Dare Essay Samples Fundamentals Explained

Dare Essay Samples Fundamentals Explained If you don't understand how to begin your essay or where to search for supporting data, we'll be happy to help you. Citations and extracts from assorted sources have to be formatted properly. Yes, there's somebody who can assist you with your essays expert essay writers at MyPerfectWords. An essay was defined in an assortment of means. A winning essay is the same from a very simple college essay, as it still is composed of the fundamental components of an essay. As a writer, you compose an essay for any given purpose. Persuasive essays are intended to be convincing, this may be to obtain a given product or maybe to earn a call to action. If you discover that the writer did not provide precisely what you expected, request a revision, and we'll make the corrections. Academic papers cannot contain any signals of plagiarism. In your class drafts aren't graded. The very first thing we have to do when confronted with a choice is specifically define precisely what it is we want to decide. Peer pressure is whenever someone attempts to secure you to do something you know isn't right. The fact of the matter is, spending an excessive amount of time on something may give r ise to a reversal of heart. Think about something you do each day. Jones mentioned that the DARE program has been in existence for quite some time. If you believe about that concept and appear at the DARE model, it is logical. This lesson you are going to be learning how to give directions to some other person when they ask you for directions about how to go somewhere. The DARE program has developed over recent years. Dare Essay Samples Features You may also get a variety of discounts on our site which will help you to save some more money for future orders or anything you want to spend them on. Don't rush and do some comparison shopping just like you would for any other item. It is recommended to look for the one which has a superior reputation and offers high-quality papers at very affordable rates. If you would like to acquire high excellent research and thesis papers in time and for a sensible price, you should probably attempt using EssaySupply.com. Much like in th e world these days, not enough people today are supporting one another's ideals and beliefs. If parents wish to actually safeguard their children, they can begin by listening to some of music they listen, and begin watching some TV programs their little one may watch. DARE works since it surrounds children with support and encouragement from many sides. The children should know that they're loved, and can come to their parent with any issue. Beginning with interesting truth about your subject will grab the eye it needs. When you inform us about all of the paper information, we'll begin searching for an acceptable writer for your paper. After the writer is appointed, they begin working on your essay based on the requirements you have specified in your purchase. Luckily, you don't need to be a professional writer to compose a winning entry. If it's the first time you're likely to use our article writing service, you most likely have a great deal of questions. Our resume writing service can spare you a great deal of grief and boost your probability of getting a superior job straight from college. In addition, a customer may ask the writer to submit part of the job for review and, if needed, ask them to make corrections. Get assistance with your writing. The Benefits of Dare Essay Samples Marijuana may get addictive and is illegal in the USA. Students lead busy lives and frequently forget about a coming deadline. Every student necessitates help with homework from time to time. The Little-Known Secrets to Dare Essay Samples It's important to collect information by conducting different manners of research. Tell our experts what kind of homework help on the internet you want to get. Whenever you opt to ask us for expert support, don't hesitate to speak to our support managers. Choosing our service, you are going t o see that studying can be simple if you gain from the help of capable experts. Ok, I Think I Understand Dare Essay Samples, Now Tell Me About Dare Essay Samples! Furthermore, when it's taken in huge quantities, alcohol can cause death or coma. Drugs can be extremely dangerous. That means you should not do drugs whatsoever. By not doing drugs is vital since if you do drugs you will damage your physique.

The Main Cause Of The American Civil War - 1047 Words

The one main cause of the American Civil war must be resolved, and while there are many ideas, history reveals that there was only one. There are many arguable motives to the start of the Civil War, but there are four main concepts. These four concepts were slavery, taxation, the election of Abraham Lincoln and lastly, struggling with power between the Northern and Southern states. To start with, the end of slavery is undoubtedly one of the most popular arguments to the creation of the Civil War. While many consider slavery as the cause of the Civil War, they are mistaken (Historynet). To support this statement, the facts simply are that slavery has been in our country ever since its formation. If slavery was the single cause of the Civil War, that war would have begun long before it truly started in 1861. While the people saw slavery as a great evil, they did not in fact go to war because of it (Historynet). Also great disputes with slavery, that were big enough to start a war, did not appear until it had ended. The ending of slavery infuriated the Southern states. The North wanted to tax the South because they were becoming more profitable on cotton (Historynet). Slavery was not the issue, as slaves fought IN the civil war for both the North and the South. Southern states saw the ending of slavery as the North seizing dominant power and overriding the union (Historynet). Southern states thought the North had no right to do this, and by doing so, Northern states wereShow MoreRelatedSlavery Cause for Civil War1483 Words   |  6 Pagesï » ¿ SLAVERY (THE MAIN CAUSE OF THE AMERICAN CIVIL WAR) US History to 1877 – HIST101 American Military University, 26 April 2014 Many factors led to the occurrence of the American Civil War. The key issues were slavery, different political ideologies, right of the people, and economic reasons. However, the key reasons that lead to the Civil War was slavery. Slavery is touted as the main cause of the conflict between the states in the northern part and those in theRead MoreWhat Caused The American Civil War1634 Words   |  7 PagesWhat caused the American Civil War from 1861 to 1865? There has been several different debates and disputes about the causes of the American Civil War. Historians have stated slavery was the primary