Business Communications Essay Example | Topics and Well Written Essays - 2000 words

Business Communications - Essay Example In the same manner the power point presentations devised by the managers to transmit a potential business message to the target business audience also gains effectiveness in that the same contributes in development of business or in meeting objectives relating to profit and business growth. Thus the information transmitted whether through media or through power point presentations must indeed be sensible enough in meeting the information needs of the target audiences to help achieve the end objectives. Thus Jerry Weissman is definitely right in putting the statement ‘media sensibility applied to business community’. Thus a power point presentation created by a business community needs to follow or satisfy certain salient points in order to become sensible in its approach. Here the power point presentation is to be considered as a potential medium like the broadcasting programs aired on television or radio through which the right and effective message needs to be conveyed to the target audience. Firstly the presentation must be prepared to render points in a clarified fashion to help the audience get a clear understanding of the message that is needed to be conveyed. Secondly apart from having clear points of view the presentation must also have clear benefits or positive attributes such that it contributes in the development of the present business situation. Thirdly it must be kept in mid by the presenter that the information need to possess a clear flow or structure to help the target audience grab the sequence of the information flow. Overlapping or leap in the flow of the information renders confusion to the information processing function and thereby distorts the meaning of the message conveyed. Similarly in the fourth case the power point presentation must not contain information that is irrelevant or excess in nature. Rather information rendered must be effectively evaluated as such that contributes in meeting the information objectives of t he end recipient. Finally the information rendered through the power point medium must not be over exhaustive. Rather the length of the message must be cut short to reduce the element of boredom relating to the end recipients. These things kept in mind would contribute in enhancing the efficacy of the power point presentations in acting as a potential medium for transmission of business messages to the target business audiences. Therefore an efficient presenter needs to effectively evaluate the information needs of the audiences and thereby streamline essential information to satisfy end needs and objectives (Weissman 1-10). The presenter while designing an effective power point presentation must endeavor to relate the concept and understandings of the different slides so as to convey a central meaning to the audiences. Each of the different slides presented tends to put in front of the recipients an entire new story or understanding. The recipient failing to relate the story or con cepts presented in each of the different slides happens to gain significant confusion about the total presentation. This failure of the recipients in availing a central meaning distorts the level of understanding of the recipients and thereby causes the rise of perceptual differences among the participants. Participants or recipients in the power point p

Knowledge, Attitude and Breast Cancer Screening Practices in Ghana Essay Example for Free

Knowledge, Attitude and Breast Cancer Screening Practices in Ghana Essay INTRODUCTION   Ã‚   Breast cancer in its simplest definition is the cancer of breast tissue. It is the most common nonskin cancer that affects women in the United States and the highest fatality rates of cancer deaths among women in low-resource countries (Anderson et al 2006). Severity of breast cancer differs based on its level of tissue invasion. Ductal carcinoma in situ is the most common noninvasive breast cancer while infiltrating or invasive ductal carcinoma is the most common breast cancer that accounts for about 80% of invasive breast cancer. Breast lumps presentation is the commonest form of presentation regardless of the breast cancer type (ACS 2005). Epidemiologic factors are attributed to dietary and environmental risk factors, although association of diet and breast cancer had varied results. Environmental risk factors involve the exposure to several toxic elements which accounts for the increased incidence of breast cancer in Western countries. Alcohol intake is also considered to effect in the increase of the number of cases in the US population. Age is also considered as cancer risk factor and can be attributed to hormonal change. Genetic variation and ethnicity are not out of scope for the investigation of breast cancer risk factors (Barton 2005). Diagnosis and Pathology of Breast Cancer: In 2002, Breast Health Global Initiative (BHGI) together with panel of breast cancer experts and patient advocates develop a consensus of recommendations for the diagnosis of breast cancer in limited-resource countries (Shyyan 2006). Histopathologic diagnosis included fine-needle aspiration biopsy which was recognized as the least expensive, core needle biopsy and surgical biopsy and had a consensus of choosing the method based on the availability of tools and expertise. They gave emphasis on the correlation of histopathology, clinical and imaging findings. They agreed on the need of histopathologic diagnosis before breast cancer treatment. In 2005, BHGI panel recommended an additional strategy of breast cancer management. They stratify diagnostic procedure and histopathology methods into – â€Å"basic, limited, enhanced, and maximal—from lowest to highest resources†. Basic level includes medical history of the patient, clinical breast examination, tissue diagnosis and medical record keeping. Limited level includes the increasing resources that enable diagnostic imaging utilization such as ultrasound with or without mammography, tests that can evaluate metastasis, use of image-guided sampling and hormone receptor sampling. Enhanced level includes diagnostic mammography, bone scanning and an onsite cytologist. Maximal level includes mass screening mammography (Shyyan 2006). Treatment of Breast Cancer: Treatment includes surgery, radiotherapy or chemotherapy or combinations of these three treatment modalities. According to American Cancer Society (2005), treatment can be local or systemic. Local treatment of the tumor is done without affecting the rest of the body. Surgery and radiation are examples of this treatment. On the other hand, systemic treatment which includes chemotherapy, hormone therapy and immunotherapy, is given into the bloodstream or by mouth to reach the cancer cells that may have spread the beyond the breast.    Radiotherapy is a treatment of breast cancer with high-energy rays to help shrink the cancer cells. It can be given outside of the body (external radiation) or can be placed directly into the tumor as radioactive materials (ACS 2005). It may be given external to the body.   