of all the parties. Limitations Broader than management & its practice Overlooks many management concepts principles & techniques that are important to practising managers. DECISION THEORY APPROACH Manager Decision maker Organisation Decision making unit. Features Management is decision making. Members of Organisation decision makers and problem solvers. Decision making control point in management Increasing efficiency t he reference of decision MIS, process & techniques of decision making are the subject matter of study. DECISION THEORY APPROACH Contributors Simon, Cyert, Forrester, etc. Uses Tools for making suitable decisions in organisations. Limitation Does not take the total view of management Decision making one aspect of management MATHEMATICAL APPROACH Management- logical entity Actions- Mathematical symbols, Relationships and measured data. Features 1. 2. 3. 4. 5. Problem Solving mechanism with the help of mathematical tools and techniques.Problems Expressed in mathematical symbols. Variables in management quantified. Scope Decision making, system analysis & both(prenominal) aspect of human behaviour. Tools Operations research ,simulation etc. MATHEMATICAL APPROACH Cont.. Contributors Newman, Russell Ackoff, Charles Hitch, etc. Uses Provided Exactness in management discipline. Limitations Not a separate give instruction Technique in decision making. SOCIO -TECHNIC AL SYSTEMS APPROACH Features Social & technicals systems interact. This interaction is important for organisational effectiveness. Organisation governed by social laws as well as psychological forces. Technical aspects of organisation modified by the social aspects. Contributors Trist, Bamforth, Emery etc. Uses Organisational effectiveness depends on looking at people and their interactions and also at the technical environment in which they operate. Change in technology Change in social interactions at work place SOCIO -TECHNICAL SYSTEMS APPROACH Limitations Lack of total managerial view boil down on factory or other production system No new contribution People aware about the role of technology of the social system of the work placeSYSTEMS APPROACH An enterprise Man-Made system Internal parts Achieve established goals External parts Achieve interplay with its environment Manager integrates his available facilities with goal achievement. Uses Quick Percepti on Better Planning Limitations Complicated Expensive CONTIGENCY SCHOOL In developing management concepts the environment within which the concepts are to be applied has to be considered. Internal environment Structure, Processess, Technology. External Environment Social, Economic, Political etc. Features Appropriateness of a management technique depends on situation. If Then approach. OPERATIONAL APPROACH Management is a process. Universalist / Classist / Traditional Approach. This school concentrates on the role and functions of managers and distills the principles to be followed by them. Features Functions of managers remain same Functions of management core of good management Framework of management Principles of management Contributors Fayol, Lyndall Urwick ,Harold Koontz, Newman, Mc Farland, Taylor. Uses Flexible & practical but not universal.

Nostalgia

A world(a) Feeling How many times have you reminisced on a certain retrospect and It almost matte up Like you were in that respect again? You could smell, see, and even taste that exact moment. These memories are always triggered by something, besides you are not entirely sure what. You are overcome with a disposition for that moment in time and the memory is so fond that you cant help but line uping warm inside. Nostalgia is the sentimental longing felt when reminiscing on the past.It is not a feeling of melancholia but more of a bittersweet sloppiness for what once was. Nostalgia has been widely used to portray many notations but has Just recently been modified to describe a positive start out. The word nostalgia was first coined in the 17th century. The term was used to describe the aesculapian examination conditions of Swiss mercenaries who longed to return home. Nostalgia soon became a name for a disease whos symptoms included fainting, high fever, endorse pain, and even death.By the late 19th century nostalgia was discarded as a medical condition and recognize as a form of melancholia and a ment aloney repressive disorder. Now nostalgia has a positive meaning. It Is sort as the term to describe the exact feeling felt when thinking of past memories. Nostalgia does have a positive effect on an individual. The Oxford English Dictionary defines nostalgia as sentimental longing for a finish of the past. Merriam- Webster Dictionary says is it pleasure and sadness that is caused by have in minding something from the past and wishing that you could bonk it again.The most leafy vegetable synonyms used when referring to nostalgia are sentimentality and yearning. The important things about these definitions are the positive tones they all have. Many flock have experienced nostalgia at some point in their life, whether that be a nod memory from childhood or a strong feeling of homesickness. Many of these happy memories even trigger an euphoriant feeling that takes you tush to that certain place or time. These overall feelings provide a sense of console when life gets difficult.Young adults find that reminiscing on past memories has helped them smoothly transition into major life changes such as moving away from home. Nostalgia has been proven to counteract boredom, anxiety, and even solitariness. When things are especially difficult in antithetic aspects of my life I find that I begin to feel lonely. Loneliness has always been a frightful feeling to cope with because there is nothing more helpless than feeling like you dont have anyone. With that solitariness I start to question the continuity of my life.Why am I not friends with that person anymore? What am I supposed to be doing with my life? At this point in my life everything Is changing and there isnt a stable thing that roots me to reality except for my memories. On the days that I feel anxiety or loneliness I always think of a certain memory that brings me back to a happier time. The memory Is always the same, but I can feel It better than I remember It. I remember the way the alarm feels a room window and noticing how the sun isnt quite as high as it normally is.I remember the exact smell of the cinnamon candle that my mom starts vehement every fall. This memory has no actual significance but somehow it gets rid of all the loneliness I feel and makes me feel continuity and optimism instead. Nostalgia itself does not involve any feelings of melancholia. The literal act of nostalgia is to suppose a memory that is fond to you in some way. The purpose of remembering past memories is to relate them to outright to provide the sense of nonentity that you need to maintain a comforting balance when life changes..The experience of nostalgia is positive the aftermath is not. Nostalgia is often confused with unpleasant feelings because of the longing that occurs when remembering a great experience from your past. But that longing is not an overall bad emotion it is just a reminder of all the positive things that once were. The term nostalgia has come a long way since it days of an actual medical condition to its description of a positive emotion. It is important to remember that nostalgia is not only Just a positive emotion but a positive experience.

A Mother’s Legacy In Mary Shelley’s Mathilda Essay

AbstractMary Wollstonecraft and her daughter Mary Wollstonecraft Shelley are cardinal writers whose ideas are likely to be similar. Shelley admits that she is influenced by her mother. Therefore, the purpose of this essay is to find out and to identify the ideas presented in Wollstonecrafts essay on womens rights A Vindication for the Rights of Woman (1792) and see if they are incorporated into Shelleys novella Mathilda (1819).My analysis of A Vindication for the Rights of Woman shows that Wollstonecrafts main ideas are that express education, the subjugation of women by the family, female dependency on men and romantic thinking are the get-go for womens inferiority. This essay identifies and examines these ideas in the light of some secondary material and tries to suggest that they are glaring as themes in Shelleys Mathilda. In Mathilda, these ideas are visible as themes throughout the novel. The tragedy that befalls the characters illustrates the humble and self-destructive te ndencies which women obtain when being subject to these conditions. On the other hand, Shelley does not emphasize a escape of education and offers an additional point of view where Wollstonecrafts views on motherhood are criticized.The conclusion bony is that Wollstonecrafts ideas must have had an influence on Shelley as the fate of the characters is an illustration of the society that is criticized in A Vindication for the Rights of Woman and its destruction. However, Shelley does not agree on ideas with the subject of upbringing and goes against a few of her mothers main points, namely the role of mothers and the pre-eminence of education. They just aboutly have a consensus as most ideas that are present in one work are present in the other only when Shelley has rebelled against some of her mothers notions.

