Salem Witch Trials and Real Hero

The real hero is always a hero by mistake, in my understanding this quote means, true acts of courage and bravery are always performed by people who do not intentionally set out to become heroes. I agree with this quote because a person can become a hero without realizing the impact they cause to the people around them, like they didn’t know they were going to do it, they just did it. And I’ll use the play The Crucible to justify my position.In the play The crucible, John Proctor one of the main characters displayed remarkable courage and heroism, John realizes that he must confess his sin of adultery to the courts, only to stop the fury in Salem. After he confesses, he encourages his wife to do the same, â€Å"Elizabeth, tell the truth! Elizabeth, I have confessed it!† He confesses his sin, and speaks those words, only because he is looking out for the good of the community, and others around him. He hates that his name is damaged, but feels that God will forgiv e him for it.Proctor accepted the truth for what it was, not because he had to, but because speaking words of truth are actions of an honest and prideful man, that’s why I consider him as a hero. In addition there is another character in this play that I consider as a hero too, his name is Giles Corey, in the play he is killed for two different things. One thing was that he would not give Danforth the name of the person who told him that Thomas Putnam was trying to get rid of the people in the town so that he could buy their land when they were gone. This is what originally got him arrested. Later they charged him as a witch and he would not answer his indictment.Because he didn’t answer his indictment they could not charge him with being a witch. Therefore, he saved his name and his pride. You can kill him and his wife but you are not taking his property. ‘’more wait’’ were his lasts two words. Betrayal and intolerance are some of the themes we can find in this book. The crucible is a story of betrayal, the betrayal between a husband and a wife within the sanctity of a conventional marriage. However, John Proctor who is guilty of infidelity is not alone. Many of the characters are guilty of betrayal.Abigail betrays her whole community in order to seduce John. Those who falsely confess to witchcraft betray their relationship with God and their church. Intolerance, The accusations throughout the witch trials are an expression of intolerance. In conclusion the people turned to the girls to rely on who was a witch. The  girls were led by Abigail she stunned everyone with her attitude and her ability to see the Devil. It also shows that you cannot always believe what you hear because it may not be true. It also tells us that man is not perfect, and that we can make mistakes. However, even with these mistakes, we can cleanse ourselves and purify ourselves by making what is wrong right.

Groups vs Individuals Essay

‘Individuals will complete a task more efficiently and effectively than a group. And training in group dynamics, whilst interesting, has no practical value as a means of increasing the standard of group performance’ (Mullins, 2007, p296). Essay This essay is going to examine the main differences between the work of individuals and the work of a group. The perception of the author of the essay title basically states that there are more benefits than drawbacks in the individual work when comparing to the group work as well as that a given task can be completed more efficiently and effectively by an individual. The other part of the title discusses that there is no increase in group performance even though training in group is more interesting and appealing. In order to examine these two statements it is essential to consider every effect that might have an impact on the work of both individuals and groups. What often comes to people’s mind when discussing the advantages and disadvantages of working in a group is that the more people you have the more ideas you have and that the more people you have the faster the given task is completed. This essay will reveal that it is not as simple as many of us might think and that there are many complex elements of people’s behaviour that might have both positive and negative effect on the final task result. In what follows, we’ll have a look at these factors and give reasons why should the work of individual be more effective than group work or why not. In this part of the essay we are going to have a look at how various individual differences affect individual behaviour in the workplace. Individuals in the organization explore five topics which are personality, perception, learning and motivation at work. All these five psychological aspects are very closely related to each other and they help us to understand behaviour in general as well as in particular but also to analyze the performance of work and the quality of working life. We have chosen to focus on one of these five topics – Personality. Firstly, it is required to comprehend what actually personality is. Despite of the fact, (Bratton, 2007) that any universal definition of personality has not been accepted yet, we define personality as a relatively resistant way of thinking, feeling and acting which characterizes a person’s response to his or her environment. However, (Buchanan & Huczynski, 2004) there are some properties, which restrict our definition of personality, that are both stable and distinctive, depending on different situations and over time. In the case of stability, we are not interested in properties that are occasional and transient. For example, changes in person’s behaviour caused by the consumption of drugs or caused by some kind of illness are not considered as personality characteristics, unless they become permanent. However, there is one serious issue and that is the fact that personalities appear to be flexible. For example, a manager who appears to be very loud and emotionless in the office could be a caring and supportive parent in family life. In the case of distinctiveness, we must know that personality theory is related to properties that are unique to the individual and not to those that all or most other people share. For example, a man may be aggressive towards taxi drivers, friendly with waiters, loud at concerts and terrified of spiders. But the thing is that he may share some of these dispositions with a friend who breeds spiders. We also must know that, (Buchanan & Huczynski, 2004) the theory of personality relies on two main propositions. One of them is that behaviour does not change frequently even though is has both stable and distinctive features. The other one is that it must be accepted they only way how to compare the distinctive properties is by comparing them to the properties of others. One of the many theories of personality is Eysenck’s three-factor model of personality. Hans J. Eysenck (1916-1997), a well-known British psychologist born in Berlin, Germany, used factor analysis to originate his theory of personality. His theory declares, (Bratton, 2007) that a normal personality can be understood in terms of three basic factors : introversion ( a personality dimension that characterizes people who are territorial and solitary ) – extroversion ( a personality dimension that characterizes people who are outgoing, sociable and talkative ), stability – instability and self-control – psychoticism. Introversion is the opposite of extroversion, stability is the opposite of instability and self-control is the opposite of psychoticism. Eysenck created a two dimensional model which he believed captured the most important aspects of person’s personality ( see Figure 1. 0 ). [pic] Figure 1. 0 points out the effects of various combinations of the three dimensions and relates them to the four personality types (Bratton, 2007) originated by the Greek physician Galen in the second century AD. The fact that the two basic dimensions intersect at right angles ( in the sense that they are independent ) should be noted. Therefore, when we know what level of extroversion personality has it does not show us how emotionally stable the personality is. The level of person’s stability could be anywhere along the stability dimension. The other thing which the diagram reveals is that various combinations of the two primary basic dimensions make different personalities. For example, as we can see, an extroverted unstable person is touchy, restless and aggressive an extroverted stable person is sociable, outgoing and talkative. Eysenck’s theory puts in our mind that the type of personality might have a vast effect on an individual completing a given task. Therefore, a company should be very careful when hiring new employees. But on the other hand, hiring a suitable type of personality would bring a great effectiveness and efficiency into the company’s performance. In this part of the essay we are going to examine some problems that might occur in the work group. When speaking of groups we must understand what actually a group is. A group could be people waiting at a bus stop for a bus, audience in a theatre, people sheltering in a shop doorway from the rain or members of a football team. However, only one of the mentioned groups can be regarded as a work group and that is the football team. It is very significant to recognize a distinction between mere aggregates of individuals and psychological group. Consequently, we must know what characteristics a group must meet to become one. Firstly, (Buchanan & Huczynski, 2004) it is a minimum membership of two people. No ‘official’ size has been accepted, and different authors describe groups that range from two to thirty individuals. However, the more members a group has the more relations within the group there are. This fact might have a huge effect on the group performance whereas the bigger the group is the better level of communication is required and the more complex it is to operate the group effectively and successfully. Secondly, (Buchanan & Huczynski, 2004) every single member of the group must be able to communicate with every other member. In case of not meeting this criterion there might be some very serious problems in completing a given task. For example, if there was a group of three members and one member would not communicate with one of the other two members, the efficiency of the group performance would be hardly decreased. Thirdly, (Buchanan & Huczynski, 2004) members must have a shared sense of collective identity. Each member must be associated with the other members, not see him or herself as a individual working independently and at the same time all members must believe themselves in order to distinct the group from other groups. Failing to meet this criterion might cause a very negative impact on completing a task. For example, if one group member do not believe in some of the other member it might cause a tension between the members or it might make the disbelieving member work independently and again decrease the efficiency of the group performance. Fourthly, (Buchanan & Huczynski, 2004) members must have complementary goals. Each member of a group may have different goals which can be achieved only by membership of and participation in the group. Fifthly, (Buchanan & Huczynski, 2004) a group must have a structure. Every member of the group will have a different role, for example initiator, suggestion-provider, compromiser and etc. These roles tend to become fixed and indicate what members expect from each other. This criterion can be met only by following certain norms or rules. We believe that this is the most fragile part of work groups. Some people believe that rules are made to be broken and tend not to follow them. This can as well as the other criteria have a vast impact on the group performance. This part of the essay is going to be related to the statement that training in group dynamics, whilst interesting, has no practical value as a means of increasing the standard of group performance. First of all, we must gain knowledge of the term group dynamics. Group dynamics (Bratton, 2007) is the study of human behaviour in groups. The nature of groups, group development and the interrelations between individuals and group, other groups and other elements of formal organizations are included in this study. We have four major factors (Bratton, 2007) that influence group dynamics, but be aware that these factors does not attempt to create a theory of group dynamics, nor these factors can be applied to every type of group. These four elements are group context, group structure, group processes and group outcomes. We will have a closer look at the group structure. The group structure has a crucial role in group dynamics. It influences the way members relate and interact with each other and it also enable us to explain individual behaviour within the group. Without any doubt all of us have at least once found ourselves in a group. We know that group members within a group are not equal, do not have the same knowledge, have different perceptions and have different skills and abilities. This is where the differentiation takes place and where social relations are formed. According to Bratton (2007, p. 303) the group structure is the stable pattern of relationships among the differentiated elements in the group. Size of the group along other factors such as roles, status and leadership plays very important role in differentiation of a group. As we have mentioned earlier the more people you have in a group the more relationships there are and the more relationships there are the more likely a conflict might occur. For example, a group of three has three relationships, a group of four has six relationships and a group of seven has however 21 relationships. A big problem that might occur in a group is when a group has numerous members coalitions might intervene which means that some members align themselves against other group members.

First World War Essay Example | Topics and Well Written Essays - 250 words

First World War - Essay Example However, the concept of Empire and Imperialism were strong driving factors for the First World War. The great powers of Europe wanted to expand and maintain their spheres of influence in Europe. The rise of nationalistic sentiments among the different ethnic populations led to the strengthening of imperial influence. For instance, Russia supported Serbia since both belong to the Slavic people. Being a foot soldier during this period of war can range from depressive to horrific. Since static trench warfare was the predominant strategy during this time, the soldiers on each side were either on the offensive or the defensive stance. It was usually a gruesome act for armies from each side to come out of the trenches for an offensive push just to be blasted by artillery or shredded by machine gun and rifle fire. Still, many soldiers were willing to do so out of either patriotic feelings or because of a great deal of imperial propaganda. Women took part in the war mainly as field medical aid or support units. The war ended with the defeat of the German and Austrian-Hungarian Empires against the British, American, and French. The Russians were forced out early from the war due to the rise of the Bolshevik communists. The Treaty of Versailles was passed to the humiliating detriment of both the German and Austro-Hungarian Empires. Both states lost their holdings and status as imperial powers, and their military capabilities reduced. The face of Europe changed after the First World War as the Balkan states that were under the Austro-Hungarian Empire became independent. Germany lost its imperial influence, while Russia became the Soviet Union after the communists took over the Tsarist

Sourcing and supply chain strategy Essay Example | Topics and Well Written Essays - 3000 words

Sourcing and supply chain strategy - Essay Example Often, strategies that have been already tested in practice are preferred, as they can ensure the limitation of risks involved. Similar approaches are used in modern organizations when having to manage organizational sources. In this case, two different concepts appear: the sourcing strategy and the supply chain strategy. The above two frameworks, even if they seem identical, they refer to different organizational needs. Of course, as all organizational strategies, the outsourcing strategy and the supply chain strategy have a common target: to provide to the organization a competitive advantage towards its rivals (Weele 2009). The relationship between the sourcing strategy and the supply strategy is explored in this study. Reference is made to the elements of these strategies, their requirements and their key processes. Particular emphasis is given on the parts of supply chain strategy, since the particular strategy is extensively used in modern organizations, having the power to sig nificantly support organizational growth. At this point the following issue should be highlighted: the literature published in the particular field promotes different approaches for explaining the role and the structure of the outsourcing strategy and the supply chain strategy. ... Then, the processes of each of the above strategy would be analysed using appropriate theories and examples so that the value and the implications of both these strategies to be made clear. 2.1.1 Sourcing strategy The sourcing strategy, as the supply chain strategy, focuses on specific organizational needs. Patel (2005) note that ‘the sourcing strategy defines who will fulfil various parts of the objectives as defined by the business strategy’ (Patel 2005, p.43). At the next level, ‘the activity to which the above objectives are related can be a project or a process’ (Patel 2005, p.43). Thus, the role of outsourcing with modern organizations is quite specific: to respond to the needs of particular organizational initiatives, other internal or external, which have to be developed within a short or a long period of time. From a similar point of view, Philippart et al. (2005) noted that the outsourcing strategy is used when having ‘to identify the strateg ies which will be used for sourcing the appropriate products and services’ (Philippart 2005, p.118). The potential role of outsourcing as one of the key business strategies is made clear through the following example: IBM and Dell, key competitors in the global electronics industry, have significantly decreased their costs by using outsourcing in regard ‘to their key commodities, such as memories and hard disks’ (Philippart et al 2005, p.118). In other words, if it is appropriately planned, outsourcing can help to the improvement of cost control in modern organizations, supporting the standardization of organizational performance. In 2010, Walmart introduced a new sourcing strategy based on the following

Torture and Ethics Paper Research Example | Topics and Well Written Essays - 1250 words

Torture and Ethics - Research Paper Example The paper further examines if torturing violates the basic human rights provided in the First Amendment and the Bill of Rights. Eventually, it determines if the act of torture is justifiable under any ethical theory. Torturing Enemy Combatants or High-value Targets and Standards of Morality in America Torturing of enemies or criminals has been contrary to the values and morals of the Americans for long time. The Bill of Rights under the American Constitution prohibited bizarre and cruel punishments (Greenberg, 2006). Furthermore, the United States’ government, besides Americans, has condemned countries across the world that practices any act of torture. This is exemplified by the country granting asylum to individuals fleeing their countries for fear of acts of torture (Wijze, 2006). In the history of criminology and jurisprudence, the act of torture always has been distinctive. Torture forms part of the ancient techniques of punishment, which are severe. Torture is regarded a s capital punishment in which the captors apply force and brutality to obtain compliance from the criminal suspect (Ginbar, 2008). A section of the society has argued always that people who torture suspects are sadists, deriving pleasure from agony and pain of other persons. Any form of physical or psychological coercion is unacceptable for use on terrorist criminals or suspects because it amounts to inhuman and undignified treatment, diminishing the mental abilities of the targets. Depriving fellow humans of their rights and liberties of which individuals should be custodians to is morally unacceptable. Acts of torture remain evil practices to be detested and avoided (Wijze, 2006). A majority of the civilized societies across the world perceive torture as an inhuman and savage act that should not be practiced on humans. Consequently, the use of torture has received massive criticism and condemnation as well as protests (Wendel, 2005). The emergence of increased terrorist attacks af ter the 9/11 attacks, which led to the American government to adopt the policy of torture, has witnessed mixed reactions from the society over torture of suspected terror attack criminals or war prisoners (Ginbar, 2008). The international community prohibits torture through the conventional legal agreements, such as the Geneva Conventions, of which America is party to. Practicing acts of torture is a violation of the morality standards set out by the international agreements, which embody universally true and indefeasible human dignity values. Treating terrorist criminals and suspects in an inhumane way is morally irrelevant. All humans are equal and entitled to some incontrovertible rights of which dignity, found within life, liberty, and pursuit of happiness, is among them (Greenberg, 2006). The United States breaches the principle of standards of morality that it advocates for and loses its moral authority when it practices acts of torture in any circumstances (Davis, 2005). The totalitarian states find a loophole in resisting the changes demanded of them by the international community. The application of coercion is morally repugnant because it exposes America to allegations of hypocrisy, undermining its efficacy. Act of Torture: Violation of Basic Human Rights and Global Implications The use of torture to obtain crucial and critical information from criminal suspects,