Radiotherapy requires safe and effective application requiring appropriate facilities, staff and equipment. Radiotherapy should be applied without delay, should be accessible to all but without prolongation of the overall treatment time exposure. It is part of an integral part of breast-conserving treatment. It is required in almost all women with the breast cancer, and therefore should be available (Bese 2006).   Ã‚  Chemotherapy is the use of anticancer drugs that are administered through injection in the vein or taken orally as a pill. It may be given before breast cancer surgery to reduce the size of the tumor or may be given after the surgery to reduce the chance of   recurrence (ACS 2005). This treatment is done in cycle the most common of which is 3-6 months. Most common side effects of these drugs usually stop   once the treatment is over such as in hair falling. Some of   drugs used as chemotherapy     are tamoxifen, cyclophosphamide, methotrexate, 5-fluorouracil doxorubicin, epirubicin, taxane and aromatase . These are usually prescribed in combination, and treatment is done with adjuvant therapy such as radiotherapy and pre- and post operation ( Eniu 2006).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Surgical management in breast cancer is very common. This is done to remove as much as the cancer as possible and to find out whether the cancer has spread to the lymph nodes under the arm. Surgery can also restore the appearance of the breast and relieve the symptoms of advanced cancer. ACS (2005) released some of the common surgical procedures in breast cancer. These are lumpectomy, partial or segmental mastectomy, simple or total mastectomy, modified radical mastectomy and radical mastectomy. RESULTS    Breast cancer patients in Ghana. The present study which included women with mean age population of 48 years   revealed an almost consistent perception with regards to breast cancer.  Ã‚   They were aware that breast cancer is highly increasing in their place but not informed of the cause of disease. All of the responders were not aware of family breast cancer history except one. Information about breast cancer was acquired through television and radio programs. Only after   consultation with doctors due to lumps or   pains in their breast and some due to liquid coming out of their breast, that they were informed that they have breast cancer. Most of them underwent breast tissue exam for confirmation of the disease. Afterwards, they were advised to undergo surgery with medical treatment. The responders were ignorant of the breast cancer screening and prevention. In fact, out of 10 responders, only 2 (20%) of them were aware of breast self examination and clinical breast examination and admitted that they occasionally practice BSE. None of the responders knew about mammogram except for one (10%) of them who has heard of it but never had tried one. The feeling towards the knowledge of acquiring the disease was also the same; the feeling of being a burden in the family was common. They were afraid to face the reality but have realized that they have to fight the disease through the encouragement and support of family members and   help of medical professionals. The sample population was aware of the herbalist and faith healers but they did not submit themselves into that kind of treatment because herbalist have not   proven cure for breast cancer.   The most common complaint of the responders was the high cost of therapies, hospitalization and doctor fees. The treatment cost ranged to    ¢250,000- ¢24 million except to one of them who received a free treatment for being enrolled to a clinical trial. Sentiments of the participants were the same. Delay of treatment was attributed to their distant place from the health clinics; some facilities like x-ray were not available in the clinics and   high cost of treatment. These people asked for the betterment of breast cancer management through education dissemination to the community by health care providers and a help from the government to provide financial support to those who cannot afford to submit themselves for treatment. Patients in breast cancer clinic. In this part of the study, women with mean age of 42 years who were in breast cancer clinic were included. Most common medical complaint was lump and pain in the breast while others submit themselves for screening because they have just heard it from the radio/TV.   The study revealed that women who were attending the clinic were not actually informed of the cause breast cancer but aware of its increasing rate of mortality. Misconception about the cause of breast cancer such as exposure to coins was not common but did not exclude the form of trauma due to manipulation of the breast. Others correlate breast cancer with smoking and taking alcoholic beverages. They were not aware of their family history of breast cancer.   Information regarding breast cancer was acquired through television and radio programs and others were through their friends and family members. Most of the respondents believed that early detection and prompt treatment of the disease can prevent the unfavorable outcome of breast cancer such as removal of their breast or the worst would be cancer death. Only one out of   10 participants (10%) actually practice breast self examination (BSE). Most of them were informed of BSE but not actually practicing it. They were also aware of healers and herbalist but they did not believe that they can cure breast cancer but did not disagree of the possibility that herbalist and healers could treat other diseases or illnesses like hypertension. The participants suggested that it would be better if the government would provide or establish more health care clinics for breast cancer screening and provide free screening programs especially to those who cannot afford to   pay for high cost of treatment of the disease and for an open-easy access to all especially to those in rural areas. One of the participants suggested   that doctors should study further about the treatment of breast cancer instead of resorting to breast surgery. Healers involved in breast cancer management. Many of the population of Ghana are still patronizing healers and herbalist as a resort   of treatment. Two healers from Ghana were interviewed regarding their management of breast cancer. The healers have been into this practice for about 20-50 years. According to them, breast cancer is very common in Ghana and they are aware of the increasing incidence of   the disease. They described breast cancer as an â€Å"obosam† disease and the other was a supernatural disease. Healers believed that their ability to cure   the disease inherited from their forefathers who taught them how to prepare herbs and provide them with dwarfs. They believed that doctors have no right treatment towards breast cancer because according to them they just remove the breasts of women   and subsequently die. According to the healers they do not promote breast   examinations to their patients because these are useless and cannot stop women from getting the disease. Despite the big machines available in the hospitals, women with breast cancer still die, according to them. Healers charge their patients with as much as  ¢200,000- ¢1( £15-60) million depending on the patients’ condition. The healers admitted that there were cases of recurrence of the disease due to lost to follow up and missed spiritual sessions. Healers do not refer patients to hospitals rather, they encourage hospital doctors to refer their patients to healers because they are more capable of treating breast cancer. Breast cancer consultants.   