cause of the American Civil War, while other historians have argued there were other causes and effects in conjunction with slavery. Research has shown all historians did agree upon the division between the North, known as the Union, and the South, known as the Confederacy, battled on the soil of theRead MoreCauses Of The American Civil War760 Words   |  4 PagesThe Civil War was on e of the most momentous and pivotal periods in U.S history. After decades of tension between the North and South over matters involving expansion, slavery, and the states rights these caused the beginning of a horrific devastating time known as the American Civil War, that lasted between 1861-1865. Within these 4 long barbaric and destructive years, it led to an innumerous amount of political, social, and economical changes for the U.S. Leaving 2.4 million dead and millionsRead MoreThe War Of The American Civil War991 Words   |  4 PagesThe American Civil War is known to most as the bloodiest war anyone has ever witnessed. It claimed the life of thousands of Americans and animosity that was built up over several years prior to it can be to blame. Most people think that slavery was the cause of this battle, and although slavery did play a part, it was not the main cause. The biggest roles played in the American Civil War were states’ rights, unfair bills, feelings of in feriority and threats to economy. The tension started duringRead MoreThe Civil War Was The First Modern War1289 Words   |  6 PagesThe Civil War was during 1861-1865 . It was known to be the first modern war . It had very high numbers in death compared to any other war .Because this war followed the Industrial revolution ,this war was the beginning of new technologies, new weapons It was a war fought between the North ( Union) and The South (Confederates). The North did not want to keep slavery but the South did . Slavery was the cause of the separation between the two.There were many laws that were created that started conflictsRead MoreThe Causes Of The Civil War1409 Words   |  6 PagesThe causes of the Civil War were complex and have been controversial since the country began. Some causes include; states’ rights, economics, and slavery. The most recognizable and popular cause is slavery. The freeing of the slaves was an important moral issue at the time and one of the greatest causes of the civil wa r. It was only by carefully avoiding the moral issue involved in slavery that Northerners and Southerners could meet on any common ground. (Goldston, 79). The time came in which ourRead MoreSocial Reasons For The Civil War1348 Words   |  6 Pages The civil war was mainly sparked by tensions between the north and the south. Both sides rarely agreed on topics and could never make a compromise. Slavery was a big reason for the start of the civil war, but the causes don’t end there. Although some may say that political or economic reasons started the civil war between the north and the south, political reasons were the real cause. This is because of important decisions made by the government, and the south seceding. Some believe that socialRead MoreSlavery And The American Civil War948 Words   |  4 Pages Slavery and the American Civil War By Adam Overman History 101 Professor Brett F. Woods June 14th, 2015 The American Civil War is also referred to as the war between the Northern and Southern States or the Rebellion War that began in 1861. Slavery was regarded as the main cause leading to the start of the war, as a high level of discrimination against the African Americans existed upon their arrival in the United States. The African Americans were either sold and traded by the eldersRead MoreJames M. Mcpherson : An American Civil War Essay1397 Words   |  6 PagesJames M. McPherson: James McPherson was born on October 11th 1936, he is an American Civil War historian. He received the 1989 Pulitzer Prize for Battle Cry of Freedom, his most famous book. McPherson was the president of the American Historical Association in 2003, and is a member of the editorial board of Encyclopedia Britannica. In his early career McPherson wanted to leave a legacy as being known for the historian who focusses on more than one point. Through skillful narrative in a broad-rangingRead More The American Civil War Essay1255 Words   |  6 PagesThe American Civil War Works Cited Not Included Horrific! The American Civil War, also known as the War Between States and the War Of Secession, was an extremely gruesome and bloody war (World Book 614). The war, which started on April 12, 1861, when the southern troops fired on Fort Sumter, and ended 4 years later, took more American lives than any other war in history (614). This war was between a divided union in whish the southern states were trying to preserve slavery while the northern

Therpay Memo for Al Husnain Clinic-assignmenthelp.com

Question: Discuss about theTherpay Memo for Al Husnain Clinic. Answer: Al husnain clinic Internal memorandum TO: All Nurses CC: Pathologist, Pharmacist, Chemotherapists FROM: Rahim Rajab DATE: October 17, 2017 SUBJECT: Addressing Infant Mortality It has come to the attention of the clinics administration and lead practitioners that there is an acute increase in infant mortality lately in the clinic. This only calls for quick action in addressing the issue herein. Our researchers have been upbeat on their job, on the numeric statistics and the main causes of the infant mortality. The results show that traumas of both the mothers and the infants unfortunately are the main causes of the infants death. In a bid to up our game concerning this we will require a lot of intensified research and attention cooperatively so we can minimize the occurrences of such. First, every pregnant woman who comes in for pre-natal care in our facility has to be tested and pathologist result sampled for further interpretation. Then chemotherapy treatments will come in handy herein because it is the most appropriate means now. The chemotherapy drugs should be administered upon payments by the patient and as per the doctors specifications and finally drugs administered by the pharmacist. Kindly note that nurses will be required to follow up strongly with the patient on the taking of the medicine and compute the results to assess how our measures are taking effect. There after we will draw conclusions and make recommendations in relation to the practice. We require a direct nurse to patient approach on this hence a relational workflow so as to make the most out of this exercise. This should be effective today henceforth. Administrator Rahim Rajab References Finando, D. (2015). Acupoint and Trigger Point Therapy for Babies and Children: A Parent's Healing Touch. New York: Simon and Schuster. Gurman, A. S. (2014). Handbook Of Family Therapy. London: Routledge.