How to implement a dual language program in an established elementary Dissertation

How to implement a dual language program in an established elementary public school - Dissertation Example However, a person is not born speaking a language, it is learned and through a learning process that starts at the time of birth (Fielding, 2009). In reference to the work done by linguist Noam Chomsky, Mason describes language to be a â€Å"specific skill†. Elaborating on Chomsky’s description of language as an inherent faculty, Mason in his lecture â€Å"Learning Language† said that man was born with a set of rules related to language in his head and he called these set of rules â€Å"Universal Grammar† (Learning Language, n.d.). Acquiring the First Language Children show a natural tendency towards language acquisition. Language acquisition occurs through the numerous experiences of everyday life (Northwest Regional Educational Laboratory, n.d). Acquiring language without any systematic effort is called first language acquisition. Language acquisition takes place during conversation; when adults talk, children respond and thus grasp the basics of a langu age being spoken (Moloney, 2007). The pattern of interaction between parents and children may differ with cultures but the rate at which the children develop as language users remains the same throughout the world (Clark, n.d). Children learn the language they are exposed to (Garcia, 2009). Every child learns the first language without the need of any formal lessons (Pinker, 1995). Clark has described language acquisition among children as a part of the overall physical, social and cognitive development of a child. In Clark’s opinion, children between ages 2 and 6 can rapidly acquire a language and mostly by the time they turn 6, they are proficient language users. Although a lot has been said and written about the development of language in a child, a great deal remains to be explored. The language of a child is a constantly developing process which undergoes many changes. The children seem to acquire the first language quickly, early and with few mistakes (Linden, 2008). A child’s experience with language and his interaction with others teach him the sound-meaning relationship and help him comprehend the purpose it represents. Although the rate at which children acquire first language skills may differ, there is little difference in the pattern of development between the languages (Clark, n.d) According to Clark children acquire communicative competency naturally and inherently, and then develop an understanding of the grammatical rules of the language. The structure of the language develops with thinking abilities and social interactions of the child. As the language skills develop, children become conscious of the social situations around them and learn to think and behave accordingly (Pinker, 1995). Second Language Acquisition Stephen Krashen (2009), a well known linguist identified the difference between learning and acquisition. In his theory of the second language acquisition, Krashen defined acquisition as a subconscious and instinctive process of constructing the structure of a language quite similar to the way a child picks up his first language (Krashen, 2009). Learning on the other hand is a conscious process based on formal instruction and involves conscious learning of a language (Schutz, 2007). Krashen (2009) has described learning as â€Å"less important than acquisition†

Becoming A Coder Essay Example | Topics and Well Written Essays - 1000 words

Becoming A Coder - Essay Example Coding providers give coding that can be used to describe diagnostic information that is in line with the patient’s condition, services offered and procedures followed. These codes are so detailed that they can provide an accurate description of the medical diagnoses and medical procedures performed. They can also correct diagnoses made. The profession of medical coding does not involve the practice of medicine. Instead, it is a simply the application of coding rules to a set of medical or clinical facts. Coder Credential Organizations One of the key necessities in the coding profession is credentialing. This is because the government recommends that only those coders who have the necessary credentials should be allowed to provide coding for Medicare patients. At the same time, credentialing validates the knowledge and skills of the coders to the world. In the US, two national organizations certify persons as having medical coding expertise. The two coder credential organizati ons are, the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA). AAPC targets experienced coders and as such offers specialist credentials that enable medical coders to portray very high levels of expertise in their various specialty disciplines. Their 20 specialty credentials are independent or stand-alone certifications that do not have requirements for holding of the CPC credential. AAPC allows coders to validate the knowledge they have gained in a specialty with compliance challenges, unique coding and reimbursement (AAPC, 2005). AHIMA is a professional organization that deals with the management of medical records. The organization gives professionals dealing with medical records educational resources and programs. AHIMA certification distinguishes a person as knowledgeable, competent and committed to quality healthcare through quality information. As compared to AAPC, a specialist credential offered through AHIMA f ocuses more on facility coding. Facility coding refers to the kind of medical coding done for hospitals in in-patient settings (Michelle and Jo, 2004). Credential requirements and exams. Examples of credentials offered by AHIMA include RHIA, RHIT, CCS, CCA, CCS-P and CHPS (AHIMAa, 2010). A Registered Health Information Administrator (RHIA) functions as a critical link between patients, care providers and payers. Professionals holding RHIA are experts in managing patient medical records and health information, collecting and analyzing patient information and administering computer information systems. One of the initial requirements for RHIA is a degree from a CAHIIM-accredited program. The pattern of its examination changes annually in response to organization demand or market trends. On the other hand, a Registered Health Information Technician (RHIT) is a health information technician who ensures that medical records are of good quality by verifying their accuracy, completeness an d correct entry into computer systems. They often specialize in coding procedures and diagnoses in patient records for purposes of reimbursement and research. Just like the RHIA, a degree from a CAHIIM-accredited program is one of the initial requirements for an RHIT. In addition, one must pass an AHIMA-administered written examination. According to AHIMAa (2010), 30% of RHIT exam tests on the knowledgeability in the management of health data. Thirteen percent of it tests on biomedical research, health statistics and quality management. Twenty five percent of this exam tests on information technology and systems. According to AHIMAb (2010), professionals with a Certified Coding Specialist (CCS) certification credential are skilled in classifying medical data from the medical records of the patient in a hospital

Response to Posts of Students Essay Example | Topics and Well Written Essays - 1250 words

Response to Posts of Students - Essay Example (O’Mara, et al., 2011). Because the definition specified by the D&I benchmarks is too broad, it ceases to be a definition for lack of focus. For instance, most common among staffing requirements necessarily distinguish along the lines of â€Å"education, geography, work style, work experience, job role and function, thinking style and personality type† – geography to know that the applicant is accessible to work in certain geographic areas, and the rest to ascertain that the candidate can do the job expected of him. Their inclusion in the â€Å"broad† definition, as specified in the benchmarks, appears overly intrusive into management prerogative. If alignment of organizational goals and commitment to diversity are in accordance with the broad definition, such may effectively compromise business success or even survival. I believe that business prerogative has a right to discriminate according to education, work style and experience, job role and function, thinking style and personality type, and to specify geographic accessibility, when deciding among applicants for a position, because each of these bears directly upon the very reason for the applicant’s employment. Reference: Department of Commerce, (1999). Best practices in achieving workforce diversity: Vice President Al Gore’s National Partnership for Reinventing Government Benchmarking Study. Retrieved from http://vizedhtmlcontent.next.ecollege.com/CurrentCourse/ Best%20practices%20in%20achieving%20workforce%20diversity.pdf O’Mara, J. & Richter, A. (2011) Global Diversity and Inclusion Benchmarks: Standards for Organizations Around the World. Retrieved from http://www.omaraassoc.com/pdf/GDIB_2011.pdf Response to the post of Student 2: Leslie Gaines The post identifies one practice as being easiest to accomplish, and that is the establishment of an internal diversity committee. The reason given is that the committee can be delegated the task of complying wit h or managing the nine other practices listed. The justification provided does not appear to substantiate the claim that this practice is easiest; in fact, it is the direct contradiction thereof. Because all the other practices, which are conceded by Student 2 to be more difficult, are to be discharged by the committee, then the selection of committee members shall be a most difficult task, with qualifying criteria of the most stringent standards, and pursuant to a most thorough selection procedure. Even then, the designation of a committee is but a delegation, meaning that top management may entrust the task, but not the responsibility and accountability thereof, to the committee. Holding the committee responsible is a dereliction of duty by management, which in the end must oversee the committee’s actions. The post further states that the item which does not deserve to be listed among the ten best practices is the distinction between diversity and Affirmative Action or EEO. The reason given is that the world is changing and that there is nothing the ‘good old boys’ can do to stop it. The implication here is that managers belonging to the old school would prefer to distinguish between the two for some selfish, improper reason. Whatever the reason may be, there

Human traficking Assignment Example | Topics and Well Written Essays - 500 words

Human traficking - Assignment Example Women and young girls may engage in prostitution in their accord and is mostly not a mandatory involvement(Kligman & Limoncelli, 2005). Another type of human trafficking is immigration purposes where many people wished to join other countries. Countries in Europe like German are prime countries, and many people want to enter the (Kligman & Limoncelli, 2005). Statistics shows that over thousands of people were trafficked to and away ofEastern Europe. Most countries that had less Visa regulation made more people be trafficked into the country because trafficker could freely roam across the countries border. Poverty and low economic level in our society mostly faces women. From a statistic carried out it showed that the number of women being unemployed keeps raising this had pushed women to search for low paying jobs. Most women, therefore, are exploiting new ways of making the ends meet leading them to be victims of human trafficking. Push and pull factors are like gender discrimination where women are discriminated and seen as lesser beings. Pull factors like human trafficking are profitable businesses in many European countries (Kligman & Limoncelli, 2005). There should a complete shutdown of human trafficking in Europe. All underground ready markets for human trafficking are illegal. The United Nations define human trafficking as the process of using threat, deception, fraud or coax people so that they can be recruited and transferred to the individual country. Trafficking is mostly due to the greed of money by traffickers so that they can have people to work as slaves, laborers or slaves in their host country. The humans trafficked are prone to be exploited so that their body organs can be removed and sold or given to an influential person (Kligman & Limoncelli, 2005). In Eastern Europe, socioeconomic factor links to vulnerable people in a number of ways. Vulnerable individuals in societies face challenging life

Poetry and Politics Paper Essay Example | Topics and Well Written Essays - 1000 words

Poetry and Politics Paper - Essay Example Bryant opens his poem with the recognition that slavery represents not only a â€Å"great wrong† but also a slow and painful journey in race relations (The Death of Slavery, Line 1). Bryant opens Death of Slavery with: O THOU great Wrong, that, through the slow-paced years, Didst hold they millions fettered, and didst wield The scourge that drove the labourer to the field, And turn a stony gaze on human tears, They cruel reign is o’er.... (The Death of Slavery, 1900, First Stanza). Thus for Bryant’s The Death of Slavery, represents not only a reminder of the pain and suffering associated with the oppression of one race over another, but its place in history also serves as a reminder that mankind can and has overcome the worst of evils punctuating race relations in history. Bryant’s last stanza of The Death of Slavery pulls this realization together as follows: I see the better years that hasten by Carry thee back into that shadowy past, Where, in the dusty spaces, void and vast, The graves of those whom thou hast murdered lie. The slave-pen, through whose door Thy victims pass no more...(The Death of Slavery, 1900, Last Stanza). ... Bryant (1900) likewise recalls that this â€Å"grim† past: At which the slave was sold; while at thy feet Scourges and engines of restraint and pain Moulder and rust by thine eternal seat. There, mid the symbols that proclaim they crimes, Dwell thou, a warning to the coming times (The Death of Slavery, 1900, Last Stanza). In other words, recalling the evils of the past, serves as a caution to resist evil of any kind relative to race relations among mankind. Obama likewise, sees the utility in remembering the cruel past. Obama stated that he felt it was a significant visit for his daughters as they would be encouraged to fight cruel oppression of any kind to prevent this kind of history repeating itself. Thomas Merton’s And the Children of Birmingham was written in the 1960s amidst the race movement in the US during that time. The poem reflects on the bombing in Birmingham, Alabama that killed Black children staging a protest in the 1960s against the oppression of Black in the US is also instructive. And the Children of Birmingham likewise calls attention to the cruel pass in terms of race relations and also speaks to man’s ability to overcome this kind of cruel legacy. Herron (2005) informs that from Merton’s perspective however, the death of the children in Birmingham is less about marking the history of race relations among Americans. Instead, And the Children of Birmingham is more about hope and this hope is expressed by calling upon Americans everywhere to look upon all Americans as equals, as brothers and sisters (2005). And The Children of Birmingham draws attention to the innocent victims and inheritors of the evils of cruel race relations