Medical health professionals play a significant role in the awareness of breast cancer. They have the power to influence their patients toward right management of the disease. In the present study, surgeon/breast cancer consultants were interviewed. Consultants as expected were aware of the increasing incidence of breast cancer but they cannot give an exact figure due to absence of cancer registry in the place however they were able to attend to 200-300 new cases of breast cancer annually with age range starting from 20 years and above. They revealed that women in Ghana associate breast cancer to death because after undergoing breast caner surgery they usually die. People in Ghana link medical intervention and death which made the women in this place afraid of   the disease and lead them to negative attitude towards the disease. Consultants believed that there were several misconceptions about the disease. They were also aware that healers and herbalist delay the   presentation of patients to   hospital which accounted for the late stage of diagnosis. National Screening Program would benefit the people in Ghana for early detection of breast cancer and prompt treatment, however, they did not deny the fact it would be difficult to establish such program due to lack of funds by the government at present time. Consultants were aware of the limited resources of the needed for the implementation of the program. They believe that it is much easier and feasible to educate the women on simple screening methods such as regular breast self examination and encourage practitioners to take advantage of examining the breasts of their patients. There are also NGOs who are engaged in some activities like providing health care assistance. Consultants revealed that they receive referrals from district regions and from private practitioners. All patients with breast cancer are candidates for surgery. There are just some procedures that lead to untoward incident which cause the people to blame the doctors. According to consultants, one big problem that they encounter is the delay of the result of tissue exam from the pathologists which sometimes lead them to acquire the high cost of private laboratory. According to consultants the 5-year survival rate in Ghan is 25% which is disappointing. According to radiology consultant, patients present themselves to treatment once they are already in advanced stage, most at stage 3 and 4. They revealed the common factors that influence the delay of treatment among Ghana women. Most of the patients were scared of the procedure of   breast cancer treatment like in breast surgery which have many social and marriage implications. The high cost of the procedure hinders the patient to go to the doctors. Consultants revealed that surgical procedure may cost    ¢2-3million   ( £ 150-200), radiotherapy is about    ¢3-4 million (  £ 200-300) and chemotherapy is around  ¢6 million ( £400). Although surgical treatment cost is covered in National Health Insurance, the cost of radiotherapy and chemotherapy are excluded. Mammography which is an effective tool in breast cancer screening costs  ¢400,000 ( £30) in private health institution and around  ¢250,000 ( £20). DISCUSSION WITH REVIEW OF RELATED LITERATURES   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The present study aimed to increase the awareness of the women in Ghana to breast cancer and the benefits that can be gained from breast cancer screening. The knowledge, attitude, behavior and practices of the women regarding early detection of breast cancer were analyzed. The ultimate aim of the study was to reduce the mortality rate of   breast cancer.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The study revealed that there were still misconceptions about breast cancer despite the information gathered from televisions and radio programs. Attendance of Ghanaian women in breast clinic did not mean that they were informed of the nature of their disease. Only few of them were also aware of preventive procedure in detecting breast cancer. Local healers and spiritualists also delayed the presentation of the patients to the hospital which contributed to the late diagnosis of the disease. Difference in the disease management of health professionals can be attributed to the location of practice and availability of resources. Several factors   thought to affect the breast cancer screening program were the poor education of the Ghanaian towards prevention awareness against breast cancer; lack of initiative of the people to spread the knowledge of   breast cancer screening such as simple breast self examination and clinical breast examination; the inaccessibility of the of primary health care and the organizers; the unavailability of the appropriate screening tools like x-ray and mammography in the community and its high cost   and the lack of support from the government.   The following   review of related literatures will help in the understanding of breast cancer and breast cancer screening. Because of the continuous increasing prevalence of breast cancer and high cost of treatment, breast cancer screening remains the most cost effective way of cancer management (Parkin and Fernandez 2006).   Most of the world faces resource constraints that hinder the capacity to improve early detection, prompt diagnosis and sufficient treatment of the breast cancer. Every country finds its way to develop evidenced based, economically feasible and culturally appropriate guidelines that can be utilized by countries of limited health care resources to improve breast cancer outcomes (Anderson 2006). Adaptive strategies should be applied to ease the growing burden of breast cancer. In 2005, according to Smith and his colleagues (2006), the Breast Health Global Initiative (BHGI) held its second summit in Bethesda, MD with the intention of reaffirming the principle of requiring all women of all resource levels to support in seeking health care and assuring the access to affordable and appropriate diagnostic tests and treatment intervention against breast cancer. They recommended breast health awareness to all women including the basic resources. They enhanced the basic facilities for effective training of relevant staff in clinical breast examination (CBE) or breast self examination and even the feasibility of mammography. MRI: Magnetic resonance imaging is one of the breast cancer screening procedures. It has been increasingly used as tool for early diagnosis of breast cancer. This screening tool has shown to detect cancers even they are small and potentially proven to be more curable than mammography alone. However, MRI is more costly than mammography and can lead to unnecessary breast biopsies, thus causing anxiety and discomfort to patient. On the other hand, a research study about the cost-effectiveness of breast MRI screening by cancer risk where they included the cancer detection ability of MRI, characteristics of women with dense breast tissue and women with high inherited breast cancer risk, revealed mortality reduction and cost effectiveness of breast MRI screening added to mammography in BRCA1 and BRCA2 mutation carriers (Kurian 2006).    