Federal Deposit Insurance Corporation Essay

The Federal Deposit Insurance fraternity was created by the entrusting performance of 1933 in response to the commiting crisis that faced the nation after the stock foodstuff crash on somber Tuesday, October 29, 1929. Although the FDIC has grown and changed since then, its purpose is still the same to guarantee the safety of bank deposits up to a authorized amount. Until recently, that amount was $100,000 but Congress, in response to the current economic crisis has temporarily change magnitude FDIC deposit amends from $100,000 to $250,000 per depositor through December 31, 2009. (Who, n.d.)All of the banks that are subdivisions of the FDIC must adhere to certain liquidity and reserve requirements in order for the banks and their depositors to benefit from the insurance. (Overview, n.d.) If a bank becomes undercapitalized the FDIC issues a warning. If the undercapitalization worsens it can take other corrective measures which may ultimately precede in the FDIC taking over management. All of this is meant to sustain the confidence of depositors so that there are no runs on the banks as so often happened in past history.The History of the FDICTo get wind the importance of the Federal Deposit Insurance Corporation in todays economic market one must look to the history that led up to its establishment as part of the Banking bet of 1933. After the crash of the stock market in 1929 the United States fell into the longest economic effect in its history from 1929 to 1939. Since loans that were made to stock market speculators were not being repaid after the crash, many another(prenominal) banks failed and bank panics were commonplace. This led to their depositors losing money, which only served to fuel the depression further.The bank failures of the early 1930s were not the first in the history of the United States, but they were the most severe to date. President Franklin Delano Roosevelt saw the need to stem the zoom of failures by enacting the Ban king characterization of 1933. Part of this act established the FDIC, gave it authority to regulate and insure banks, and the act withal provided its funding.The purpose of the FDIC was to build the confidence of the American people in their banks and to assure them that their funds would be safe, at least up to a certain amount. (FDIC Timeline, n.d., 1930) This is still the general purpose of the FDIC, although much has changed since its birth in 1933. According to the FDIC website since the start of FDIC insurance on January 1, 1934, no depositor has lost a single cent of verify funds as a result of a failure. (Who, n.d.)When the FDIC was established in 1933 it was a temporary agency. simply just two years later the Banking Act of 1935 made it a permanent agency. (FDIC Timeline, n.d., 1930) This was the first of many changes and adjustments to the FDIC over the years. The Federal Deposit Insurance Act of 1950 raised the insured amount to $10,000 and that amount has increased s teadily until now, it is $250,000. The 1950 legislation also gave the FDIC the authority to lend to any insured bank in risk of infection of closing if the operation of the bank is essential to the local community, and authorized the FDIC to examine national and state member banks for their insurance risk. (Important, n.d.)In 1989, in response to the savings and loan crisis gripping the nation, the Financial Institutions Reform, Recovery and Enforcement Act (FIRREA) added two more functions to the FDIC, eliminating the Federal Savings & Loan Insurance Corporation (FSLIC). The FDIC was given the authority to superintend and administer two other insurance funds that replaced the FSLIC the Savings Association Insurance Fund (SAIF) and the Bank Insurance Fund (BIF). (FDIC, n.d.)Still more powers were given to the FDIC by the Federal Deposit Insurance Corporation Improvement Act (FDICIA) of 1991. This act addressed issues that the FIRREA did not, giving the FDIC more authority as well as more obligations. The FDIC continued to grow both in funding and authority until it reached the status that it holds in our economy today.The Structure of the FDICThe FDIC of today is run by a five-member board of directors headed up by Chairman of the gameboard, Sheila C. Bair who has been in that post since she was sworn in on June 26, 2006. She will serve a five year boundary and at the expiration of that term, she will remain on the Board of Directors until 2013. Each Chairman of the Board is appointive by the President to serve a five-year term and each appointment is subject to the approval of the US Senate. (Barrymore, n.d.) Since the chairman is appointed by the President, she can also be removed by the President.The other members of the Board are the Vice Chairman Martin J. Gruenberg, Director Thomas J. Curry, Comptroller of the Currency John C. Dugan, and Director of the topographic point of Thrift Supervision John M. Reich. (Board, n.d.) The Board meets about onc e a month in both open or closed meetings. The public may attend open meetings as a result of the Government in the Sunshine Act. (FDIC Board Meetings, n.d.) In 2008 there were ten open meetings held.The FDIC has seven divisions. The section of Finance directs the accounting and auditing aspects the Division of Information Technology oversees and maintains the computer network of the organization the Division of politics provides administrative support the Division of Supervision and Consumer Protection conducts reviews to assure that each bank is sound and that its congenital controls are adequate the Division of Resolutions and Receiverships goes into action when a bank is in danger of failing the level-headed Division handles the corporations litigation and the Division of Insurance and Research keeps an eye on the economic health of the nation, examining agate line activity, markets, etc. (FDIC Divisions, n.d.)To run these seven divisions the FDIC employs about 5,000 peopl e in its Washington, D.C. headquarters as well as in six regional offices and in field offices around the country. (Who, n.d.)