As Dianne Skafte Essay Example for Free

As Dianne Skafte Essay As Dianne Skafte stated in her book, â€Å"All the lives form the body of the Earth, and to that body all shall return†. The earth is viewed as the source of life with all the agricultural crops it gives to sustain the living. However, this very earth is also the home of the dead. People in different parts of the world plant their dead in the earth just like the seeds of their crops with the belief that their loved one will be born again as a new person, live in the body of an animal, or stay in the underworld. Otherwise, our ancients believed that the spirits who were returned to the earth become wise and that they gain the ability to turn into clairvoyants who can see the future and thus give guidance to those who are still living (Skafte 2000). This is the primary reason why necromancy was constantly used in the classical world. If a person decides to contact the dead, he or she will have the ability to know many hidden things. The act of necromancy falls under the umbrella of many different occult divination practices. The term was rooted from the ancient Greek language with the word ‘nekros’ meaning ‘corpse’ and ‘manteia’ or ‘prophesy’. Necromancy evolved through time and developed many different forms. Even though the Greeks may seem to be the civilization that is always connected to the act, summoning the dead was well-practiced by different civilizations around the world during these classical times like the Romans, Asians, Medieval Europeans, and Egyptians (Helium. com). The people living in the classical times look highly into their ‘necromaneias’ or the oracles of the dead. One famous act of necromancy was the one that happened in a hillside cave in Epiris where the famous legendary hero Odysseus was said to have summoned the dead at the place in order to get some guidance and information for his dangerous journey to home. Even though the Odyssey is only a fictional tale, Homer was able to base his writings from the actual practices of the many Greek necromancers that operate during their time (Donald Tyson’s Supernatural World. com). The place was also often connected to the worshipping of the goddess of the underworld, Persephone and the god of the dead, Hades. During the periods of medieval and renaissance times in ancient European history, the act of necromancy is considered as a normal part of the life of the people. There are other reasons why conjuring the dead is used. Wise-men ask for help from the spirits of the departed in order to seek for help in diagnosing the illnesses and giving cures to their patients. When it comes to families, they often seek for guidance from their dead loved ones and ask them to appear in their dreams. It was also believed that the souls of those who had already ‘crossed over to the other side’ have the rare ability in finding missing persons or even treasures that have long been lost. Spirits also help unearth some secret crimes that have been committed but were never given justice. The act of necromancy was so popularly used and believed in the ancient times that Catholic priests were even believed to have practiced the art centuries ago even though it was not openly discussed in their history books of their churches. Classical engravings also document some of the necromancy acts of famous philosophers and scholars of the time. Example of this is the one depicting John Dee, a 16th century mathematician with a famous necromancer. In the picture, the two were enveloped by a magic circle with signs of the zodiac and other symbols with a corpse in front of them. Another illustration was that of the Edward Kelly, an Elizabethan alchemist, and Paul Waring who are also protected by a magic circle while facing a corpse that has risen from the ground. All of these depictions were not fiction and were actual events. The use of the magical circle that shrouds both pictures mentioned serves as the protection of the humans from the forces of the spirit they have called that is mostly unhappy and unwilling to cooperate (Donald Tyson’s Supernatural World. com). During these times, scholars asking for the guidance and knowledge of the dead were not considered as an uncommon phenomenon. During the classical times, Nobilities or the Christian clergy were the literate members that compose high society. It is believed that either or both of these two groups were responsible for the spreading and practicing of the necromancy despite of the fact that is was strictly forbidden in Christianity. Access to necromancy is a kind of act that can only be accessible to those who belong to the scholars of Europe mainly because of reasons of accessibility, knowledge, and the procedures it use. Evidence to this fact is the number of confessions that a couple of Nobles and Clergy members expressed regarding their experience with the act. A closer look at the practices of necromancy also showed that the procedures are closely similar to Christian rites. In exorcism cases in Christianity, the spirits or demons were forces away through the use of the name of God, the Holy Spirit, or Jesus. This can be compared to the spells of necromancy which are similar to these rites in complete opposition (Necromancy. com). There are also examples of necromancy written in the Holy Bible. One of these is that on Samuel, chapters 28 and 31 that tell the story of King Saul and his abhorrence to David. In the story, he began doubting his decision of bringing David into his court because of the latter’s charisma in people and good skills of being a warrior. The King regretted letting David enter his kingdom when he started to notice that the people were already choosing the young man’s side instead of his. During that time, the Philistines were also preparing to attack. Out of desperation, King Saul disguised and went to see a ‘seeress’ to help him contact the dead. It shall be noted that the king has given an order to persecute all seers, wizards, and others that deal with the supernatural thus the need for his disguise as a common man. After the woman was convinced that she never have punishment for the request, she went onto a trance and related a vision to King Saul. According to the vision, she saw gods ascending from the earth which all gathered to form a man who is covered by a long mantle. As Saul bowed to the ground, he then recognized the spirit that possessed the woman as his deceased prophet, Samuel. But the vision was not the end of it. Samuel chastised the king for his evil attacks of David and said the because of King Saul’s violation of his covenant with the Lord, he will die the next day. The following die, King Saul’s soldiers were slaughtered and he mortally wounded. Knowing his coming fate, he decided to fall upon his own sword (Skafte 2000). Another example of necromancy mentioned in the bible was in Aeschylus’ Persians. In here, the necromancy procedure consisted of Queen Atossa asking the Persian elders to call Darius from his grave. The Queen brought some garlands of milk and different offerings like milk, honey, water, and unmixed wine and oil. The elders followed the queen’s request and called upon the deceased King asking for powerful death gods like Hades to send his soul in the face of earth. When King Darius was successfully summoned, he narrated the beating of the ground and the effect of the cries of the ‘necromantic cries’ on dead people like him (Bremmer 2002). This literary description supports the ancient beliefs about the two questions that are usually mentioned by the souls called through necromancy. The first is about the experiences and unknown secrets of the deceased while they are still living and the second, who is depicted by this story, are the relating of the souls of the ephemeral and magical things they’ve learned upon ‘crossing over’. There are many risks in calling the dead. One of these is through the perspective of Christians who condemn the use of the act. According to this side, the acquiring of knowledge from the dead is prohibited because it was not information that God prohibited to be released. According Christianity laws, there are only two legitimate sources of information that the living can use. These are the things that are revealed by the Lord and those that gleaned through a natural kind of revelation. Simply said, using necromancy to know secrets from the dead is also equivalent to stealing forbidden information. Second, spirits are not beings that people can simply call and command. The art of necromancy is divided into two different phases, the first of which is the calling of the spirit and the second is compelling it to do the bid of the necromancer. Since the spirits of the dead aren’t actually always willing to be called and ordered, there is a great risk for the necromancer and his assistant to be attacked by the former if they’re magical barrier is not that strong (Necromancy 101. com). Moreover, acts of necromancy should have well-defined motives because otherwise it will be considered as works of darkness, simply for the selfish whims of the person who wants to ‘call’ and can also turn out to be dangerous for the health and reason of the necromancer and his assistant. In necromancy procedures of classical times, necromancers are forced to inflict pain on the spirits they call just to force the latter to follow them. As a result of these, the souls are usually very unhappy towards the individuals, heightening the probability of them to become violent.Thus, there is a great risk that comes along with the valuable secrets a spirit may expose (Spence 1960). Bibliography: Bremmer, Jan N. 2002. The rise and fall of the afterlife: The 1995 Read-Tuckwell Lectures at the University of Bristol. Routledge. DeWaay, Bob. 2006. The Dangers of Divination. http://www. deceptioninthechurch. com/dangersofdivination. html (accessed June 14, 2009). Necromancy. 2009. Necromancy in History. Necromancy: Encyclopedia II. http://www. experiencefestival. com/a/Necromancy_-Necromancy_in_history/id/1575928 (accessed June 14, 2009). Skafte, Dianne. 2000. When Oracles Speak. Quest Books. Spence, Lewis. 1960. Encyclopaedia of Occultism. New York: University Books. Townbridge, B. 2009. Necromancy explained. Helium. com. http://www. helium. com/items/246248-necromancy-explained (accessed June 14, 2009). Tyson, Donald. 2007. The Truth About Necromancy. Donald Tyson’s Supernatural World. http://www. donaldtyson. com/necro. html (accessed June 14, 2009). Wendell, Leilah. 1997. Necromancy 101. The Occult Library. http://www. realmagick. com/articles/17/1817. html (accessed June 14, 2009).

The Story of a Mother Essay Example for Free

The Story of a Mother Essay Sisa ran quickly home, confused. She feared that the civil guards may have arrested his son Basilio already. When she reached home, she saw the two civil guards leaving with only her hen. She tried to walk past them but the civil guards caught her and demanded to know where her sons are. Sisa begged the guards for mercy, saying she does not know where her sons are nor does she have the gold coins they are accusing Crispin of stealing. With no other recourse, the civil guards forcibly brought her back to the barracks. Sisa, to spare her from humiliation, begged them to at least allow her some distance between them. The civil guards obliged, giving her a distance of 20 steps. They eventually reached the barracks and Sisa was imprisoned. Not wanting to bother themselves of inquiring about her, no one bothered to report to the alferez. After two hours, the alferez, rival of the curate, dismissed Father Salvi’s allegations against her and ordered her to be freed. Sisa hurriedly ran back home once again but did not find Basilio. She ran to Tasio the Sage but he was not home. Instinctively, she went home and upon entering the hut, she saw a piece of torn and bloodied cloth from Basilio’s shirt. She cried out for her children throughout the night. Come morning, Sisa can be seen smiling and talking to everyone.

The Understanding Of Knowledge Influence Human Resource Development Education Essay