Butler’s Tourism Lifecycle Model Essay Essay Example

Butler’s Tourism Lifecycle Model Essay Paper Butler developed a theoretical account which shows how any tourer resort may turn. A resort may get down off from being a little. low key. finish. He suggests that all resorts go through the same kind of procedure. The seven phases of tourer development A graph of Butler’s resort life rhythm theoretical account 1. Exploration – a little figure of tourers visit the country. The country is good and few tourer installations exist. 2. Involvement – local people start to supply some installations for tourers. There starts to go a recognized tourer season. 3. Development – the host state starts to develop and publicize the country. The country becomes recognised as a tourer finish. 4. Consolidation – the country continues to pull tourers. The growing in tourer Numberss may non be a fast as earlier. Some tensenesss develop between the host and the tourers. 5. Stagnation – the installations for the tourers may worsen as they become old and run down. The Numberss of tourers may worsen excessively. 6. Rejuvenation – investing and modernization may happen which leads to betterments and visitant Numberss may increase once more. 7. Decline – if the resort is non rejuvenated ( present 6 ) so it will travel into diminution. Peoples lose their occupations re lated to touristry. The image of the country suffers. The Butler theoretical account is a generalization. and so non all resorts will follow this procedure. We will write a custom essay sample on Butler’s Tourism Lifecycle Model Essay specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Butler’s Tourism Lifecycle Model Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Butler’s Tourism Lifecycle Model Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Application of Butler’s Tourism Lifecycle Model to Calafell A ; Sitges. Spain ( MEDC ) Sitges and Calafell are about equal-sized colonies lying to the south West of Barcelona. Both rely on touristry as a major beginning of income and employment and the survey aims to compare the comparative success of touristry. in its assorted signifiers. by using the Butler Model. 1. SITGES Sitges – a brief history Sitges is a town of about 25. 000 people and is located about 30 kilometers south of Barcelona. Originally occupied by the Romans on a defensive promontory looking out to sea. Sitges’ port was used to merchandise merchandises from the Penedes part and other topographic points from the Roman Mediterranean. Despite its direct contact with the sea. the town had more peasant husbandmans than fishermen. with vineries being the chief economic activity. In the eighteenth century Catalonia obtained permission to merchandise straight with the West Indian Spanish settlements and by 1833 more than 27 % of the Catalans trading with Cuba were Sitgetans. The lucks made were invested in the purchase or fix of the town’s old houses. Sitges. although located near to Barcelona. was still difficult to entree at the clip. but began to develop as a summer resort for taking the Waterss. Equally early as 1879. there are records demoing that baths were already being used as medicative therapy and watering place partisans straight became beach partisans. However. it was non until 1881. with the reaching of the railroad line from Barcelona. that touristry in Sitges truly began to develop. With the reaching of Santiago Rusinol in 1891 – one of the designers of Modernism – Sitges became the cultural Centre of the modernists. In 1909. Sitges was visited by Charles Deering. a North American millionaire who converted a street in the historic nucleus into a castle. the Palau Maricel. This castle and Rusinol’s abode helped launch Sitges to tourist celebrity. In 1918. the Terramar garden metropolis and the Passeig Maritim or Esplanade were constructed. Atraccion de Forasteros ( Tourist Attraction Company ) was created in 1928 and the Tourist Information Office in 1934. From so on. Sitges would go a European touristry standard compositor. Aerial position of Sitges’ historic nucleusThe Butler Model applied to Sitges1. Sitges Discovery Sitges was discovered early by people from the metropolis of Barcelona. It subsequently began to pull many creative persons and intellectuals such as Rusinol. Many affluent Catalans besides built 2nd places in Sitges to get away a much polluted Barcelona. Much of the early wealth of Sitges was based on trade with the West Indies and Cuba in peculiar. The houses on the southern portion of the Esplanade reflect this Cuban influence. 2. Sitges Growth and Development The local tourer industry remained in topographic point until the developments of the 1960’s when touristry from abroad first began to filtrate into the town. The development of the bundle vacation whereby riders booked flights. transportations and adjustment all in one engagement made topographic points such as Sitges accessible to people from Northern Europe. Furthermore. the usage of jet aircraft made such sensed heroic poems journeys now possible in under half of a twenty-four hours. Sitges responded to these developments with the building of big hotels such as the Terramar and Calipolis on the sea forepart. Other smaller hotels were besides built. frequently in converted Cubanesque houses. Restaurants. stores and bars besides opened to provide for the demands of the increased figure of tourers who visited in the chief season widening from mid-May until the terminal of September. 3. Sitges Success Sitges is now a major tourer resort. perceived as high position and providing for more flush visitants. It has a broad scope of 36 hotels and 12 pensions. numbering 2. 540 suites. It is popular with the homosexual community. many of whom vacation in Sitges during the summer season. This has added to the success of the town and is further reflected in the scope of high position stores and eating houses found at that place. There are over 150 apparels stores and 175 bars and eating houses. four times more than expected in a town the size of Sitges. Sitges has besides attracted many migrators non merely to work in the tourer industry but besides others to populate in the town. These include affluent people from elsewhere in Spain. every bit good as others from around the universe. The migrators comprise of 63 % from Europe and 30 % from Latin America. Many of the Europeans are populating for good in Sitges while others ain 2nd places in the town. Proximity to Barcelona airdrome and the coming of low-priced air hoses such as Easyjet and Ryanair have been an added encouragement to Sitges in pulling people on short interruptions. Today big Numberss of the tourers are independent travelers. doing all of their ain vacation agreements via the cyberspace instead than utilizing a High Street travel bureau. This has been particularly of import since the economic downswing as the bulk of visitants are here for short interruptions merely. 4 Sitges Stagnation Tourism trends alteration. Many of the early tourers to Sitges now looked for cheaper options to topographic points they may hold visited before or go tired of. New resorts opened as the Mediterranean states of Greece. Turkey. Cyprus and others developed their tourer potency and more established resorts such as Sitges saw a autumn in their traditional client base. This stage saw holiday companies such as Thompson remove Sitges from their vacation booklets. 