Why I Am An Engineer - 907 Words

1. Choosing to be an Engineer was one of the easiest choices I’ve had to make in my life. I’ve grown up being told engineering is one of the best majors to have. My mom is a mechanical engineer and since day one she’s been helping me develop skills and knowledge that engineers have. I remember being in kindergarten and my mom would sit me down at the kitchen table at my grandma’s house and she taught me basic algebra. She taught me how to think critically and problem solve. She helped me in all my academic courses, and taught me math from 6th grade trough my junior year in high school. Majoring in engineering was never a question, what type was always the big question. When I was fourteen I underwent a few extensive surgeries. All though the surgeries weren’t fun to experience it peaked my interest in how the body self heals. The idea of becoming a doctor quickly crossed my mind. Junior year after my most recent surgery I came across Utah State†™s engineering programs and learned of biological engineering. It seemed to fit me best. It is the perfect undergraduate degree. It has plenty of science, my favorite subject; easy path for pre-health, if I so desire to take that route; and it is a form of engineering, the best major to have. I never had resistance in becoming an engineer, if anything I had pressure to become one. It was never bad pressure, it was the kind I need and appreciate from my family, teachers, and friends. They helped me recognize my natural abilities andShow MoreRelatedWhy I Am An Engineer1576 Words   |  7 Pagesa vast field of opportunities. The buildings we work at, the cars we drive, the technology we use have all been made possible by the work of engineers. That is the main reason why I desire to be an engineer. I want to work in a field that I will be able to make a difference and have a job that am proud of and still enjoy. The first engineering class that I attended was quite surprising. My perception of engineering had always been of technical equations and solving complex issues. This class on theRead MoreWhy I Am An Engineer926 Words   |  4 Pagesproblem-solving skills. I, Bhaskar Nayak am an Engineer in Information Science from Sapthagiri College of Engineering, a reputed institution under Visvesvaraya Technological University. I am applying for the admission to Master’s program in Business Intelligence and Analytics. The goal to pursue a career in the field of business has always been part of my plans since my early teen years. I believe that the interest I possess leads to continuous learning process. As an Engineer with work experience,Read MoreIndustrial Engineer Essay1650 Words   |  7 PagesWhere would you be without industrial engineers? You probably do not even know what an Industrial engineer does. When the word engineer comes to mind, people just assume some guy sitting in an office doing a bunch of complicated equations day in and day out. Although that is not wrong, it is not true for industrial engineers. Industrial engineers are solving a new problem everyday in new and innovative ways. Industrial engineers are not a widely known career, but are a cornerstone to our workplacesRead MoreDiscover Engineering: Architectural Engineering 1245 Words   |  5 Pagesgreat inventions since then. Many of the things that have been constructed or built in the world have happened because of en gineering. The four disciplines of engineering have helped many of the great engineer’s in what they have designed. This is why these four major disciplines are very important to the engineer’s themselves. There is a driving question which is, what do engineer’s do on a daily bases? What engineer’s do on a daily bases is working on things that they have to do in order for themRead MoreApplication Of A Software Engineer1240 Words   |  5 Pagesemployment of software engineers. Employment for software engineers is expected to grow 17% from 2014-2024, faster than average. I want to be a software engineer largely due to my passion for technology, especially computers. I am curious of the variety of computer applications, what it takes for software engineers to make them. It’s definitely not easy, but it’s definitely fun! Another reason as to why I chose software engineering for my career is because software engineers can develop almost anythi ngRead MoreApplication For A Management Job934 Words   |  4 Pages In this case I am about to apply for a management job. One of the requirements for the job is that I have to be proficient in CAD, but at the time of the application I’m only taking classes for CAD. So the question is, do I still apply knowing that I am not fully qualified for the job. To answer this, we first need to weigh the facts. First I am more than qualified for the job besides the slight fact that I am not yet proficient in CAD. So, what’s the problem? Well it comes down to ethics. InRead MoreWhat I Did You Make It Do That?882 Words   |  4 Pagesemergency landing, and I ran to repair the aircraft. Looking at the blueprint I drew up, I adjusted the weight mechanisms, and realigned the wings. It took off again, performing victory acrobatics for the onlookers. â€Å"Tyree, you should be an engineer.† â€Å"You have great hands, you will make a great factory worker.† I looked down at my hands, which held the bridge that granted me acceptance into a pre-engineering high school. The likelihood of achieving my goals increased. I thought my adviser wouldRead MoreGoals in Life Essay1249 Words   |  5 PagesMy whole life I have always wanted to become a successful engineer, and graduate from the University of Cincinnati. Some of my goals in life are to go to the University of Cincinnati. Another one of my goals is to become some type of engineer. But as of right now I would like to be a aerospace engineer. To be honest I really don’t know what influenced me to want to become and engineer. But something about engineering always appealed to me for some reason. But lately my engineering teacher has hadRead MorePersonal Statement : Becoming A Computer Engineer849 Words   |  4 Pagesbecome a computer engineer. To be an engineer, I have to face lots of difficulties but I ha ve strong determination to achieve my goal. There are multiple reasons and importance of my choice to be an engineer. When I was a small kid, I saw a man using a computer in Kathmandu, the capital city of Nepal and it’s made me wonder and then I said to him, â€Å"can I touch it?† He didn’t give me a chance to touch the computer. This thing affects my life and I felt that one day I’ll be an engineer. The reason toRead MoreChernobyl Informative Speech Essay1181 Words   |  5 Pagesdevastating of these incidents was the core meltdown of reactor 4 at Chernobyl, better known as the Chernobyl disaster. Introduction: Today I am going to tell you 3 things about Chernobyl. * First, I am going to tell you what Chernobyl was. * Second, I will tell you Why it happened and * Finally, I will tell you what the effects were and why it’s relevant today. Body 1 â€Å"What was Chernobyl†?: * April 26, 1986 in the early morning hours, an explosion rocked a thriving city near

The Prevention Of Hiv / Aids - 1772 Words

There are many blood borne viruses, which produce financial penalties and which can differ in their consequence depending on locality (Bell, Selby, McMickens, 2011). Some are Hepatitis B and C, syphilis, chlamydia and HIV/AIDs just to name a few. This report will focus on the HIV/AIDs virus. HIV is a deliberate retrovirus, meaning that not merely does it take months to display any signs but then can also take years to mature fully (Bell, et. al, 2011). The virus attacks the white cells by replicating itself in reverse inside them. The white cells are the cells, which would normally yield anti-bodies to assist the body s resistance against infection (Hunter Hunter, 2014). It is therefore simply spread by biological interaction and†¦show more content†¦Economic significances of HIV/AIDs are:  · The expenses of backing research  · The price of immunisations  · The forfeiture of individuals of employed to the community  · Loss of salary due to condensed efficiency lead ing also to declining Gross National Product  · Individual hardship - loss of the main source of income. (Barlow, 2011) Where did the virus originate? The virus originated in sub-Saharan Africa, passing over from a troop of chimpanzees to individuals in the 1930 s this might have been from contaminated meat or a bite from a pet (Rogstad, 2011). A mixture of worldwide travel, suburbanisation, contaminated body fluid, sexual promiscuity and intravenous drug use (IDU) may have produced a mounting pandemic (Rogstad, 2011). HIV/AIDs was first seen in the human populace in considerable figures in San Francisco in the USA (Rogstad, 2011). In San Francisco HIV/AIDs was considered as the Gay Plague as it was frequently found amongst homosexuals (Rogstad, 2011). This prohibited the heterosexual community from regarding it seriously or ever bearing in mind they could be at jeopardy (Rogstad, 2011). Paralleling Nations The worst, effected by far, is the sub-Saharan district of Africa being home to 24.7 million individuals existing with the HIV/AIDs virus. About 1.5 million new contaminations transpired there in 2013 (Case, Hallett, Gregson,

Transcendentalist Free Essays

A Modern Day Transcendentalist The story of Chris McCandless is an inspiring one. Transcendentalism is the act of finding inner peace and relaxing. David Henry Thoreau and Ralph Waldo Emerson are two authors who are transcendentalists. We will write a custom essay sample on Transcendentalist or any similar topic only for you Order Now The idea of transcendentalism was started in America in the 1850’s. Chris McCandless is a college student who decides to become a transcendentalist. Chris McCandless is an example of a modern day transcendentalist because he fits the ideals of Walden, Self Reliance, and Civil Disobedience. One of the big ideas of Walden is that a person needs to separate himself from society to inner peace. Thoreau writes â€Å"I went to the woods because I wished to live deliberately, to front only the essential facts of life. † Chris McCandless fits this idea because he goes into the woods to find inner peace after college along with other adventures in the desert and Denali National Park. Another big idea of Walden is a person only needs to live with the essentials. Thoreau writes â€Å"†¦ to drive life into a corner, and reduce it to its lowest terms. Chris McCandless fits this idea because he only brings a backpack, a gun, a bag of rice, and a sleeping bag into the woods. Nature has a lot to teach is also a big idea of Walden. Thoreau writes â€Å"†¦and see if I could not learn what it had to teach. † Chris McCandless fits this idea because he learns a lot of survival techniques while in nature and he lives and dies while in nature. One of the big ideas in Self Reliance is trust yourself. Emerson writes â€Å"Trust thyself: every heart vibrates to that iron string. Chris McCandless fits this idea because whenever he is offered help he declines it. Another big idea of Self Reliance is do not be afraid to be different and do not conform to others standards. Emerson writes â€Å"Whoso would be a man must be a nonconformist. † Chris McCandless fits this idea because he does not care what other people think about him and he did not conform to others expectations. For example his parents want him to go to college and he decides not to because he wants to go into the wild. Do not envy what others have is another big idea of Self Reliance. Emerson writes â€Å"There is a time in every man’s education when he arrives at the conviction that envy is ignorance. † Chris McCandless fits this idea because rejects supplies, his parents, his car, and help. One of the big ideas of Civil Disobedience is laws do not have to be followed because each person should make their own laws. Thoreau writes â€Å"That government is best which governs not at all. † Chris McCandless fits this idea because he goes to Mexico without a passport, he kayaks into Mexico, he burns his money, and he train hops. Another big idea of Civil Disobedience is the majority is not always right and that people should follow their own beliefs and thoughts. Thoreau writes â€Å"When the power is once in the hands of the people, a majority are permitted, and for a long period continue, to rule, is not because they are most likely to be in the right, nor because this seems fairest to the minority, but because they are physically the strongest. † Chris McCandless fits this idea because people may not support his way of life because it is against how the majority live. He lives differently in a lot of people’s eyes because he lives out in the woods instead of being with society. Based on his belief in the ideals of Walden, Self Reliance, and Civil Disobedience, Chris McCandless is a modern day transcendentalist. This type of lifestyle is not all that abnormal. Many people in the world live just like Chris McCandless. They all want to get away of society and live peacefully. The story of Chris McCandless gained popularity in the late 1990’s. One reason people are drawn to this story is because McCandless is a young guy and lives such a different lifestyle. How to cite Transcendentalist, Essay examples