The hallmark of morality and morbidity of breast cancer can be attributed to the late presentation of the patients at an advanced stage of breast cancer. It is when there is no or little benefit that can be derived from any treatment modality. In a study conducted by Okobia and colleagues (2006), the knowledge, attitude and practice of community dwellers of Nigeria towards breast cancer were analyzed. They recruited urban-dwelling women with conducted an interviewer-administered questionnaires to elicit sociodemographic information regarding knowledge, attitude and practice towards breast cancer. It was found out that the participants had poor knowledge of breast cancer. Only 214 out of 1000 participants knew that breast cancer is presented initially with breast lumps. Breast cancer examination practices were low. Only 432 participants were able carry out breast self examination while only 91 participants had clinical breast examination. This study revealed that participants with higher level of education were significantly more knowledgeable about breast cancer. Ethnicity or race-related culture and beliefs are factors that affect the increase in prevalence of breast cancer mortality. Paterniti (2006) investigated how ethnically diverse women who are eligible for tamoxifen prophylaxis because of their breast cancer risk decide about tamoxifen use for risk reduction. Prior to the study, there was discussion of the benefits and risks of tamoxifen as prophylaxis. The study which included African-American, White, and Latina women, of 61–78 years, revealed that fear of breast cancer was not prominent and they were not inclined to take tamoxifen as preventive therapy after receiving the information. Participants showed limited unwillingness to take the medication with potential adverse effects. This study revealed that women felt that they had other options other than taking the risk of tamoxifen to reduce their risk of breast cancer, including early detection, diet, faith and other alternative therapies.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Graham (2002) conducted a research about   the relationship between beliefs and practice of breast self examination (BSE in a black women population of 20-49 years of age. It was found out that health beliefs were much stronger in determining BSE performance for a given individual than were demographic characteristics. Breast self examination was related to increased perceived seriousness of breast cancer, benefit of the procedure and health motivation and was noted to have inverse relationship with perceived barriers. A related study was reported by Mitchell and colleagues (2002), about the effects of religious beliefs with other variables on breast cancer screening and the intended presentation of self-discovered breast lump. This study included women aging 40 years and above and were interviewed in their homes. Most of the interviewees believed that doctors cure breast cancer with God’s intervention which was labeled as â€Å"religious intervention with treatment†. This dimension was found out to be correlated with self-reported mammography but no clinical breast examination or intention to delay presentation of self-discovered breast lump. Minority of them believed treatment of breast cancer was unnecessary because only God could cure the disease which was labeled as â€Å"religious intervention in place of treatment†, and was significantly more common among African-American women who   are less educated and older. This was correlated with the strong intention of delaying the presentation of self-discovered breast lump. It was concluded that   religious intervention in place of treatment contributes significantly the delay presentation of breast cancer among African-American that contribute largely to the advanced-stage cancer diagnosis. The cause of breast cancer is still unclear. Adjei (2006) who grew up in Ghan and had some work about breast cancer. In his letter, he revealed his sentiments about the genetic differences in breast cancer. He had been aware of the incidence of breast cancer in Ghana since 1974 to 1999. He noted that the peak incidence of breast cancer in Ghana is in younger women with age range of 40-45 years while in United States and Caucasians, the peak incidence is in older age groups. Adjei (2006) pointed out that women of different places and environments, with different diets have similar epidemiology of breast cancer. In an argument which revealed number of breast cancer in African-Americans but rare in native African has been used to suggest that ethnicity is one factor of acquiring the disease, however, according to Adjei (2006), this information is leading because cancer has not been well-studied in Africa. Researchers are still finding their ways to fully disclose the correlation of genetic signature in breast tumors that are presently noted   to be a powerful predictor of cancer spread and cancer death. In a limited study conducted by Kolata (2002), she included few patients who are relatively. As she stated in her report, scientists said that the activity of a collection of 70 genes appear to predict cancer mortality   better than traditional measures like tumor size, cancer stage or lymph node spread to the axilla of women. She revealed in her study that 5.5% of women with good genetic signature died within the next decade while 45% of women are those of with bad genetic signatures. Adherence to the treatment regimen of breast cancer plays a big role in the improvement of disease outcome. There are no much literature about the factors associated to the behavior that influence the patient to delay or cause an incomplete adherence to the recommended follow up in patients with breast cancer. In a study conducted by Kaplan (2006), race/ethnicity, country of birth, financial issues fear of pain and difficulty of communicating with the healthcare providers are the barriers to seek follow up consultation Breast Cancer Screening: There was decline in breast cancer mortality rate of 0.9% in African American women while 2.1% was the decline in breast cancer mortality rate in non-Hispanic White women (Stewart et al 2004 as stated by Settersten , Dopp, and Tjoe, (2005).    