5 Sitges Decline or Rejuvenation The autumn in the traditional tourer base has led Sitges to seek to develop more sustainable schemes. Many environmental betterments are in advancement and the resort has been rebranded as an all-year finish. To this terminal the calendar of events that Sitges offers extends good beyond the traditional vacation season. The extension of the season has been promoted with the production of a DVD with the subject ‘Sitges the art of living’ . This entreaties to high income professional groups to do Sitges a lasting base for multiple short interruptions in the Mediterranean Sun. Sitges has capitalised on its propinquity to Barcelona to go one of the chief finishs for Business and Conference touristry in Catalonia. Its specialized hotels in this sector include the Dolce Sitges. with over 30 meeting suites and the Melia Sitges. with a conference hall siting more than 1. 300 delegates and 16 meeting suites. Furthermore. the Sitges Council is shiping on a undertaking called ‘QUALIA Sitges’ to heighten touristry by working what is called the ‘creative economy’ . This refers to the development of activities associating to creativeness. art and civilization which will congratulate Sitges’ tourer based economic system. It aims to construct upon the earlier function o f Sitges as a Centre of art and civilization based upon the plants of the creative person Rusinol in the late nineteenth and early twentieth centuries. It aims to promote and advance cultural and artistic tradition with new engineering. The undertaking is a long term program covering the following 10 old ages and will see the development of a province of the art campus with a school of music and dance. a University of the Performing Arts and a Design Centre. These installations will convey in to Sitges up to 2. 000 pupils a twelvemonth every bit good as a farther 2000 occupations including academic staff and other professionals working in the QUALIA installation. It has been estimated that each pupil will pass about 750ˆ per month in Sitges of which 150ˆ will be on tourer and leisure installations. Added to this are the household and friends of the pupils coming to see them who are expected to add a farther 25. 000 guest darks in Sitges and the usage of the town’s tourer installations. Therefore. Sitges can be seen as traveling frontward in its programs to stay a major leisure finish by diversifying to guarantee long term sustainability. 2. CALAFELL Calafell – a brief history Calafell has a population of about 25. 000 people and lies 50 kilometer South of Barcelona. It owes its beginnings to a palace and occupied a defensive site on an inland hill. The name Calafell means ‘small castle’ and the earliest mention to it dates from 999AD. For old ages the economic system of Calafell was devoted to agriculture and angling. Like Sitges. the reaching in the late 1880’s of the railroad from Barcelona led to a alteration in its economic lucks. Calafell became more accessible and the development of 2nd places around the railroad Stationss flourished with the 1947 Garden City undertaking known as the Quadra de Segur. At first people lived there merely during vacation periods. but now the bulk of the population are lasting occupants. It was non until the 1960’s that touristry began to develop strongly in Calafell. particularly along the 5km of uninterrupted beach where legion flat edifices and hotels were constructed. With the approval of consecutive metropolis councils. a immense speculative roar in the 1970’s led to an eternal row of 6-storey flats confronting the sea. Later ordinances prevented inordinate perpendicular growing whilst inland the prohibition of edifice over two and a half floors led to more green infinite and a lower population denseness. Today. the town of Calafell is delimited into three really distinguishable countries. To the North. narrow streets surround the palace and the old church. To the South. and disconnected from the historic nucleus. the former seafront fishing small town has been converted into tourist country. And to the E is Segur de Calafell. a former Garden City of 2nd places developed on farming area environing the railroad station. | Calafell palace: the historic nucleus of Calafell is disconnected from the seafront beach resort| |Calafell seafront: 6-storey flats confronting the sea| The Butler Model applied to Calafell 1. Discovery Calafell. like Sitges. benefited from the gap of the railroad line but because of its greater distance from Barcelona. there was really slow development until a immense speculative roar in the 1970’s. Developers constructed hotels and flats to take advantage of the resort’s greatest plus – its long and broad beach. 2. Growth and Development The building of the promenade and the completion of the sea forepart flats and hotels attracted households from Madrid and northern Spain. peculiarly in the summer months. New concerns opened to provide for the demands of these people. 3. Success The 5 kilometers stretch of coastline consisting the beach resort of Calafell became to the full occupied during the high seasons of the 1970’s and 1980’s. However. Calafell neer attracted the bundle circuit operators in the manner that Sitges has done and the scope of hotels is really limited. 4. Problem – Stagnation The bad roar of the 1970’s and 1980’s resulted in the devastation of about all of Calafell’s original seafront. The fishing bungalows were replaced by an eternal row of 6-storey flats confronting the sea. As a consequence. the seafront lacks character and appeal and with the economic crisis and competition from other resorts in Spain and overseas. the figure of hotel suites has decreased by 17 % in the last decennary ( from 1. 690 in 1996 to 1402 in 2006 ) . The immigrant population now represents 20 % of the entire population of Calafell. holding grown quickly in recent old ages. However. Calafell has non attracted big Numberss of affluent people from elsewhere in Spain and Europe in the manner Sitges has. Alternatively. about 50 % of the immigrants are from North Africa. subsiding in the country of Segur de Calafell. Calafell therefore seems to be in stagnancy or diminution manner. Calafell: merely one bungalow from the original seafront remains today 5. Decline or Rejuvenation Like Sitges. the autumn in the traditional tourer base has led Calafell to seek to develop more sustainable schemes. Many environmental betterments are in advancement and the resort has been rebranded as an all-year finish. However. touristry in Calafell has taken a instead different way to Sitges. The family-orientated nature of the resort has been promoted. with Calafell gaining the ‘Family Holiday Destination certificate’ from the Catalan authorities in 2007. This recognised the family-oriented adjustment. eating houses and a scope of leisure activities provided. Calafell has a Children’s Club in the summer months and. like Sitges. has a tourer train running along the sea forepart and a 2nd associating the beach country with the historic nucleus inland. Calafell has helped open up the tendency for more active vacation chases and in 2008 became the first resort in Spain to offer Nordic walking. This. together with trekking and mountain biking are provided free of charge. with certified ushers. However. despite following the motto ‘Calafell tot l’any’ ( ‘Calafell. all year’ ) . the resort has struggled to widen the tourer season every bit efficaciously as Sitges. Calafell’s 2009 Municipal Urban Plan ( POUM ) seeks to halt the uncontrolled urban growing of the town. protect the natural and historical heritage and maintain and heighten the touristry that forms its economic base. Calafell needs to widen its touristry offer and new economic activities need to be attracted to diversify its economic system if it is to avoid going a dormitory town for Barcelona. It can hence be seen that both Sitges and Calafell cater for tourers but are two really different towns. The propinquity of Barcelona has enabled Sitges to turn much more quickly and diversify its touristry more efficaciously than Calafell with the consequence that the two towns have developed and evolved in different ways.