Corporate Sustainability Approaches and Governance †Free Samples

Question: Discuss about the Corporate Sustainability Approaches and Governance. Answer: Introduction Sustainability approach is an important aspect to successful business management in todays society (Bansal, DesJardine, 2014). The society has changed and people do not just want products from an organization but are also concerned on how they are produced (Formentini, Taticchi, 2016). Sustainability business strategies are largely informed by management accounting. Sustainability in businesses has been enhanced by current laws and regulations, need for managing risks, reducing costs and a desire to engage in responsible business operations. Management accounting enables managers to make production decisions (Gray, Adams, Owen, 2014). Sustainable practices in an organization refer to strategies that minimize negative impact on environment, society, and increase economic benefits. Organizations should consider all it stakeholders in ensuring their practices do not compromise or threat future needs (Schaltegger, Burritt, Petersen, 2017). This necessitates businesses to protect the environment, remunerate fairly and work for common good of all stakeholders. Sustainability in business is recorded in sustainability report and is part of annual report. Organizations that engage in sustainable practices get long term profits and have good public reputation as a result of good brand name and competitive advantage. The following write up is a discussion of social, economic, environmental, and financial issues in relation to sustainability approach a case study of Spice Girls Company. The write up also highlights further information that Spice Girls company need to gather in resolving issues in adopting a sustainable approach in it production. The first problem of Spice Girls Company is on the issues of production. The company is considering relocating it processing plant from Geelong to Buranda. The set up of the factory will cost A$3.6million. Secondly, the company is considering the chemicals sprayed on plantations from Buranda and Qumran where it has been importing its supplies from. The chemical used burn workers lungs when inhaled for a prolonged period of time. Lastly, the employees working on plantations are underpaid at A$ 4 per hour and are forced to work long hours. Setting up a factory in Buranda will reduce the cost of processing spices from the current A $0.99 to A$0.33 per kilogram. The financial issues for sustainability in Spice Girls Company involve minimizing cost and risks associated to funding or investing in an organization. The financial issues in Spices Girl Company approach to sustainability are; first, the Company setting up a factory in Buranda will lower production cost in the long term. Though, the company will incur A$3.6 million to set up the new factory, the company will reduce it cost per kilogram by 67%. The cost per kilogram will reduce from A$0.99 to A$0.33. This reduction in prices will increase the revenue of the company and shareholders wealth will be increased in the long term. Therefore the company will be able to reduce its costs in the long run thereby operating on sustainable costs and be able to meet the shareholders objective of wealth maximization. The environmental issues in first problem of Spice Girls Company approach to sustainability are the impact of the chemicals used in the plantation. The countries that the company import supplies from use toxic chemicals that have long life. These chemical have several effects on the environment because they stay for longer time than normal chemical stays. The chemical are inhaled by people that lead to burning of lungs. Therefore, the chemical used in the Spice Girls Company supply chain pollutes the air for long time that has adverse impact on people aspiratory system. The social issue in Spice Girls Company first problem is employees remuneration and working hours. Employees are paid $ 4 per hour is is far much less than the minimum pay per hour in Australia which is $18 per hour. The employees also work long hours in the supply chain which is endanger their lives as a result of chemical sprayed in the plantations. Therefore, the Spice Girls Company has to consider employees compensation and working hours to ensure that employees life is considered in the company. There are also economic issues in Spice Girls Company that have to be considered in the sustainability approach. First, the will be economic development in Buranda. The company will increase job opportunities of Buranda people, and increase level of income that will improve the living standards of the Buranda citizens. The company factory will also pay taxes to the government that will increase public revenue. The Company will also have it profits maximized by having minimal total cost and high revenues. Therefore, the Spice Girls Company will have to consider the both the micro and macro economical benefits when deciding of sustainability approach. The second problem Spice Girls Company in approach to sustainability is the emission from the current plant in Geelong. The environment emission of the company meets the basic standards. The emissions cause neighbors to complain because of smell and discolor companys buildings. The company is considering investing on filtering system that will cost $870000 and a maintenance cost of $52500 per year. The financial issue in the second problem is the high cost of installing a filter system and maintaining cost. The Company will have to incur $870000 to install the filter system that will filter the smell and maintain the filter system at $ 52500 per year to maintain the system. This system will improve the Company reputation in the long run and build a brand name for company. The company will not have negative publicity from the local newspapers that will improve the company brand (Kurdve et al., 2015). Therefore, the company should put in account the financial issue in adopting sustainability approach of installing s filter system in the company. The environmental issue in second problem of Spice Girls Company is the emission from the current Geelong plant. The environmental emissions cause air pollution that leads to neighbors complaining about the smell (Formentini, Taticchi, 2016). Though, the facility meets government standards, there is, the emission are unpleasant to people and also causes discoloration of buildings. Therefore, the company should consider filtering the emissions to reduce air pollution that causes unpleasant smell to neighbors and discoloration of the building. The social issue in Spice Girls Company second problem is the discomfort of smell from the company emissions. The neighbors of the company are not able to inhale fresh air as a result of emissions from the company (Johnson, 2015). This issues lead to complaints from neighbors of the company and critique by the local newspaper. The issue affects how people live and therefore should be put into account when adopting sustainable approach in the company. The second problem also has economic issue that has to be put in consideration. The environmental emission cause negative externalities that lead to bad reputation. The emission negatively affects the neighbors of the company. Secondly, the installation of filters in the company will increase the costs of operating in the company. This will reduce profit margins in the short run (Lopez-Valeiras, Gomez-Conde, Naranjo-Gil, 2015). Therefore, the shou7ld consider reducing externalities and long term profits margin from investing in filter system when adopting sustainability approach for the company. The third problem of Spice Girls Company is the low morale of employees in the Geelong plant. There is disagreement between the production staffs. The manager is considering offering staff redundancies to employees to change the situation. The financial issues in the third problem are the manager offering redundancies to staffs to improve employees morale. The offer total cost is $855000. The offer also requires an external consultant to mediate between the management and staff in production at a cost of $129000. Therefore, the company will be considering using a total of $984000 to calm the situation and improve the morale of employees in the production department. The third problem of Spice Girls Company has not environmental issue. There are emissions or weight of waste in the problem. The social issue in Spice Girls Company is low morale in the workplace. The production department previous manager ran the factory in military style that led to serious clashes. The staff is not motivated and this is likely to affect the level of production in the factory. The company should focus on improving the staff morale so that they can be motivated in their workplace in order to achieve the company goals. Motivated workforce meets task objectives, work efficiently, and have high level of job satisfaction (Schaltegger, Hansen, Ldeke-Freund, 2016). Therefore, it is important to consider employees moral when adopting a sustainability approach. The economic issue in the third problem of Spice Girls Company is the cost of the offer to staff. The offer of redundancies will cost the company $984000 to implement. This will increase total cost and reduce the company short term profits. The company will earn high returns in the long run from effective labour. Therefore, the company should consider the economic gains in the long run when adopting a sustainable approach in the company. Further information to resolve issues Spice Girls Company should gather more information before resolving the issues to avoid sustainability strategies from being ineffective. In the first problem, the company should gather further information in the following aspects; first, the company should gather information on the cost of transportation from Buranda to Australia where the company has the largest market share. The cost of transport will enable the company determine the profit margin that it will get after deduction of all total cost and the revenue received (Lee, Wu, 2014). Secondly, the company should gather further information on minimum wage in Buranda to know the amount to advocate for or pay employees in the plantations (Bebbington, Unerman, O'Dwyer, 2014). The company should get information of the labour market of the country. The company should also analyze the effectiveness of other substitute chemicals that have less long time compared to the current chemical used in plantations (Adams, Muir, Hoque, 2014 ). Lastly, the company should gather information on the government policies and laws in relation to foreign investment in the country. This will ensure the company is able to comply in setting a factory in Buranda. In the second problem, the company should gather the information before implementing the sustainable strategy on environmental emissions; first, the company should gather more information on the health effects of the smell. This will ascertain the impact of the emission to human life (Ball, Grubnic, Birchall, 2014). Secondly, the company should gather more information on the cost of coloring discolored buildings and the lifespan of the filtration system. This will enable the company determine the amount saved from the project and the time that the filter system will last being effective in the factory (Maas, Schaltegger, Crutzen, 2016). In the third problem, the company should further gather information on the following issues; first, the company should gather information on the causes of conflicts in the factory. This includes the causes of clashes that happened. Secondly, they should gather information on the level of production when production staff are in low morale and compare with when they were highly motivated. This will enable determined expected level of produced when employees are motivated (Schaltegger Wagner, 2017). Lastly, the company should gather further information on the factors that motivate staff in the factory. This will ensure that the sustainable approach taken by the company is appropriate and effective to restoring morale to the staff. Employees are not motivated by the same factors and therefore it necessary to ascertain what improves staff morale before proceeding with redundancies and mediation. Conclusion Sustainable approach requires additional resources to implement. This means that there is increase in short run cost of operations. Spice Girls Company require resources to set up new factory in Buranda, install and maintain filter system in the Geelong plant, and improve staff morale in the production department. The sustainable approach need a for dimension consideration hen implementing. They include financial, economic, environmental, and social. These enable sustainable approach analysis to ascertain costs, impact on human life, impact on the environment and economic benefits of strategy implementation. Therefore, sustainability approach requires an analysis in order to make informed decisions on production and ensure win-win situation to all organizations stakeholders. References Adams, C., Muir, S., Hoque, Z. (2014). Measurement of sustainability performance in the public sector. Sustainability Accounting, Management and Policy Journal, 5(1), 46-67. Ball, A., Grubnic, S., Birchall, J. (2014). 11 Sustainability accounting and accountability in the public sector. Sustainability accounting and accountability, 176. Bansal, P., DesJardine, M. R. (2014). Business sustainability: It is about time. Strategic Organization, 12(1), 70-78. Bebbington, J., Unerman, J., O'Dwyer, B. (Eds.). (2014). Sustainability accounting and accountability. Routledge. Formentini, M., Taticchi, P. (2016). Corporate sustainability approaches and governance mechanisms in sustainable supply chain management. Journal of cleaner production, 112, 1920-1933. Gray, R., Adams, C., Owen, D. (2014). Accountability, social responsibility and sustainability: Accounting for society and the environment. Pearson Higher Ed. Johnson, M. P. (2015). Sustainability Management and Small and Medium?Sized Enterprises: Managers' Awareness and Implementation of Innovative Tools. Corporate Social Responsibility and Environmental Management, 22(5), 271-285. Kurdve, M., Shahbazi, S., Wendin, M., Bengtsson, C., Wiktorsson, M. (2015). Waste flow mapping to improve sustainability of waste management: a case study approach. Journal of Cleaner Production, 98, 304-315. Lee, K. H., Wu, Y. (2014). Integrating sustainability performance measurement into logistics and supply networks: A multi-methodological approach. The British Accounting Review, 46(4), 361-378. Lopez-Valeiras, E., Gomez-Conde, J., Naranjo-Gil, D. (2015). Sustainable innovation, management accounting and control systems, and international performance. Sustainability, 7(3), 3479-3492. Maas, K., Schaltegger, S., Crutzen, N. (2016). Integrating corporate sustainability assessment, management accounting, control, and reporting. Journal of Cleaner Production, 136, 237-248. Schaltegger, S., Burritt, R., Petersen, H. (2017). An introduction to corporate environmental management: Striving for sustainability. Routledge. Schaltegger, S., Wagner, M. (Eds.). (2017). Managing the business case for sustainability: The integration of social, environmental and economic performance. Routledge. Schaltegger, S., Hansen, E. G., Ldeke-Freund, F. (2016). Business models for sustainability: Origins, present research, and future avenues.

The International Financial Reporting Standards a Report on the Roadmap and Roadblocks to Implementation free essay sample