On the contrary, De Koning (2000), questioned in his study the cost effectiveness of breast cancer screening. His idea came out when he analyzed his expectations of the reduction of breast cancer mortality after breast cancer screening. He stated in his study that the Dutch program of 2-yearly screening for women aged 50-70 would produce a 16% reduction in the total population. As stated in his research paper, the actual benefit that can be achieved from breast cancer screening programs is overstated. According to him breast cancer screening need to be carefully balanced against the burden to women and health care system. De Koning (2000) stated that â€Å"effects of breast cancer screening program depend on many factors such as epidemiology of the disease, the health care system, costs of health care, quality of the screening program and the attendance rate†. Groot, M. T. et al (2006) estimated the costs and health effects of breast cancer interventions in epidemiologically different regions of Africa, North America and Asia. They developed a mathematical simulation model of breast cancer using the different stages of cancer, its distribution and case fatality rates in the absence and presence of treatment as predictors of survival. The study resulted to a conclusion that untreated patients were the most sensitive to case fatality rates. This study suggest that treating breast cancer at stage 1 and introduction of an extensive breast cancer program are the most cost effective breast cancer interventions.   Ã‚   This study is supported by the research done by Aylin and colleagues (2005). They recruited women at the mammography clinic to evaluate the knowledge about breast cancer and mammography as breast cancer screening procedure. The striking result of this study is that most of the participants (95.3% of the total participants) were aware that women should have mammography screening periodically. They were informed of the fact that breast cancer screening such as mammography could help in the early detection of breast cancer. However, less than 50% of them admitted that they had never had mammography screening. Majority of the respondents (71.1%) were practicing breast self-examination. Another related study was conducted by Dundar and colleagues (2006), since breast cancer is the second leading cause of cancer deaths in Turkey , they determined the t the knowledge and attitudes of women in a rural area in western Turkey about breast self examination and mammography. They recruited women with age ranging from 20-64 years. Although majority of the participants have heard or read about breast cancer only 56.1% of them had sufficient knowledge about breast cancer and some admitted that they acquired the information from their health care professionals. Those with information of beast cancer were also those who practice breast self examination. This study revealed that health care professionals play a big role in information dissemination about breast cancer. Table 1. Recommendations for routine mammographic screening in North American women aged 40 years or older who are at average risk for breast cancer* Group (date of recommendations) Frequency of screening (yr) Included ages (yr) 40-49 50-69 70 Government-sponsored and private groups US Preventive Services Task Force (2002)** 1-2 Yes Yes Yes*** Canadian Task Force on Preventive Health Care (1998, 1999, 2001) 1-2 No Yes No National Institutes of Health consensus conference (1997) No+ American Cancer Society (1997) 1 Yes Yes Yes National Cancer Institute (2002) 1-2 Yes Yes Yes Medical societies American College of Obstetricians and Gynecologists (2000) 1-2 if aged 40-49 yr 1 if aged 50 yr Yes Yes Yes American Medical Association (1999) 1 Yes Yes Yes American College of Radiology (1998) 1 Yes Yes Yes American College of Preventive Medicine (1996) 1-2 No|| Yes Yes American Academy of Family Physicians (2001) 1-2 No+|| Yes No American Geriatrics Society (1999) 1-2 Yes*** Advocacy groups National Breast Cancer Coalition (2000) No + No National Alliance of Breast Cancer Organizations (2002) 1 Yes Yes Yes Susan B. Komen Foundation (2002) 1 Yes Yes Yes The above table   was taken from the study conducted by Barton (2005) There are several ways presented and studied for breast cancer screening. Its concern is to reduce the prevalence of cancer mortality and to improve the quality of life as a result of early detection, however, there are still people that are not aware of breast cancer screening In response to increase the worldwide awareness of breast cancer, breast cancer advocacy movement has been analyzing the common experiences of women with breast cancer around the world especially those with limited resources. They found out that although there are language barriers, sentiments were consistent across cultures; cancer survivors have the same experiences and fears. The beliefs and taboos about breast cancer hinder the awareness programs and treatment. There are also limited resources for public education and awareness. Difficulty in understanding and translating the concept of the disease into English also hinders them in the public awareness of breast cancer (Errico and Rowden 2006). In accordance with this, sociological review of the barriers experienced by the women from different traditional cultures is essential not just to understand patterns of late breast cancer diagnosis but also the importance of interventions and programs. This is necessary for them to understand the preventive health care, specifically in breast cancer. This is because many are still ignorant of the breast cancer. According to Remennick (2006), health care providers and policymakers should try to understand and influence women especially those who are cancer risk to be aware of the disease to detect and treat breast cancer early. There are many structural barriers that hinder women especially those living in rural areas. Socioeconomic factors include poor health insurance, distance to medical facilities and inability to take time off work. Organizational barriers include difficulty in navigating complex health care systems and interacting with medical staff. Psychological and sociocultural barriers are poor health motivation, denial of personal risk, fatalism mistrust of cancer treatments and fear of becoming a burden on the family members. Still in other cultural behavior, especially in Muslims, women are strongly controlled by men and therefore may prohibit women in breast cancer screening. Remennick (2006) includes in his study the different approaches that lower the mentioned barriers, including implementation of uplifting the educational programs that would enlighten people regarding cancer myths and fallacies. He suggests that health care professional must outreach to their co ethnics. Primary health care providers play a critical role in   determining the compliance with treatment and preventive practices through direct recommendations to their patients. Family physicians and general internists showed that 70% of women who received a provider referral completed a screening mammography within one year versus only 18% of self-referred women (Grady   et al 1997 as stated by Santora 2003). However, Over 90% of rural women report that a doctors recommendation to have breast cancer screening is important† (Sparks et al 1996 as stated by Santora 2003). It should be noted that clinician compliance is contributed by several factors such as relation with provider, guideline of the treatment, patient’s behavior and environmental factors. Several studies have been conducted to report the   differences of health services in rural, urban and suburban areas with regards to their   health care services in the family practice clinics. It has been pointed out that lower utilization has been a significant factor. Those rural health practitioners have less access to health care services.   