An Analysis of A People’s History of the United States by Howard Zinn Essay

A Peoples History of the united States is a 1980 non-fiction book by American historian and political scientist Ho contendd Zinn. In the book, Zinn seeks to prove American history done the eyes of the common mint rather than political and economic elites. A Peoples History has been assigned as reading in populacey high schools and colleges across the join States.1 It has also resulted in a alteration in the focus of historical work, which now let ins stories that previously were ignored.2 The book was a runner-up in 1980 for the National Book A struggled. It has been frequently revised, with the most recent variance covering events through 2005. In 2003, Zinn was a contendded the Prix des Amis du Monde Diplomatique for the French version of this book, Une histoire populaire des tats-Unis.3More than two million copies stomach been sold. Reviews take over been mixed. Some bedevil called it a brilliant overlyl for advancing the cause of social equality.Others have called t he book a revisionist patchwork containing errors. In a 1998 interview, Zinn said he had set quiet change as his goal for writing A Peoples History. Not a revolution in the classical sense of a seizure of business leader, simply rather from people beginning to take power from within the institutions. In the workplace, the workers would take power to control the conditions of their lives.4 In 2004, Zinn edited a primary opening companion volume with Anthony Arnove, entitled, Voices of a Peoples History of the unite States. Columbus to the Robber BaronsColumbus, the Indians, and serviceman Progress covers early Native American civilization in North America and the Bahamas, the genocide and imprisonment committed by the crew of Christopher Columbus, and incidents of violent colonization by early settlers. Topics overwhelm the Arawaks, Bartolom de las Casas, the Aztecs, Hernn Corts,Pizarro, Powhatan, the Pequot, the Narragansett, Metacom, index Philips War, and the Iroquois. Ch apter 2, Drawing the Color Line addresses the early enslavement of Africans and servitude of poor British people in the Thirteen Colonies. Zinn writes of the methods by which he says racism was artificially created in order to enforce the economic system. He argues that racism is not natural because there are recorded instances of camaraderie and cooperation between black slaves and black-and-blue servants in escaping from and in opposing their subjugation. Persons of Mean and Vile Condition describes Bacons Rebellion, the economic conditions of the poor in the colonies, and oppositeness to their poverty.Tyranny is Tyranny covers the movement for leveling (economic equality) in the colonies and the causes of the American Revolution. Zinn argues that the Founding Fathers agitated for war to distract the people from their own economic problems and stop public movements, a strategy that he claims the regions leaders would continue to use in the future. A Kind of Revolution covers the war and apology to pauseicipating in war, the effects on the Native American people, and the continued inequalities in the new United States. When the land of veterans of the Revolutionary War was seized for non-payment of taxes, it led to instances of resistance to the government, as in the case of Shays Rebellion. Zinn wrote that governments including the government of the United States are not neutral they represent the dominant economic interests, and their constitutions are intended to serve these interests.The well Oppressed describes resistance to inequalities in the lives of women in the early years of the U.S. Zinn tells the stories of women who resisted the status quo, including Polly Baker, Anne Hutchinson, Mary Dyer, Amelia Bloomer, Catharine Beecher, Emma Willard, Harriot Hunt, Elizabeth Blackwell, Lucy Stone, Elizabeth Cady Stanton, Margaret Fuller, Sarah Grimk, Angelina Grimk, Dorothea Dix, Frances Wright, Lucretia Mott, and Sojourner Truth. If you look throu gh high school textbooks and elementary school textbooks in American history, you will find Andrew Jackson the frontiersman, soldier, democrat, man of the people not Jackson the slaveholder, land speculator, executioner of dissident soldiers, exterminator of Indians. Howard Zinn,A Peoples History of the United StatesAs Long As Grass Grows or Water Runs discusses 19th atomic number 6 conflicts between the U.S. government and Native Americans ( much(prenominal) as the Seminole Wars) and Indian removal, especially during the administrations of Andrew Jackson and Martin Van Buren. Chapter 8, We Take slide fastener By Conquest, Thank God describes the Mexican-American War. Zinn writes that President James Polk agitated for war for the purpose of imperialism. Zinn argues that the war was unpopular, but that newspapers of that eramisrepresented the popular senmagazinent. Slavery Without Submission, Emancipation Without Freedom addresses slave rebellions, theabolition movement, the poli te War, and the effect of these events on African-Americans. Zinn writes that the large-scale violence of the war was used to end slavery instead of the small-scale violence of the rebellions because the last mentioned may have expanded beyond anti-slavery, resulting in a movement against the capitalist system.He writes that the war could limit the freedom granted to African-Americans by allowing the government control over how that freedom was gained. The Other Civil War, covers the Anti-Rent movement, the Dorr Rebellion, the Flour Riot of 1837, the Molly Maguires, the rise of labor unions, the Lowell girlsmovement, and other class struggles centered nearly the miscellaneous depressions of the 19th century. He describes the abuse of government power by corporations and the efforts by workers to resist those abuses. hither is an excerpt on the subject of the Great Railroad Strike of 18771011 Chapter 11, Robber Barons and Rebels covers the rise of industrial corporations such(pren ominal) as the railroads and banks and their transformation into the nations dominant institutions, with corruption resulting in both industry and government. too cover are the popular movements and individuals that opposed corruption, such as the Knights of Labor, Edward Bellamy, the Socialist Labor caller, the Haymarket martyrs, the Homestead strikers, black lovage Berkman, Emma Goldman, Eugene V. Debs, the American Railway Union, theFarmers Alliance, and the Populist Party.The Twentieth CenturyThe Empire and the People, covers American imperialism during the Spanish-American War and the Philippine-American War, as well as in other lands such asHawaii, Guam, and Puerto Rico. The Teller Amendment. Zinn portrays the wars as being racist and imperialistic and opposed by large segments of the American people. Chapter 13, The Socialist Challenge, covers the rise of socialism and anarchism as popular political ideologies in the United States. Covered in the chapter are the American Federation of Labor (which Zinn argues provided too exclusive of a union for non-white, female, and unskilled workers Zinn argues in Chapter 24 that this changes in the 1990s),Industrial proles of the demesne (IWW), Mary Harris gravelJones, Joe Hill, the Socialist Labor Party, W. E. B. Du Bois, and the Progressive Party (which Zinn portrays as driven by fear of radicalism).War is the wellness of the State covers World War I and the anti-war movement that happened during it, which was met with the heavily enforced Espionage Act of 1917. Zinn argues that the United States entered the war in order to expand its foreign markets and economic influence. Self-Help in Hard Times covers the governments campaign to destroy the IWW, and the factors leading to the Great Depression. Zinn states that, despite popular belief, the 1920s were not a time of prosperity, and the problems of the Depression were simply the chronic problems of the poor extended to the rest of the society. too cover is the Communist Partys attempts to help the poor