A Report on the Roadmap and Roadblocks to Implementation in the US and Abroad Robert B. Shaw Term Paper Prof. Paul Strohmenger GBA 521 002 Financial Accounting and Reporting Fall Semester December 2010 2) how is it progressing? 3) how does it differ from GAAP? 4) will it be implemented how? The International Financial Reporting Standards, otherwise widely known as the IFRS, are a set of high quality financial reporting standards that are designed to be used globally by profit making enterprises. The continuous development of such international standards is an example of the international harmonization witnessed in the global financial sector over the last two to three decades. The history of the IFRS only spans the length of a decade or so and can be best summarized by the following milestones. (www. ifrs. org) In 2001, the International Accounting Standards Board (IASB) and the International Accounting Standards Committee (IASC) Foundation were formed. The next year the European Union passed regulation to adopt IFRS for listed entities in the year 2005. We will write a custom essay sample on The International Financial Reporting Standards: a Report on the Roadmap and Roadblocks to Implementation or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page In addition, the FASB and the IASB signed the â€Å"The Norwalk Agreement† which was a commitment to reduce differences between US GAAP and IFRS. This was the beginning of all the conversion efforts that are presently in process today. By the year 2005, nearly 7,000 listed entities in Europe adopted IFRS. The following year brought about an announcement from the IASB regarding a â€Å"three year stable platform period,† in which entities that have already adopted IFRS will not need to implement new IFRS until 2009. In 2007, the SEC removed the reconciliation requirement for non-U. S entities reporting under IFRS. This single act brought about further pressure from all the parties in the global financial community to further support IFRS. A proposed roadmap was published in 2008 by the SEC which identified potential mandatory adoption of IFRS by U. S. Filers. Finally, the most recent major actions in relation to IFRS were the reluctance to fully support the roadmap to IFRS by the Mary Shapiro, the current SEC Chairman, and the Group of Twentys (G20) support of IFRS as the most important step towards reforming the current global financial system. www. iasb. org) The IFRS was originally established by the International Accounting Standards Board (predecessor is the International Accounting Standards Committee? ) and its located in London, UK. The IASB is a full time organization, and functions independent of preparers, auditing organizations, and accounting agencies. The IASB has 14 board members which consists of a balance of financial industry leaders. These le aders are appointed based on their technical expertise as well as their experience in their respective fields. This ensures that the balance between these diverse groups produces a set of standards that satisfies the needs of the various users in the ever-developing, global version of the investor-creditor financial community. (www. kpmg. com) It is now apparent more than ever that the world is attempting to come together in the accounting and financial reporting arena. As it stands, the US adheres to its own Generally Accepted Accounting Principles (US GAAP) while the rest of the world has gradually accepted that the IFRS standards are needed and welcomed. This is due to the fact that capital resources are required around the world. Therefore, investors need a uniform set of standards and this is further supported by the open acceptance by international organizations such as the G-20. The original goal of the IASC was to have onset of standards so that every investor in the world would understand the principles that go into the creation of corporate financial reports and corporate financial statements. Those in support of the IFRS argue that global accounting standards will improve the functioning of global capital markets by providing better information to investors and other users of financial statements. They will achiever this by decreasing the cost of preparing and interpreting financial statements and reduce the cost of capital. Some of the additional benefits are specific to certain groups. The capital markets will benefit from enhanced world wide comparability for investors and more efficient capital allocation. In addition, foreign investors will perceive enhanced credibility of local market entities while US securities will be suitable for foreign listings. Finally, the IFRS will eliminate the need to develop and maintain national standards. On the other hand, the benefits to companies include easier consolidation and cross-border acquisitions and increases the overall understanding of the financial statements of overseas suppliers, customers, vendors, and subsidiaries. However, though the benefits seems very clear to the global financial community, there seems to be an apparent hesitation on the part of the US to adopt or immediately identify specific intent to implement IFRS. The notion is that IFRS doesnt have strong guidance and will lead to further chaos. Especially, if it is accepted in haste. www. bcbs. org) In relation to the progression of acceptance abroad there is a stark contrast between those who support IFRS and those who do not. Since 2000, with the creation of the IASB and its takeover from its predecessor, the acceptance of these standards saw a substantial increase in its use, especially by European countries. Switzerland was one of the first major countries to apply the standards. All of the major fina ncial markets in the world recognized the standards after Australia and the European Union recognized the standards. The United States has yet to adopt the standards as the SEC still subscribes to the US GAAP regulations and standards. These standards are primarily for listed companies but each jurisdiction may adjust the standards to their particular needs. The point of having one set of financial reporting standards is for investors to invest time into understanding only one set of principles that is useful for all investors. However, it doesnt limit the corporation from using other reporting tools or options. As it stands, the SEC is interested in IFRS but the question must be asked: What are the incentives? Why would the SEC be interested in converting from GAAP? Mary L. Schapiro, SEC Chairman since 2009, has stated that she is committed to convergence and has a roadmap to implementation in place. The SEC currently has a 5 year plan that doesnt specify a date for adoption. There is an opposition that exists within the US and there is evidence that supports there position. The details of the standards are flexible in that they may be changed in regards to the details of interpretations, recognition, and alternatives in reporting. (www. sec. org) The US is hesitant to rapidly implement this reporting standard for two main reasons. One is the US Taxation system and the other is the need to have trained professionals prepared to handle this workload. To expand on this, these are the requirements necessary for the potential use of IFRS in the U. S. The requirements are improvements in the accounting standards, the accountability and funding of the IASC Foundation, the improvement in the ability to use interactive data for IFRS reporting and the immediate need for education and training. However, the SECs roadmap is actually a 5 year convergence plan. There are three areas of concern that are key to the SEC Chairman. They include the pace of the timeline, the independence of the IASB and the cost of the IFRS adoption. These concerns are all valid, but it is more likely that this delay is truly due to the change in the political party that is currently in office. (www. sec. org) The global perspective is different as GAAP exists for each country independently in that each has they each originally had their own respective set of standards. Approximately 110 of the 195 countries on the planet have accepted IFRS. The this unbalanced acceptance has the SEC under significant pressure to address the idea of quickly implementing a unified set of globally accepted standards in addition to the development of competitive exchange markets. Nonetheless, the idea of adopting IFRS originally came up in 2007 when the SEC decided to excluded a long-standing requirement by incorporating the use of IFRS to substitute certain GAAP requirements for corporations that were established in other countries. There is also the likelihood that the SEC may be attempting to increase its position in the global market by accruing power as the global regulator of corporate standards by delaying the implementation and leaning towards the idea of convergence. The Big Four, which was actually once known as the Big Eight prior to mergers, are all for the requirement for corporations to adhere to IFRS as it poses an opportunity for an thrust in the demand for financial consulting services and increased earnings. Thus, the question that must be answered is whether or not IFRS is truly better than the current GAAP system in place in the United States. The reality is that each country has historically had its own set of standards to which it adhered to. Some are better than others. For example, France has been said to have a weaker set of standards in comparison to that of the United States. Therefore, the IFRS would be better suited for a country with a weak set of standards to consider as it would be an immediate improvement and allow that country to be in the collective of those who already subscribe to IFRS. (www. deloitte. com) When one considers the cost-benefits associated with the use of IFRS in the United States they vary due to the variety of stakeholders involved. The reality is that costs have not been sufficiently quantified by the SEC, however, estimates state that the cost associated in conforming to these standards may range in the area of 1% 3% of an organizations total revenue. In addition, audits are more likely to incur a heavier costs in the future as there will only be so many parties trained to handle such matters as it is totally new to the industry on a whole. The cost will also affect educators as they scramble to develop curriculums and select ufficient literature to support the demands to produced knowledgable and qualified employees for the financial services market. The issue that many will face in the varied fields associated with IFRS is the challenge of shifting from a rules based system of financial accounting and reporting to a principles based system. The key to the successful recognition of the IFRS standards will be the goal of convergence. The reason many are willing to wait on subscribing IFRS in the U. S. Is the concern for the conflict of standards based on principles versus rules. The US GAAP standards are developed on specific rules, while the IFRS are strictly principles based. This means that IFRS are very limited. They seek out to provide the same results but the keys to doing so may result in different answers. This is where the convergence process will suffice in bringing all parties to a consensus on how to best apply the standards. The reality is that the US accounting industry and the global financial system ought to be fairly pleased with this open support, but investors, companies and firms continue to be in the dark on the exact date of this transition.

Romeo and Juliet by William Shakespeare Essay Essays

Romeo and Juliet by William Shakespeare Essay Essays Romeo and Juliet by William Shakespeare Essay Paper Romeo and Juliet by William Shakespeare Essay Paper this concept was shown as Romeo cries out that everything is linked to fate, every action, every life and death was all believed to be linked to fate. Although it was Shakespeare who was created everything in the play, speech, death, love, including Romeos character. Behind the scenes for Romeo was Shakespeare who was playing his game. So Willium Shakespeare was Romeos fate. The Prolouge was set at the beginning of the play and we were told the summary of the play. We were told the plot of the play/storyline, A pair of star-crossed lovers. This implies two fated lovers against the law. The Prolouge also mentioning Two households, both alike in dignity ,. This emphasies two waring families both high in stature. From ancient grude to new munity, this infers that both famillies with an ancient grudge, and know comming to a new problem. We are told this at the start of the play because by doing this the audience gains an idea of the story and also to capture the audiences attention. The themes that are established in The Prolouge are love, violence and hate, all these themes are used in the play, as they are used in the small summary (The Prolouge). Act 1 Scene 1 starts by two servents from the house of Capulets, Sampson and Gregory teasing each other, talking about fighting servents of the Montagues The quarrel is between our masters and us their men. This demonstrates that their eager to fight. They were also talking about raping the Montague women, Me they shall feel while I am able to stand tis known, I am a pretty peice of flesh. This shows their sense of humour and how they like to say rude jokes. Initially the atmoshere is jolly with a jokey mood, this is shown by their reference to sexual inuemos mentioned above. But the mood quickely changes when two of the Montague servents, Balthasar and Abram, entered the play and approached closer to the Capulets. Sampson and Gregorys good-natured rivalry is immediatly converted to hostility. In this act and scene we learn a fair amount of information about Benvolio, his personality and his character. Benvolio is Romeos cousin, he is a solemn, sensitive young man whose name indicates his peace making role in the play. During this act and scene, Benvolio tries to make peace with the gang fight and fails. It also reaveals that Benvolio speaks the truth, whilst slightly backing his family(Montague) up. I do but keep the peace. Put up thy sword. This shows his character and person, what he is like. Not liking to stir up trouble, being his peaceful self. Tybalt enters half way through this scene. We learn a good amount of information about him, his character and especially aggresive personality and nature. As Tybalt enters the play, we learn that he is violent and certainly not peace loving as he mentions. What, drawn, anf talk of peace? I hate the word, as I hate hell, all Montagues, and thee. This implies that Tybalt has a aggressive nature, this quote also shows how much he hates the Montagues. As he speaks slowly and cleary to the Montagues, truely expressing his feelings about them. The audience may feel like their prepare to watch a fight, as Tybalts entry builds up great tension around the audience. This scene ends when the prince of Verona appears and splits up the murderous brawl and gives them a threatning warning. If you ever disturb our streets again, your lives shall pay the forfeit of the peace. This infers on how serious, and angry the prince is, about their continued fighting in the street and even giving a death penalty as a warning to both Capulets and Montagues. The audience may start to calm down as the tension starts to drop, because of the arrival of the prince stopping the fight. Act 3 Scene 1. This scene is important as it comes half way through the play, Romeo and Juilet have been married. This is important to what is to follow. This scene plays a large majority of the play, as the audience are firstly indroduced to the main theme of violence of the play. A large fight is played and the characters expressions are all dramactically expressed. This scene is full of dramatic irony, as the audience knows that Romeo is married to Juilet anf that Tybalt is Romeos cousin through marrige. Tybalt doesnt realise this and is very eager to fight, because of the introdtion to the party that happened before. Romeo refuses to fight because of his marrige to Juilet. He is now Tybalts cousin. He cannot tell Tybalt the truth because of the feud between Capulets and Montagues. The audience know the truth and are interested in what will happen. At the start of the scene, the weather is hot causing people to be adjutated, Benvolio asks Mercutio to go home, because the Capulets are wandering around. I pray thee good Mercutio, lets retire. The day is hot, the Capulets abroad. This emphasises Benvolio is trying to keep the peace yet again, trying to avoid the sight of the Capulets, as he knows that trouble will stir up and they wont be able to escape once a fight starts. He is also trying to protect Mercutio from trouble, as Benvolio knows Mercutio character. On this scene we learn that Mercutio is a very humourous character, always making jokes and he seems to be very friendly with Benvolio, teasing him. But Benvolio always tries to keep every situation as calm as possible, incase anything gets out if order. Mercutio also, tries to include Benvolio on how Italy is feeling Thy head is a full of quarrels as an egg is full of meat, and yet thy head hath been beaten as addle as an egg for quarrelling. This implies Mercutio is trying to include Benvolio in the family struggles, because he wants to make Benvolio same as anyone else keeping him on his side. At the start of the scene the atmoshere is similar to the beginning to act 1 scene 1, when Benvolio and Mercutio is joking and teasing each other, but Benvolio tries to keep the stituation calm and peaceful as possible. The audience would probaly feel sorry of Benvolio as by now they should realise that Benvolios peace making role is a lost cause. The atmoshere immediatly changes as soon as Tybalt and his men enter the play, it changes because the audience already knows what Tybalt is like and what the outcome will be, violence. As soon as Tybalt is caught in sight of Mercutio and Benvolio, Benvolio says By my head, here come the Capulets. This demonstrates how instantly worried he is. But Mercutio replies to him By my heel, I care not. This emphasises on how Mercutio is cocky, arrogant and doesnt care about the Capulets and Tybalt. Mercutio also knows that theres a crowed around and even whilst Tybalt and his men has arrived armed, Mercutio seems to try and stir it up even more, by being a showman, causing a comedy show and jokes as though he doesnt care. In behaviour, Mercutio is like Tybalt, someone who is easily angered and who likes to fight. He feels that Tybalt has insulted Romeo and Romeo allowed him to. A fight is the last thing Romeo wants, as Mercutio is his friend and Tybalt is now his kinsman. When Tybalt kills Mercutio it creates tension as the audience wait to see how Romeo will act. The mood becomes tense again because Romeo enters the scene. Another dramatic irony was included in this scene, as the audience knows that Tybalt is looking for Romeo and they know that violence will occur once Tybalt sees Romeo. As Romeo gets into a duel with Tybalt, Mercutio is concerned about Romeos fencing, O calm, dishourable, vile submission ! . This implies how Mercutio cant believe that Romeo isnt fighting back and is also confused on why hes not. After this Romeo is trying to keep the peace Gentle Mercutio put thy rapier up,. This demonstrates, that Romeo is trying to stop Mercutios actions from getting into trouble. Also mentioning about the penalties Tybalt, Mercutio, the prince expressly hath, Forbid this bandying in Verona streets. . This is infers Romeo is trying to part the fight whilst also protecting Mercutio, Mercutio knows hell be punished and yet he still fights for Romeo. And the result of this lead to his death, as Mercutio and Tybalt fight, Romeo got in the way allowing Tybalt to thurst his sword in Mercutio. Mercutio blames both families, as he is no Montague or Capulet. I am hurt; A plague on both your houses ! I am sped. In this scene he repeats A plague on both your houses ! three times. This implies he is cursing both families, hes wounded and about to die, the fact hes saying it three times emphasises his, fear and anger. And during Shakesperean times, three times meant bad luck. Romeos reaction when Mecutio dies is important. My very friend hath got his mortal hurt In my behalf my reputation staind With Tybalts slander. He sees that he is responsible for his death and his love for Juilet has made him less of an man. O sweet Juilet Thy beauty hath made me effeminate And in my temper softend valourss steel ! Tybalt returns and the audience want to know what Romeo will now do, take revenge. We also know that The Prince has threatened to punish with death anyone who fights. Shakespeare brought The Prince back to remind the audience the consequences that will occur. Romeo is very angry, fire-eyed fury be my conduct now and fights with Tybalt and kills him. This tells us how angry Romeo is, mentioning the word fire-eyed fury, fust as if he has fire in his eyes. The audience knows that this is disastorious for both Romeo and Juliet. He has killed Tybalt, Juliets cousin and also, faces The Princes Punishments. Shakespeare again keeps the audience interested in what will happen next. After Romeo has killed Tybalt, Shakespeare uses Benvolio to remind the audience of the danger Romeo is now in. He tells Romeo to fly away, be gone and reminds us all of what the prince will do, the prince will doom thee death If thou art taken. This infers that The Prince will execute him. Romeos language is important. His final words remind the audience of the opening Prolouge to the play that spoke of two star-crossed lovers. Yet again, after Romeo causes a brash action (killing Tybalt) he blames someone else than himself. I am fortunes fool, this infers that he feels that fate is against him, because he wanted went downhill and people had a strong fate in god at Shakesperean times. Romeo leaves and Shakespeare has now created a tension because the audience await The Prince and wonder what will become of Romeo and Juliet. When The Prince arrives, the discussion between Benvolio and The Prince is important, as it changes Romeos destiny. The prince seeks the fight starters Benvolio, who began this bloody fray. Knowing that Benvolio will always tell the truth, even though hell get his family in trouble. Lady Capulet doesnt care, I beg for justice, which thou, Prince must give, Romeo slew Tybalt; Romeo must not live. . This emphasises that she only wants Romeo to die. Also another reason why the disscussion between Benvolio and The Prince tis important , And for that offence Immediatly we do exile him hence . This implies The Princes punichment has changed, banishing Romeo instead of killing. The change wouldnt have happened if it wasnt for Benvolio. Act 5 scene 3, so far Romeo has been informed of the catastrophe of his bride Juliet. In order to avoid Juliet getting married to Paris, Juilet fakes her death for a short period of time, which occured in ant 4 scene 4. This scene Act 5 scene 3 is important beacause it is the very last scene, and the audience will be eager to await for the finale. It is also because this is the part of the play where both of the main characters (Romeo and Juliet) dies. In this last act and scene, we learn a very great deal about Romeos character. We learn that he is very irrational and could be very violent. I dont think he manages to live up to the stereotype of the Romantic, because I think Romeos mood effects his speech, and especially the way he acts. At one speech in this scene he says By heaven, I will tear thee joint by joint and strew this hungry churchyard with thy limbs. This demonstrates how violent Romeos mind could come up and heaven do. The theme of violence is so important beacause, it alternates hte storyline of the play multiple times and also changer the behavior and roles of the characters. The violence can be most memorable, because violence is exiciting, it grabs the audiences attention and it adds unpredictabililty to the play. Violence stirs up peoples emotions, causes shock, distress, and it is often unexpected. The audience like to watch contrasting characters good vs bad. I think at the end of each scene the audience would be thinking what will happen next, beacause Shakespeare makes every act and scene interesting and reminding for us.