In a study done by   Pol and his colleagues (2001), suggested that rural health services do not lag for patients with access after revealing that 9 out of 16 services examined were as high or higher in rural areas. Another   study to examine the variations in breast cancer screening among primary care clinicians by geographic location of   clinical practice was done by Santora (2003). Physicians, nurse practitioners and physician assistants were included in the study and were classified into urban, rural and suburban categories based upon practice location. The study revealed that although there was no significant difference in the practice location, there was evident variation in the practice of   breast screening. It was reported that urban and suburban health practitioners were less compliant with the use of breast cancer guidelines as compared to clinicians in rural areas.   Primary care clinicians, including physicians, nurse practitioners and physician’s assistants lack a consistent. This study revealed   that geographical location is not the main factor of inconsistent medical approach to breast cancer screening. Although the difference in the approaches to the procedure is uncertain in this study. A related study about General Practitioners’ (GP’s) knowledge, beliefs and attitudes toward breast screening, and their association with practice based-organizations of breast cancer screening, was conducted by Bekker, Morrisona and Marteau (1999). This study revealed that women’s attendance for breast cancer screening may be increased due to raising GP’s perceptions of the   threat of breast cancer. General practitioners addressed their concerns about the procedure and enhanced their views on the importance of primary health care in breast cancer screening programs. REFERENCE Adjei, A. A., 2006, â€Å"A final word about genetic differences†, American Association for Cancer Research, Available at http://www.aacr.org/page4444.aspx. American Cancer Society 2005, Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_2_1X_What_is_breast_cancer_5.asp Anderson, B. O. et al, 2006, â€Å"BREAST HEALTH GLOBAL INITIATIVE Breast Cancer in Limited-Resource Countries: An Overview of the Breast Health Global Initiative 2005 Guidelines†, The Breast Journal, vol 12 no. 1, pp. S3–S15. Aylin et al, 2004, â€Å"Knowledge about breast cancer and mammography in breast cancer screening among women awaiting mammography†, Turkey Medical Journal Science, vol 35, pp 35-42, Available at http://journals.tubitak.gov.tr/medical/issues/sag-05-35-1/sag-35-1-6-0409-8.pdf Bakken, S. 2002, Acculturation, knowledge, beliefs, and preventive health care practices regarding breast care in female Chinese immigrants in New York metropolitan area. Barton, M. B. 2005, â€Å"Breast cancer screening: benefits, risks and current controversies, Symposium on Women’s Health, vol 118 no 2, pp. 27-36, Available at http://www.postgradmed.com/issues/2005/08_05/barton.htm Bekker, H., Morrisona, L. and Marteau, T. 1999, â€Å"Breast screening: GPs beliefs, attitudes and practices†, Family Practice, vol 16 no. 1, pp.60-65, Available at   http://fampra.oxfordjournals.org/cgi/content/full/16/1/60 Bese, N.S. 2006, â€Å"ORIGINAL ARTICLE: LIMITED-RESOURCE INTERVENTIONS Radiotherapy for Breast Cancer in Countries with Limited Resources: Program Implementation and Evidence-Based Recommendations†, The Breast Journal, vol 12 no. 1, pp. S96–S102. De Koning, H. J., 2000, â€Å"Breast cancer screening; cost-effective in practice?†, European Journal of Radiology, vol 33 no. 1, pp. 32-37, Available at http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrievedb=PubMedlist_uids=10674787dopt=Abstract Dà ¼ndar et al, 2006, â€Å"The knowledge and attitudes of breast self-examination and mammography in a group of women in a rural area in western Turkey†, BMC Cancer vol 6 no 43, Available at http://www.biomedcentral.com/1471-2407/6/43 Eniu, A. 2006, â€Å"BREAST HEALTH GLOBAL INITIATIVE Breast Cancer in Limited-Resource Countries: Treatment and Allocation of Resources†, The Breast Journal, vol 12 no. 1, pp. S38–S53 Errico, K. M. and Rowden, D. 2006. â€Å"Sociocultural barriers to care, Experiences of breast cancer survivor- Advocates and advocates in the countries with limited resources: a shared journey in breast cancer advocacy†, The Breast Journal, vol 12 no. 1, pp. S111–S116 Graham, M. 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Effects Of Cramming For Examinations Education Essay

Effects Of Cramming For Examinations Education Essay Cramming is an ineffective learning strategy adopted by a majority of students in higher educational institutes because it causes negative psychological and physical effects. R.Sommer (1968) defined cramming as a period of neglect of study followed by a concentrated burst of studying immediately before an exam (p. 104). In this definition, concentrated burst of studying refers to a study strategy which involve studying for consecutive hours with or without short rest on the eve of examinations. Cramming or massed practice is, therefore, an intensive and quick study of subject contents for the sole purpose of passing examinations. Students who procrastinate by habits are more likely to delay tests preparation and indulge in valueless cramming. The purpose of this paper is to address the widespread practice of cramming and its ineffectiveness with regards to its negative effects on students. Researchers in the field of psychology and education have argued for decades on the goals of education and students learning experiences. In todays complex and challenging environments, change is imperative. P. Ramsden (1998) argued that learning is interpreting and understanding of reality in a different way to facilitate a student to comprehend the world by reinterpreting knowledge. Learning by students should be viewed as a constructive, self-regulated and goal-oriented individual process so that they can construct meanings from knowledge (de Corte, 2000, p. 254). Towards this end, graduate students are expected to have developed a fair expertise in critical thinking skills to help them adapt to participate in economic, political and scientific issues of the world. Educational pedagogy must enable students to analyze, theorize and intellectually engage with each other and with the world around them. Despite teachers