Critical Study of The NHS breast screening programme The WritePass Journal

Critical Study of The NHS breast screening programme Introduction Critical Study of The NHS breast screening programme IntroductionPathway through the Breast servicesConclusionReferencesRelated Introduction The NHS Breast Screening Programme began in 1988 and was set up by the Department of Health in response to the recommendations of a working group, chaired by Professor Sir Patrick Forrest. The report Breast Cancer Screening was published in 1986, and popularly known as The Forrest Report. NHSBSP began inviting women for screening in 1988 and started covering nationally in the mid 1990s. A report by the Department of Health Advisory Committee published in 1991 suggested that the programme would save 1,250 lives each year by 2010(Breast Cancer Screening 1991: Evidence and Experience since the Forrest Report, Department of Health Advisory Committee, NHS Breast Screening Programme 1991).The NHS Breast Screening Programme is an effective part of the UKs efforts to reduce the death toll from breast cancer. In September 2000, research was published which demonstrated that the screening programme had lowered mortality rates from breast cancer in the 55-69 age group. Early detection of breast cancer is an important factor in improving breast cancer survival. Breast screening is an opportunity for early detection of breast cancer. In 2010, research shows that benefits from screening mammography outweigh the harm in over diagnosis. . Between 2 and 2.5 lives are saved for every over diagnosed case. The aim of this essay is to critically analyse and evaluate the pathway through breast services with the relevant departments. Pathway through the Breast services Women registered with the General Practitioner, aged between 50 and 70 years old are routinely invited for breast screening at their local breast screening unit, it could be hospital based or in a mobile trailer. An invitation is sent once every three years.   Women over 70 years old will not receive an invitation but they are encouraged to make their appointment for the breast screening programme. Enclosed in the invitation is a leaflet about the facts about the screening programme.The author finds the leaflet very helpful because it has a lot of facts about the breast screening programme, and its benefits.   The leaflet sent is written in English. There is an available format with this leaflet from large print in English; for women who do not speak English as their first language, the leaflet is also available in other languages such as Arabic, Bengali, Cantonese, Polish, Punjabi and Urdu. It is even available in Braille format and a DVD for British sign language. The Departmen t of Health Cancer Reform strategy announced that effective on 2012 the NHSBSP would be extending the invitation to women aged between 47 and 73 years old. The author visited a mobile breast screening unit, based in the breast screening department car park. There were 55 patients booked on that day.   There were two women who did not attend their appointment.   The author observed that the unit was very relaxing despite the very busy list. Background music was playing while women waited for their mammograms to be performed. Music has been very successful in distracting patient’s attention from pain (Hawthorn and Redmond, 1998). The author strongly agrees with Hawthorn and Redmond that music helps in distracting ones attention from pain. One woman made a comment that music helped her relaxed since it was her first breast screening and the woman was very anxious and a little bit nervous. When a woman arrives for breast screening appointment, the radiographer will then greet the woman. The radiographer will check the woman’s personal details and reviews the questionnaire answered by the woman. In the x-ray room, the radiographer will explain the whole procedure such as the need of compression during the examination. The radiographer will answer all the woman’s questions before carrying out the examination. Giving proper applied compression is very important in producing a good mammography image (Bassett and Hendrick, 1994). Basett and Hendrick (1994) recommended that to give proper compression the radiographer should let women know the importance of compression, and inform when it is about to be initiated, it also should be done slowly and until the skin of the breast is tight without causing pain. After the mammogram, the woman was then given a leaflet for further information about the result of the examination, a contact number for inquiries and more i nformation and it also states that there is a possibility for a recall for assessment. The aim of breast screening assessment is to identify the abnormality found in the screening mammograms. If there is abnormality found, further tests are then needed. Testing for breast cancer should include a clinical examination, breast imaging, fine needle aspiration or core biopsy. These three tests are called triple assessment. Women recalled for further assessment from the breast screening, around one in six to have cancer (NHSBSP Pocket Guide, 2008). The assessment clinics have breast care nurses that help women during assessment or women who are diagnosed to have breast cancer. Breast care nurse gives advice, support and information. According to the Breast Cancer Care and Royal College of Nursing, the key role of the breast care nurse during the treatment pathway is to give information and emotional support. They give information about treatments, options and what to expect during the entire treatment (Breast Cancer Care and Royal College of Nursing December, 2004). The author strongly believes that having a breast care nurse is crucially important to women who are undergoing treatment. It would make their life a bit easier during treatment because someone is there to listen and help them throughout. The author asked a woman on how helpful the breast care nurse during the treatment pathway, and the woman said that her treatment would be totally different without the help of the breast care nurse. The breast care nurse has helpe d the woman from the day she was recalled for further assessments from breast screening. The breast care nurse has given her a lot emotional support and has given her a lot of information during the treatment journey. The woman is extremely glad that someone is there to listen to all her worries during tough times. The author visited an assessment clinic and observed the flow of the clinic that day. The author observed a woman recalled for assessment. The mammograms were read by two consultant radiologist. Double reading has been practiced in the breast screening programme. The opinion of the author is that having two readings is more effective than just having a single reading. Research shows that double reading may boost the number of cancers detected by some 9 to 15 percent (Brown et al, 1996). However, around 13% of the health service costs happen during the breast screening assessment (Clark and Fraser, 1996). The author visited a busy assessment clinic; one the cases observed was that the reporting radiologists have found in the mammogram a calcification in the upper inner quadrant of the left breast that is why the woman was recalled for further tests. Additional views were suggested specifically, left lateral and left magnification views.   