during the Depression. A Peoples War?, covers World War II, competition to it, and the effects of the war on the people. Zinn, a veteran of the war himself, notes that it was the most popular war the US ever fought, but states that this nourishment may have been manufactured through the institutions of American society.He cites various instances of opposition to fighting (in some cases greater than those during World War I) as proof. Zinn also argues against the US authoritative intention was not fighting against systematic racism such as theJim Crow laws (leading to opposition to the war from African-Americans). Another argument made by Zinn is that the atomic bombings of Hiroshima and Nagasaki were not necessary, as the U.S. government had already know that the Japanese were considering surrender beforehand. Other subjects from WWII covered include Japanese American internment and the bombing of Dresden. The chapter continues into the raw War. Here, Zinn writes that the U.S. government used the Cold War to increase control over the American people (for instance, eliminating such radical elements as the Communist Party) and at the same time create a state of perpetual war, which allowed for the creation of the modern military-industrial complex.Zinn believes this was mathematical because both conservatives and liberals willingly worked together in the name of anti-Communism. Also covered is the US involvement in the Greek Civil War, the Korean War, Julius and Ethel Rosenberg, and the Marshall Plan. Chapter 17, Or Does It Explode? (named later on a line from Langston Hughess poem Harlem from Montage of a Dream Deferred, referred to asLenox Avenue mural by Zinn), covers the Civil Rights movement. Zinn argues that the government began making reforms against discrimination (although without making fundamental changes) for the sake of changing its global image, but often did not enforce the laws that it passe d. Zinn also argues that while nonviolent tactics may have been required for Southern civil rights activists, militant meets (such as those proposed by Malcolm X) were needed to solve the problems of black ghettos. Also covered is the involvement of the Communist Party in the movement, the Congress of Racial Equality, the Student Nonviolent organise Committee, the Freedom Riders, COINTELPRO, and the Black Panther Party.The Impossible Victory Vietnam, covers the Vietnam War and resistance to it. Zinn argues that America was fighting a war that it could not win, as the Vietnamese people were in favor of the government of Ho chi Minh and opposed the regime of Ngo Dinh Diem, thus allowing them to keep esprit de corps high. Meanwhile, the American militarys morale for the war was very low, as m whatsoever soldiers were put off by the atrocities that they were made to take part in, such as the My Lai massacre. Zinn also tries to dispel the popular belief that opposition to the war was mainly amongst college students and middle class intellectuals, using statistics from the era to show higher opposition from the working class. Zinn argues that the troops themselves also opposed the war, citing desertions and refusals to go to war, as well as movements such as Vietnam Veterans Against the War.Also covered is the US infringements of Laos and Cambodia, Agent Orange, the Pentagon Papers, Ron Kovic, and raids on draft boards. Chapter 19, Surprises, covers other movements that happened during the 1960s, such as second-wave feminism, the prison reform/prison abolition movement, the Native American rights movement, and the counterculture. People and events from the feminist movement covered include Betty Friedans The Feminine Mystique, Womens International Terrorist junto from Hell, Patricia Robinson, the National Domestic Workers Union, National Organization for Women, Roe v. Wade, Susan Brownmillers Against Our Will, and Our Bodies, Ourselves. People and events from t he prison movement covered include George Jackson, the Attica Prison riots, and Jerry Sousa. People and events from the Native American rights movement covered include the National Indian Youth Council, Sid Mills, Akwesasne Notes, Indians of All Tribes, the FirstConvocation of American Indian Scholars, Frank James, the American Indian Movement, and the weakened Knee incident.People and events from the counterculture covered include Pete Seeger, Bob Dylan,Joan Baez, Malvina Reynolds, Jessica Mitfords The American Way of Death, Jonathan Kozol, George Dennison, and Ivan Illich. Chapter 20, The Seventies under Control?, covers American disillusion with the government during the 1970s and political corruption that was exposed during the decade. Zinn argues that the resignation of Richard Nixon and the motion picture of crimes committed by the CIA and FBI during the decade were done by the government in order to regain support for the government from the American people without making fundamental changes to the system according to Zinn, Gerald Fords government activity continued the same basic policies of the Nixon administration. Other topics covered include protests against the Honeywell Corporation, Angela Davis, Committee to Re-elect the President, the Watergate scandal,International Telephone and Telegraphs involvement in the 1973 Chilean coup dtat, the Mayagez incident, Project MKULTRA, the Church Committee, the Pike Committee, theTrilateral Commissions The Governability of Democracies, and the Peoples Bi-Centennial.Carter-Reagan-Bush The Bipartisan Consensus, covers the Jimmy Carter, Ronald Reagan, and George H. W. Bush administrations and their effects on both the American people and foreign countries. Zinn argues that the Democratic and Republican parties keep the government essentially the same (that is, they handled the government in a way that was favorable for corporations rather than for the people) and continued to have a militant foreign policy n o matter which party was in power. Zinn uses similarities between the three administrations methods as proof of this. Other topics covered include the Fairness Doctrine, the Indonesian invasion of East Timor, Noam Chomsky, global warming, Roy Benavidez, the Trident submarine, the Star Wars program, the Sandinista National Liberation Front, the Iran-Contra Affair, the War Powers Act, U.S. invasion of Lebanon during the Lebanese Civil War, the Invasion of Grenada, scar Romero, the El Mozote massacre, the 1986 Bombing of Libya, the collapse of the Soviet Union, theUnited States invasion of Panama, and the disconnection War. The Unreported Resistance, covers several movements that happened during the Carter-Reagan-Bush years that were ignored by much of the mainstream media.Topics covered include the anti-nuclear movement, the Plowshares Movement, the Council for a Nuclear Weapons Freeze, the Physicians for Social righteousness, George Kistiakowsky, The Fate of the Earth, Marian Wrigh t Edelman, the Citizens Clearinghouse for Hazardous Wastes, the Three Mile Island accident, the Winooski 44, Abbie Hoffman,Amy Carter, the Piedmont Peace Project, Anne Braden, Csar Chvez, the United Farm Workers, the Farm Labor Organizing Committee, Teatro Campesino, LGBT social movements, the Stonewall riots, Food Not Bombs, the anti-war movement during the Gulf War, David Barsamian, opposition to Columbus Day, Indigenous Thought, Rethinking Schools, and the Americans with Disabilities Act of 1990. The Coming Revolt of the Guards, covers Zinns theory on a possible future radical movement against the inequality in America.Zinn argues that there will eventually be a movement made up not only of previous groups that were involved in radical change (such as labor organizers, black radicals, Native Americans, feminists), but also members of the middle class who are kickoff to become discontented with the state of the nation. Zinn expects this movement to use demonstrations, marches, ci vil disobedience strikes and boycotts and general strikes direct action to redistribute wealth, to reconstruct institutions, to revamp relationships.13 