American Foreign Policy in 1950s 1970s Essay Example | Topics and Well Written Essays - 1250 words

American Foreign Policy in 1950s 1970s - Essay Example Perhaps, the United States could have substantially reduced effectiveness of the Soviet propaganda, but the first obscure signs of the threat remained unnoticed by American politicians. As a result, US foreign policy during the period between the Korean and Vietnamese wars can be characterized as unbalanced and short-sighted. By the mid-1950s the Soviets failed to restore the pre-war balance of powers, but the gap was gradually closing. The Soviets created nuclear weapons, and continued to rebuild the ruined economy. As a result, the United States lost the opportunity to impose its will on Europe in general and the USSR in particular: economic and technological parity with the USSR made it obvious that the need for some other options to compete. Both, the United States and the Soviets focused upon bringing international discredit upon each other: the war of ideologies began (Glynn, 1992). For the sake of objectiveness, it is necessary to admit that the Soviets could hardly be accused of much defamation: the free American society provided the world with such calling examples of civil rights violation that there was simply no need to defame. Keeping in mind that the United States actively participated in the Human Rights treaty which proclaimed racial, religious, and sexual equality the major value of the forthcoming epoch, ongoing domestic discrimination severely damaged international image of the country (Borstelmann, 2002). Some experts noticed the danger in the very beginning of the Cold War, but their warning remained unheard. Thus, Secretary of State Dean Acheson wrote in 1947, "The existence of discrimination against minority groups in this country has an adverse effect upon our relations with other countries. We are reminded over and over by some foreign newspapers and spokesmen, that our treatment of various minorities leaves much to be desired.... We will hav e better international relations when those reasons for suspicion and resentment have been removed" (Dudziak, 2000, p. 80). International situation in the late 1950s - early 1960s turned domestic discrimination into literally vital issue that might affect the future of the whole world. World War II triggered the anti-colonial movement in Asia and Africa, and the balance of powers in the world - given approximate parity between the communist and capitalist blocks - depended upon what form of political establishment those new countries would choose. And again, in the 1950s several politicians tried to draw attention of the federal government to the link between discriminatory domestic policies of racial segregation and failure of the American efforts to extend political influence over new Asian and African states (Borstelmann, 2002). In 1952, Chester Bowles, U.S. Ambassador to India, pronounced a speech at Yale University in which he clearly specified the causes of repeated failures those regions: "A year, or even a week in Asia is enough to convince any perceptive American that the colored peoples of Asia and Africa, who total two-thirds of the world's population,

Leadership Essay Example | Topics and Well Written Essays - 750 words - 1

Leadership - Essay Example This system is clearly working since Employee 1 is doing more than the minimum with the aim of accessing the end-year bonus. The second source of power in an organization is expert power, where an individual possesses significant knowledge or skills in a certain domain in the organizations operations. In most cases, the individual performs a duty or responsibility that others cannot undertake to the same level, and hence is an important asset to the organization. Since the organization does not wish to lose such an individual, it seeks to make them comfortable and thus submits to their requests. Employee 2 draws his power from being the only expert accountant in Corporate A. Since he is the only individual who can prepare the company’s financial statement he has negotiated for a 4 day work-week that is inaccessible for the rest of the employees in the accounting department. His being the only Certified Public Accountant is a source of power within the organization. The other b asis of power in organizations stems from personal characteristics. Having individual special qualities such as charisma and people skills results in admiration from the rest of the workforce and management and thus places one in positions from which they can gain audience within the organization. Charismatic qualities make certain employees convincing enough to side with, besides making their ideas attractive. This is certainly the case for Employee 3 who despite having not been in Corporate A longer than the other employees is already influential in the company. The rest of the employees are attracted to his positive and charismatic personality, and this is a source of power to him as we can see his project idea being spiritedly adopted by the department. Coercive sources of power are felt in the case where leaders create the perception of threats to the employees. This can either be through making others believe that the individual may implement punitive measures, reprimand them or withdraw certain advantages. Individuals can also coerce the management to listen to their wishes for example through threatening to withdraw service through labor unions. The marketing manager clearly coerces his staff members to work beyond the minimum through threatening to withdraw end year bonuses which for individuals like Employee 1 are absolutely crucial if they are to afford certain desired things. The last source of power is legitimate/positional power which is wielded by leaders within organizations by virtue of being appointed to head other employees. The extent of positional power is dependent on the position one holds, for instance middle level managers, senior managers among others. Corporate A scenario presents three examples of positional power in the marketing manager, the accounting department manager and the sales manager who lead employees in their respective department. Relationship between Dependency and Power According to Murphy and Willmott (2009) there i s a relationship between power and dependency because the power resides implicitly in another person’s dependency. Examples of this can be clearly seen in Corporate A, where the marketing manager wields power on employees who are dependent on him due to his discretion in distributing rewards. Due to the various sources of power within

Impact of National Culture on Organisational Culture Literature review

Impact of National Culture on Organisational Culture - Literature review Example While Johns (2006) stated that national culture restricts the disparity in the culture of the organisations (Martocchio, & Liao, 2009, p. 4). It is important that organisations around the world should know certain parameters on which cultural difference is based. Cultural differences can be a matter of concern as well as can be advantageous for the organisations. Its effect can have a greater impact on the productivity and functioning of the organisations in global market. The effects of differences between national culture and organisational can may be functional and dysfunctional depending on the situation. As far as dysfunctional effect of culture is considered, innovation and change is affected and group thinking is encouraged (Aswathappa, 2010, p. 176). Literature Review Organisational Culture is the cooperative encoding of the brain that differentiates people from a particular organisation from people belonging to some other organisation. National Culture on the other hand can be defined as the cooperative encoding of the brain that differentiates people of a particular group from the people belonging to other group (Hofstede, n. d). It is believed that culture is a concept but still the forces created in the situations related to organisation culture are said to be powerful. The difference between national and organisational culture may affect an organisation but on the hand it is also noted that there is a strong linkage between national and organisational culture. Moreover, organisational culture derives from national cultures. This signifies the advantage lying in organisational culture being derived from national culture as it would create a better understanding of the working culture in the host country. But, disadvantage associated with it also cannot be denied as the true culture of organisation is subjugated in presence of national culture. Newman & Nollen (1996) have put forth the theory saying managing business with one best possible method is a wrong assumption. Cultural differences in different countries emphasises on different management practices by organisations. Diversity in the culture of organisation and the host country is a sensitive issue. Organisations around the world face challenges in diversified environment with different cultures. Different people have different religious beliefs, come from different ethnic groups, and belong to different countries and most importantly cultural difference. The complexity and the differences that arise between organisational and national culture gives rise to entities which are beyond expectation. It is believed that national culture’s impact on employees is higher than the impact of organisational culture. Every organisation develops a culture of its own in the process of evolution as a global player. Organisational culture development becomes all the more important to overcome the problems related to adaption in external environment. Globalisation on the other han d has made organisations improved entities and their cultures have made significant influence on the employees and their work culture. It is believed that multinational organisations have strong culture to overpower the impact of national culture, thereby helping multicultural people to assimilate in a team (Saiyadain, 2003, p. 262). National cultures cannot be neglected as they have considerable