After the additional views were done, the wo man went to the examination room and the radiologist explained the suspected abnormality found in the mammograms and further imaging required to confirm or exclude any abnormality. After hearing out the Consultant Radiologist’s explanation regarding examinations needed during the visit, the woman got so anxious and stressed out. The breast care nurse was there to give support in these times. A woman scheduled for breast biopsy procedures suffers anxiety about the result of their diagnostic procedures. The author believes that breast care nurse plays a very important role in the assessment team. Preoperative nurses have special ways in providing quality nursing care for patients waiting for breast biopsy procedures and their definitive diagnosis (Deane, 1997). The woman had a clinical examination; Stereotactic guide biopsy with specimen radiography was performed. The radiologist took five flecks of representative calcification and was sent to the pathology department for analy sis. Result will be ready for the multi-disciplinary team for review in two days. According to the clinical guidelines for breast screening cancer assessment, women who will have further tests should have their results discussed in a multidisciplinary meeting. There are two routine outcomes for assessment; the woman will still be invited for the breast screening programme or the woman will have further treatment (NHSBSP, Publication 49). The author visited a â€Å"one stop breast clinic† at a local breast care unit. Most patients were referred by their GP and there was a patient referred from breast screening assessment. A specialist should see GP referrals or referrals from the breast screening unit within two weeks from referral. Cancer reform strategy 2007 announced that in December 2009, all patients referred to a specialist with breast symptoms even if cancer is not suspected should be seen within two weeks of referral (DOH, 2007). The clinic had a mixture of patients. There were new referrals from the GP, follow up appointments from previous treatment and follow up for results of tests. The clinic had a consultant breast surgeon, registrar, breast care nurses, consultant radiologist, radiographer, and consultant pathologist, consultant oncologist. They are referred as the breast care team.   The Surgical guidelines for the management of breast cancer, Association of Breast Surgery, BASO 2009 states tha t it is now widely accepted that breast care team should be provided by breast specialists in each discipline and that multidisciplinary team form the basis for best practice.   â€Å"One Stop Clinic† is similar to the assessment clinic for women recalled from breast screening. The author observed that triple assessments were done just like women recalled for further assessment from breast screening and these tests are based on clinical examination, breast imaging, fine needle aspiration or core biopsy. Men who have suspected breast cancer will have the same investigations (NICE guidelines, 2009). The author’s opinion, it is important that every woman or man referred to a Consultant Breast Surgeon should have triple assessment, if possible for accurate diagnosis and should be done at the same visit. â€Å"Routine use of triple assessment can increase the speed and accuracy and reduce the cost of diagnosis. When the three tests give consistent results, a definite positive or negative diagnosis can be given 99% of the time. Thus minimises the need for open biopsy, thus preventing unnecessary surgery and reducing anxiety (NICE, 2009).† National Institute for Clinical Excellence suggested that the triple assessment should be available to patients with suspected breast cancer at a single visit (NICE, 2009). The author observed another woman in the outpatient clinic, a woman referred from breast screening that had shown in the mammograms clusters of micro calcification in the right breast. Core biopsy was done during her first visit in the assessment unit and in which turned out to be breast cancer. The woman’s case was reviewed with the Multidisciplinary team and further treatment was recommended. The woman was so anxious, and felt so hopeless but with the help of the breast care nurse to give support and advice, the woman felt a little better. Treatment was discussed during the visit. Another woman referred by the GP complaining on having breast lumps. The Consultant surgeon reviewed the woman’s notes before bringing the woman into the room. After reviewing the notes, the breast care nurse then brought the woman in for clinical examination. The surgeon thoroughly examined the woman’s breast. The surgeon then wrote down an imaging request form with its clinical indications for a Mammogram. The author then accompanied the woman to the Mammography Section of the Breast Unit and was then met by the radiographer.   The radiographer then explained the examination, like how many views to take, and the need to compress both breast and informed the woman might feel a little bit uncomfortable. The author has observed that the radiographer have explained very well about what happens during the whole examination. Good communication between a radiographer and patients is an important factor. The author visited the Pathology department and observed what happens in the department.   NHSBSP uses triple approach, known as triple assessment. Having a fine needle aspiration or breast core biopsy is part of the triple assessment. Fine needle aspiration entails placing a very thin needle inside the mass and extracting cells for microscopic evaluation. The samples are then smeared on a microscope slide and allowed to dry in air and fixed by spraying, or immersed in a liquid. The fixed smears are then stained and examined by a pathologist under the microscope. According to Bateman (2006), fine needle aspiration is the fastest and easiest method of breast biopsy, and the results are rapidly available, fine needle aspiration cannot distinguish between in situ and invasive carcinoma. Core biopsies are samples of cells are taken from the lump or area of abnormality using a needle. It can be performed under local anaesthesia in the outpatient setting. The sample will be sent to the Pathology department. The Consultant Pathologist will evaluate the sample. The accurate diagnosis of breast cancer and the pathological assessment of breast cancer tissue are big responsibilities by pathologists working within the field of breast disease. It is very important to distinguish the pathological changes of benign breast disease from those of early and established breast cancer. Once cancer is confirmed, the pathologist is required to provide an evaluation of the pathological features determining prognosis and the requirement for further treatment (Bateman, 2006). The author has realized that diagnosing a breast cancer relies on the pathological assessment of the breast cancer tissues and that the Consultant pathologist plays a very important role in giving the diagnosis accurately and the pathological assessment of the breast cancer tissue. The consultant pathologist is responsible in establishing the pathological assessment of the breast cancer tissue. The author’s opinion is that excellent histological diagnosis plays a very important p art to breast cancer staging and management. Woman diagnosed with breast cancer picked up from breast screening should be under the care of the Multidisciplinary team. There are some factors that they need to be considered on what treatment is best. The consultants will consider the stage and grade of cancer, health, and whether the woman has been through menopause. Different methods define the stage of cancer; the TNM system of staging describes the tumour size, number of affected lymph nodes, and what extent the cancer has spread (breakthrough).   When treating cancer, the breast consultant will discuss on what treatment is best for the patient. Before an operation is done, the surgeon will talk to the woman concerned about the best surgery that should take place for the woman’s case. According to the BASO surgical guidelines (2009), surgery should only be performed by a specialist who specialize breast diseases and who performs surgery of at least 30 cases per year The NHS Cancer Plan sets a maximum of one month wait from the date of diagnosis. Women diagnosed with breast cancer are given their first treatment within 2 months of an urgent GP referral or women who came from breast screening. Surgery is often the first treatment for breast cancer to remove cancerous tissues, and to find out if the lymph nodes are affected. Surgery is usually the first line of attack against breast cancer.   A range of operations should be available. If the cancer is not too large or diffuse, surgical options include mastectomy and breast conserving surgery. In such cases the choice should be made jointly by the surgeon and the patien t, who should be fully informed of all opinions and their potential risks, benefits and implications for further treatment (NICE, 2002). Before the operation, patient will be seen by a member of the breast surgical team for a pre-admission appointment.   