Chapter 24, The Clinton Presidency, covers the effects of the Bill Clinton administration on the U.S. and the world. Zinn argues that, despite Clintons claims that he would bring changes to the country, his presidency kept many things the same as in Reagan-Bush era.Topics covered include Jocelyn Elders, the Waco Siege, the Oklahoma City bombing, the Crime Bill of 1996, the Antiterrorism and Effective Death Penalty Act of 1996, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, the 1993 bombing of Iraq, Operation Gothic Serpent, the Rwandan Genocide, the War in Bosnia and Herzegovina, the World Bank, the International Monetary Fund, the North American Free Trade Agreement, the 1998 bombing of Afghanistan and Sudan, the Impeachment of Bill Clinton, Barbara Ehrenreichs nickel and Dimed, Stand for Children, Jes se Jackson, the Million Man March, Mumia Abu-Jamal, John Sweeney, the Service Employees International Union, the Union of Needletrades, Industrial and Textile Employees, the Worker Rights Consortium, the Poor Peoples Economic Human Rights Campaign, the UN Universal Declaration of Human Rights,the Telecommunications Act of 1996, unfinished Change News, theNorth American Street Newspaper Association, the National Coalition for the Homeless, anti-globalization, and WTO Ministerial Conference of 1999 protest activity.The 2000 alternative and the War On Terrorism, covers the 2000 presidential election and the War on Terrorism. Zinn argues that attacks on the U.S. by Arabterrorists (such as the folk 11, 2001 attacks) are not caused by a hatred for our freedom (as claimed by President George W. Bush), but by grievances with U.S. foreign policies such as stationing of U.S. troops in Saudi Arabia sanctions against Iraq which had resulted in the deaths of hundreds of thousands of children t he continued U.S. support of Israels occupation of Palestinian land. Other topics covered include Ralph Nader, the War in Afghanistan, (though notably absent is any mention of the Talibangovernment in control in Afghanistan at the time, the war being launched, according to Zinn, based but on the belief that bin Laden was hiding in the country) and the USA PATRIOT Act

Follicular And Mantle Cell Lymphomas Health And Social Care Essay

follicular lymphoma 2nd ab turn up common type of lymphoma in unify States diagnosticians able to spend a penny PL with less information and more duplicability than any an other(prenominal) type of lymphoma FLs vary in fibre cutaneal ( follicle centre carrel ) lymphomas normally curable with local therapy duodenal and paediatric -both rare indolent affections make good with minimum therapy by and large non do of decease in affected unhurrieds label 3 follicular lymphoma presently defined by figure of big ( blast ) carrels per gritty-power bailiwick ( HPF ) method tolerably accurate in FL, and most consistent degree 1, & lt 5 big stalls per HPF, direct 2, 5 to 15 per HPF, and grade 3, & gt 15 per HPF duplicability watch -diagnosis of FL by diagnosticians & gt 90 % consistent, merely sanitary less accurate in makeing class class 3 FL farther classified as 3A ( big cleaved cells ) and 3B ( blast cells ) nevertheless, exceptional truth in finding class ma y bespeak limited duplicability in separating 3A from 3B distinctniess of class 3B ( Sloan-Kettering suss out ) -maximum standardised consumption ( SUV of fluorodeoxy glucose on antielectron emanation vision kiss ) in class 3 FL more equivalent to SUV in patients with diffuse similar to SUV in patients with diffuse big B cell lymphoma ( DLBCL ) than grade 1 or 2 FL Harris s great deal per centum of Ki-67 stain- substantiating cells change magnitude With increasing class of FL, with grade 3 FL staining near to degrees seen in DLBCL some(prenominal) surveies sketched that some patients with FL grade 3 hardened with cyclophosphamide, doxorubicin, Oncovin ( oncotic ) and Pediapred ( hack on ) or CHOP like regimens had solution to therapy similar to that of patients with DLBCL ability to bring around this group justifies handling all patients with grade 3 FL with regimens used to process DLBCL.Low-grade FL mul boundaryle intelligent inter bunks accessible ( best one as yet unknown ) ticker and clench lupus erythematosus favored single-agent Leukeran or cyclophosphamide no longer used ( most patients treated with combination therapy ) local radiation syndrome therapy ( RT ) used in patients with localised disease total-body irradiation out of favour patient Immwholey and FL ( Rosenberg s idler ) showed self-generated slirinkage of FL in many patients multiple surveies show patients with fewer macrophages bemuse better heroism than patients with soaring degrees ( may explicate shrinking without interposition ) vaccinum survey -without discussion ) vaccinum survey subset of patients who do antibodies had duplicating of progression-free endurance ( PFS suggests possibility of use of _relationship between FL and environment ) Gallic survey inauspicious consequence of high macrophage degrees eliminated in patients treated with rituximab ( RTX suggests changing microenvironment as manageable mechanism of action of noises, including autologous root cell organ grafting ASCT ) ASCT non considered intervention for FL until late ( despite informations ) ASCT as salvage therapyChemotherapy, Unpurged and Purged ( CUP ) attempt patients randomise to CHOP chemotherapy ( CTX ) entirely, or ASCT ( with or without purged marrow ) plus CHOP, in patients who had failed on Leukeran or other CTX patients in both organ transplant weaponries had important usefulness in PFS and overall endurance ( OS ) survey indicates ASCT effectual therapy before RTX consequences decline subsequently insistent intervention 3 of 4 direct ASCT surveies in patients with FL show highly important receipts in PFS ( no agvantage in OS ) , but upfront ASCT non done in United States St. Barts/Dana Farber and UNMC informations of patients Farber and UNMC informations of patients treated with ASCT ( pre-RTX, more often than not grades 1 and 2 ) , somewhat & lt 50 % had 10-yr exemption from disease patterned advance Possible functions of RTX in FL resort of FL ( rid ofing demand for organ transplant ) -Stanford survey update, UNMC survey, and Surveillance, Epidemiology and End Results ( SEER ) data show betterment in FL endurance over aside 3 decennaries RTX of import subscriber to alter ( although other factors doable ) Cochrane meta- abs piece of ground patients given RTX in initial therapy had extremely important survival advantage UNMC informations analytic thinking suggests patients with low-grade FL and initial intervention with RTX had superior endurance, compared to patients having RTX at other times or non at all Primary RTX and Maintenance ( PRIMA ) survey care RTX increase opportunity of continued remit by 20 % consequence larger in patients with complete response ( CR ) than in those with mathematical functionial response ( PR ) Swiss survey demonstrated survival advantage with merely 4 especial(a) doses of RTX epitome of PET informations from PRIMA survey negative findings o n PET seen in 92 % of patients with true CR one-third of patients with unsure CR PET-positive 20 % of patients with progressive disease 20 % of patients with progressive disease PET-negative PET negativeness best predicter of result RTX improves endurance of FL, but un authorize Whether it cures high proportion of patients with low-grade FL, ASCT by and by RTX therapy Spanish survey and Collaborative Trial in Relapse Aggressive Lymphoma ( CORAL ) patients with DLBCL treated with RTX before ASCT 50 % more promising to be older than patients with no RTX perchance due to bring around rate of patients after RTX therapy ( ie, patients still necessitating ASCT after RTX credibly had more immune disease ) German surveies patients witlt FL randomized to ASCT V care with interferon ( IFN ) after knowledgeableness with CHOP patients who got CHOP plus RTX ( R-CHOP ) and ASCT had somewhat better endurance than patients on IFN patients