Salem Witch Craft Hysteria History Essay

Salem Witch Craft Hysteria History Essay The age old question Was the Salem witchcraft hysteria a product of womens search for power? is debated that it whether it was or wasnt a product of their search for power. There are many different examples that it was, but if you think about it most of those are not conclusive, because you could easily have many reasons to why those events happened and were caused. The examples that women were do witch craft because they did unexplained activities such as assume odd postures, writher in agony, necks cracked, and more are not true, because those actions are easily explained. For example cracking your neck is common to people who had a sore neck. More of these action like the ones I name have no logic to it if you think about it. Some people will say yes to this question, due to the fact that when Tituba confessed she was a witch, she also said there were others out there, but no one really confessed to being a witch. Most of the accused were either related to some else who was accused or victims of paranoia that enveloped that community. Also some people will say that they were looking for power because most of the accused were women, but most were being accused due to their gender because most women did not have right back then. When the accused had been accused it was due to the fact that they did something thats was uncommon or unheard of. I say no they were not looking for power, because if they were they would not have been living in fear of being accused and would not wait to be accused, but admit that they were witches without fear. You may say that some women like Tituba, did confessed for more power to women, but they probably only said they were because they did not have an explanation to why those acts of witch craft accrued due to the fact that most of those actions were uncommon back then, but did some accepted the accusation just to rebel a little. Also most women probably only did confess like Tituba so they will not have been subjected to harsher punishments. The fits and rampages that had happened out of nowhere were factors in being accused in this time, but the thing is that these rampages were widely spread to not only the humans, but the livestock too. Even some people said that witch craft were the only explanations to these unexplained actions. People mostly only probably said this because back then people were scared of what they did not know and this was the only way they would know this in this time period. In later years similar events had swept Europe, as time went one all the unknown questions and unexplained event were becoming more and more known, so it would not have made sense that women did those things to gain and show power in their lives. If you look back to what was considered as witchery to now you would see it was fear of the unknown and paranoia that made it seem as womens act of gaining power and not conrisidents. Back to being accusers, they had many problems in their social lives and believe and accusing other was the only way to restore their problems in life and their self-worth. Accusers had gained more power from the witch accusation then the accused women did. With fear from the unknown and uncommon was established unknowingly the only way they became unfearful was to accuse others from these seemingly mysterious actions. Some of the accused were either different or untraditional and that was considered another trait of witchery. You may say that the untraditional women and fee-spirited women were only looking for power, but in reality it was the unconscious start for women to be able to have a little more freedom. Some of the witches like Susannah Roots were also accused for entertaining people late at night or adultery, but just because they did those kinds of things did not mean they were looking for power or attention from the whole town, but from the people they did it with. What we know now that did not know then is that the accused must have had been sick in some way or form. We can conclude this with the fact that the symptoms of witchery are the same symptoms as the Encephalitis Epidemic that accrued in the early 1900s to the mid-1900s. For example the bites made by witches were really red marks that bleed thru the skin. The visions they had were really hallucinations that accrued from ant diseases that they endured. More of the symptom that were cause back then would be perfect examples of the epidemic that will have swept Europe. With no proper heat back then the cold worsened the symptoms that were considered witchery symptoms. The illnesses that cussed these were from insects that might have infected the so called witches in the past. As the years went on less and less accusations stopped probably due to the weather change in which the insects could not live and in return not infect the people. Women had not really wanted to have power because they would have found some way or pretended to have done witchery actions to continue their search of power instead of letting it become only something in the past. We can also conclude that it was not really the womens idea of gaining power because if the events were becoming part of that past most things will not change, but be the same and they will have had continued the search of power. Many more insects had been spread all over Europe witch caused the diseases that were the causes of the witch accusations. If the diseases did not spread people would not have been infected and jugged. Another idea to consider is if the disease causing insects were not common and had not infected the accused will they still be considered witches. That is a question that you should ask yourself and think about. Some of the accused witches were women were highly esteemed members of their church and community. Even their daughters as young as four were accused, from the hysteria. If you think about it, it wound not make sense that the witches were doing godly things. Also this will be no way of trying to gain more power because otherwise they would not be as highly esteemed as they are. Even though women protested against being witches or having family being accused they still were not looking for power. The women were only trying to convince the accusers that they were wrong and that they were indecent the only way they could think of. Sure they got attention and some power, but so did the male members of the community who protested with them. As hysterias spread and more were accused the punishments got worse and so did the deaths. Even though women wanted to get more power they probably would not have gone as far as death, because they most would want to live for their families and not chose power.as time went on with these more and more people were trying to help them from being wrongfully accused like many did. If you were to face death like these wrongly accused women were would you accept death or would you beg to be spared? These women had to decide this question their selves, and they said they will beg because they were not looking for power they were just subjected peoples fear in that time period. with not accepting being witches and begging it will naturally cause less power and the argument that women wanted more power that they had made the witch trials a big deal would be false. Not all the accused were being murdered for being witches. If they had confessed even if they were innocent they will be spared. The women who were confessing to their crime were only doing it to save their lives and ant gain power like some people think. Many were trying to get set free and not die so they did anything to get found not guilty. Women did not want power they wanted to go back to their lives without free of dyeing. Most of the time when women were accused they were not given a fair chance to prove they were not witches which means they did not want the power people said they wanted. So as I we think about the question thats been asked for ages we also should think about how and why the women were accused and why they said and did what they did. There may be people still out there believing that it was womens act to gain power, but it was not because they tried to get free and prove they were not lying. Also they action they did can always have an explanation to them because of what we know today. Even though the accused were trying to prove they were innocent and that they wanted to be free, they were strong and just trying to survive and live their lives no matter what other will think. Soon the trials had become part of the past and an important part that no one will forget.

Abortion in the First Trimester Only Essay -- Pregnancy Ethics Essays

The argument that has torn the nation apart for ages is abortion. Each individual needs to take the time out to research every aspect of the ideals behind abortion. The two main sides to abortion are pro-choice and pro-life. Both sides make strong arguments to support their side. The main question behind abortion is whether the act is murder of an unborn child or the right of the mother to choose what happens to her body. A lot of research is needed before an individual can make a rational decision about what side of the abortion issue they take. This paper focuses on the argument that abortion is a woman’s choice in her first trimester of her pregnancy only, and after that time period is over the unborn child has the right to life just like any other human being. "This middle ground is what a lot of people believe these days, the right for a woman to choose in the first trimester only" (Baird 179). People who believe this are stuck between the two sides of abortion. These peo ple are just to be named as the middle ground, where both sides make good points, but they only agree with a few parts of the arguments. The basic idea is that a woman has the right to choose until the first trimester is over and from then on the unborn child has the right to life and should be carried to full term and delivered. The pro-life movement believes that the killing of any child, abortion or not, is murder and the dead, unborn child should be protected by the laws of the states just like any other victim of murder. "Pro-life advocates declare that the fetus is a person with the same rights and interests as a born person, therefore the mother does not have the right to privacy if by doing so they murder another person, their unborn child" (McDonagh 47). The advocate’s state that their argument is in the idea that an unborn child has the rights as the mother and that the unborn child would choose life, just as the mother would choose murder as her choice. Although the pro-life advocates make an argument that seems reasonable, what they are not stating is that under law the woman has the right to privacy, freedom, and the right to choose what actions happens to her body. The woman has control to do what ever she likes to her own personal body. Therefore, if a woman chooses to have an abortion, she may be able to in the first trimester of her pregnancy only. The developi... ... facts state that an abortion is the woman’s choice in the first trimester and the unborn child’s right to live in the second trimester and on. This belief is known as the middle ground in the abortion issue and many people believe in this kind of action. Although the abortion issue will be an on going dispute, the middle ground is a reasonable and logical answer to the abortion problem. This is why the mother has the right to choose in the first trimester only and after that the fetus has the right to life, like anyone else. Works Cited Baird, Robert M. and Stuart E. Rosenbaum. The Ethics of Abortion. New York: Prometheus Books, 2001. Johnson, Robert V. Mayo Clinic Complete Book of Pregnancy & Baby’s First Year. New York: William Morrow and Company, Inc., 1994. Mason, J K, and R A McCall Smith. Law and Medical Ethics. London: Butterworths, 1994. McDonagh, Eileen L. Breaking the Abortion Deadlock. New York: Oxford University Press, 1996. Reiman, Jeffrey. Abortion and the Ways We Value Human Life. Boston: Rowman & Littlefield Publishers, INC., 1999. Solinger, Rickie. Abortion Wars. Los Angles: University of California Press, 1998.

Leadership Path-Goal Theory

IntroductionLeadership is a serious task that has to betaken by those who are able to understand the society in an objective way. Certainly, the idea of becoming a leader requires serious thinking.   Becoming a leader requires efforts that start with personal development and adjustments. There are numerous theories and practices that help the hopeful leaders in becoming the person that they want to be. In the paper to follow, a reflection on one’s ability and self-improving processes would be discussed in the view of the author of this paper.Being a leader is a serious task that requires serious effort and determination to adjust on the part of the person who wants to pursue on being a leader in his or her own field of interest. As Peter Northouse refer to leadership as a â€Å"change that would affect the whole personality of an individual†(2006, 16). It is not true that leaders are born, they are made. Through self-restructuring of themselves, the leaders of today h ave sprung out from actually being nothing to becoming influential personalities in the human society.How? Because of their determination to make a change to the society that rooted out from the changes that they had to make on themselves in the first place. This is the reason why in this paper, a self-examination process shall be utilized to learn the importance of self-adjustment in becoming a leader. Leadership is one of the most common practices that is found and applied on the different organizations around the world. The need for governance has mainly increased the pressure on institutions specializing in educating aspiring leaders with the needed skills that they are expected to have when they are already working on their own fields of interest.Leadership for many is a virtue learned through the experience of becoming great followers. It requires effort and ample time before it could be said to be the perfect way of showing leadership.   It could be obviously seen how much the people who are considered leaders in the world are viewed as exemplary people and not as people who knows only to command and drives other to work. When it comes to the business industry, the character involving refined leadership is a must to be possessed by everyone. Yes, as leadership itself has strongly affected the lives of many people in the business industry, it indeed is an important character. The idea of being a leader itself is never that easy. Though, through careful and patient learning in adjusting one’s self to be able to adapt to the necessary needed characters of a leader, a refined leadership is never that impossible to acquire.When it comes to the definition of leadership, many groups or organizations have their own view of the characters and responsibilities involved in being a leader. As for example,   House defines â€Å"leadership† organizationally and narrowly as â€Å"the ability of an individual to influence, motivate, and enable others to contribute toward the effectiveness and success of the organizations of which they are members† (House, R. J. 2004: page 15). Indeed, the success of the leader would naturally determine the success of the organization he or she is acquainted with. This is the main reason why many people tend to really deeply learn the art of leadership. Mainly aiming to alleviate the effectiveness of one’s leadership skills, leadership schools and courses were opened especially regarding the business industries. This is the reason why the need for path-goal theory application is an insisted demand upon those individuals who are longing to become effective leaders of the organizations that they are aiming to serve.How the Path-Goal Theory is Effectively UtilizedThe path goal theory is more of a directive motivation on the part of the individuals who are aiming to become leaders of their own groups. The idea is to motivate themselves to motivate others. It is undeniable that people ge t personal motivation from different areas of life. They naturally get influenced by the different systems of understanding that they particularly grow fond of as they deal with the different challenges that they need to face as individuals everyday. These growth sources could be both derived from theoretical assessments of the situation along with the experiential measure of the situation. It is undeniably true that experience itself makes the theoretical background of each individual grow to a more applicable aspect of learning on the part of each person’s growth.Theoretical learning aspects could be sourced out from institutional instructions while that of the actual learning aspect could be sourced out from on the job trainings or from actual based experiences. Self-learned theories could be observed to have the personal impact of insisting administrative practice of leadership upon a person’s life. How could self-assessment be performed by an individual wanting to be an effective leader?Applying Personal Growth in Leading the GroupBeing a leader requires many humane aspects in different personality region. Mainly, it requires psychological stability for holding together the team which is to be lead or the subordinates, mental capacity for making critical reasoning and proper judgment, and sociological for relating with the people within the team. Certain traits aside from these are also much required such as interpersonal charisma and pleasing personality.All of these are vital in leadership because of the main fact that the people within the team will look up to him or her for the decisions, actions and guidance thus his or her responsibility is quite complex and morally challenging (Lashway, 1996). Since being a leader is an important task and it deals with people, performing it involves many moral and ethical aspects and if these issues are in contrast with the leader’s personal values then severe contradictions can occur. Thus, th e personal ethics is important in playing the role of a leader because whatever the leader’s moral values are will reflect to his team thus influencing their performance and relationshipBefore making a decision, critically analyzing the consequences and the action itself will provide some ethical enlightenment to the problem that is being faced. Though taking the job, which is considered unethical, would not compromise the moral values of the person, it will surely affect the conscience and the performance of the person and being a leader, this scenario would not post pleasant environment. Considering the impact of the unethical nature of the company would give the applicant a broader contextual perception of the dilemma. (Center for Ethics and Business, 2006).Thus, by looking at the problem completely then other perspective can be considered such as the consequences that the person can do to influence the ethical position of the company. As a leader in the company, the perso n can establish certain ethical policies that can promote positive outcomes instead of solely focusing on the negative aspect of the company. As an example, making policies and regulation that strongly prohibits smoking among the minors or launching campaigns educating the public regarding ideas of moderate smoking which would increase the pleasant appeal of the company to the society.It may sound very idealistic but it will surely affect the ethical and moral perception of the people with the company thus reflecting positive economic asset to the enterprise itself. A leader has the responsibility to promote the moral values and ethics in his or her work place and this also includes the company’s image itself. By being a leader, a person powers can extend to aspect such as creating an ethical environment regarding the employment he or she pursue with moral adhesion. Instead of seeing a certain job as something unethical, consider a perspective of how a person can make a certa in job ethical for himself or herself and the social community they belong lived in.Dealing with such issues of organizational assistance of truthfully realizing their organization’s worth to the society should be faced with the leader with integrity and power over what is wrong. How does he know what is wrong? The theoretical background that he may have learned from school or other instructional institutions that he has attended may as well serve well in these particular situations. Whereas on the other hand, his personal experiences on the matter could profoundly assist him in making considerable decisions that are bound to do something that is progressive for the entire business.The present world is beset with problems that defy solution. So as to be able to meet the challenges of becoming a fine leader for the majority, this paper then requires personal adjustments on a hopeful leader. As it is believed by Northouse, a leader is someone who has competencies in changing th e society by starting within himself. (2006, 25) Yes, changing the society is a large responsibility. Providing the people of what they need is a vital part of the responsibilities of being a leader.A hopeful leader could not attain the said goals and complete the said responsibilities without working on his personality first. Not unless he is able to reach his best potential as a person would he be able to bring out the best potential on others that could help them attain their dreams as well. Yes, personal development is essential for creating a leader within one’s self. Realizing one’s personal capabilities and limitations would help one recognize that others too have their own limitations and capabilities. People who have the capability of seeing people as persons who are capable of improving and developing are the ones who become successful leaders of the society.Applying the Leadership Concepts as Learned from Theory and ExperienceThere are different issues of le adership that each person faces in terms of organizational administration. It is indeed helpful that one knows how to deal with each situation as one actually differs from the other. There are at least five major ways of leadership that could be applied in this particular situation of personal growth.Model the WayThis particularly refers to the ability of the appointed leaders to become role models for other members of the group. The fact that they are placed in position, means that they have a certain characteristic that is   particularly inspiring. The utilization of the said character shall help the leader set a pattern for others to follow. Once the road has been set, the reality of success is not that hard to foresee.Inspire a Shred VisionUnity is one of the primary reasons behind the success of different organizations. Once each member is able to envision the real goal of the organization as to where they are actually headed to, the inspiration begins. Indeed, everyone has t he right to get involved in what is happening and thus be able to understand where the direction of the group is taking them.Challenge the ProcessChallenging the process does not mean changing the procedures of the organization abruptly. With ample time of adjustment and informing the members of the changes that are to be made, the procedural changes could occur. From this particular way, the organization is beginning to open its doors to other alternatives of meeting the goals of the group. However, to do so, careful planning and examination of the possibilities should be done.Enable Others to ActIncluding other members of the group within the system of procedural arrangements is one type of motivation that makes everyone in the organization feel that they are of great use for the achievement of the group’s goal. Hence, achieving the goals with them leaves them with the satisfaction of work that they primarily expect from the group upon joining.Encourage the HeartSimply invo lving the members within the job are not enough. Leaders ought to encourage their members through making them realize of their worth to the group. To do so, the leaders are expected to be able to figuratively touch the hearts of the members of the group so as to empower them to perform better not only for the organization’s sake but for their own benefit as well.Through the consideration given to the five steps of leadership as enlisted above, it could be expected that the appointed authorities would be equipped with the necessary skills that they need to set a straight path for success for the entire organization. However, to do so, it should be remembered that the effective utilization of empowering communication should be applied as well. Without the existence of the said connection between the leaders, the victory that is being achieved may not become reality at all.ConclusionSetting path-goal theory as a major source of improvement upon organizations is a primary effecti ve process of strengthening the capability of the leaders and of the other members as well to face the different issues that the entire groups need to face with everyday.   This particularly means that the changes that organizations are required to meet every now and then require an ample amount of patience and courage from the leaders. Aside from that, it also requires sturdiness when it comes to decision making on the part of the leaders.The policy of â€Å"what must be implemented must be implemented† should always be carried on through by the leaders with an ample scaling of the ethical values that are involved within the situation. Yes, the fact that leadership is not an easy challenge that needs to be conscientiously met identifies the qualities and the attitudes that leaders or aspiring organizational head personnel should posses. Hence, a leader is then supposed to face the said challenges in full courage and knowledge of the strategies that need to be applied in pa rticular situations that they are to meet.Changes need to happen individually. However, making a leader out of one’s self is not an easy task. As they say, the worst enemy one could ever have is one’s own self. This is why learning the art of leadership requires the determination to do well on the said matter. If one is determined to become the best leader he could be, he should be able to accept self-changes and adjustments to be able to attain the goals of becoming and efficient leader. Hence by becoming individually effective as a leader, the learning of theoretical leadership along with the implication of the learning that one gains from experience could be established well as part of the major aspects of application that could be utilized for establishing a fine practice of leadership as per noted by an individual upon himself and his colleagues as well. Through personal assessment of the matter, motivating people would become an easier task on the part of the lea der himself.References:Bolman, L.G. & Deal, T.E. (2003) Reframing Organizations: Artistry, Choice and Leadership, San Francisco, CA: Jossey-Bass.Howard Garland. Relation of Effort-Performance Expectancy to Performance in Goal-Setting Experiments. Departments of Management and Psychology, The University of Texas at Arlington. Journal of Applied Psychology. 1984, Vol 69, No 1, 79-84.Thomas W. Lee. Explaining the Assigned Goal-Incentive Interaction: The Role of Se/f-Efficacyand Personal Goals. Journal of Management 1997, Vol. 23, No. 4, 541-559.