repeated intervention to teach students appropriate learning stra tegies, most students still widely adopt surface learning approaches to learning in contrast to deep learning approach. P.Ramsden in his book, Learning to Lead in Higher Education (1998), has described surface approaches lead at best to the ability to retain unrelated details, often for a short period. They are related to lower levels of academic performance and more limited development of generic skills (p. 48). Such kind of approach entails the use of rote-memorization, chunking of factual knowledge, an inability to understand context from a deeper perspective, learning to achieve a minimal pass in the examinations and most importantly, students are driven by extrinsic motivation to achieve passing grades and obtain qualifications. The question arises: why do educational psychologists and teachers encourage students to take up a deep learning approach for examination purpose? The next part of this paper contains a discussion of the question and highlights the negative effects of c ramming for examinations. Todays observation of societies around the world reflects a dearth of intellectual persons with true and acquired individuality. The societies around us reflect individuals who are not faithful or devoted to their administrative tasks whether as public servants or politicians of a country. Harold E.Gorst in his book, The Curse of Education (1901), implicitly stated that progress means development of ideas and mediocre individuals do not engage in such ideas which are progressive to a country. He further states that as long as education is synonymous with cramming on an organized plan, it will continue to produce mediocrity (p. 6). Gorsts statement resonates the fact that cramming or the vast accumulation of factual and superficial knowledge, which has been forced upon the students, are partly the results of improper teaching, learning and assessment methods (examinations) of educational systems and partly the results of students learning strategies. Consequently, the achievement outc ome of such educational systems which crams students to follow rigid pedagogical approach is at a higher level but it produces the biggest ill effect of this type of cramming system of education: the failure of adequate personality and intellectual development of students who are capable of thinking for themselves as well graduates who regard the goal of learning as a process in itself and an end product. Such students outshine in the knowledge domain only, but their cognitive domains (intellectual reasoning) along with his affective domains (concepts of self esteem, emotional development) are rapidly halted. In order to understand what is learning, it is very important to view learning in its specific contexts. For example, in the early systems of Japan and Hong Kong, learning was viewed as a process to attain knowledge and then an assessment of the knowledge. With an end to the learning process, the whole ensured meaning of learning was lost. In these countries, educational systems were dictated by higher authorities as a means to deliver fast paced teaching and to prepare students for higher education entrance examinations. The result was that competitive examinations were seen by junior and high school students as a measure to show their knowledge, memory and problem-solving skills rather than their intellectual reasoning and capacity building skills. However, still today, most parents and students in Taiwan still believe cram schooling have positive effects on students learning achievement (Chen, S.Y. Lu, L. 2009). But the same study concludes that the time spent in cram schools neg atively affected the psychological well being of students and made them prone to depressive symptoms. The next part of the paper concentrates on the negative impacts of cramming on those students who cram by choice rather than necessity. Students who cram out of choice and habits are usually adept at the art of cramming and often pass their examinations. They have come to envisage the purpose of education to attain knowledge through learning of subject content. The aim is targeted towards attaining only extrinsic rewards: achieving good grades and qualifications. Driven by extrinsic motivation, with a surface approach to memorizing factual knowledge in the spurt of hours before examinations, these students are putting themselves into states of sleep deprivation and stress disorders. Students claim that they recall materials better when learnt hours prior to examinations and feel less stressed. But, according to a research published in the newsletter, Monitor on Psychology (2001) of American Psychological Association, lack of sufficient sleep is a widespread problem among teens and adolescents are at high risk for cognitive and emotional difficulties, poor school performance, accidents and psychopathology. Several sci entific researches has also concluded that young people need adequate amount of sleep and resting periods to allow regeneration of the brain cells called neurons. Continued exertion of the brain leads to lesser regeneration of new memories and decreased brain activities in the cerebral cortex, the part of brain responsible for cognitive functioning. Limited cognitive abilities lead to poor memory retention, concentration and attention to details (National Institute of Neurological Disorders and Stroke, 2007). From these evidences, lack of sleep and intense brain activities without rest causes fatigue and stress in these students. Stress can produce a long term effect which causes many students to develop further psychological and behavioural disorders ranging from anxiety, guilt and attention deficit disorders to patterns of irritability and aggression. Contrary to these research findings, students who cram often become adept at it, and use these strategies over again with few changes in their habits. Therefore, it is very crucial to raise awareness of the negative effects of massed practice on sleep patterns, stress and physiological derangement in the forms of chronic diabetes, obesity and hormones disturbance. Moreover, psychologists are in agreement, that spaced or distributed practice over consecutive days to achieve learning is more beneficial in terms of the physical and psychological well being of students. Conclusion The preceding parts of the paper have provided evidences of the negative effects of cramming on students. The goal of education and learning is in complete contrast to the outcomes produced by cramming practice. It is fair to assume that students, who adopt surface learning strategies with a cynical view of education, cannot get far in terms of longevity since his intellectual and psychological development is incomplete. Being equipped with an extrinsic motivation to performance, the need of todays times is for graduates to learn continuously with intrinsically driven motives. In view of the ill-effects of cramming, it can be fairly said that cramming is an ineffective learning strategy, and produces mediocre individuals.