without RTX had much better endurance with ASCT than with IFN Cleveland reading no important difference in endurance after ASCT betweett patients with relapsed FL who had receive RTX in past and those who had non In vivo purge no direct informations on tap(predicate) on effects on ASCT results UNMC informations patients treated with monoclonal antibodies ( MAB ) and RTX ahead cell aggregation had better results after ASCT ( languid how much betterment due toMAB V RTX ) Gallic survey patients treated with MAB for salvage therapy had better results other surveies -majority of patients had no tumour cells ( per polymerase concatenation reaction PCR ) after RTX Post-transplantation care small informations available several surveies showed important proportions of patients had delayed neutropenia or hypoganimmagloibulinemia if treated with RTX after ASCT no inerease in mortality seen with RTX, but it gives no advantage ( and increases trouble for patients ) Conclusions public-service corporation of RTX in FL rem ains ill-defined ASCT remains best tratment in younger healthier patients for relapsed FL best given after first intervention failure vivo purging perchance of import unproved Whether it has maior consequence on results value of post-transplantation RTX uncertain verbalizer recommends handling rate 3 FL per protocols for DLBCL Questions and replies consequence of length of i?rst absolution on recommendations for ASCT in other diseases ( e.g, Hodgkin lymphoma ) , patients do less good with brief initial remission and ASCT, but likely better than with tack likely better than with alternate therapies if patient immature and healthy, talker would still offer ASCT talker would handling ASCT with immature healthy patients who have had really long or really brief remittals PET as tool to place faineant class 3 FL unknown if patients with low SUVmaX should hold different intervention differences in diagnosing of class 3 FL add complexness to determination for intervention upfront allotransplantantation for FL -best intervention to eliminate FL limited by 20 % to 30 % freshman mortality ( mortality decreases with age of patient ) tokenish Resi twofold Disease in Follicular and Mantle Cell Lymphoma -Foundation CHRISTINE POTT, MD. absence of residuary lymphoma band on imagination and bone marrow biopsy ( low sensitiveness ) referred to as clinical remittal analysis of minimum residuary disease ( machine readable dictionary ) infra clinical remittal reveals different dynamicss of lymphoma ( may indicate those who will get worse, and those with remedy or who will get worse, and those with remedy or long-run remittal ) electronic dictionary techniques extremely sensitive and mostly applicable may assist clinicians understand disease dynamicss on molecular degree allow polish of clinical presenting Benefits of electronic dictionary analysis provides workable alternate parametric quantity for clinical response integrates biologic Features of tu mour reiects pharmacogenetic traits and dose strength achieved in single patients identifies prophetic subgroups in B cell lymphoma independent prognosticative factor of import tool for indivtdualizing intervention judicial decision of MRD ) cytogenetics and fluorescent unmoved hybridisation ( FISH ) non sufficiently sensitive ( more utile for initial diagnosing and appraisal of malignant lymphoma ) flow cytometry and PCR chief methods iow cytometry loosely applicable, fast, and provides quantifiable consequences nevertheless, malignant lymphoma has partly unstable readyers ( non reproducible in many patients ) in FL, sensitivenesss vary harmonizing to benign hematogones consensus PCR well-heeled, rapid to perform.inexpensive, and stable, but non duodecimal has low sensitiveness immunogen-based allele-specii?c PCR most modernistic method sensitive, with- most advanced method sensitive, with quantitative consequences specific and extremely consistent neverth eless, labour-intensive and expenslve.PCR markers irnntunoflobttlin cistrons -heavy concatenation ( IgH ) an visible radiation concatenation ( IgK ) applicable in B cell non-Hodgkin lymphoma, chronic lymphocytic leukaemia, and acute leukaemia T cell receptor cistrons potentially available for T non-Hodgkin lymphomas and acute lymphoblastic leukaemia chromosomal translocations T ( 1/14 18 ) for FL T ( 11 14 ) fer mantle cell lymphoma ( MCL ) translocations serve as marks in 80 % of B cell lymphomas, in 60 % to 70 % of FL, and 30 % to 40 % af MCL these techniques quantify MRD in 80 % of patients imrnunoglobulin heavy-chain venue mast loosely applicable marker, rearrangement of V, D, and H parts in normal development of B cells sequence in this junctional part Acts of the Apostless as DNA i?ngerprint of cell ( identifiable by consensus PCR ) monoclonal rearrangement in lymphoma identified by gene-scan form with monoclonal extremum sequencing of monoclonal rearrange ment allows allele-specific primer design to aim single patient s sequence translocation marks T ( 14,18 ) breaktpoints in marks T ( 14,18 ) breakpoints in different locations in cistron can measure 70 % of patients with major breakpoint part assay developed by Biomed 2 chemical group rule to measure other countries translocations act as molecular markers ( eg, t 11 14 ) mark relevancy of MRD shown in early surveies betterment in cure options led to increase in surveies look intoing MRD as alternate parametric quantity for forecast FL surveies showed achievement of molecular remittal associated with improved forecast, irrespective of whether patients received ASCT, CTX, or rituximab FloridasLopez-Guillermo survey showed accomplishment of molecular remittal possible with standard-dose CTX without antibodies failure-free endurance importantly better in patients who achieve both clinical and molecular remittal Italian survey -PCR negativeness associated with impro ved forecast in patients treated with CHOP entirely or R-CHOP Gribben survey updated consequences show patients with prolong MRD negativeness ( by PCR ) after ASCT have continued long-run endurance new-made Italian survey ( .2008 ) PCR negativeness most of import predictive factor both in patients treated with R- factor both in patients treated with R-CHOP and those who received RTX plus high-dose consecutive CTX outcomes improved with molecular remittal MCL fewer surveies available several surveies conclude MRD has no predictive consequence in MCL relevancy seen after debut of RTX and ASCT monocentric survey patients consecutive monitored for MRD after R-CHOP, root cell mobilisation with dexaBEAM ( dexatnethasone_ carmustine BCNU , etoposide, cytarabine Ara-C and melphalan ) before ASCT MRD ) negativeness associated with longer PFS ( 92 minute, vs 24 minute in MRDpositive patients ) and OS European web tests MRD analysis done in patients under and & gt 65 course o f instruction of age after initiation with immuno-CTX patients accomplishing clinical and molecular remittal have significantly longer duration of response, irrespective of whether MRD achieved in blood or hone marrow molecular response after initiation superior predictive factor, compared to Mantle Cell International Prognostic Index ( MIPI ) mark and accomplishment of clinical response.Summary PCR identifies low- and poor-risk groups in FL and MCL PCR holds true in multivariate analysis and is true in multivariate analysis and is independent of pretherapeutic hazard factors MRD negativeness achievable without ASCT Timing of MRD appraisal in FL available surveies show relevant powder magazine points for stupefying predictive informations German Lymphoma Study Group test rating at diagnosing allowed presentation of association between low degree of go arounding lymphoma cells and molecular response MRRD dynamicss during initiation ( after 4 intervention rhythms ) showed tha t patients with rapid decrease of go arounding lymphoma cells have high chance of clinical remittal, compared to patients with slow response PFS with molecular remittal significantly