Educational system in 1920’s in America Essay

Around the year of 1920s, there were two types of schools in Americas education system. Generally, it consists of Public Schools and Private Schools. The Oregon School System does play a crucial role in their countrys education system, started from the year of 1922. A group of people which is also known as Ku Klux Klan and the Scottish Rite Masons had also involved in the formulation of educational system for the sake of the society in that time. They set the requirements of education for their young generations in that period of time. Basically, it requires all of the young generations especially children, who are free from physically disability, live more than three miles from the nearest road, have already completed the eighth grade in their previous school, and their age must be ranges from 8 to 16, to attend the Public School to further their studies. By the effecting of state law in 1 June 1925, it required all of the children in America to attend the public schools instead of neither private schools nor parochial schools. In order to ensure that such system is fully obeyed and followed by the parents, those parents who did not send their children to such schools will receive some punishments. They can be fined one hundred dollar or get into jail up to one month or both of the punishments. (http://www.nd.edu/~rbarger/www7/pierce.html)However, this type of education system do brings some protestation and objections from the society. The society especially parents wonder why they do not have the rights and choices to send their children to what kind of school and receive what type of education. Thus, such system was soon been challenged by the Society of Sisters of the Holy Names of Jesus and Mary, which it was originated from Catholic Nuns. They are promoting a private military school. Throughout such educational school, all orphans and young men between the ages of 5 to 21 will be taught in such institution. (http://www.nd.edu/~rbarger/www7/pierce.html) In The Great Gatsby, Nick Carraway was graduated from New Haven School in 1915. Moreover, there were some rumours saying that Jay Gatsby was graduated from Oxford. Gatsby studied in college of St. Olafs, which is situated in Minnesota. But after 2 weeks, he quit from the college. Back to the author of The Great Gatsby, F. Scott Fitzgerald, he has attended St. Paul Academy in 1908. While in the year of 1911, he furthers his studies in Newman School, Hackensack, New Jersey. Lastly, he was enrolled in Princeton University in the year of 1913. (http://education.yahoo.com/homework_help/cliffnotes/the_great_gatsby/1.html)Moreover, the educational system in America had experienced some drastic changes in 1920s. For instance, the increases in numbers of students who attend public school had lead to the rises of demand of teachers. Besides that, Red Scare, religious controversy and political strife had also influenced the education system as well. Furthermore, the changes also included the opening of new classes for science subjects, physical education, home economics, geography and industrial arts. The educational system had slightly experienced small changes as well, which has only focus on Three Rs (Reading, Writing and Arithmetic). In 1896, Plessy v. Ferguson established the doctorine of separate but equal schools for minority ethnics. Indirectly, it greatly take advantage of the blacks. For sure, it does insured separation, but definitely not equality in education between Blacks and Whites. For example, we can see that the average expenditure of states and municipalities for educational purpose of white students was far more outweighing than black students. Furthermore, blacks are always being deterred from certain occupation and jobs as well.