The patient will stay overnight to prepare her for the operation the next day. Surgical considerations are; wide local excision is the removal of the breast tumor and some of the normal tissue that surrounds it. The breast is left intact with less disfigurement. Sentinel lymph node biopsy involves a tiny incision in the axilla and removing one to four lymph nodes, before having this surgery, radioactive tracer is injected two to twenty-four hours prior to surgery. When patient is already under general anaesthesia, blue dye will then be injected around the areola.   Both radioactive tracer and the blue dye will help in identifying the sentinel lymph nodes during the operation, once they are identified the consultant breast surgeon will then remove it and sentinel lymph nodes are sent to the pathology department for analysis.   Axillary clearance takes place if the sentinel lymph nodes are affected by cancer the consultant breast surgeon will remove the entire lymph glands in the axilla. If cancer cells are found in the sentinel lymph nodes patients are given another operation in about two weeks time or after the pathology report is available. The second operation involves the removal of further lymph nodes in the axilla. Research shows th at 20,000 women who will undergo sentinel node biopsy will be spared from unnecessary breast cancer surgery each year ( Goyal and Mansel, 2008).   According to Professor Mansel, ninety two percent of women who had sentinel node biopsy had a quick recovery and they were able to do their normal activities after three months compared to women who had a conventional operation and also they only stayed one night at the hospital compared to four nights. Under the written breast local guidelines, a woman who has had surgery of the breast should be identified on which adjuvant treatment should be given consideration(BASO,2009.). Adjuvant treatment includes radiation therapy, endocrine therapy, hormone therapy and targeted therapy. Radiation therapy is needed to the remaining breast tissues after an operation.   It is often used in combination with other treatments, such as chemotherapy to shrink the size of the tumour before removing it. Radiation therapy to the breast is a localised treatment. The target is directly aimed to the cancer.   It uses high-energy rays to stop cancer cells from spreading and growing. It is often used to destroy remaining breast cancer cells in the breast, chest wall, or axilla. The oncologist may suggest treatment in a specific area; it could be the breast alone, axilla and supraclavicular area. The author visited the Radiation Therapy and observed  Ã‚   what happens in the department.   The author observed that for the patient’s first appointment will be a planning session in the planning CT scanner or in a stimulator. This is not formal consultation. The main purpose of this first visit it to plan and arrange the radiation therapy. The author observed a woman for h er first appointment. The woman’s breast cancer was detected through breast screening. When the woman arrived for her first appointment, the woman was asked for her details and appointment card then she was then told by the receptionist to go to the stimulator. The stimulator is where the planning takes place. This stage helps the consultant oncologist to target the specific area for treatment. Measurements are measured accurately and ink marks are marked on the patient’s skin for the accurate target. This stage helps the consultant oncologist to target the specific area for treatment. After all accurate measurements are recorded the next stage would be treatment. The radiographers are not in the room with the patient although they are equipped with video camera and intercom so they can see and hear the patient in the treatment room at all times.   The Radiation therapy team consist of radiographers, physicist and oncologists.   The author observed that the unit is very busy and not enough staff for a very busy unit. The author asked the radiographer about patient waiting during the visit and the specialist radiographer said that it is quite difficult to judge how long each patient will take and also to get start the radiation therapy process, there is a long wait for appointment for radiation therapy. Patient can get an appointment as long as three months. According to Dr Michael Williams , vice president of the Royal College of Radiologists, in The Telegraph article, he said current waiting times were â€Å"simply not acceptable†.   There are shortage of radiographers and radiation therapy units. The author believes that if the government invests and expands the coverage for radiation therapy units in various places in the United Kingdom then waiting time will be reduced and patient anxiety will lessen. The oncology unit provides a wide range of services such as clinical and support services. The breast care team in this unit includes a consultant oncologist, two breast care nurses, clinical oncology assistant, and nursing team. The breast care team work closely together with the radiology department at the local NHS hospital to ensure that patients are given the multidisciplinary approach. Patients with breast cancer are given a holistic service in their battle with breast cancer.   There is a 24 hour emergency contact number for patients undergoing chemotherapy. The breast care nurses in this unit are always ready to respond to patients needs and concerns during their treatment. After treatment for breast cancer, women should have a care plan with the GP or a Specialist to detect local recurrence or side effects of any treatment the woman has had.   A written care plan should be made for every woman diagnosed with breast cancer. Dates of review for any adjuvant therapy, details of surveillance mammography, and contact details for any urgent referral to a specialist and support services should be in the care plan. Copies are given to the general practitioner and to the woman (NICE, 2009.) Breast care service does not end after having treatment.   After treatment, women are given follow ups and are offered yearly mammography.   Women who are part of the NHSBSP are given yearly screening for five years and will have the routine screening every three years after that. Conclusion The author has learned and gained a lot of knowledge through this essay. Research and visits to various departments that are part of the pathway through breast care services has been extremely educational and helpful in the author’s profession as a radiographer. The pathway through breast services with the relevant departments work really hard as a team. Each individual who is part of the pathway is very dedicated, committed and has the understanding to women undergoing breast screening and to women fighting with breast cancer. The experience that the author had with all the research and visits is very valuable; it made the author become a better radiographer and has gained the motivation to pursue Post Graduate Award in Mammography. It has given the author to put into practice all the experiences learned from Consultants, nurses and patients during the department visits. As a future mammographer, it has instilled in the author’s mind and heart that high quality standar ds should be carried out at all times, it is vital to follow the quality assurance guidelines for radiographers to be able to give a first class service. NHSBSP was established in 1988. In the last 22 yrs since NHSBSP has started its service for breast screening to women in England, between 50 to 70 years old every three years, over 100,000 women had their breast cancer detected in this programme.   