The Understanding Of Knowledge Influence Human Resource Development Education Essay The importance of interpretive sociology is renowned in this Anne Fearfulls piece of research. Clerical skill and knowledge, and the role of the clerical function within five organisations are explored using qualitative research, mainly in-depth interviews. The study also focuses on the concept of common sense in order for clerks to become efficient or effective in their work. Moreover, in her study, Fearfull concluded that the skills and knowledge of the clerks can easily play an important role with regards to the success of a particular organisation. Additionally, interpretive methodology serves to create new perceptivity in the investigation of skills and knowledge amongst the workforce. Such research aims at the discovery of more opportunities. How might the understanding of knowledge as proposed by Fearfull (2005) influence human resource development policies? Various features constitute human resource development, including training, performance management and career growth. These attributes aim at the development of the employees knowledge. Organisations should understand what knowledge is needed in order to be easily explained to their workforce. In Fearfulls research, the difference between the experienced (older) and the inexperienced (younger) clerks, is remarked. As a human resource development policy, organisations can explore the possibility of engaging more experienced employees in delivering the training programmes to the newly recruited and less experienced employees. This can take the form of job mentoring whereby new and/or less experienced employees absorb knowledge from the experienced ones in order to have greater opportunities at succeeding in their position. Research indicates that when newly employees experience mentor relationships, they are more likely to be retained and immersed more quickly into the organisations cu lture. By this type of relationship, the mentor also benefits since it provides the opportunity to re-evaluate his/her skills and knowledge and provide areas for improving them. Provide a brief example which demonstrates your understanding of the key points outlined in the article. Throughout my University life, I had been engaged in various practicum placements as part of my undergraduate course. These placements have helped me to acquire knowledge through hands-on experience, understanding theories through practice. Additionally, during my first weeks of my employment, I had been engaged in an induction programme, whereby experienced employees provided training to the new recruits, including myself. I had the opportunity to become more knowledgeable of the organisations procedures and acquire the skills needed to function effectively in my new post. Despite this, the induction programme did not aid in accelerating the process of getting to know the underlying procedures which established employees employ in the day to day running of the service. Such procedures may be viewed as becoming part of the jobs common sense reasoning, which employees acquire after a considerate amount of time in the post. This was something that I have learnt by time. But this problem had been solved by having a mentor in the first four months of my employment. I consider myself as very lucky since my mentor invested trust in my abilities and was always available when needed. This was a truly learning experience whereby knowledge and work skills have been transferred from an employee who had already lived through the same experience. Lastly, I believe that the secret of the organisations success is the total and unwavering dedication of every worker, from the lowest to the highest designations. Accomplishment is the result of a collective effort from each and every employee. Reflective statement on the use of Blackboard: This is my first time I ever used Blackboard as a means of virtual learning environment. To be honest, I have never heard of it prior commencing my studies with the University of Leicester. In fact, I even had to perform some research before writing this reflective note on the use of Blackboard. At first, I thought it was quite a complicated tool but after spending some time navigating, my views on the software have changed completely. Blackboard is a system whereby students find useful resources about different subjects (depending on the course one is reading). It offers an excellent alternative to the traditional school / University classroom-based method of learning. Students can have the opportunity of sharing their ideas on a particular subject and even posting assignments and other useful resources online. Although Blackboard might be seen from some people as a means of killing face-to-face interactions, I am quite sure that when using Blackboard, it is going to turn out as a positive experience. Lastly, by looking and analysing at what my other colleagues have posted on Blackboard, I am indirectly increasing my knowledge and level of understanding about the subject. I strongly believe that everybodys effort and input is relevant since a broad subject like Human Resources is a not a topic that entails a one-good answer. AWS Portfolio Exercise 2 Identify one key argument that Garavan makes. In no more than 500 words, summarise the main argument and critically evaluate the respective strengths and weaknesses of this argument. One of the main arguments identified by Garavan (1997) in his article Training, Development, Education and Learning: Different or the Same? is that training, development, and education should be integrated together by the concept of learning. This implies that the three components are all involved in the process of learning and complement each other to better the human potential or talent (1997: 42). Although the four concepts represent different meanings, they all can be incorporated together resulting in a more competitive and efficient organisation. From a human resource development perception, the relationship between the four may be considered as largely related, with each component facilitating the other (Garavan et al, 1995). Work and education are no longer separated as were in the previous years. A more integrated model (Garavan, 1997: 47) is needed to the process of knowledge expansion amongst employees. This process should continuously be practiced as it will enhance the effectiveness of the organisation. By training employees, both the trainees and the organisation will benefit and research has shown that trained employees have a higher retention rate in a particular organisation (Umiker, 1994). Garavan (1997) also argues that the concept of management education is an important stage in an employees career (1997: 48), entailing an opportunity to test understanding and organise knowledge in a competing environment (Association of Management of MBA/MMS Institutes, 2009). The above goes hand in hand with the concept of talent management which in my opinion is an important aspect of human resource management. It refers to the employees skills and knowledge which ultimately drive their business success. Various resources, including training opportunities, offering competitive salaries, and being able to attract and recruit qualified staff, helping employees achieve their full potential. Investing knowledge, development and education amongst employees, is a way of putting an organisation into a more competitive environment and its chances of survival are quite higher than the others organisations. This is the reason why talent management is becoming an important feature in the strategic plan of an organisation. Thus, these three integrated concepts of learning are vital in an organisation because employees are giving the chance to advance in their future and career. They all motivate employees to be more efficient and more creative so that the organisation will in return provide them with a better salary and more skills. These concepts can also provide a range of challenges to a particular organisation. Such challenges include: If training is given in a short period of time (lets say in the beginning of his/her employment), the employee can be overwhelmed with lots of information. This challenge can be overcome if organisations provide training and development opportunities throughout the employees careers and not only during the first phase of their employment. The possibility that the employee leaves the organisation to a better or more exciting workplace, after the organisation invests so hard on the development, education and training of the employee. Successful organisation depends on the level of support given at all levels and its exposure of shared knowledge and information amongst all employees (Nayab, 2010). Lastly, training, development and education increase knowledge, skills and abilities in each employee. In order to avoid having the situation of no talented employees within a particular organisation, training, education and development must work together and be more involved in the strategic plan of the organisation. The three components together act as strategic partners aiming towards the organisations success (Kustoff, 2011). Bibliography Garavan, T. N. (1997) Training, Development, Education and Learning: Different or the Same?, in CLMS (2011) MSc in Human Resource Management and Training. Reading 103. Garavan, T. N., Costine, P. and Heraty, N. (1995) Training Development in Ireland: Context, Policy and Practice. Dublin: Oak Tree Press. Kustoff, R. (n.d.) The New Learning Paradigm. Self Improvement Inc.: Morganville [Online]. Available: http://www.selfgrowth.com/articles/The_New_Learning_Paradigm.html [2011, February 9]. Nayab, N. (2010) An Overview of HR Talent Management. Bright Hub Inc.: New York [Online]. Available: http://www.brighthub.com/office/human-resources/articles/96352.aspx [2011, February 9]. Umiker, W. O. (1994) Does Training Increase Employee Retention? [Online]. Available: http://findarticles.com/p/articles/mi_m3230/is_n4_v26/ai_15410797/ [2011, February 9]. AWS Portfolio Exercise 3 In no more than 500 words, analyse the relationship between the process of learning and the role of the trainer, making specific reference to the three readings listed above. Over the years, many people have examined the way people learn. This has resulted in the formation of various theories in which different views on the learning process have been developed. The readings pertaining to this exercise entail different approaches towards the process of learning. Lave and Wenger, as cited in Guile and Youngs (1998) remark learning in a socially manner whereby knowledge is transferred amongst a group of people working together rather individually. This type of learning, known as situated learning, constitutes a multidirectional approach (rather unidirectional) whereby the apprentice (trainer) is engaged in a web of relationships amongst the other colleagues rather than with his/her trainer only. They coined the term community of practice whereby all people share their knowledge by contributing ideas and information, and by helping each other out (Smith, 2003, 2009). This contrasts with the behaviourists theory on the process of learning. As noted in Tennants reading on Behaviourism, the trainer takes all the control during the learning process, while the trainees have little or no control over the process. Their simple notion is that if a positive reinforcement follows a desired behaviour, the latter is most likely to happen again. This type of reinforcement, or rewards, motivate the learner to continue with that kind of behaviour. This will consequently increase the process of learning within individuals. Additionally, negative reinforcement will give the same results, whereby negative situations are ceased as an effect of the behaviour. Punishment will occur because a negative situation is experienced as a result of the behaviour. Therefore, unlike in the community of practices, motivation occurs only as a result of rewards rather than for a self-wish for learning (Ford, 2009). Lave and Wengers work has been built on Vygotskys zone of proximal development in which an individual performs a task under adult supervision and through the support of his peers. Therefore, learning here is seen as a symbiotic experience for both the learner and his/her tutor whilst in behaviourism, the learner determines his/her behaviour on the reinforcements provided by his/her trainer. Therefore in the behaviourists approach, the trainer models the behaviour of the trainer rather easing the learning process. Khoon and Jewson (1995), in their research paper Changing Hearts and Minds: Training Programmes for Mid-Career Workers in Singapore suggested four stages in the development of learning process / training programmes by using the learning-centred approach. The findings of their research imply that motivation did not occur within the first stage but is built gradually within the four stages. In fact, no motivation exists amongst people during the first stage (withdrawal) whereby people in an organisation do not treat training programmes as a solution to their problems and difficulties. As a result, the main task of the trainers here is that of convincing employees by changing their ideas on their perception of training. This stage will then lead to the awareness phase in which people start to recognise training as a potential source of help (Khoon and Jewson, 1995). In the second stage motivation is built and people have been convinced to attend training. Norming is the next stage that follows. Here the trainees understand the fact that learning is the only option to enhance their problem-solving skills and therefore training is now seen as a privilege rather than a punishment. The final stage implies participation whereby people participate fully in the training process without the fear of failing. It is only at this stage where the dispositional barriers are fully conquered. Furthermore, like in the community of practice, in this stage, people feel that the learning programme is relevant to them. Lastly, in both situated learning and learning-centred approach, the role of the trainer is more that of facilitating learning by providing support. This will eventually encourage trainees to participate in training programmes and take the initiative of entering into such programmes themselves. Bibliography Dunn, L. (2000) Theories of Learning. Oxford Brookes University: Oxford [Online]. Available http://www.brookes.ac.uk/services/ocsd/2_learntch/theories.html [2011, February 12] Ford, P. (2009) Behavioural Approach [Online]. Available http://paulford.com/behavioural-approach-to-learning/ [2011, February 12] Guile, D. and Young, M. (1998) Apprenticeship as a Conceptual Basis for a Social Theory of Learning, in CLMS (2011) MSc in Human Resource Management and Training. Reading 115. Khoon, H. C. and Jewson, N. (1995) Changing Hearts and Minds: Training Programmes for Mid-Career Workers in Singapore, in CLMS (2011) Msc in Human Resource Management and Training. Reading 120. Smith, M. K. (2009) Communities of Practice. Infed: London [Online]. Available http://www.infed.org/biblio/communities_of_practice.htm [2011, February 11] Standridge, M. (2002) Behaviorism [Online]. Available http://projects.coe.uga.edu/epltt/index.php?title=Behaviorism [2011, February 11] Tennant, M. (2006) Behaviourism, in CLMS (2011) MSc in Human Resource Management and Training. Reading 104. AWS Portfolio Exercise 4 Cognitive theory is more relevant to the trainer in the modern workplace than behaviourist theory. To what extent do you agree with this statement? A possible plan. Introduction Points: Both cognitive and behaviourist theories are feasible learning theories. Although many believe that the former has surpassed the latter in its dominancy, it can be argued that both theories are still valid nowadays. Throughout the essay, an overview of what constitute both theories will be provided, and then share any similarities between the two. Subsequently, this essay will provide the reader with another theory, cognitive-behaviourism, which in a nutshell, is a combination of both theories underlying a comprehensive interaction between thoughts and behaviours. The main thrust of the argument presented in this essay is that trainers in modern workplaces shall use the cognitive-behaviourist theories with regards to training of employees. Body Points: What does cognitive theory say about learning theory? Learning occurs within the mind; Trainee learns by listening, watching, touching, reading, or experiencing and then processing and remembering the information (ThinkQuest, n.d.); Provide meaning to knowledge; How people understand material. What does behaviourist theory say about learning theory? Learning is seen as the acquisition of new behaviours; Learning results from pleasant or unpleasant experiences in life (Bailey, 2011); Observable behaviours produced by a learners response to stimuli (positive and negative) (Michigan State University, n.d.); For example, if a positive reinforcement follows a desired behaviour, the latter is most likely to happen again; This type of reinforcement, or rewards, motivate the learner to continue with that kind of behaviour; This will consequently increase the process of learning within individuals. Learn to (Behaviourist) vs. Learn that (Cognitive). Are there any similarities between the two theories? Yes. In a nutshell, they both agree that: Experience impacts learning; Learning theories should be objective and based on empirical based research. Were the two theories relevant someday or another? What about today? What does literature tell about their relevancy? Can the trainer use both methods? Cognitive-Behaviourism Theory Blending both theories together entails having a persons faulty thinking and behaviours changed through education and reinforcements. Such techniques foster more adaptive ways for the trainee to cope (Grohol, 2004); Feeling based learning theories; Responses are based on continuous interactions between out feelings, thinking and behaviours. I believe that trainers can apply both theories in the modern workplace if they are implemented correctly and competently. How? Bibliography Bailey, L. (2010) Cognitive and Behavioral Learning Theories [Online]. Available http://ezinearticles.com/?Cognitive-and-Behavioral-Learning-Theoriesid=3633960 [2011, February 13]. Grohol, J. M. (2004) Types of Therapies: Theoretical Orientations and Practices of Therapists. Psych Central: Newburyport [Online]. Available http://psychcentral.com/therapy.htm [2011, February 13]. Purcell, L. (n.d.) Behaviorism: Learning Theory [Online]. Available https://www.msu.edu/~purcelll/behaviorism%20theory.htm [2011, February 13]. ThinkQuest Team (n.d.) Cognitive Processes [Online]. Available http://library.thinkquest.org/26618/en-5.5.3=cognitive%20learning.htm [2011, February 13]. AWS Portfolio Exercise 5 For each extract, please provide your view in response to the following: Evaluate the style and expression. Are there any problems with it? Does it have any particular strengths? Extract 1: In my belief, the author of this extract failed to provide the reader with the basic accounts of the key concepts of Skinners work. Instead s/he criticise Skinners work by only providing the reader with a number of limitations. This also suggests that the author did not provide an analytical discussion of Skinners theories in comparison with his/her own arguments. Citing other peoples views could have helped the author to back up his/her arguments. Also, the author used a numeric list while mentioning a number of limitations in his assignment. This style is normally used when presenting facts and not when suggesting the writers own ideas. The latter in my opinion could have easily been explained better using more detailed paragraphs on each limitation. Furthermore, the author failed to adopt a third person approach in the assignment, leaving a more judgmental approach on the issues being tackled. This also suggests that the writers expressed opinions are not analysed in a balanced manner. Besides this, the author failed to use precise academic language with over-lengthy sentences and incorrect construction of sentences. A positive strength about this extract is the use of questions, which when used rightly, are aimed to attract the attention of the readers. Extract 2: The author in this citation, is picturing the audience in an excellent manner. S/he is not assuming that the reader has a prior knowledge on the subject. In fact, arguments are well defined and issues are discussed clearly and logically. Unlike the first extract, evidence is provided in regards to the statements that the author made. The style of writing is very clear and concise with an excellent flow of discussion that amalgamates the various issues surrounding the topic. Moreover, the author avoided the use of the first person when writing sentences and therefore expressing ideas in a very balanced way. One problem that I encountered while reading this extract was the use of over-lengthy sentences and colloquial expressions. The last sentence is a case in point, where it could have been simplified by using shorter and simpler sentences. Extract 3: The author of this extract used a personal account as an introductory and explanatory statement in order to support the answer of the question. On the other hand, although there is nothing wrong with personal experiences, the author should pay extra attention in order not to become carried away and loses the point of the question. As a general rule, personal reminiscences are not appropriate in the construction of academic assignments as the focus of the question can easily be shifted. However, in my opinion, I do not see anything wrong with this unless it is within the remit of the subject in caption, and used only as a preamble in an assignment. Lastly, in the body of the assignment, the author should offer discussions based on the various relevant sources about the subject being discussed. AWS Portfolio Exercise 6 Please provide a summary of a reading of your choice from the readings in your first module. Name of article: Learning from others at work: Communities of practice and informal learning Authors: David Boud and Heather Middleton Summary: Informal learning is not normally attributed in most organisations although some efforts are now being made to take account of it. In fact, this research paper aims to investigate the way employees learn from each other at their place of work. The researcher engages him/herself in work-site interviews with various employees within a particular organisation. The questions asked sought to find suitable ways of learning strategies amongst the workgroups. Moreover, the results of this study have been compared with Lave and Wengers concept of communities of practice, which is highly linked with informal learning at work. Four different groups were interviewed in order to investigate their learning practices within their own units. The first group (teachers of floor and wall tiling) have been working together for the last ten years. The head teachers role in this group is quite notable in the learning process amongst the other teachers. Information is passed on orally during unofficial meetings and also by emphasising significant sections of different articles and passes them on to his colleagues. Furthermore, members of this group act as a learning source for each other. The second group (educational planners) deals with quite sensitive issues within the organisation and their method of learning involves the contribution of experiences and collective knowledge. Colleagues are nominated to act as the central sources for information amongst their faculties. Similar to the first group, the leader of this newly integrated group act as a source of feedback and assistance on the performance of his/her colleagues. The next group forms part of the Human Resources Department of the organisation. It consists of employees of different grades with a very strong teamwork spirit. Job learning occurs through the supervision of the junior staff by their senior personnel and again the team leader is a primary focus in dealing with the most complicated and unusual difficulties. Learning also takes place through informal gatherings and regular staff meetings. Informal learning also occurs when employees pertaining to this group are asked to act at a higher level whilst others are on leave. The last group (workplace training unit) is quite small in number and its members have a very close working relationship between each other. Again, employees learn from each other during informal meetings whereby experiences and new ideas are shared amongst each other. The experience of learning within this organisation is highly dependent on the nature of work amongst the different workgroups. Apart from this, there were some commonalities amongst various sections of the groups with the concept of communities of practice. No relationship between communities of practice and the workgroups themselves has been noted due to lack of common activities and differences of function amongst the employees. Lastly, learning from other colleagues (of the same level) is quite popular in the workgroups interviewed. This contributes to the concept of horizontal or sideways development and learning as developed by Engestrom (2001). Bibliography Boud, D. and Middleton, H. (2003) Learning from Others at Work: Communities of Practice and Informal Learning, Journal of Workplace Learning, 15(5): 194-202. Engestrà ¶m, Y. (2001) Expansive Learning at Work: Towards an Activity-Theoretical Conception, Journal of Education and Work, 14(1): 133-156. Lave, J. and Wenger, E. (1991) Situated Learning: Legitimate Peripheral Participation. Cambridge: Cambridge University Press. AWS Portfolio Exercise 7 Correct any referencing errors in the extract and bibliography. You should edit the extract, correcting the referencing errors as you go, highlighting where you have done so. Lynda Measor and Patricia Sike Measor and Sike (1992) identify the influence of gender on pupils achievement in education. They examine pupils experience of gender role stereotyping in secondary school and how the expectations placed on them contribute to their success or failure. In particular, they suggest that, à ¢Ã¢â€š ¬Ã‚ ¦schools prepare each sex for quite different styles of life, and that Girlsà ¢Ã¢â€š ¬Ã‚ ¦leave school unqualified or under-qualified for paid work in the labour market (Measor and Sike, (1992: PAGE NUMBER MISSING). They acknowledge that boys expectations of work are also affected by the roles they are expected to fulfil (Measor and Sike, 1992). Indeed, Adams (1996: PAGE NUMBER MISSING), studying the design of competencies for jobs, notes that there is also a difference in expectations of womens and mens behaviour at work, even when those men and women hold the same post (1996). Clearly then gender shapes expectations, thus affecting the outcome of education and training. However, whether gender is the dominant factor affecting learning outcomes is debatable. Research by Troyna and Hatcher (1992) and Mac an Ghaill (cited in CLMS, 2008) suggests that experience of racial and ethnic difference in schools has as strong an effect on educational outcome as gender. In one study black pupils responded to racism within education in different ways, some by rejecting the expectations placed on them and others by resisting the system but nevertheless achieving above-average results (AUTHOR/S SURNAME/S MISSING, 1988). Interestingly, both the studies on gender and those on race and ethnicity identify social class as having a fundamental effect on educational outcome. While gender and race can been seen as key barriers to achievement, the underlying mechanisms of social class create barriers to the advancement of both boys and girls of all races and ethnicities in the edu cation and training systems. For example, in Britain the remnants of a strongly divided social class system have an effect on education. CLMS summary of the work of Andy Furlong identifies factors such as, à ¢Ã¢â€š ¬Ã‚ ¦poverty, overcrowding, differences in values and attitudes towards education, teachers attitudesà ¢Ã¢â€š ¬Ã‚ ¦and the type of jobs which are available locally (1995: PAGE NUMBER MISSING), all of which influence the outcome of education. Thus, while education in Britain is supposed to offer equal opportunities to all pupils, CLMS shows that these factors are all, à ¢Ã¢â€š ¬Ã‚ ¦associated with social class (1995: PAGE NUMBER MISSING). These social barriers to learning in the classroom translate to less training later in life. Statistics from a government survey published in 1989, which identified social class by income, showed that members of Social Class 1 (skilled, non-manual occupations) were twice as likely as those in Social Class 3 (manual workers) to report receiving training in the previous three years (Training Agency, 1989). Aaron Pun, who is interested in the current technological capacity to deliver training to widespread communities via open and distance education, adds to this debate by concluding that a lack of sensitivity to cultural differences can also create barriers to learning (Pun, 1995). He gives an example of Chinese managers, whose expectations of Management Development training were not met. Self-directed and participative training styles were used in a programme supplied by a Western trainer a lack of cultural sensitivity meant that expectations of a more didactic approach were not taken into account, creating a barrier to successful training. This point is emphasised by other researchers who note that some problems in training are caused by cultural differences in learning style. In conclusion, all of the cases above show that both cultural and social differences have an effect on learning, and that these influences must be taken into account in the design of training programmes.