Cancer management The WritePass Journal

Cancer management Introduction Cancer management IntroductionLiterature review criteria:Primary search terms:Secondary search terms:Exclusion criteria:Patient case presentationScreening and HPV testingFertility preservationPsychological SupportChemotherapy and TrialsConclusionReferencesRelated Introduction The aim of this case report is to provide a source of information regarding patients with Bulky stage 1B cervical cancer by focusing on optimum care and treatment pathway of a patient.   The author aims to describe important scientific observations from clinical trials, and therefore provide insightful information to expand knowledge and new research already present. Despite a ‘well established’ UK screening programme for detecting cervical pre-invasive disease there are still approximately 2,800 cases of cervical cancer per annum and 1,000 women still die from cervical cancer each year (Cancer research UK, 2003). The case study focuses on a patient with squamous cell carcinoma of the cervix uteri (exocervix and endocervix), poorly differentiated and staged by FIGO staging system at IB2 N1 (appendix A). The FIGO staging system (Appendix 1), is based on clinical evaluation (inspection, palpation, colposcopy), radiological examination of chest, kidneys, and skeleton, and endocervical curettage and biopsies.   The FIGO staging recommendations were last revised in 1995.   Stage IB (T1b) includes all invasive tumours limited to cervix larger than stage 1A2 lesions.   Stage T1b occult is no longer used.   Stage IB lesions (confined to cervix) were subdivided into stage IB1 clinical lesions (≠¤4cm in size) and stage IB2 lesions (4cm in size).   There were no changes in other stages, including the 1987 definitions of stages IA, IA1, and IA2 (FIGO, 1995). Brady et al (1999) acknowledge squamous cell carcinoma of the uterine cervix originating at the squamous columnar junction (transformation zone) of the endocervical canal and portio of the cervix.   This lesion is frequently associated with severe dysplasia and carcinoma in situ, which has the possibility of progressing to an invasive carcinoma in 10 to 20 years. The malignant process breaks through the basement membrane of epithelium and invades the cervical stroma.   If invasion was less than 3mm, the lesion was classified as microinvasive or superficially invasive (stage IA1) the probability of lymph node metastasis is about 1% (Bohm et al, 1976). Perez et al (1998) suggested incidence of pelvic node metastases to be approximately 15% in stage IB, 25% to 30% in stage IIB, and 50% in stage IIIB disease.  Ã‚   Incidence of para-aortic node metastases was found to be approximately 5% in stage IB, 19% in stage IIB, and 30% in stage IIIB disease. Fagundes et al (1992) submitted the tumour may spread to adjacent vaginal fornices or to paracervical and parametrial tissues, with eventual direct invasion of bladder, rectum, or both.   They advocated the most common metastatic sites as lungs (21%), para-aortic nodes (11%), mediastinal and supraclavicular lymph nodes, bones, and liver. Literature review criteria: The most recent form of literature available was published scientific articles in form of electronic journals. Literature found included, reviews on the subject of Cervical cancer and published clinical trials which demonstrated clinical benefits and subsequent evaluation.   Journals were accessed via internet using PubMed and Science Direct databases.   Papers were selected based on merit of abstract and relevant articles were extracted from reference lists. Primary search terms: ‘Cervical cancer’ ‘Squamous cell carcinoma of cervix’ ‘Cancer of the cervix’ Secondary search terms: ‘Poorly differentiated IB2 N1 Cervical cancer’ ‘IB2 N1 Cervical Cancer’ ‘Ovarian Transposition + Cervical Cancer’ ‘Phase 1 trials +Cervical Cancer’ ‘Treatment pathway + Cervical Cancer’ ‘Supportive care + Cervical Cancer’ ‘HPV + Cervical Cancer’ Exclusion criteria: Most of the references used were less than eight years old, although older articles were reviewed to note development of treatment. Patient case presentation The patient case is of a twenty two year old women (gravida 0, para 0).   She had no familial history of Cervical cancer or any other type.   She consumes two units of alcohol per week and is an occasional smoker with a one pack per year history.   She is currently employed and works thirty-six hour per week. In November 2008, patient presented with an abnormal cytologic (Papanicolaou) smear test and some postcoital spotting.   She denied any forms of vaginal discharge but remarked a feeling of heavy fatigue and pelvic pain. A general physical examination of the patient was carried out with special attention to supraclavicular (nodal) areas, abdomen, and liver.   A careful pelvic examination which included a bimanual palpation of the pelvis took place. Following an abnormal smear test the patient was referred for a colposcopic examination, where high grade cervical dysplasia was discovered.   The patient was consequently referred in October to her local hospital for a LLETZ (large loop excision of transformation zone of cervix) biopsy of cervix.   Specimens obtained during this procedure identified an invasive, moderately differentiated squamous cell carcinoma of large cell keratinising type.   Vascular invasion was not identified.   The tumour was staged as IB+. November 2008, contrast MRI of abdomen and pelvis completed, which concluded a large homogenous mass being seen arising from lower end of cervix extending slightly more to the right.   Cervical canal was noted to appear preserved and the endometrium and rest of uterus appeared normal.   There was suspicion of extension of tumour into the upper vaginal wall.   A right sided simple ovarian cyst was noted, with a normal left ovary observed.   A large lymph node was seen in the right pelvic sidewall highly suspicious of being metastatic.   No Para- aortic lymphadenopathy noted.   Concluding staging on MRI grounds was recorded as a Stage T2b, N2 cervical cancer. Based on MRI findings, patient was referred for EUA (examination under anaesthesia) for consideration of trachelectomy, in November.   Trachelectomy is a surgical removal of the uterine cervix.   EUA recorded a large 5cm exophytic tumour and on looking around it on 360⠁ ° no macroscopic infiltration into vagina was seen.  Ã‚   In order to give better definition an endo-cervical coil MRI was performed in December 2008, which further confirmed a definitive 6cm exophytic cervical cancer and enlarged right pelvic lymph node.   Due to this the patient was not an ideal candidate for a trachelectomy. The patient was next referred for a EUA, cystoscopy, colonoscopy, sigmoidoscopy and biopsies.   Procedure was uneventful. No vaginal or parametrial involvement were identified.   Cystoscopy, sigmoidoscopy and colonoscopy were normal.   This gave a concluding staging of Ib/2a. The patient’s case was discussed within a MDT (multi-disciplinary team) meeting.   Here it was decided that chemo-radiotherapy would be preferred treatment. The patient’s main concern was preservation of fertility due to her young age.   Due to the progression of disease and quick follow through from diagnosis to treatment, the patients family, patient and partner all became very distressed, and a referral was made to a specialist gynae – nurse, where information regarding treatment, prognosis and side effects could be explained and discussed again. The oncologist referred patient to a fertility specialist in December 2008, to discuss possible options for fertility sparing prior to patient commencing radiotherapy and chemotherapy.   From this meeting it was decided that the patient was to undergo ovarian transposition to exclude them from the radiation scatter effect from the proposed adjuvant radiotherapy. Within the same procedure in December, patient underwent a laparoscopic para-aortic node assessment, which subsequently defined the radiotherapy field.   The results of the assessment were discussed within a MDT meeting whereby it was found that the frozen section of the suspicious right obturator node confirmed malignancy, although, the para-aortic lymphadenectomy was negative.   Patients consent, height and weight were taken in order to calculate Cisplatin chemotherapy dosage needed for concomitant chemotherapy. December 2008, patient proceeded to commencing radiotherapy prescribed at 50.4Gy in 28 fractions with a four field technique at 10MV.   In addition to this she commenced her first concomitant chemotherapy of Cisplatin 40MG/M2 60MG, first of four cycles. The patient was reviewed throughout her radiotherapy and chemotherapy and tolerated both well with minimum side effects.   Subsequently the patient was consented for intrauterine and intravaginal high dose rate brachytherapy for February 2009. The patient was noted to be down and depressed and very tearful and expressed concerns of not coping.   The patient was referred to a CLIC/Sargent social worker for support and advice in January 2009. Prior to first fraction of brachytherapy, patient underwent EUA.   It showed a good regression of tumour, but was still bulky.   A smit sleeve was inserted as well as intrauterine tube and ovoids.   Patient was admitted for brachytherapy (16.5Gy to point A in three fractions) which proceeded without complication, patient was subsequently discharged.   Following brachytherapy, an external beam pelvic side wall boost was performed at 5.4Gy in three fractions. The patient was reviewed five weeks post treatment in March 2009.   She noted slight bowel changes and noticed that she was leaking small amounts of urine.   This was dismissed as radiotherapy related.   The patient was given vaginal dilators and provided with instructions as well as an explanatory DVD.   Patient relayed her fears of being re-infected by HPV.   Patient was encouraged to talk with long partner regarding HPV testing.   The patient also mentioned experiencing a few night sweats and hot flushes, actioning referral for an estradiol level, FSH and LH check. April 2009, patient was given news that hormonal tests taken showed signs of menopause.   Patient devastated as ovarian transposition was not successful.   Patient referred for hormone replacement therapy.   Three month follow up MRI scan and clinical examination revealed no sign of disease. July 2009, three months post follow up, patient seen in clinic complaining of recurrent pain in right upper quadrant.   Patient was on regular analgesics, but denied any per vagina bleeding or discharge.   Bowels and micturation not working properly, denied it being associated with pain.   Patient sent for CT scan of thorax, abdomen and pelvis in conjunction with FBC and U and E’s. Results of patient scans discussed within an MDT in August 2009, where it showed recurrent disease in the transposed side ovary.   The plan decided within MDT is to perform a diagnostic laparoscopy and removal of said ovary.   Patient and family were extremely distressed and emotional on hearing this news. Final pathology of biopsies taken laparoscopicaly in September 2009 confirmed malignancy in the right ovary.   Following discussion at MDM, decision made to give the patient three cycles of Carboplatin and Taxol and reassess to see if surgical excision were possible.   It was noted that peritoneal washings taken at time of biopsy were positive, which implies that peritoneal disease is elsewhere.   Patient was consented for further chemotherapy and was distressed about possibility of hair loss due to chemotherapy.   Patient was referred to MacMillan team for assessment of grant for financial assistance. An interval CT scan was taken post 3rd cycle of chemotherapy in November 2009.   This showed a response in disease with the mass having reduced slightly in size.   Patient proceeded with a further two cycles of chemotherapy with G-CSF support (granulocyte-colony stimulating factor) a growth factor that stimulates the bone marrow to produce more white blood cells. After the patient had finished five cycles of Carboplatin and Taxol, patient was consented and referred for a laparotomy and exploration of lesser sac and paracolic gutter in December 2009.   This showed evidence of metastatic disease in form of omentum nodules, which subsequently tested positive for metastases on frozen section.   The tumour was found in right hepatic flexure and was fixed to the right para-colic gutter involving head of pancreas and infiltrating liver.   From this discovery of metastatic disease, it was considered inappropriate to proceed with the proposed right hemicolectomy, cholecystectomy, resection of part of liver and excision of the Gerota’s fascia. Patient and family were understandably very distressed about intra-operative findings.   They were given a psychological support referral.   Family were seen by a clinical psychologist, although the patient declined the appointment, but opted to speak to a CLIC Sargent social worker.   Community palliative care team were to liaise and follow up with patient and family.   The patient and family were additionally put in contact with a local hospice within their catchment Based on findings the clinical oncologist felt that the Carboplatin and Taxol regime was ineffective in controlling disease progression and spread and was therefore stopped.   In December 2009, next chemotherapy line suggested was Topotecan, although a request was made to consider the patient for a Phase 1 agent. Due to patients increasing pain and problems with control the patient was not a suitable candidate for Phase 1 chemotherapy.   Therefore patient was commenced on fives cycles of standard palliative chemotherapy Topotecan in January 2010. Patient had extensive meetings and liaisons with social worker for young people.   Macmillan nurse, from hospice arranged for home visits to assess pain medication.   The patients ECOG performance was ranked as 1 (Appendix 2).   Re-staging CT was performed which showed an increase in size of tumour with further encroachment onto liver, new malignant lesions were identified as well as more dilated bowel loops. Patient completed intended cycles of Topotecan but was admitted for treatment of Sepsis with IV antibiotics in March 2010. Subsequent CT scans in April 2010 displayed disease progression despite Topotecan.   Patient commenced on Tamoxifen therapy due to her disease having some ER positivity. Patient’s family were seen separately from patient, advised of patient’s prognosis to be less than 6 months.   Patient’s mother raised concerns of patient expressing suicidal ideation.   Macmillan nurse visited patient’s home. May 2010, patients pain became difficult to control, home visit made by consultant in palliative medicine as patient became increasingly drowsy.   Patient deteriorated rapidly and was commenced on the Liverpool Care Pathway.  Ã‚   Marie curie nurse, present most evenings with patient at familial home. June 2010, patient passed away with family around her. Screening and HPV testing Since first being introduced as a screening test for cervical cancer by Papanicolaou in 1927 (Papanicolaou, 1928), the cervico-vaginal smear test has proved to be one of the most cost effective test within medicine.  Ã‚   The American Cancer society (1997) states that according to the National Cancer Institute, mortality rate from cervical cancer has dropped   70% over the last 70 years. Currently only 30% of cervical cancers are screen detected, the majority of these cases occur in women who have never had a smear (PAP- Papanicolaou) test or regularly attend a screening programme.   The patient discussed (patient A), was part of this statistic as she had never had a smear test due to the UK cervical screening age being 25.   Patient A presented with symptoms aged 22.   Standard practice within the UK is for women aged between 25 and 60 to be contacted every 3 to 5 years and asked to go for a cervical screening test.   In patients A case, a smear test was only done due to other symptoms such as post coital bleeding. An article in ‘The Times’ (2009) confirmed that new guidance will be issued to all GP’s and practice nurses to increase awareness and management of cervical cancer, but age at which women are screened will not be lowered to 20, announced by the department   of health.   This decision was finalised after a review by the Independent Advisory Committee on Cervical Screening (ACCS) which found that risks for women under 25 of false positive results and premature births outweighed benefit of identifying a â€Å"few extra cases†. The ACCS found that treating women for abnormal cervical cell changes has been linked to an increased risk of premature birth.   While women of all ages who are treated are more likely to give birth prematurely, benefits of screening older women outweigh this risk, the panel said. One in three women under the age of 25 will have an abnormal result compared with one in fourteen for older women, the ACCS said, meaning that there are many false positives identifying abnormal changes in cells that often return to normal without treatment. A study by Sasieni et al (2009) further confirmed the ACCS’s findings that cervical screening in women aged 20-34 is less effective than in older women.   By studying the effect of screening in smaller age groups, Sasieni et al showed that efficacy of screening decreases with decreasing age, even within the age 20-34.   On average, participation in the UK cervical screening   programme by a woman aged 35-64 reduces her risk of cervical cancer over the next five years by 60-80% and her risk of advanced cervical cancer by about 90%.   The benefit of screening for women aged 25-34 is more modest.   Screening in women aged 20-24 has little or no impact on incidence of cervical cancer under the age of 30. HPV is a factor being recognized as a major risk factor in pathogenesis of squamous cell carcinoma of   cervix.   Any woman who is sexually active is at risk of infection from human papillomavirus (HPV).   Patient A was sexually active from aged 16. De Villiers et al (2004) identified Over 100 subtypes of HPV. A significant proportion of HPV disease is attributed to four subtypes; 6, 11, 16 and 18. HPV subtypes 16 and 18 cause approximately 70% of cervical cancer cases worldwide. HPV subtypes 6 and 11 infections are responsible for genital warts (Wiley et al, 2002). Arbyn et al (2007) acknowledge that HPV is the major cause of nearly 100% of all cervix cancers.   This finding rapidly led to the development of vaccines against common and aggressive virus strains causing cervix cancer, the HPV genotypes 16 and 18 (Harper et al, 2006). According to Tornesello et al (2011), the role of HPVs in the etiology of cervical cancer precursor lesions and invasive carcinoma development has been well established.   Bouvard et al (2009) found that at least 12 viral genotypes of alpha genus (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59) have been found associated with a high relative risk of cervical cancer and labelled carcinogenic to humans.   Although holding different prevalence rates, HPV types 16 and 18 were the most common viral types in invasive carcinoma of the uterine cervix worldwide (Li et al 2008). Cheryl et al (2000) explain the HPV as replicating primarily within the proliferating basal cells of squamous epithelium.   In order for the virus to infiltrate these cells, disturbance of the overlying epithelium must occur.   