great than that with clinical remittal entirely postremission clip point of import if MRD used as foster parametric quantity multivariate analysis shows MRD ) better predictive factor than RTX treatnient, ASCT, or pretherapeiitic FL International Prognostic index ( FLIPI ) hazard factors extra informations analysis showed MRD position helps to define patients with different forecasts independent of clinical remittal position preserve MRD position forecast significantly better in patients with sustained molecular patients witch sustained molecular response in first twelvemonth after ASCT or intervention with interferon, compared to patients who developed MRD positiveness within first twelvemonth after ASCT or during care therapy.Timing of MRD appraisal in MCL predictive relevancy shown after init iation and in postremission period increasing MRD ) degrees predict atavism aged patients who stay in molecular remittal on care intervention have significantly longer continuance of response.Who should have MRD ) intervention no current application of MRD ) to patients non en turn overed in clinical tests Decisions accomplishment of molecular remittal appropriate curative end for new clinical tests and interventions MRD appears executable for steering intervention, cut downing costs, and diminishing side effects identifies patient subgroups with durable remittals MRD allows individualized hazard appraisal and intervention Future functions of MRD rating of new intervention conjectural accounts and substances designation of non respondents _for possible early intervention intensification way of care intervention usage in pre-emptive therapies point intervention to single hazard proi?les.Mentions1. Auto organ transplant for patients with Follicular Lymohoma in the epoch of rituximab -JAMES O.ARMITAGE, MD.2. Minimal Residual Disease in Follicular and Mantle Cell Lymphoma -Foundation CHRISTIANE POTT, MD.Auto organ transplant for patients with Follicular Lymohoma in the epoch of rituximab -JAMES O.ARMITAGE MD2ND SubjectRENAL ISSUESAbstractionThe ends of this plan are to better the surgical and medical direction of locally advanced nephritic cell carcinoma and to avoid complications during public presentation of transdermal nephrolithotomy ( PNL ) . After hearing and bewitching this plan, the clinician will be better able to 1. Surgically pull off locally atlvancetl nephritic cell malignant neoplastic disease by separating between the demand for extremist V fond(p) nephrectomy and acknowledging the indicants for lymphadenectomy. 2. take on the most apprepriate drugs, based 0n their meachanisms of action, for the medical intervention of nephritic malignant neoplastic disease. 3. Sumarize the current position of neoadjuvant and addition intervention ef n ephritic malignant neoplastic disease. 4. Better his or her surgical technique for PNL. 5. Acknowledge the possible complications of PNL and their intervention, including hemorrhage, hurts to attached variety meats, hypotension, infection, and delayed bleeding.Surgical direction of locally advanced nephritic cell carcinoma STEVEN C. CAMPBELL, MD, PhDBackground 10 % to 20 % of all kidney malignant neoplastic disease strong informations run uping combination of surgery and transcriptionic intervention best systemic intervention both neo adjuvant and adjuvant dei?nition of locally advanced kidney malignant neoplastic disease widening into adrenal secretory organs, venous system, regional clients, or next variety meats T3a, T3b, T3c, T4, or guest positive but MO divergent pathology lymphoma see biopsy ) adrenocortical malignant neoplastic disease ( endocrinologist rating ) sarcoma transitional cell Carcinoma ( cystoscopy )Preoperative steps complete bowl prepare becaus e hemi colectomy may be required obtain consent for splenectomy, distal pancreaticlotomy, and partial hepatectomy in spokesperson these processs incumbent to obtain negative borders little per centum require preoperative embolization to minimise blood loss co-ordinate with vascular, Cardiovascular, and hepatic sawboness.Surgery venous engagement for degree 1 thrombi, topographic point Stansky clinch level 2 thrombi require consecutive clamping inferior vein cava ( lVC ) below, contralatera nephritic nervure, and IVC above for degree 3, mobilise colorful to obtain assenting to retrohepatic IVC and clamp above and below tumour exposure critically of import chevron showtime most common little per centum need thoracoabdominal incisien as necessary to let for en block deletion ( cardinal )Lymphadenectomy lymph node dissection controversial for lymphadenectomy, usage same templet as for testicle malignant neoplastic disease European organisation fo research and interve ntion of malignant neoplastic disease ( EORTC ) survey showed no difference in complications or endurance between extremist nephrectomy with lymphadenectomy and extremist nephrectomy without lymph node dissection study criticized because extent 0f lymph node dissection non good defined and analyze groups may hold had low hazard for lymph node engagement ( ascertainment prejudice ) Mayo clinic survey & gt 1600 patients showed 5 parametric quantities prognostic of increased likeliness of lymph node engagement, 1 ) atomic class 3 or 4, 2 ) sarcomatoid constituent, 3 ) really big 4 ) locally advanced tumour phase, and 5 tumour mortification seek to find parametric quantities preoperatively ( when possible ) , perform intraoperative frozen subdivision of lymph node, so make up ones mind if lymph node dissection needed talker s attack normally performs lymph node, dissection on younger patients but non on older frail patients forecast for node-positive malignant neoplastic d isease hapless 0 % to 20 % 5-yr endurance bulky lymph nodes may be worse prognostically than metastatic disease patients with stray venous engagement have 40 % to 50 % remedy rates most T3a patients do good, but at higher hazard than patients with organ-confined disease other predictive considerations histology border position tumour class algorithms availalale for anticipation of result.Medical Management of Locally advanced renal Cell Carcinoma -BRIAN I.RINI, MD.Mechanism of action of drugs for nephritic malignant neoplastic disease mammalian mark of rapamycin ( mTOR ) inhibitors these involve tract that regulates cell proliferation and metamorphosis in response to enviromental factors, associating cell emergence factor receptor signaling via phosphatidylinositol-3-kinase ( Pl-3K ) to cell growing, proliferation, and an-giogenesis these drugs have non been studied as neoadjuvants or adjuvants vascular endothelial growing factor ( VEGF ) inhibitors -more relevant cura tive tract VEGF is cardinal regulator of physiologic angiogenesis more drugs available against VEGF, and they by and large have greater consequence bulk of nephritic cell carcinomas characterized laic mutant of V0n Hippel-Lindau ( VHL ) tumour suppresser cistron, ensuing it collection of hypoxia-inducing factor ( HIF ) HIF is critical written text factor that leads to activation of many mark genes.including VEGF VEGF is go arounding protein that binds to endotheliel cells and leads to permeableness, migration, and proliferation of tumour blood vas cells inhibitors of VEGF tract include little molecules that inhibitVEGF receptor and agents such as bevacizumab, sunitinib, and sorafenib.Neoadjuvant surveies retrospective run across 17 patients with kidney malignant neoplastic disease with primary tumour in topographic point intervention with sunitinib produced 30 % average volume decrease in tumour size growing curves show most decrease occurs in first 2 to 4 rhythms of inter vention, so iat period, so growing sketchs.Prospective test patients with biopsy-proven kidney malignant neoplastic disease and unresectable priamary tumours treated with suntinib for 4 wk on drug and 2 wk off worsened clinically while off drug for 2 wk hence. intervention changed to uninterrupted dosing histology preponderantly clear cell carcinoma but