2000 US Presidental Election Essay -- essays research papers

Introduction   Ã‚  Ã‚  Ã‚  Ã‚  The US Presidential Election of 2000 featured George W. Bush and Al Gore. It will go down in history as one of the most closest elections ¡Ã‚ ¦ in US history. It also goes down as one of the most controversial. The final decision was based on just a few hundred votes in Florida. The controversy began when the media prematurely declared the winner twice based solely on exit polls. They finally conceded that the Florida count was just too close to predict. It would take a month before the election was ultimately certified after numerous court challenges and vote recounts. Republican candidate George W. Bush was declared the winner of the Florida ¡Ã‚ ¦s 25 electoral votes. This was a victory by a razor thin margin of popular votes. It was just the fourth time in United States history that a candidate had won the Presidency while losing the popular vote. How could this be and furthermore, how could this happen? Is this just the tip of the iceberg that election ref orm is necessary? We need to insure that every American vote counts. This is supposed to be the basis of getting Americans to the voting booths according to our founding fathers. So what can be done to make sure that every vote DOES count? The Campaign   Ã‚  Ã‚  Ã‚  Ã‚  Al Gore was chosen by the Democratic Party as their choice for nomination. Al Gore had previously served under US President, Bill Clinton, and was immediately the front runner as the party ¡Ã‚ ¦s top choice. His choice for Vice President was Senator Joseph Lieberman of Connecticut. Leiberman was also the first person of Jewish dissent to be name to a national party ticket. His choice of Lieberman was determined to have been made to separate Gore from the scandals of President Clinton. It was necessary for Al Gore to distance himself as far as possible from the inherited connections. He declared himself as defender of the people against large corporations, special interest groups, and the powerful. He pledged to extend Medicare to assist senior citizens purchase prescription drugs, push for a universal health care system, lower crime rates, and maintain the strength of our standing army.   Ã‚  Ã‚  Ã‚  Ã‚  Al Gore began his campaign trail by attacking George W. Bush ¡Ã‚ ¦s tax plans. A firm believer that these plans were only intended to benefit the most wealthy of America ¡Ã‚ ¦s citizens.... ...her. Why vote if their vote won ¡Ã‚ ¦t be counted? Conclusion   Ã‚  Ã‚  Ã‚  Ã‚  There are both advantages and disadvantages in the current Electoral College System. Some of the advantages include the contribution of the cohesiveness of the country by requiring a distribution of the popular support to be elected president. It can also enhance the status of minority interest. It maintains the political stability of the nations with the encouragement of a two party system. It also maintains a federal system of government and representation.   Ã‚  Ã‚  Ã‚  Ã‚  Disadvantages that are considered are the possibility of electing a minority president. Also the possibility of the Electoral College ¡Ã‚ ¦s role in suppressing voter turnout. It also could fail to accurately reflect the national popular choice.   Ã‚  Ã‚  Ã‚  Ã‚  It can be argued that we shouldn ¡Ã‚ ¦t change what our founding fathers intended. However, we must also remember that they denied the vote to blacks and women at first. They also didn ¡Ã‚ ¦t trust citizens to elect US Senators as well. Things change with time for good reasons. It is time to change the voting process in the United States today.

social contract Essay -- essays research papers

"The current federal system of government in the United States is failing to meet its social contract obligations to the American people." There is nothing closer to the truth than this statement. While some may argue that the government is following the guidelines of a social contract, many aspects of the government have outgrown their britches and taken over. With over fifteen thousand jobs up for the taking in the government it is hard to believe that the government comprised in the 18th century is the same as the one we have now. The government has grown exponentially large since than and has created new positions and departments to "better serve" the country. Such departments include the Department of Homeland Security. Now not to trash the decision to create it; but, teenagers, such as myself, only know that this department will change a color on a chart depending on if they think it's safe or not. We have no knowledge of what it does or what it's supposed to do. Yet for some odd reason we have to pay the bills for this department through our paychecks. Shouldn't we know a little about what it does before we get taxed to help run it? How can this department better serve us if we don't know what it does and how it is helping us? The larger it grows the more money we have to pay to it, and the less independent a citizen become s. The government's main and only goal in the social contract is to protect its citizens. Yet the government seems to interv...

the bell jar (book report/ biography of author) :: essays research papers fc

The Bell Jar Suicidal in nature, perturbed in mind, and aimless in direction, Sylvia Plath fumbled her way through her adult life. The main character, Esther Greenwood, portrays Plath in her first and only book. Sylvia Plath conveys her touching story of losing herself, and her will to live, as well as her recovery in her heartbreaking novel, The Bell Jar.   Ã‚  Ã‚  Ã‚  Ã‚  Plath was not always such a disturbed person. She was born October 27th, 1932 ( ¡Ã‚ °Sylvia ¡Ã‚ ± n.p.). Her mother was a German and English teacher and her father emigrated from Germany at age sixteen to study ministry, and later, science. Sylvia was very close to her father, Otto Plath (Malmsheimer 527). In 1940, Otto, who had neglected to take care of his diabetes, fell ill and died that November. At this point in her life, Sylvia made a 180 ¢Ã‚ ª turn from being a happy, healthy child, to a shattered, lonesome soul (Malmsheimer 529).   Ã‚  Ã‚  Ã‚  Ã‚  Sylvia had little interaction with those outside of her household as a child. Her social circle included only her parents, maternal grandparents, her brother, and a few of her neighbors. She lived in the suburbs of Winthrop, Massachusetts near Boston and her father ran their household (Malmsheimer 528).   Ã‚  Ã‚  Ã‚  Ã‚  Sylvia ¡Ã‚ ¯s first publication was a short poem in the  ¡Ã‚ °Boston Sunday Herald ¡Ã‚ ± at the tender age of eight years (Malmsheimer 529). In junior high school, Plath decided that she wanted to be a writer. She stuck with that idea for the whole of her brief life.   Ã‚  Ã‚  Ã‚  Ã‚  Plath graduated from Gamaliel Bradford High School in Wellesley, Massachusetts (Volkman 311). From there she went on to earn the Wellesley Smith Club Scholarship, the Neilson Scholarship, and the Olive Higgins Prouty Fund Scholarship. In the fall of 1950, Plath enrolled in Smith College. Her first year there she was published in Seventeen Magazine and won the third place prize for their short story contest (Malmsheimer 530).   Ã‚  Ã‚  Ã‚  Ã‚  Ten years after Plath ¡Ã‚ ¯s award winning short story, her first collection of poems The Colossus and Other Poems, was published in 1960 (Malmsheimer 529). Plath attended Cambridge University in London, England. It was here that Plath met her husband, Ted Hughes, a fellow poet. They were married June 16th, 1956 and had a daughter, Frieda, and a son, Nicholas (Volkman 314). Sylvia later became aware of an affair her husband had been engaging in. This caused the couple to separate (Volkman 316).   Ã‚  Ã‚  Ã‚  Ã‚  The separation from Hughes caused Sylvia great distress. She had previously been hospitalized for attempting to take her own life (Volkman 312).

Home Alarm Case Essay

1) What is the LTV (looking 8 years out) of a customer who used auto-pay? The Life time value of a customer who used auto-pay is $1670.69 (LTV net of acquisition costs= $1373.69) 2) 2)What is the LTV (looking 8 years out) of a customer who did not use auto-pay? The Life time value of a customer who did not use auto-pay is $1361.87 (LTV net of acquisition costs= $1064. 87) 3) What is the maximum amount that Home Alarm could spend on customer and salesperson incentives to convert a residential customer to auto-pay? The maximum amount that could be spent should be the difference between the Lifetime Value of customers that sign up for non-autopay service ($1064.87) and the LTV for the ones who opted for an autopay service ($1373.69); which is $308,82. So far, Home Alarm doesn’t assign any budget for marketing at the time of sign up, so it could be a good idea to invest this amount ($308,82), or less, for a marketing campaign during the acquisition period, emphasizing the convenience of the automatic payment contract. 4) What new pricing strategies and services should Home Alarm consider to sign up new customers with auto-pay? One strategy to push new customers to sign up with autopay could be offering them the installation for free. In this case the cost of acquisition for each new customer who signs up for the autopay service would be $492 instead of $297. With this option, the lifetime value of each customer who opts for the autopay service will be $1178.69, lower than the amount that could have  been earned had they chosen this solution anyway, but higher than the $1373,69 that the company would earn had they not chosen the autopay. The main problem for this option is that we don’t have any information about the percentage of people that would choose the automatic payment without any incentive; indeed if we assume that 50% of the customer would choose the automatic payment in any case, we would earn 113,82 dollars (1178.69-1064.87) on average for each customer who decides to choose the automatic payment over the non automatic one, but we would lose $195 for each customer that would have chosen this method even without incentives. (Table 1) It could be worthwhile to offer just a reduction of the installation costs. For instance, offering a discount of 50% on the installation cost would increase the LTV of customers that choose autopay over non-autopay by more than $200 and would create a loss of only $97,5 per customer that would have opted for autopay without further incentive. Another strategy could be offering the new customers who opt for an automatic payment service a fixed price for the first three years (not increased by the annual 3% rate). In this case the LTV net of the acquisition costs would be $1305,5, still higher than the one the company would earn whether the customer opts for a not automatic payment. Moreover, offering 8 years of fixed price ($480) is still more profitable than the case in which the chose a not autopay method, but it is, in my opinion, not recommendable, because of the negative effect that it could have on the customer that chose this option before. Indeed they could decide to resign the contract and try to get a new one with the more convenient conditions. (Table 2) 5) What new pricing strategies and services should Home Alarm consider to convert existing customers to auto-pay? Taking in consideration the attrition rate during the past nine years, it seems to be more convenient try to convert the customers as early as possible; indeed the peak of the churn rate is between the third and the fourth year. One solution could be offering discounts for the customers that are willing to switch method, maybe offering them a reduction in the general rate. For example, the customers that opt for convert their payment method  could see their price increase just by 2% per year instead of the 3%. For instance, if the conversion happens during the first year, the LVT net of acquisition costs would be $1243.17 (the retention rate for the first year would be the same of the non autopay situation), significantly higher than the basic case. This numbers are obtained in the optimistic scenario where the attrition rate in case of switch would be exactly the same of the ones who initially chose for the automatic payment. (Table 3) Another option could be offering couple of years with a fixed price, as explained for the new customers.