The author therefore concludes that the programme is a vital factor in detecting early stage of breast cancer and it definitely does save many lives. The author would like to thank the people behind the NHSBSP for their commitment and effort to make this programme a success, job well done! The author wishes continued success with this programme. From 1988 up to the present, there have been a lot of changes with NHSBSP, like in 2008; the government invested  £100 million in digital mammography equipment throughout the NHS and also the programme will expand its age group between 47- 73 years old in 2012. Therefore, the author concludes that   with these changes, a lot of women will benefit more and will be given the best service and with the latest technology there is to offer in the pathway through breast services. Through the years, breast care awareness has increased rapidly with the help of the NHS Breast Screening Programme. â€Å"Be Breast Aware† leaflets from the NHS Cancer screening programme is available and it gives a lot of information on how to be become aware of the changes of the breasts , what normal breasts feels like, and what changes you need to look out for .A lot of women nowadays even men are breast aware with the help NHSBSP campaign. It is essential to be breast aware before it is too late in the detection of any breast diseases. The author agrees with the facts, research, studies and department visits gathered together, the author concludes that having routine breast screening definitely helps in detecting early stage of breast cancer. The author would like to extend a big heartfelt thank you to the breast care team and to all those individuals who have given their time and effort during the authors’ department visits even with their busy tight schedule. The author is very much thankful to the women who had given their time with the author in sharing their bad and good experiences with their treatment journey. The breast services pathway is continually improving and the author concludes that in order to improve the pathway in breast services, it is important that  Ã‚   consultants, radiographers, breast care nurses, and the rest of the staff who work in the relevant departments in the pathway through the breast services should work hand in hand as a team. Good communication within the team and to the women that belongs in the NHSBSP are key factors to ensure that   Ã‚  good service is maintained for each individual undergoing breast screening or any examination in relation to breast diseases. References Hawthorn,   J.   and Redmond, K (1998). Pain: causes and management. Blackwell   Sciences Ltd., UK. Breast Cancer Care and Royal College of Nursing (2004). Time to care: maintaining access to breast cancer nurses. [Online]. Available from: http://rcn.org.uk/_data/assets/pdf_file/0008/78641/002494.pdf .[Accessed 18 December 2010] Brown, J. et al. (1996). Mammography screening: an incremental cost effectiveness analysis of double versus single reading of mammograms. March, 312 (7034). [Online]. Available from: http://bmj.com/content/312/7034/809.full. Date accessed: 20 December 2010 NHSBSP (2001). NHSBSP Publication No. 49, NHS Cancer Screening Programmes. [Online]. Available from: http://cancerscreening.nhs.uk/breastscreen/publications/nhsbsp49-1st.pdf. [accessed: 2 January 2011]. National Institute for Health and Clinical Excellence Guidelines(2009) Early and Locally Advanced Breast Cancer: Diagnosis and Treatment. The National Collaborating Centre. [Online]. Available from: nice.org.uk/nicemedia/pdf/CG80NICEGuideline.pdf. [Accessed 3 November 2010]. Deane, K A (1997). The Role of the Breast Clinic Nurse. AORN Journal. 66(2): 304-7, pp 304-310. Goyal , A and Mansel, R. (2008). Current opinion in oncology. Recent Advances in Sentinel Lymph Node Biopsy for Breast Cancer. November, 20 (6), pp 621-626. Bassett, L and Hendrick R E. (1994). Quality Determinants of Mammography: Clinical Practice Guidelines. AHCPR Publication. 13. pp 23-24. British Association of Cancer Oncology (2009).Surgical Guidelines for the Management of Breast Cancer. Elsevier Publication. [Online]. Availablefrom: baso.org.uk/Downloads/YEJSO_2782.pdf .[Accessed: 20 January 2011]. NHSBSP, (2008). Breast screening:   a pocket guide. Department of Health Publications.   [Online]. Available from: cancerscreening.nhs.uk/breastscreen/publications/nhsbsp-pocket-guide-2008.pdf . [Accessed 26 October 2010]. Bateman, A C. (2006). Womens health medicine. Pathology of Breast Cancer. January, 3 (1), pp 18-21. [Online]. Available from: http://download.journals.elsevierhealth.com/pdfs/journals/1744-1870/PIIS1744187006001193.pdf . [Accessed   12 January 2011]. Donnelly, L.   (2007). Government pledges to cut radiation therapy wait. The Telegraph. 2 December 2007. [Online]. Available from: telegraph.co.uk/news/uknews/1571199/Government-pledges-to-cut-radiotherapy-wait.html .[Accessed 27 January 2011]. Does breast screening save lives?. [Online]. Available from: cancerscreening.nhs.uk/breastscreen/save-lives.html . [Accessed 29 October 2010]. Going further on cancer waits: the symptomatic breast two week wait standard (2009). [Online]. Available from: http://ncin.org.uk . [Accessed 24 January 2011]. Healthcare services for breast Cancer (2002). Improving Outcomes in Breast Cancer. National Institute for Clinical Excellence. [Online]. Available from: nice.org.uk/nicemedia/live/10887/28766/28766.pdf .[Accessed 3 November 2010]. Breakthrough Breast Cancer. The best treatment. [Online]. Available from: http:// www.breakthrough.org.uk . [Accessed 18 November 2010].

History of My Surviving in Math Classes Essay Example | Topics and Well Written Essays - 500 words - 1

History of My Surviving in Math Classes - Essay Example Second grade, third grade and fourth grade passed and I struggled to at least survive in math class. I felt isolated from the rest of the class by just the mere sight of them participating in recitations, taking a look at each other's satisfactory score, whilst I hardly pass any quiz or seatwork at all. Whenever I get a grade that was barely passing, I felt happy while my classmates frown upon looking at theirs, despite the wide gap their scores possess over mine. I thought I was never meant to go to college if my math malady was not going to be resolved. I was a bright student in other subjects and my classmates sounded upset whenever I told them my math problems. I thought I was the only one who had it - excellence in other subjects and a loser at math. I approached my Math teacher and told her that I feared to flunk the subject and that it would not be unfair if she were not to give me any consideration; I deserved a failing grade. She had that look on her face that looked as if she understood my situation right away, as though she had also been through a struggle exactly like mine. "In the first place, why did you not come earlier I was more than willing to boost your spirits up.  When I saw you, I saw myself.†   Right there and then, she had told me her story; she not only hated math when she was my age but failed a number of times, then got encouraged by her teacher.

Marketing plan Essay Example | Topics and Well Written Essays - 1500 words - 1

Marketing plan - Essay Example It presses towards creating resources that earn it a global reputation. Haier group mainly manufactures appliances that are used in homes. They are manufactured to meet quality needs of customers all over the world. Heir classifies its products into four: white, brown, client solution business and manufacturing group’s equipment components. The classification facilitates departmentation and focus in the company. The white products include refrigerators, water heaters, washing machines, air conditioners and kitchen appliances. Brown products include computers, mobile phones and colored television sets. Client solution business products involve medical equipment, interior kitchen decoration, integrated kitchen, intelligent home appliances and central air conditioners. Manufacturing group equipment component include electronic control integration and metal and plastic product plate production line. To increase their market, the products will have their quality increased and manufactured in technologically competitive way in order to attract customer s. In the year 2008, Haier was in command of 30% of China’s local electronic market of its products. The company aims at getting the market share to over 50%. The product air conditioners’ market in the same year was 145, way below that of its competitor named Media and Gee that was 47%. The company has divided China into five sections of the market in order to enable it win over the competitors. The products’ market across the world are fair, facing competition from the local products. With increased products’ quality, the sales of the products in the target markets are expected to increase with up to 20% upon execution of the marketing plan (Stapleton 1982). Haier Group Company has its headquarters at Qingdao. The company has established 11976 service centers, 56 trading centers and 38000 sales offices in the areas that it distributes its products. They are able to get the products