Once present in the basal squamous cell, HPV early genes are expressed, which lead to viral replication and host cell duplication. Previously no specific antiviral treatments existed for HPV-associated diseases, including genital warts, cervical, vaginal and vulval dysplasia as well as cervical cancer.   The development of vaccines against HPV is an attractive strategy for both prevention and therapeutic intervention against genital tract HPV infections (Sherman et al, 1998). Two HPV vaccines have been developed: Cervarix ® (GlaxoSmithKline, London, UK) a bivalent HPV (types 16, 18) vaccine and Gardasil ® (Merck Co., Whitehouse Station, NJ), a quadrivalent HPV (types 6, 11, 16, 18) vaccine. Both are prophylactic vaccines that have been shown to be effective in young women prior to HPV exposure.   Following advice of the Joint Committee on Vaccination and Immunisation (JCV I) the Government and Department of Health (DOH, 2007) have introduced HPV vaccines for girls aged 12 to 13 years of age, starting from September 2008 (Garland et al, 2007).   This was implemented three months after Patient A’s diagnosis. Cricca et al 2006 recognised an increased interest being focused on HPV detection in cervical lesions.   They subsequently reported that detections of HPV DNA in the absence of cytological abnormalities may indicate persistent high-grade squamous lesions which may have been missed by PAP screening within the follow up of CIN3 – cervical intraepithelial neoplasia (severe dysplasia, carcinoma in situ- Dysplastic cells extend into the upper third and may occupy the full thickness of the epithelium) treated patients. A study carried out by Silvana et al (2007) found HPV testing significantly predicts disease clearance or persistence, in comparison to PAP smear whose results did not register any statistical significance.   The study further suggested that after treatment women should be followed up at 6-month intervals, for a minimum of 2 years with both PAP and HPV testing being carried out. Patient A only received HPV testing after her abnormal smear test was analysed.   Introducing routine HPV testing as part of screening process every three years could have had a marked impact on her prognosis. Fertility preservation Patient A’s initial main concern was preservation of fertility and a referral was made by the clinical oncologist for her to see a fertility specialist to seek advice.   In women who preservation of fertility is anticipated, an alternative to simple/radical hysterectomy is a radical trachelectomy. This process requires vaginal resection of cervix, upper 1 to2 cm of vaginal cuff and medial portions of cardinal and uterosacral ligaments. The cervix is transected at lower uterine segment and a prophylactic cerclage is placed at time of surgery . Landoni et al (1997) argue that for early stage disease, surgery conserves ovarian function and avoids effects of early menopause. They further propose that less shortening and fibrosis of vagina occurs compared to radical radiotherapy which gives better results in terms of residual sexual function.   Surgery was thought to be the preferred treatment option in young women excluding the presence of any contraindications.   Patient A fell into the young woman classification and initially had no contraindications to surgery.   Relative risks and benefits of different surgical management approaches should be thoroughly discussed with the patient on an individual basis (Shepherd, 2009).   Patient A had a thorough consent process prior to each surgical procedure and was put in contact with a specialist gynaecological nurse to answer any further questions. Patient A presented with a 5cm exophytic tumour.   She undertook a radical trachelectomy, although research suggests that it does not appear to increase rate of recurrence, provided tumour diameter is no greater than 2cm (Landoni et al, 2005).   Safety of radical trachelectomy in women with lesions that are greater than 2cm in diameter is not known as the majority of reported cases of radical trachelectomy have been in women with tumours less than 2cm in diameter.   A recent prospective multicentre study by Renaud et al (2004) of radical trachelectomy combined with laparoscopic pelvic lymphadenectomy reported three recurrences in 100 treated patients (FIGO IA1, IA2, and IB1). NICE (national institute for clinical excellence) guidelines (2010) state, that women requesting fertility conservation should be offered radical trachelectomy and pelvic lymph node dissection, providing   tumour diameter is less than 2cm and no lymphatic-vascular space invasion is present.   As established within the case notes, Patients A tumour presented at 5cms, which means guidelines were not properly followed. In addition to trachelectomy patient A underwent ovarian transposition.   Preservation of ovarian function is an important concern in premenopausal cancer patients whose treatments include external beam radiation to pelvic structures that incorporate ovaries applicable to patient A.   Ovarian transposition was developed to displace ovaries from their normal anatomic position and away from direct radiation, with goal of maintaining long-term ovarian function.   Ovarian transposition is seen as 40-50% successful (Shepherd, 2009). Techniques for ovarian transposition using a laparoscopic approach depend on radiation field size and location.   Tinga et al (1999) have described transposition of ovaries in a fixed position behind uterus (to lie beneath an external midline block) as well as a superior transposition to level of iliac crest. They contend that the disadvantage of midline oophoropexy (surgical fixation or suspension of an ovary) is a higher level of internal radiation scatter, as the area is generally surrounded by in-field radiation.   Morice et al (1998) reported a series of 24 patients who underwent ovarian transposition to paracolic gutters, before radiation for gynecologic malignancies.   Authors concluded that this procedure was a safe and effective method of preserving ovarian function. Complications in both of these reports were rare.   The fact of Patients A recurrence being at sight of transposition was noted as extremely rare and was the first case experienced by the clinical oncolo gist.   No literature was found outlining risks of recurrence of cervical cancer with ovarian transposition.   It could be noted that perhaps Patient A’s size of tumour was too large for radical fertility sparing surgery. Psychological Support Patient A and her family experienced a great deal of distress during the care pathway.   In 1983 Derogatis et al acknowledged cervical cancer as having a significant psychological and psychosocial impact on the individual and felt it was important to develop strategies to deal with this. Fallowfield et al (2001) recognise psychological distress as being common in patients with all forms of cancer and advocate it as remaining undetected.   Regardless of socio-demographic characteristics or clinical characteristics, the well-being of patients with cervical cancer changes during the course of their disease (Greimel et al, 2000).   A study by Greimel et al (2000) of 119 patients’ newly diagnosed gynaecological cancer evaluated psychological well-being and functions of daily living before surgery, three months after surgery and one year after surgery. Greimel et al (2000) noted a decline in psychological well-being and functions of daily living scores at three months after surgery.   After one year there was a significant improvement in psychological well-being and no significant difference in functions of daily living compared to before surgery.   Greimel (2000) recognised that in patients treated with surgery, level of psychological distress may be related to extent of surgery. The multidisciplinary team (MDT) should routinely screen for presence of psychological distress and be aware of risk factors for very high levels of psychological distress from point of diagnosis onwards (including during follow-up review phases) (Fallowfield et al, 2001).   The MDT team involved with patient A routinely screened her psychological well-being and monitored it closely due to the young age of the patient.   Patient A had regular contact with a support group and social worker for young patients in a similar circumstance.   She was able to discuss matters which she was unable to share with her family and partner, such as body image and sexuality issues. As illustrated by Fallowfield et al (2001), many of psychological, physical and practical challenges facing women with cervical cancer are common to all cancer patients. These include, coping with shock of diagnosis, pain, nausea, fatigue and disfigurement from surgery as well as treatment worries over practical issues such as travel costs and loss of income.   These above challenges were all experienced by Patient A.   MDT supported the patient through these challenges.   There is evidence that providing psychological and practical support may have a positive effect on patients’ well-being (Slevin et al, 1996). Evidence identified in relation to support needs of cancer patients was from small heterogeneous studies such as Walker et al (1999) and types of help offered are very varied.   No studies found were specific to patients with cervical cancer but were comparable to cervical cancer population.   Interventions included structured psychological support, relaxatio n techniques, orientation programmes and general psychological support. The interventions reduced anxiety levels and improved quality of life.There are many national and local support services, for example, voluntary agencies, clinical nurse specialists, liaison psychiatry, clinical psychologists, local support groups, drop-in centres and day centres.   These support services may offer complementary therapy services, such as yoga, aromatherapy and reiki.   Reflexology was undertaken by patient A which, was offered by one of these support services. NICE guidelines (2010) state that â€Å"Patients with cervical cancer should be offered psychological support at time of diagnosis and at intervals throughout their management.   Information about local support services should be made available to patients.   Carers, families and dependants should be made aware of support available including local and national organisations. Multidisciplinary teams across healthcare settings should have agreed protocols for offering support for carers, families and dependants of patients with cervical cancer.†Ã‚   These guidelines were adhered to in the treatment of patient A. Near the end of Patients’ A life, a MDT decision was made to commence the Liverpool Care Pathway.   Over past few years a major drive has been underway to ensure that all dying patients, and their relatives and carers receive a high standard of care in the last hours and days of their life.   The Liverpool Care Pathway for the Dying Patient (LCP) is a key programme within the palliative care pathway for a patient. LCP was recognised as a model of best practice in the NHS Beacon Programme (2001).   It was recommended in NICE guidance on supportive and palliative care for patients with cancer (2004) as a mechanism for identifying and addressing the needs of dying patients.   It was recommended in the Our Health, Our Care, Our Say white paper 2006 as a tool that should be rolled out across the country.   It is recommended in the End of Life Care Strategy DH 2008. Optimal management of cervical cancer involves a multidisciplinary team as demonstrated in Patients A case.   The challenge for the team is to individualise treatment.   As cervical cancer commonly occurs between ages of 30 and 45, this includes offering women with early disease the option of having fertility conserving surgery, where appropriate.   Patient A did not fall into common age group for occurrence of cervical cancer. Patient A presented aged 22.   For those such as Patient A, with intermediate or advanced disease, aim is to minimise treatment side effects without compromising outcome. Chemotherapy and Trials Within the last ten years concomitant chemoradiation has been the standard of care for advanced cervical cancer.   Patient A received Cisplatin with radiotherapy followed by Adjuvant Topotecan.   Varying proposals have been made that to control occult metastatic disease adjuvant chemotherapy after chemoradiation will improve outcome. In 2009 Duenas-Gonzalez et al described results of a phase III randomized trial which compared chemoradiation with gemcitabine and cisplatin followed by adjuvant gemcitabine and cisplatin for two additional cycles VS chemoradiation with cisplatin in women with stage IIA to IVA cervical cancer.   Results showed a significant survival benefit for patients receiving chemoradiation plus adjuvant chemotherapy, the results concluded a 3 year survival of 74% in the chemoradiation plus chemotherapy arm against 65% in the chemoradiation arm.   In order to confirm these results future trials are imperative, Kitchener et al (2010) aim to randomise women receiving chemoradiaiton after radical hysterectomy to four additional cycles of carboplatin and paclitaxel or no additional therapy. Chemotherapy is recognised as a standard treatment for women with late stage disease and those with recurrence not eligible for chemoradiation or surgery applicable to patient A.   Monk et al (2009) published results of a phase III trial which compared 4 platinum containing doublets.   Patients were randomised to receive cisplatin combined with either paclitaxel (the reference arm), vinorelbine, gemcitabine or topotecan.   The results showed that progression free survival and response rates were similar in all four arms.   Cisplatin with paclitaxel was found to have the best toxicity profile with quality of life similar across the four arms Angiogenisis is the formation of new blood vessels that grow into the tumour, giving it nutrients and oxygen to assist its growth.   As with other cancers the role of anti-angiogenic targeted agents are of interest and importance in the treatment of cervical cancer.   A phase II trial of bevacizumab in women with persistent or recurrent cervical cancer concluded a median progression free and an average overall survival range 3.4 – 7.3 months thus showing favoribilty within cervical cancer (Monk et al, 2009).   Leading from the results of this trial Kitchener et al (2010) constructed a phase III trial where women are randomised to one of four arms using bevacizumab with cisplatin/paclitaxel or topotecan/paclitaxel. Monk et al (2010) identified Pazopanib as a second anti-angiogenic agent usuable within the cervical cancer patient population.   This agent is known as an oral tyrosine kinase inhibitor which targets the vascular endothelial growth factor receptor.   It was found that patients treated with pazopanib had a median overall survival of 50.7 weeks. Patient A received topotecan as a single adjuvant agent, if combined with an anti-angiogenic agent such as bevacizumab or pazopanib she may have had a prolonged life expectancy.   Funding, costing and PCT approval may have been a barrier to access. Conclusion Patients A case is a sad case.   The patient underwent ovarian transposition in order to preserve fertility but unfortunately the disease recurred at this site.   Perhaps if the transposition was not undertaken then she may have still been alive.   Ultimately it was the patient’s choice and due to the patients young age fertility preservation was very much applicable and supported by the clinician. There is a lot of controversy surrounding the topic of lowering the age of PAP smear testing and the standardisation of HPV testing as routine.   If patient A had had regular smear tests and HPV testing as research has proved beneficial her disease may have been identified earlier and put through radical treatment. The availability of anti angiogenic has not yet been standardised by some PCTs, patients A access to chemo drugs such as pazopanib may have prolonged her life further. Throughout the past years there have been many advances and discoveries in the prevention and treatment of cervical cancer,   Within the next five years there are many other advcances and technologies that will possibly impact the management of this common indiscriminatory disease.   Active areas of research that can change the management and practice include the use of PET/CT imaging to guide therapy and PET or high-field MRI to monitor response to treatment, combined use of hyperthermia and radiation therapy to treat locally advanced disease and the role of intensity modulated radiotherapy. Appendix 1 FIGO staging of cervical carcinomas Stage I: Stage I is carcinoma strictly confined to the cervix; extension to the uterine corpus should be disregarded. The diagnosis of both Stages IA1 and IA2 should be based on microscopic examination of removed tissue, preferably a cone, which must include the entire lesion. Stage IA: Invasive cancer identified only microscopically. Invasion is limited to measured stromal invasion with a maximum depth of 5 mm and no wider than 7 mm. Stage IA1:   Measured invasion of the stroma no greater than 3 mm in depth and no wider than 7 mm diameter. Stage IA2:   Measured invasion of stroma greater than 3 mm but no greater than 5 mm in depth and no wider than 7 mm in diameter. Stage IB: Clinical lesions confined to the cervix or preclinical lesions greater than Stage IA. All gross lesions even with superficial invasion are Stage IB cancers. Stage IB1: Clinical lesions no greater than 4 cm in size. Stage IB2: Clinical lesions greater than 4 cm in size.    Stage II Stage II is carcinoma that extends beyond the cervix, but does not extend into the pelvic wall. The carcinoma involves the vagina, but not as far as the lower third. Stage IIA: No obvious parametrial involvement.   Involvement of up to, upper two thirds of the vagina. Stage IIB: Obvious parametrial involvement, but not into the pelvic sidewall. Stage III Stage III is carcinoma that has extended into the pelvic sidewall. On rectal examination, there is no cancer-free space between the tumour and the pelvic sidewall. The tumour involves the lower third of the vagina. All cases with hydronephrosis or a non-functioning kidney are Stage III cancers. Stage IIIA: No extension into the pelvic sidewall but involvement of the lower third of the vagina. Stage IIIB: Extension into the pelvic sidewall or hydronephrosis or non-functioning kidney. Stage IV Stage IV is carcinoma that has extended beyond the true pelvis or has clinically involved the mucosa of the bladder and/or rectum. Stage IVA: Spread of the tumour into adjacent pelvic organs. Stage IVB: Spread to distant organs. Source: TNM Classification of malignant tumours. L. Sobin and Ch. Wittekind (eds.), UICC Internation Union against Cancer, Geneva, Switzerland, pp155-157; 6th ed. 2002 Appendix 2 ECOG Performance Status These scales and criteria are used by doctors and researchers to assess how a patients disease is progressing, assess how the disease affects the daily living abilities of the patient, and determine appropriate treatment and prognosis. ECOG PERFORMANCE STATUS Grade ECOG 0 Fully active, able to carry on all pre-disease performance without restriction 1 Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work 2 Ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours 3 Capable of only limited self-care, confined to bed or chair more than 50% of waking hours 4 Completely disabled. Cannot carry on any self-care. Totally confined to bed or chair 5 Dead As published in Am. J. Clin. 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