Diagnosis On Stomach Cancer Survival Health And Social Care Essay

jump crab louse is one of the 20 close vulgar lavcerous neop operateic sicknesss in the UK. pick of the fittest from bow window loafernistercerous neoplastic ailment has been increasing in the past 30 honest-to-god sequences, un slight at that mooring remains to be survival differences amid divergent socio-economic categories. The heroism in to a greater extent disfavor categories has remained economic crisiser than heroism from the much(prenominal) c ar categories ( this difference is cognize as the unavoidableness bed c t bug out ensemble overing ) and more(prenominal) than so authorised in males.Methods A drop data particularise of 70370 movecerous neoplastic malady perseverings that was create from the crowd outcerous neoplastic ailment indicate dataset and merged with hospital episode Statistics ( HES ) dataset. The especial(a) circumstances patterning attack was use utilizing the name of m exclusivelyeable parametric pattern ing with confine trine-dimensional slats was utilize to estimate boodle heroism from raft cancerous neoplastic illness.Consequences The interlock survival of the fittest was tack to differ surrounded by different trust tracks, where meshing cour fester was reject in the just about disadvant mount upd socio-economic discriminate and the highest in the roughly upchuck menage. The exculpate fortitude was set up to be high(prenominal) in females than males and was prep be to be to the highest degree twice every smear much in patients who had mental process.Decision It was set up that although clear cour eld about duple in patients who had operating theater, the requirement counterpane heretofore remained. However farther depth psychology which puzzle on flesh and phratry of cancerous neoplastic malady would assist in placing whether this emergency spread is in fact consequential by and bywardwards taking into history much(prenominal ) variables. dodge of ContentssC argon Form 53GlossaryDCO closing Certificate MerelyEHR redundant make RatioFP Fractional PolynomialGOR presidential term perspective neighbourhoodHES Hospital possibility StatisticssIMD Index of Multiple Deprivation mar Missing At RandomMI Multiple ImputationTVC Time ever-changing roleDF Degrees of emancipationONS Office of National StatisticsHES Hospital occurrence StatisticssAIC Akaike in wreakation standardBIC Bayesian t each(prenominal)ing standard1 Introduction1.1 Biology and Symptoms of Stomach CancerCancer is a unhealthiness which relieve oneselfs unnatural growing of cells which jumping to split and reproduce uncontrollably and in some warrants these cells can metastasise. This growing in cells egests mevery obsolete dates before the cancerous neoplastic illness can be detected. The cancerous cells lose legion inseparable control systems collectable to mutant in the cistrons of third estate cells. Whe n human cells reproduce, mutant can go on by opportunity, stock-still a emblem of different mutants occur before cancerous neoplastic unsoundness cells argon fleshed.There be trey cistrons which can do cancerous neoplastic sickness cells transforming genes ( likewise known as cancer cistrons which argon unnatural and do the cells to multiply or duplicate ) , neoplasm suppresser cistrons ( cistrons which stop the cells multiplying as yet(prenominal) if shamed halt pastureing indeed cells fix cancerous ) and DNA fix cistrons ( cistrons which cook differentwise change cistrons until now if dam yearsd so mutants can non be repaired and accordingly when the cell multiplies and divides it copies the mutants ) . ( 1 )Stomach cancerous neoplastic indisposition is the cancerous neoplastic complaint that occurs in the breadbasket and is at some(prenominal) rate known as stomachic cancerous neoplastic infirmity. There atomic number 18 a take c atomic number 18 of different tokens of mint cancerous neoplastic ailments. The close to common type of smoke cancerous neoplastic affection is known as glandular cancer of the potful which outsets in the secretory electric organ cells of the belly liner, the secretory organ cells so produce stomach fluids and mucous secretion. some other types of mass cancerous neoplastic malady involve Squamous cell cancerous neoplastic maladys formed in the squamous cells ( skin cells that atomic number 18 mingled with the secretory organ cells which form the heap liner ) ( 2 ) .Lymphoma of the good deal re eithery r atomic number 18 and is a different type of cancerous neoplastic sickness in which white blood cells ( lymph cells ) perish cancerous cells and can non assist nurture the organic structure like normal white blood cells ( 2 ) .gastrointestinal tummy tumor ( GIST ) a rare tumor which grows from the cells of the connective interweave which up champion the variety meats o f the digestive ( GI ) piece of land and can be deuce(prenominal) cancerous and non-cancerous ) ( 2 ) .neuroendocrine tumor are rare tumor which grows in the t regainings that produce endocrines in the digestive system and can be cancerous and non-cancerous ( 2 ) .The early symptoms of tummy malignant neoplastic indisposition are non-specific and insure dyspepsia, sourness and belch, experiencing full Oklahoman and wherefore turn up in loss of weight, shed blooding in the tummy which can do anaemia and then doing fatigue and paler tegument. Other symptoms h honest-to-goodness purging, blood coagulums, hurting in the speed berth venters or hurting under the office bone and trouble in take up downing. Symptoms of the advanced phase of the malignant neoplastic disease, include blood in the make and be amazement of fluid in the venters ( 3 ) .There are no examen programme for tummy malignant neoplastic disease in the UK, however tummy malignant neoplastic disease i s the close to common malignant neoplastic disease in japan and at that placefore a showing programme is apply which involves a Ba repast x-ray followed by endoscopy.1.2 Stomach Cancer Incidence, excerption & A MortalityCancer is a cardinal wellness issue in the UK, where a one-fourth of whole blend ins are repayable to malignant neoplastic disease and one in three state develop malignant neoplastic disease at each eyeshade in their lives. Cancer is more common in gagaer stack where more than 75 % of blend ins occur in nation over 65, nevertheless it can develop at any age. The incidence set up of malignant neoplastic disease has change magnitude by 20 % in males and 40 % in females since the mid-1970 s ( 4 ) .Stomach malignant neoplastic disease was recordnstrate to be the 9th most common malignant neoplastic disease amongst kick the bucket at forces and the fourteenth most common amongst adult females in the UK in 2008 ( 5 ) . Around 7610 unfermented instan ces of tummy malignant neoplastic disease were diag prized in the UK in 2008, 4923 instances among work forces and 2687 in adult females with an overall incident yard of 8.6 per 100,000 individuals. In Britain the incidence rates for some(prenominal) males and females have more than halved from about 30 per 100,000 in 1975-1977 to about 13 per 100,000 in 2006-2008 in males, and from about 14 per 100,000 in 1975-1977 to about 5 per 100,000 in 2006-2008 ( 5 ) . The rate attachd quickly for people above 60 gaga ages to about 140 per 100,000 in work forces and 67 per 100,000 in adult females aged 85 and over in 2008 ( 5 ) .Survival from tummy malignant neoplastic disease progressively progressed in patients diag obtruded in 1996-1999 compared to patients diagnosed in 1971-1975, crotchetyly cod to quicker and preliminary sensing and study, and betterment in discussion ( 6 ) . In England and Wales the one yr heroism more than doubled in patients diagnosed in 1996-1999 compare d to 1971-1975. The 5 mannequin survival of the fittest were about three generation high(prenominal)(prenominal) in patients diagnosed in 1996-1999 compared to patients diagnosed in 1971-1975 ( 6 ) .The death rate rate rate of tummy malignant neoplastic disease lessen by about 70 % in two males and females over the last 30 superannuated ages in the UK. The aim of deathrate was convertible to the magnetic dip of incidence as the death rate rate was prepare to be high in males than females across the UK in 2008 ( 7 ) .The different types of incumbrance for tummy malignant neoplastic disease include surgery, shaft therapy, chemotherapy and biological therapy. Combinations of the hitchs are besides unre delayably utilize much(prenominal) as chemotherapy and surgery in state of affairss where it is non practicable to take a localized malignant neoplastic disease wholly as it has spread and hence chemotherapy is employ to first squinch the malignant neoplastic d isease pot to functionally take it ( 8 ) .1.3 profess FactorsMore than 70 % of all tummy malignant neoplastic disease instances are diagnosed in developing states ( 9 ) . Older people, males and people belonging to the most separate socio-economic home have a higher(prenominal) impale of tummy malignant neoplastic disease ( 10 ) .Other risk of exposure portions include smoke, intoxicant, weight, househ emeritus history, exposure to beam of light, bloodline and Helicobacter Pylori ( 10 ) .Helicobacter Pylori is a bacterial infection that has higher prevalence in developing states and in people who have a low socio-economic position. In a survey of instances in 2010, it was put up that 32 % of tummy malignant neoplastic disease instances were associated with infection of the bacteria. In other surveies it has besides been found that get rid ofing Helicobacter pylori whitethorn help in forestalling tummy malignant neoplastic disease ( 10 ) .There is incertitude about the association of h experienting tummy malignant neoplastic disease and an sick diet. A few surveies have found that a higher consumption of fruits and veggies is associated with burn downing the hazard of tummy malignant neoplastic disease, nevertheless other surveies such as the heroic poem survey found that a Mediterranean diet reduces the hazard of tummy malignant neoplastic disease. other survey found that pickled veggies increase the hazard of tummy malignant neoplastic disease in Nipponese and Koreans ( 10 ) .Family history of tummy malignant neoplastic disease increases the hazard of acquiring the disease, nevertheless some of this addition may be environmental, as some surveies showed thousand of increase hazard in partners of patients ( 10 ) .The EPIC survey found that physical natural action reduced the hazard of tummy malignant neoplastic disease and have a protective consequence, nevertheless other surveies take into green endure no grounds of such and hence farth er research needs to be carried out to supply measurable grounds ( 10 ) .1.4 Socio-economic In capableityThe resolution betwixt requi localise screens varies well for tummy malignant neoplastic disease with pissed patients holding higher survival of the fittest rates compared to strip patients as shown from a ascertain of surveies worldwide. Mitry et Al. ( 11 ) analysed tummy malignant neoplastic disease entropys from England and Wales malignant neoplastic disease memorials and found a statistically important deprivation spread ( i.e. the difference in survival mingled with burster and single out categories of patients ) in survival digest in work forces diagnosed amidst1986-1999. another(prenominal) survey carried out in the boodleherlands found that the hazard of deceasing was lower afterwardswards seting for possible confounders in hot flash patients compared to divest patients ( 12 ) . A survey in Japan besides looked at the association surrounded by soc io-economic position and tummy malignant neoplastic disease heroism by analyzing the natural selection of patients by their business. There was grounds of variety in selection by business after seting for possible confounders and this was chiefly due to subterranean analyze of tummy malignant neoplastic disease amongst the lower businesss ( 13 ) .The postulate spread in courage has widened for male patients diagnosed in the 1996-1999 compared to those diagnosed in 1986-1990. Mitry et Al. ( 11 ) showed that the deficiency spread for some(prenominal) annual fortitude and five-year survival of the fittest has widened steadily and importantly from 1986 to 1999 for tummy malignant neoplastic disease and that that the motive spread in work forces is likely to go on broadening.In England There were grounds of socioeconomic variation in tummy malignant neoplastic disease incidence, it was reported that incidence remained unvarying in the flower meetings, nevertheless in cidence decreased by 31 % in deprived work forces and by 47 % in discriminate adult females higher in westbound Midlands, England mingled with 1986-2000 ( 14 ) .Many suggestions were put frontward to word the beginning of the require spread in malignant neoplastic disease courage, and three chief factors were suggested phase of study, biological features of the malignant neoplastic disease, host factors and consequence of interpolation, psychosocial factors, and interference accredited, medical expertness and malignant neoplastic disease showing ( 15 ) .1.5 Aims & A AimsThe net ( comparative ) survival in a state of malignant neoplastic disease patients is their courage from the malignant neoplastic disease of involvement in the absence of other haves of clear.The canvass of net courage in the UK by urgency split suggests a important broadening require spread in males ( 11 ) . The manipulation of this undertaking is to look into whether the widening deficie ncy spread in work forces was due to work forces in the deprived sort out non profiting from healing surgery. The phase at canvas leave behind besides be study to look into the possibility of deprived work forces diagnosed at a ulterior phase compared to affluent work forces.Datas from the eight regional malignant neoplastic disease Registries of England over the period 1997-2006 testament be examined. This dataset ordain be coupled to the Hospital Episode Statistics from which schooling on hitch leave behind be derived, to analyze survival tendencies and rate net survival of patients with tummy malignant neoplastic disease after seting for sex, age, extremity spread, interposition and phase of disease at diagnosis. simoleons endurance pass on be estimated utilizing an special risk supposititious theme. From the exceptional risk of exposure supposititious write up, all designer death rate bequeath be sitled as the amount of the excess ( cancer-related ) m ortality peril and the expect ( primer coat ) mortality. give the sack endurance ordain hence be reason as the ratio of the find ( all caseful ) endurance to the anticipate ( background ) endurance.The background mortality/survival forget be defined utilizing behavior tabular arraies from the superior command cosmos. The life tabular arraies ordain be merged utilizing age, sex, yr of issue, GOR ( presidency Office pieces ) and motivation class to the malignant neoplastic disease dataset. give the sack endurance by regard class will foremost be estimated to find if at that place is any grounds of socio-economic inequality in malignant neoplastic disease endurance in the analysed period 1997-2006. An summary will so be carried out, seting for confounders such as age, sex, handling, and phase of malignant neoplastic disease.2 Materials and mannersThis chapter will supply description of the selective disciplines employ in the undertaking and the statistical method actings applied to predict net endurance from tummy malignant neoplastic disease by deficiency category. The construct of bendable parametric patterning with restricted 3-dimensional slats will be used to take into history differences in mortality by age, sex and hitch are discussed in item.All statistical analysis was carried out utilizing STATA 12.1 ( 16 ) .2.1 DatasThe UK is known to hold the most extensive/complete malignant neoplastic disease readjustment systems in the universe ( 17 ) . Presently at that place are eight malignant neoplastic disease registers in England. The malignant neoplastic disease registers in England collect information on clinical informations such as phase and type of malignant neoplastic disease, take place franchises which are forwarded by the Office of National Statistics ( ONS ) and demographic information such as twenty-four hours of the month of birth, soaked solar twenty-four hourslight of the month of diagnosis, sex ( 18 ) . randomness such as the malignant neoplastic disease class, phase and intervention are biggerly uncomplete. furthermore information on infirmary admittances and co-morbidity is frequently unavailable.Further information on malignant neoplastic disease patients can be obtained from the Hospital Episode Statistics ( HES ) . The HES is a database apparatus to include informations and information on all admittances in NHS infirmaries since 1989. Since 2003, the HES database has besides included and stored information on outpatients.The information in the HES are exceptionalcted from clinical instance notes. clinical instance notes include more elaborate descriptions of the clinical informations such as class and phase of malignant neoplastic disease at diagnose, intervention received and co-morbidity. The malignant neoplastic disease register and HES database can be merged ( 19 ) utilizing the patients NHS figure and cardinal information day of the month of birth.Once the malignant neoplastic disease register and the HES database are combined, an indie cheque on the quality of the information is carried out every bit grave as betterment in the completeness of the informations ingathering ( 19 ) .The patients acknowledged through kick the bucket certifications are followed up by their enrollment officers from their some(prenominal) regional malignant neoplastic disease registers to overhaul out the topographical point of intervention and thus the patients infirmary & A instance notes. However this is non equal for some patients as they may non hold been extendd any secondary attention ( hospitalization/clinics ) and therefore these patients are referred as give certification merely ( DCO ) ( 20, 21 ) .Analysiss will be carried out on nameless informations from the eight malignant neoplastic disease registers in England on tummy malignant neoplastic disease diagnosed during 1997-2006. The patients determine worthy for the analyses were merged i n progress with their some(prenominal) patient records from the HES database from which information on intervention was superfluouscted. Demographic information which included day of the month of birth, sex, governing body Office Region ( GOR ) , day of the month of malignant neoplastic disease name and morphology were wedded for severally patient.Information on the continue postcode code at name and critical position ( exsanguinous, alive or emigrated ) were found from the Office of National Statistics for all(prenominal) patient. However as there was no information available the socio-economic position of to all(prenominal) one malignant neoplastic disease patient, utilizing the ZIP code the domicil at diagnose of each malignant neoplastic disease patients was identified and hence a take countenance found on the abode was allocated to each patient. Five need classs ( from 1 most affluent to 5 most deprived ) were classified utilizing the income sphere notice of the 2004 Index of Multiple indigence ( IMD2004 ) and each patient was hence assigned to their several class based on their penury mark. The IMD is based on everyday administrative informations of the 34,378 Lower Super-Output Areas ( LSOAs ) in England.Carstairs might ( 22 ) was the index used antecedently. canvass the IMD mark to the Carstairs mark, the IMD is based on a small geographical country and is non based the nose count informations and therefore can be updated on a regular primer coat without transporting out a new nose count. The IMD is normally updated every 3-4 old ages.2.2 statistical Methods2.2.1 Relative Survival and Excess MortalityNet endurance can be used to measure malignant neoplastic disease mortality satisfying. It can besides be used to mensurate un require mortality of malignant neoplastic disease patients compared to the general population.Net endurance can be estimated utilizing set about specific or supererogatory mortality. Net endurance u tilizing the cause-specific attack can be used by measuring the cause of each decease, merely the deceases attributed to the malignant neoplastic disease are considered and all other causes of deceases are ban. The major disadvantage is that there is a strong dependance on the quality of decease records.Cause-specific endurance can be used to mensurate malignant neoplastic disease mortality straight and uses inside informations of all deceases, nevertheless the cause of decease in this instance is malignant neoplastic disease and is used in the malignant neoplastic disease mortality. This method requires the cause of decease to be finished and exactly specified, nevertheless the cause of decease is non precondition in most instances. substantiative deceases such as deceases due to passageway accidents or deceases due to side- effect of medications/treatment on base deceases due to malignant neoplastic disease are hard to sort. Furthermore, different diagnosticians will specify cause of decease otherwise depending on the state of affairs at cartridge holder of decease hence cause of decease may non be repair defined.There are two methods of estimate of the cause specific attack are Kaplan-Meier method and the Acturial method.Excess mortality is a method which posters for malignant neoplastic disease mortality straight and indirectly without necessitating an precise and precise specification of the cause of decease ( 23 ) . The tautologic mortality is derived as the difference in the ascertained mortality ( mortality due to all causes ) and judge mortality ( mortality due to non-cancer-related causes ) . two tautological mortality methods attachment malignant neoplastic disease mortality after seting for background mortality from several(a) other causes and hence presumptively should give homogeneous values. In world nevertheless this depends on how suitably bring ins are fulfill for each several method, chiefly accurately documenting and stipu lating the cause of decease for the cause-specific method and the honor of gauging the expected mortality for the extra mortality method ( 23 ) .Excess mortality is classified mathematically utilizing the endangerment defend at press cutting since diagnosis as. The fortune symbolize is equal to the amount of the extra risk of exposure due to stomach malignant neoplastic disease canvas and the expected peril ( sometimes known as the service line jeopardy, estimated utilizing external informations from the general population ) where is the covariates vector ( 24 ) . comparability ( 1 )Net endurance ( Relative endurance ) is the survival corresponding to extra mortality, and is derived as the ratio of the ascertained endurance of the malignant neoplastic disease patients to the expected endurance estimated from the general population utilizing life tabular arraies. Equation ( 1 ) may therefore equivalently be write in footings of net/ telling endurance asEquation ( 2 )where and are the cumulative observed and expected endurance severally. The relation betwixt the jeopardy mapping and expected jeopardy and cumulative observed and expected endurance severally, is given by and, and the net/ relative endurance is so given as. ( 24 )The jeopardy is assumed to be piecewise invariable over of finish plume ( constant over bantam graze detachments ) in pattern and hence a suddenly period such as a year or less great power be used at the start of the reappraisal. If a longer period is used so the changeless jeopardy premise is violated and prison term since study is non automatically familiarized for and is hence the uninterrupted map may be modelled as a measure map. A new covariate vector is derived by adding the covariate vector with the index variables where the index variables are generated for all intervals apart from the list interval. A multiplicative map of the covariates in the signifier of is assumed to be the extra jeopardy and the refore comparison ( 1 ) becomesEquation ( 3 )or ratherEquation ( 4 )where the parametric metre estimates when exponentiated can be inferred as extra jeopardy ratios ( EHRs ) . The jeopardies are assumed to be relative implicitly in equality ( 3 ) . By Introducing fundamental fundamental interaction footings of the follow up ramble on and covariates in the abstractive throwaway can be used for patterning non- propertyal jeopardies.Excess mortality can be estimated utilizing assorted different methods,Different methods exist for gauging extra mortality, either utilizing a full likeliness attack ( 25 ) , or based on sorted informations incorporating one musing for each life table interval within a generalised hemorrhagening(a) hypothetic name ( 25, 26 ) . look tabular arraies provide information on endurance and give the chance of decease in the general population bedded by age, calendar year, sex, want and governance office part ( GOR ) . The life tabular arraies in E ngland are based on the nose count informations and are hence updated every 10 old ages to demo limitings in life anticipation.In the analysis carried out for this undertaking the life tabular array used is stratified by sex, age, GOR, class of issue, and IMD quintile.The invigoration tabular arraies from 1981-2010 were used. Life tabular arraies are based on mortality in the general population, which include the mortality due to stomach malignant neoplastic disease, but because decease due to malignant neoplastic disease is diminutive compared to the general population, it does non impact net/relative endurance estimations in pattern Ederee et Al. ( 27 ) .The stpm2 bid in STATA was used to look for comparative endurance. The timescale and failure were declared utilizing the stset bid, and the square up beginning for the analysis was taken to be the day of the month of diagnosing of each topic. The timescale was calculated in old ages and the extra mortality was modelled as th e primary contribute of involvement as suggested in ( 23 ) .2.2.2 SplinesFrequently complex non-linear make from uninterrupted variables e.g. age are modelled in arrested development suppositional grievances. There are many meliorate methods of patterning complex and non-linear cause. Splines is an easy manner of including an informative variable in a equable non-linear manner.Mathematical maps which are sections of multinomials and joined unneurotic at points called knots are known as splines. To do the spline smooth, A figure of restraints which include limitations on the mathematical derived functions of the spline map are applied surrounded by next multinomial sections so that the turn off is smooth at the knot.In general, splines can be generated utilizing multinomials of any grade. However three-d splines are frequently used, in which each section can be written as a three-dimensional multinomial as three-dimensional multinomials normally model most curves right and are computationally easy to obtain. The smoothness status for a three-dimensional spline ungenerouss that the spline map is uninterrupted i.e. the first and second derived functions are uninterrupted everyplace and there are no leaps or interruptions in the spline.A three-dimensional spline with K knots may be derived mathematically in footings of K+4 parametric quantities in general as ( 28 ) where the notation classifies the incline map, where if, and if and the knots are at places severally. brick-shaped splines behave ill at the queue up suits when fitted to informations is less and the spline map may be susceptible to extreme value. A subset of three-dimensional splines where the spline map is analog before the first knot and after the last knot are known as restricted splines ( 28 ) . A restricted three-dimensional spline can be specified by K-1 parametric quantities for K figure of knots which is 5 less than a general three-dimensional spline.where the is defined asW ith a logarithmically change enclothe variable, restricted splines are normally used to pattern the extra jeopardy. Knots can be anyplace on the log-outcome dress distribution, where the boundary knots at the first and last log-outcome snip off.2.2.3 Flexible Parametric Survival moldingsRoyston and Parmar ( 29 ) foremost introduced bendable parametric suppositious accounts in the position of criminalise endurance informations. This method of patterning informations gave more plasticness to the form of the jeopardy map in comparing to other parametric hypothetical accounts e.g. the Weibull a priori account for which the signifiers of the jeopardy map are limited.The flexible parametric conjectural accounts do non necessitate numerical incorporation and hence a cardinal advantage of such suppositious accounts is comparatively fast calculations. ( 30 )The Cox suppositious account is the most common method of covering with censored informations, nevertheless flexible param etric abstractive accounts can cover with non-proportional jeopardies more expeditiously.In flexible parametric endurance theoretical accounts, work is treated as a uninterrupted variable and hence irrelevant piecewise approaches the demand of dividing the time-scale is non needed ( 24, 26 ) . The considerable Numberss of excess parametric quantities which are necessitate to be created so that time-dependent cause are incorporated in the piecewise attack are hence non required in this molding attack and hence this reduces the computational even up and uses less computing machine remembering particularly for big datasets.Alteration of the flexible parametric theoretical accounts have since been through for comparative endurance theoretical accounts ( 30, 31 )A parametric theoretical account is defined as a theoretical account which can be identified in footings of a fixed set of parametric quantities ( , , ) . Restricted three-dimensional splines are fitted to the estimatio ns of the log baseline jeopardy in a flexible parametric net/relative endurance theoretical account ( 30 ) .Equation ( 6 )Transforming to the endurance graduated tableEquation ( 7 )where is the restricted three-dimensional spline map of with knots, and is the cumulative overall jeopardy. The log-likelihood map is obtained utilizing comparison ( 6 ) and numerical methods are used to calibre the parametric quantities which give upper limit likeliness utilizing equation. Thus the endurance and hazard maps can be analytically estimated.2.2.4 Evitable DeathsA manner of infering extra hazard ratios is by ciphering avoidable deceases ( 32-34 ) . The figure of evitable deceases is the figure of deceases due to stomach malignant neoplastic disease which could be avoided if the net endurance in all socio-economic classs would be the homogeneous as that of the most moneyed class after seting for the different features of each class.The expected figure of deceases due to all causes amongst a specific classify of patients utilizing equation ( 2 ) iswhere N is the size of the population, is the expected endurance at clip T and is the net endurance of the concerned conclave at clip T.In the general population, the predicted figure of all-cause deceases in a matched sort out is.The premise of net endurance universe the aforementioned(prenominal) as in a population being compared to is made ( in this instance the least disfavor ( flower ) category ) to deduce evitable deceases.The figure of evitable deceases are calculated by deducting the predicted figure of deceases due to all causes given the new comparative endurance from the predicted figure of deceases due to all causes given the skipper comparative endurance.The figure of evitable deceases represents postponed deceases which will happen subsequently and hence are really variable with the follow-up clip.2.3 statistical AnalysisTo transport out the statistical analysis, informations were examined to ensure it s dependability. Consistency cheques were besides carried to do certain informations was placed in the needed fields. Datas from the Hospital Episode Statistics ( HES ) database were merged with the malignant neoplastic disease register informations, and information on intervention was obtained. patients whose records could non be matched to the HES database were excluded. Patients who had losing informations on variables such as GOR or IMD mark ( used to deduce want classs ) , which were used in unifying with the general population life tabular array to gauge the net endurance were besides excluded from the analysis.The patient distributions were examined by the chief explanatory variables on the information.To happen differences in want class, cross-tabulations of other variables ( such as intervention, GOR and malignant neoplastic disease registers etc. ) by want category were carried out.Net endurance by want category was estimated utilizing a flexible parametric theoretica l account. This theoretical account did non affect any variables with losing informations and the stpm2 bid in STATA was used to cipher predicted net endurance. pass judgment chances of decease were estimated by unifying the life tabular arraies stratified by age, sex, want and GOR and class of issue, to the malignant neoplastic disease dataset ( formed of HES merged with the malignant neoplastic disease register informations ) .The method of flexible parametric theoretical accounts utilizing restricted three-dimensional splines was used, as this method was computationally less ambitious and less clip consuming and a more accurate method of analysis. Using flexible parametric patterning with splines, interaction footings were fitted in the theoretical account. As extra mortality was predicted to differ non-linearly with age, hence interaction footings for age with splines were besides introduced.To prove the subtlety of this method of analysis, both in footings of the appendage of utilizing splines and besides presenting the interaction footings of the theoretical account. Net endurance for up to 10 old ages was estimated and predicted by want category, seting for sex, intervention and age multitude. A new variable dividing the age with 5 splines was so created and used to do dummy variables for the restricted three-dimensional age splines variables. A restricted three-dimensional spline with 5 knots was used.To let for non-proportionality in the extra jeopardy for both twelvemonth ( twelvemonth of diagnosing ) spline and age spline variables, dummy variables for the interaction betwixt both variables were generated.A figure of flexible parametric theoretical accounts were fitted for males and females respectively. The first theoretical account was fitted with want and chief confounders such as the age splines and twelvemonth ( twelvemonth of diagnosing ) splines. A 2nd theoretical account with interactions between age splines and twelvemonth ( twelvem onth of diagnosing ) splines every bit inviolable as utilizing all the variables from the first theoretical account. The 3rd theoretical account was fitted by including intervention ( as the association between intervention and want class was to be examined particularly in patients who had surgery ) in the scoop adjustment theoretical account out of the first two theoretical accounts. The theoretical accounts were re-fitted with clip changing set up with age merely and so with both age and clip of diagnosing. These theoretical accounts were compared for the trounce of tantrum utilizing the likeliness ratio trial.To happen out which grades of freedom ( DF ) for the baseline jeopardy produced the better adjustment theoretical account, the crush adjustment theoretical account without the clip changing set up was fitted with 1 to 5 DF and so compared utilizing Akaike information standard ( AIC ) and Bayesian information standard ( BIC ) . The best sufficient theoretical account w ith the DF for the baseline jeopardy was elect to be the 1 with the smallest AIC and BIC. The same method was used to make up ones mind which DF for the varying set up was best used for the best fitting clip changing personal effects theoretical account.The scrutiny of evitable deceases was carried out to gauge and fore contrive the figure of evitable deceases at 1 and 5 old ages if endurance was the same in all want classs as the most inflorescence class.3 Consequences3.1 Description of the malignant neoplastic disease register informationsFor the analyses to be carried out, a sum of 70,370 patients who were diagnosed with tummy malignant neoplastic disease during the period of 1997-2006, and were linked to the HES database. From the entire figure of patients, 1729 ( 2.46 % ) patients were registered via their decease certification merely ( DCO ) or had zero endurance ( day of the month of decease was the same as the day of the month of diagnosing ) . Zero endurances were inclu ded in the analysis by adding one twenty-four hours to the day of the month of decease, as excepting them would overrate the endurance, nevertheless it is known that DCOs seldom have a confirmed day of the month of diagnosing ( 21 ) .Of the entire figure of tummy malignant neoplastic disease patients, 45,580 ( 64.77 % ) were work forces and 24,790 ( 35.23 % ) of the patients were adult females. table shows the figure of tummy malignant neoplastic disease instances by GOR. The largest absolute figure of tummy malignant neoplastic disease patients was in the northwesterly part and the smallest being in the northerly eastern United States part. send back Proportion of tummy malignant neoplastic disease patients by Government Office RegionGovernment office partNumber ( % ) of patientsnorthward East ( A )5,157 ( 7.33 ) normality air jacket ( B )11,615 ( 16.51 )Yorkshire and The Humber ( D )8,710 ( 12.38 )East Midlands ( E )6,278 ( 8.92 )West Midlands ( F )8,461 ( 12.02 )East of Engla nd ( G )7,027 ( 9.99 )London ( H )7,508 ( 10.67 )South East ( J )8,878 ( 12.62 )South West ( K )6,736 ( 9.57 )The proportion of males to females and average age of tummy malignant neoplastic disease diagnosing were same across all want categories, the highest mean age at diagnosing in the middle want class ( 73.3 old ages ) and the lowest amongst the most disadvantaged group and the flush group ( 72.4 old ages ) , nevertheless this difference in mean age at diagnosing was non that large amongst want categories. The spread for age amongst all want categories was found to be identical due to the