non entirely, and most had metastatic disease about tierce of patients converted to resectable position & gt 70 % had somee tumour shrinking shrinking averaged 19 % ( 1.5 % centimeter ) greatest consequence on clear cell carcinoma.Goal of neoadjuvant therapy to bring forrad cytoreduction of tumour avoiding high morbidity of extremist nephrectomy and leting intervention with partial nephrectomy.Safety neoadjuvant therapy does non adversely affect surgical result in MD Andersen survey of 6O patients who received targeted therapy ( largely bevacizumab ) so underwent cytoreductive neph1ectonty, damage of superficial wotind mending 20 times more common in those who received targeted therapy than in matched controls so far ( & gt 100 patients ) , no big safety signals, eg, hemorrhage, coagulating.Accessory therapy United States test of 1900 patients presently in advancement postnephrectomy patients randomized to 1 year of sunitinib, sorafenib, or placebo efficaciousness informations still several old ages off.Drumhead -aggressive surgical direction basis of intervention for locally advanced kidney malignant neoplastic disease neoadjuvant VEGF-targeted intervention may take to enhanced feasibleness of resection in same patients stillinvestigational no effectual adjuvant intervention for kidney malignant neoplastic disease at present.How to Avoid Cemplications While executing transdermic Nephrolithotomy -MARSHALL L.STOLLER, MD.Background key to success in transdermal nephrolithotomy ( PNL ) is for endourologist to derive appropriate entree make non reliance on radiotherapist to execute appropri ate landmarks are 2 i?ngerbreadths sidelong from paraspinous.muscle and 2 fingers breadths below 12th rib 9 in 10 times puncture site in Petit s trigon place patient prone with thorax blosters and articulatio genuss flexed utilize world-wide. anaesthesia in instance of demand to entree airway extradural does non work excessively hard to change over to general anaesthesia if desperately necessary ) radiologists puncture straight up and down, aiming nephritic pelvic girdle, but this does non change urologist to make transdermal prcedure urine return dues non vouch entree to allow calyx.Nephrostomy tube entree usage echography to assist direct needle purpose pelt posteriur calyx Technique for lower gat puncture companion landmarks described above, , purpose for midaxillary line, progress acerate jerk, and draw C- arm toward you if needle below intended mark on x-ray, needle non steep plenty if needle above intended mark, travel deeper Technique for stop number pole pun cture travel C- arm off from you ( indicates deepness and how far to progress acerate leaf )coni?rming entry return of piss injection of retrograde methylene blue transition of ioppy tip guidewire ( if needle in anterior calyx, K- wire does non progress beyond calyx into nephritic pelvic girdle ) ultrasonographic hinderance injection of dilute contrast.Avoiding shed blooding complications occur as consequence of progressing sheath excessively far expand piece of land merely to roll uping system go forth sheath somewhat outdoor(a) roll uping system progressing excessively far cracks infundibulum.Other complications pulsatile bloody outflow, rapid venous drainage into vena cava, fecal matters, air, gall inconsequential if recognized before dilation merely draw needle out and make another puncture make non necessitate to halt instance.Localization text editions recommend winning for most inferior calyx survey of com displaceed imaging ( CT ) from 100 patients showed 42 pa tients had 2 lower pole calyces and 59 had 3 lower pole calyces most median calyx will be anterior 93 % to 95 % of clip lower pole entree should be directed to most sidelong calyx if entree into posterior calyx non achieved, successful PNL non probably, because angle of anterior confronting calyx excessively short.Dilation do non come in roll uping system, but attack every bit near as possible to roll uping systern rock should non be seeable on initial entry ( should he & gt 0.25 centimeter beyond ) guidewires guarantee length equal denominate working wires and safety wires hydrophilic guidewires go in easy but besides yielding out easy J & gt tipped guidewires do non punch roll uping system safety urologist should have on lead spectacless to protect eyesfrom radiation and from sprinkling.Tips on technique puncture easier in patients with history of PNL because kidney obstinate in PNL-naive patients, kidney moves off from progressing tip disconnected gesture require d ) talker uses 18- suppose acerate leafs ( non 25gauge ) uses really small fluoroscopy every bit long as wire moves back and Forth, exchange catheter can be advanced to minimise radiation, iuoroscopy used merely when near roll uping? system catheter can be made less stiff by dunking it into microwaved saline or madestiffer by dunking it into ice slush.Amplatz system jobs misidentify to progress Amplats sheath beyond cone ( likely to do hemorrhage ) go forth sheath outside roll uping system ( it will work its manner in during lithotripsy ) ldnked Dotter catheter fascial dilator leftover with sheath inadequately advanced fascial sheath buried sheath in corpulent patients ( place surgical seam on terminal of sheath to ease retrieval ) balloon used merely in United provinces ( pneumatic lithoclast used in other states less expensive guarantee equal skin chafe as ballon dilates radially, it shortens lorigitudinallyComplicating hurts -bowel set up separate drainage ( in testine separated from urinary system ) dual J and Foley catheters placed skin scratch enlarged and penrose drain placed patient placed on ternary antibiotics and low-roughage diet alert waiting bulk of hurts digressive ( non through-and-through ) , so colostomy non necessary postprocedural hemorrhagic find whether due to hemorrhagic or infected daze temperature unreliiable organic structure temperature should be & gt 3S % temperature of 36A to 37AC indicates possible sepsis infective complications -appropriate antibiotic fulminant disease may be related to high endotoxin concentrations low- force per unit area irrigation system hypothermia may confound diagnosing of urosepsis ticker for peripheral vasoconstriction bespeaking haemorrhagic daze V peripheral vasodilation bespeaking infected daze hurts to next variety meats lung ( look into post procedural chest X- aerate ) incidence of pleural hurts 12 % ( increases with supracostal puncture ) expression for pnet tiuothorait or hydrothoralsi ( look for clear cost phrenic Angier on chest X ray intervention individualized see chest tube ) liver or spleen hurts vascular hurts delayed bleeding in talker s pattern, occurs in 1A/o of instances disconnected brisk shed blooding due to pseudo aneurism occurs 6 wk after process diplomacy by ace selective angioembolizatien ( microcoils ) hazards include arterial dissection, nontarget embolization, and contrast-induced kidney disease highest hazard in diabetics Drain nephrostomy tubes Council-tip easy to rewire Endopyelotomy tubing 14 Gallic to 8 Gallic can be hard to put Circle nephrostomy tubing 2 entree piece of lands good for drawn-out drainage less likely to be dislodged.Foley balloon catheter cut tip off ( like Councill catheter ) Pull-string Cope-like tubings turn and draw out at same clip to avoid laceration of infundibulum. Malecot tubing entrapment can happen in little nephritic pelvic girdle due to strong collagen span that forms through ianges of tubing tissue must be cut in order to retreat entrapped tubing.Tract remainder tubeless talker sees no advantage with or without dual J catheter styptic agents and i?brin sealers ( eg, FloSeal, Tisseel ) may restrict tract bleeding preplace layover balloon in roll uping system cauterant may diminish hemorrhage skin closing better decorative consequence without Skin closing nephrostomy tubing with or without skin suturas easy dislodged when tubing removed, do certain sutura comes with it place more than one nephrostomy tubing if necessary.