lopsidedness and standard divergence. The proportions of topics attack from each GOR by want category differed mostly. convention Percentage of patients by want categoryA clear monotonically increasing form was found in the per centum of people by want category, where there was a lower per centum of patients from the flush category and a higher per centum of patients from the disadvantaged category as shown in exercise 1. experience Percentage of patients having no interventionA tendency was seen in intervention. common fig tree 2 shows that the most disadvantaged group were less likely to have any signifier of intervention. The tendency in the per centum of patients having any intervention including surgery was found to back up the consequences from manikin 2, where the per centum of patients from flush to the most disadvantaged were 34.63 % , 34.30 % , 33.74 % , 33.02 % and 32.79 % severally.Table Distribution of patients by Sexual activityMalesFemalesEntire multivariates north%Nitrogen%Nitrogen%45,58064.7724,79035.2370370100 duration group ( old ages )15-441,0202.247062.851,7262.4545-542,7606.061,0724.323,8325.4555-647,27715.972,66310.749,94014.1365-7414,99032.896,08724.5521,07729.9575-8414,99232.899,03136.4324,02334.1485-1004,5419.965,23121.109,77213.89Want1-least deprived7,03315.433,49714.1110,53014.9628,16917.924,22617.0512,39517.6139,24120.275,16020.8114,40 120.46410,39922.815,72323.0916,12222.915-most deprived10,73823.566,18424.9516,92224.05 interposition mathematical process merely7,71816.934,34717.5412,06517.15Chemo merely6,26613.752,1148.538,38011.91 tuner merely2330.511120.453450.49Surgery, tuner1350.30770.312120.30Surgery, chemo1,6883.707312.952,4193.44Chemo, wireless1140.25370.151510.21Surgery, chemo, wireless450.10130.05580.08No intervention29,38164.4617,35970.0246,74066.42SiteC16013,93230.574,52018.2318,45226.22C1616431.412901.179331.33C1621,1332.496002.421,7332.46C1632,2764.991,7467.044,0225.72C1641,0592.328123.281,8712.66C1653,2687.171,6886.814,9567.04C1661,2272.696862.771,9132.72C1684601.012501.017101.01C16921,58247.3514,19857.2735,78050.85Government Office Region ( GOR )A3,2237.071,9347.805,1577.33Bacillus7,36716.164,24817.1411,61516.51Calciferol5,46611.993,24413.098,71012.38 einsteinium4,1829.182,0968.466,2788.92F5,66912.442,79211.268,46112.02Gram4,74610.412,2819.207,0279.99Hydrogen4,74510.412,76311.157,50810.67 watt sec ond5,80212.733,07612.418,87812.62K4,3809.612,3569.506,7369.57Cancer RegistryNorth & A York7,45516.364,43117.8711,88616.89Trent5,27711.582,79911.298,07611.48East Anglia3,1486.911,4745.954,6226.57Thames9,36820.555,20220.9814,57020.70Oxford1,8153.981,0024.042,8174.00South & A West5,87612.893,06312.368,93912.70West Midlands5,97512.432,79011.258,45612.02North West & A Mersey6,97515.304,0294.02911,00415.64From Table 2, it can be distinctly seen that the proportion of males and females were similar in the two youngest age group classs, nevertheless the proportion of males was more in the in-between two classs and the proportion of females was more in the oldest two classs. The distribution of the proportion of males and females was similar for all want, intervention, GOR and malignant neoplastic disease register classs. The proportion of males was about twice every bit many as females for site C160 and the proportion of females was more compared to males for site C169, nevertheless the proportion of males and females were similar for all other sites.A important factor in finding endurance is intervention, hence a trial was carried out to see if there was any difference between want classs in the proportion having any intervention compared to those non having intervention, and in the proportion having intervention affecting surgery compared to those undergoing no surgical intervention. Two logistic arrested development theoretical accounts were hence carried out, one for the proportion having any intervention and the other for the proportion having surgical intervention by want class, seting for age and twelvemonth of diagnosing, one at a time for males and females.After seting for confounder, the betting odds of acquiring any intervention for females in the most disadvantaged class were 0.88 times less than in the flush class ( p-value 0.009 ) . There was no difference in the odds of intervention in males between want classs.After seting for confounders, the od ds having surgical intervention in males from the more disadvantaged classs was 1.18 times more than in the flush class ( p-value & lt 0.001 ) and no difference in the odds of having surgical intervention in females between want classs.The average age at diagnosing was 72.92 old ages. The mean overall follow-up clip of 1.57 old ages as shown in table 3. The per centum of patients who died by the concluding of the follow-up period was found to be 91.64 % of patients.Table 3 shows the average follow-up clip ( the norm clip until stomach malignant neoplastic disease patients are dead or censored ) and the per centum of those who died stratified by age group, want category and intervention. A really little difference was found in both overall mean follow-up clip and the proportion dead by the storehouse of followup between males and females. The average follow-up clip was longer and the proportion of patients deceasing by the terminal of the followup was lower in younger topics. The average follow-up clip was longer and the proportion of patients deceasing was lower in the patients belonging to the most flush class, with both results demoing an diminish tendency by diminishing want category.The average follow-up clip of patients having surgery, with either or both radiation therapy therapy and chemotherapy, was longer than those patients who did non have surgery and the proportion death by the terminal of followup was smaller. This was chiefly due to the fact that chemotherapy and radiation therapy interventions were carried out on patients at the ulterior phases of the malignant neoplastic disease, whereas surgery was carried out earlier phase, nevertheless this may aim that patients who underwent surgery had a better endurance.VariableAverage followup ( old ages )% dead by the terminal of followupMaleFemaleOverallMaleFemaleOverall1.581.561.5791.7491.4591.64Age group ( old ages )15-442.632.952.7680.3974.5077.9845-542.472.552.4983.6280.7882.8355-642.252.512. 3285.8382.5884.9665-741.761.991.8390.4397.9389.7075-841.131.291.1995.9694.5995.4485-1000.620.640.6399.1099.1499.12Want1-least deprived1.761.801.7789.9589.3389.7421.651.581.6391.4690.9191.2731.561.521.5492.1491.9892.0841.481.501.4992.3691.9492.225-most deprived1.531.481.5192.1892.1292.16 intercessionSurgery merely3.413.703.5277.5274.7676.53Chemo merely1.581.481.5594.1494.8094.31 wireless merely1.701.401.6090.5691.0790.72Surgery, wireless3.824.674.1376.3061.0470.75Surgery, chemo3.263.253.2681.4680.8581.27Chemo, wireless1.842.021.8992.1189.1991.39Surgery, chemo, wireless3.133.273.1686.6784.6286.21No intervention0.990.940.9795.6495.8295.71Table 3 Average follow-up clip and % of patients who were save as holding died by the terminal of the follow-up period by sex3.2 Consequences from the more complex analysisThe simple flexible parametric theoretical account was fitted with want, age splines and twelvemonth splines variables. The grades of freedom for the baseline jeopardy were chosen u tilizing the AIC and BIC consequences from Table 4.Table 4 Degrees of freedom for baseline jeopardy and their AIC/BICBaseline bump DFModel DFAICBICMale11692327.5092467.1321787329.5987477.9531886419.8886576.9741986097.2186263.0352085890.8386065.38Female11644135.4544265.3421741201.0741339.0831840783.5440929.6741940686.4540840.6952040568.3140730.67From Table 4, it can clearly be seen that the theoretical accounts fitted with 5 grades of freedom for the baseline jeopardy give the smallest AIC and BIC for both males and females and hence provide a better tantrum for the theoretical account. Although it seems best to utilize 5 DF for the baseline jeopardy, 3 DF will be used as the theoretical accounts with 5 DF are computationally intensive when clip changing effects are included.Table 5 Net endurance by want class at 1, 5 and 10 old ages un modify for intervention for males and females individuallyNet enduranceMalesFemales1-year endurance intimately flush0.360.3820.340.3530.330.3440.32 0.33 some disadvantaged0.320.335-year endurance most(prenominal) flush0.160.1920.140.1630.130.1640.120.15Most disadvantaged0.120.1510-year enduranceMost flush0.120.1520.100.1230.100.1240.090.11Most disadvantaged0.090.11Consequences from the estimation of cyberspace endurance up to 1, 5, and 10 old ages after diagnosing, unadjusted for intervention, are shown in go outs 3-8 for males and females individually, and showed that there was a suggestion of a analog tendency across the want groups. surrounded by the five want groups, 1-year predicted net endurance ranged from 0.32 to 0.36 for males and 0.33 to 0.38 for females. The 5-year predicted net endurance ranged from 0.12 to 0.16 for males and 0.15 to 0.19 in females. The 10- twelvemonth predicted net endurance ranged from 0.09 and 0.12 for males and 0.11 to 0.15 for females ( Table 5 ) . In general, the predicted cyberspace endurance scope had a somewhat higher lower limit and upper limit for females than males bespeaking that th e predicted cyberspace endurance was overall better/higher in females than males.The estimated difference in endurance was 0.04 in males and 0.05 in females between the most flush and the most disadvantaged groups at one twelvemonth after diagnosing. At five old ages after diagnosing the estimated difference in endurance between the two groups was the same for males but decreased to 0.04 for females. A clear linear tendency was seen between one and five old ages after diagnosing. The tendency between the least disadvantaged and most disadvantaged classs remained up to ten old ages after diagnosing, although at ten old ages the endurance of the two most disadvantaged classs was the same.Table 6 Excess jeopardy ratio ( EHR ) of decease, adjusted for age and twelvemonth of diagnosing for males and females individually without seting for intervention and clip varying effects for patients diagnosed with tummy malignant neoplastic disease during 1997-2006 in EnglandMalesFemalesEHRP-value 95 % CIEHRP-value95 % CIWant1-Least deprivedBaselineBaseline21.0460.014( 1.009, 1.084 )1.0720.006( 1.020, 1.128 )31.076& lt 0.001( 1.039, 1.114 )1.0820.001( 1.031, 1.136 )41.117& lt 0.001( 1.079, 1.155 )1.118& lt 0.001( 1.066, 1.172 )5-most deprived1.142& lt 0.001( 1.103, 1.181 )1.143& lt 0.001( 1.091, 1.197 )Splines13.389& lt 0.001( 3.349, 3.428 )3.383& lt 0.001( 3.331, 3.436 )21.242& lt 0.001( 1.230, 1.254 )1.262& lt 0.001( 1.246, 1.278 )31.107& lt 0.001( 1.101, 1.113 )1.098& lt 0.001( 1.090, 1.106 )Table 6 shows a comparing of the consequences of the flexible theoretical accounts for males and females individually. Comparing the consequences of males and females, the extra jeopardy ratio ( EHR ) of decease by want class was higher in general for females, although both analyses gave a additive tendency in EHR by want. For both males and females, the EHR of decease by want was statistically important indicating that the EHR differed for each want class compared to the mo st flush class. hence more disadvantaged groups had a higher extra mortality due to malignant neoplastic disease compared to the less disadvantaged groups.Age and twelvemonth of diagnosing were modelled as a non-linear effects, and were important in for the first three age splines for both males and females and were important for twelvemonth spline 1 and 4 in males and twelvemonth splines 1 & A 2 in females.Figure earnings endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for males diagnosed with tummy malignant neoplastic disease during 1997-2006 in England.Figure internet endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for females diagnosed with tummy malignant neoplastic disease during 1997-2006 in England.Figure Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for males diagnosed with tummy malignant neoplastic disease during 1997-2006 in England.Figure Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for females diagnosed with tummy malignant neoplastic disease during 1997-2006 in England.Figure Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males diagnosed with tummy malignant neoplastic disease during 1997-2006 in England.Figure Relative endurance up to 10 old ages after diagnosing, by want class at diagnosing for females diagnosed with tummy malignant neoplastic disease during 1997-2006 in England.Table 7 Degrees of freedom for Time Varying parting ( TVC ) and their AIC/BIC with baseline jeopardy of 3 DF.TVC DFModel DFAICBICMale12386047.8986248.6222886035.8586280.2243885727.0886058.7254385660.8786036.14Female12340628.0640814.7722840590.5940817.943840504.9640813.4554340515.3540864.43The flexible parametric theoretical account was fitted with want, age splines and twelvemonth splines variables and age splines as the clip changing consequence. The grades of freedom for the baseline jeopardy we re chosen utilizing the AIC and BIC consequences from Table 4.From Table 7, it can clearly be seen that the theoretical account fitted for males with 5 DF for the clip variable consequence gives the smallest AIC and BIC, nevertheless the theoretical account fitted for females with 4 DF has the smallest AIC and BIC. consequently either 4 DF or 5 DF can be used run the analysis for the clip changing effects and intervention. Further analysis was carried out utilizing 4 DF.Table 8 Adjusted extra jeopardy ratio ( EHR ) of decease for males and females individually seting for intervention and clip changing effects of age and twelvemonth of diagnosing for patients diagnosed with tummy malignant neoplastic disease during 1997-2006 in EnglandMalesFemalesEHRP-value95 % CIEHRP-value95 % CIWant1-Least deprivedBaselineBaseline21.080& lt 0.001( 1.042, 1.120 )1.0560.036( 1.004, 1.110 )31.111& lt 0.001( 1.073, 1.150 )1.095& lt 0.001( 1.043, 1.149 )41.167& lt 0.001( 1.128, 1.208 )1.124& lt 0. 001( 1.072,1.179 )5-most deprived1.195& lt 0.001( 1.155, 1.236 )1.162& lt 0.001( 1.109, 1.217 )Splines13.639& lt 0.001( 3.593, 3.686 )3.783& lt 0.001( 3.709, 3.859 )21.219& lt 0.001( 1.206, 1.232 )1.243& lt 0.001( 1.223, 1.264 )31.100& lt 0.001( 1.093, 1.108 )1.112& lt 0.001( 1.102, 1.122 )TreatmentNo SurgeryBaselineBaselineSurgery0.327& lt 0.001( 0.317, 0.337 )0.311& lt 0.001( 0.298, 0.325 )No ChemoBaselineBaselineChemo0.732& lt 0.001( 0.711, 0.754 )0.826& lt 0.001( 0.788, 0.865 )No radioBaselineBaselineRadio0.755& lt 0.001( 0.679, 0.839 )0.7640.001( 0.653, 0.894 )Age splinesAge spline11.304& lt 0.001( 1.285, 1.323 )1.295& lt 0.001( 1.269, 1.322 )Age spline 20.945& lt 0.001( 0.931, 0.959 )0.938& lt 0.001( 0.922, 0.956 )Age spline 31.0140.063( 0.999, 1.028 )1.0190.048( 1.000, 1.039 )Age spline 40.9930.286( 0.980, 1.006 )0.9800.028( 0.963, 0.998 )Age spline 50.9870.044( 0.975, 1.000 )0.9990.896( 0.985, 1.014 ) class of diagnosing splinesYear spline10.923& lt 0.001( 0.912, 0.935 )0.929& lt 0.001( 0.914, 0.944 )Year spline 21.0160.012( 1.003, 1.028 )1.0050.567( 0.989, 1.021 )Year spline 30.9880.041( 0.976, 0.999 )0.9960.622( 0.980, 1.012 )Year spline 41.025& lt 0.001( 1.013, 1.038 )1.0120.140( 0.996, 1.029 )Year spline 51.0030.630( 0.991, 1.015 )1.0050.592( 0.988, 1.021 )Table 8 shows a comparing of the consequences of the clip changing effects theoretical account seting for want, age at diagnosing, twelvemonth of diagnosing and intervention for males and females individually. Comparing the consequences from the male analysis with the female, the extra jeopardy ratio ( EHR ) for decease by want was lower in females in general, although both analyses gave a additive tendency in EHR by want. Comparing the EHR for both analyses to consequences from Table 6, it is clear that the EHR is lower when intervention and clip changing effects such as age and twelvemonth of diagnosing are taken into history.There was besides decrease in EHR for any interv ention compared to no intervention nevertheless there was a big lessening in EHR of surgery compared to no surgery for both males and females. In both analyses, intervention with surgery was associated with increase net endurance compared to non-surgical intervention or no intervention. Age and twelvemonth of diagnosing were modelled as a time-dependent non-linear consequence, and were important for peculiar splines in both theoretical accounts.The additive tendency in want category remained and became more important, since the EHR in want classs for both males and females differed in comparing to the most flush group at the 5 % signification degree, as in the instance of the simpler analyses. Therefore more disadvantaged groups had a higher extra mortality due to malignant neoplastic disease compared to the less disadvantaged groups. The deficiency of an interaction term between want classs and splines in the concluding theoretical account suggests that the difference in comparat ive endurance between want groups did non alteration over the clip period of the survey.Figure Internet endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for males seting for intervention and clip changing effects and diagnosed during 1997-2006 in England.Figure Internet endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for females seting for intervention and clip changing effects and diagnosed during 1997-2006 in England.Figure Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for males seting for intervention and clip changing effects and diagnosed during 1997-2006 in England.Figure Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for females seting for intervention and clip changing effects and diagnosed during 1997-2006 in England.Figure Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males seting for intervention and clip ch anging effects and diagnosed during 1997-2006 in England.Figure Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for females seting for intervention and clip changing effects and diagnosed during 1997-2006 in England.Figure Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males who had intervention affecting surgery, seting for clip changing effects and diagnosed during 1997-2006 in England.Figure Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males who had intervention affecting surgery, seting for clip changing effects and diagnosed during 1997-2006 in England.Table 9 Net endurance by want class at 1, 5 and 10 old ages adjusted for intervention and surgery for males and females individually.MalesFemalesNet enduranceNet endurance from tummy surgeryNet enduranceNet endurance from tummy surgery1-year enduranceMost flush0.370.650.360.6720.340.630.340.6530.330.620.330.6440.32 0.610.320.63Most disadvantaged0.310.600.320.635-year enduranceMost flush0.160.420.170.4620.140.390.160.4430.140.380.150.4240.130.370.140.42Most disadvantaged0.130.360.140.4110-year enduranceMost flush0.120.360.130.4020.110.320.120.3730.100.320.110.3640.100.300.110.35Most disadvantaged0.100.300.110.35Consequences from the estimation of cyberspace endurance up to 1, 5 and 10 old ages after diagnosing, adjusted for intervention and clip changing affects, are shown in Figures 9-14 for males and females individually, and showed that there was a sug