The Health Benefits of Exercise :: Physical Exercise Fitness Health

Exercise is important for many reasons. If you do not exercise your body you will eventually loose it. Your body will become weak and you will loose muscle tone. Your organs won't function properly. Doing a few simple exercises each day will not only keep you fit but will also tone your body. Exercising for at least 30 minutes a day will improve your overall health. Not only does exercise help your body, it helps cleanse your mind. The good news is that you do not have to spend money to join a gym. You can achieve the benefits of exercise in the comfort of your own home. Yoga The word yoga originates from the Yuj which is a Sanskrit word meaning to join. It indicates joining all aspects of the human being. It unites the body with the mind and soul to bring fourth a joyful, balanced and useful life. Yoga spiritually combines the person with the principle. Research show that practicing yoga helps control anxiety, chronic fatigue syndrome, depression, diabetes, stress, and more. Physically, yoga can increase your flexibility and strength. It can also improve your posture. Yoga – Information on the benefits of yoga and different beginner exercises to try. The Secrets of Yoga - Information on the different positions of yoga. Yoga, As a Lifestyle – A guide on everything you need to know about yoga. 10 Ways Yoga Can Improve Your Life- The different ways that yoga can improve your life. Some Important Aspects of Yoga – The different aspects of yoga such as Hatha Yoga, Bhakti Yoga, Jnana Yoga, and Raja Yoga. Yoga:Tap into the Many Health Benefits of Yoga – Information on how yoga can help minimize chronic stress. Videos: Yoga – Learn yoga poses and positions. The Yoga Workout for Flat Abs – Yoga exercises that work your abs and heal your body making you feel relaxed. Pilates A system of the of the mind-body exercises are known as Pilates. Pilates were brought fourth by a man named Joseph Palates. Pilates can change the way your mind and body feel by building strength without developing mass, composing a smooth toned body with a flat stomach and slender thighs. Pilates help get your mind in tune with your body. The exercise focuses on proper breathing and helps correct spinal and pelvic alignment. Breathing properly is vital to achieve different movement and power while exercising. Pilates require concentration which allows your body move in a continuous and gentle flow.

Arthur Miller uses Alfieri for Dramatic Essay

In the second part of his speech, Alfieri brings about a notion of tragedy, ‘Another lawyer, quite differently dressed, heard the same complaint and sat there as powerless as I, and watched it run its bloody course. ‘ This gives the audience a hint as to what is going to come ahead. The fact that Alfieri speaks in the third person indicates that the calamity has already happened and he was powerless to stop it. The idea of fate and destiny and destiny is also brought about. When Eddie, the protagonist of the play is introduced the scenario of a typical Greek tragedy is set up. Eddie is a good person but he has a flaw; his obsessive love for his niece, Catherine. If he is then put in an appropriate circumstance where his weakness is tested, he is likely to encounter tragic circumstances. The next time Alfieri addresses the audience the story has already been put into context. The audience are unaware of Eddie’s love for his niece and he could be easily mistaken as an over protective father. Eddie pays for her typing lessons and has ambitions for her to rise to a different class. ‘You ain’t all the girls. ‘ He is proud of her looks, yet concerned she will attract the wrong sort of men. ‘The heads are turning like windmills. ‘ In addition Eddie finds it difficult to admit that Catherine has become an independent woman. ‘I guess I just never figured†¦ that you would grow up. ‘ This Alfieri soliloquy helps the plot to progress. Again he uses the past tense, reminding us that he is recalling something which has taken place. Eddie is described as good and hardworking man, the audience can therefore sympathise and even like him. However Eddie has a fate and destiny which he cannot control. Towards the end of this short appearance, Alfieri notifies us on the arrival of the cousins and the play again unfolds. Subsequently we meet Alfieri who again mentions Eddie’s destiny. ‘Eddie Carbone had never expected to have a destiny. ‘ Yet again we are given the impression that Eddie is a good person and is someone you would expect to have a fairly normal life. ‘A man works, raises his family, goes bowling, eats, gets old, and then he dies. ‘ However we are reminded as Alfieri closes his speech that Eddie does have a flaw and as a result there will be devastating consequences. As a result of which, the audience are left in suspense and uncertainty as to what is to come ahead. ‘There was a trouble that would not go away. ‘ His next appearance is one of the most important in the play. Alfieri begins by saying how he is acquainted with Eddie and his family, which helps to put his relationship with the husky, middle-aged longshoreman into context. He then reveals that Eddie came to visit him in the first instance. ‘I remember him now as he walked through my doorway – his eyes were like tunnels. ‘ Which indicates that Eddie was out of control and looked fierce. Alternatively this could make the audience feel concerned towards his actions and what is to come next. It is the first time in the play that Alfieri transforms from being a narrator to actually a part of the action. As an actor taking part in the action, both his language and behaviour are more formal. In terms of language, Alfieri is more articulate and elevated; his sentences consist of professionalism and throughout this scene he is the voice of reason and sanity as opposed to the prejudiced and hurt Eddie. However Eddie is aggravated by Alfieri’s clear and focused attitude towards the law, as Eddie cannot differentiate between the law and the justice of the vendetta. ‘But the law is very specific†¦ The law does not. ‘

The Revolutionary Republic of Iraq essays

The Revolutionary Republic of Iraq essays In ancient times the area now known as modern Iraq was almost equivalent to Mesopotamia, the land between two rivers.2 Mesopotamia was set between the Euphrates and Tigris Rivers. This area is known as the Cradle of Civilization, because around 4000 B.C. the Sumerian culture thrived. The first written language was developed during the Sumerian culture. After the fall of the Sumerian culture, many different empires invaded and ruled Mesopotamia. Formerly part of the Ottoman Empire, modern day Iraq is a country of many diverse ethnicities, religions, and beliefs. Seventy-nine percent of all Iraqi people are Arabic, sixteen percent are Kurdish, three percent are Persian, and two percent are Turkish. The majority of the Iraqi people practice the Muslim religion, while only three percent practice Christianity or another religion. These ethnicities and religions make up a nation of more than 22,000,000 The people of Iraq have a life expectancy of 66.53 years, where the male lives 65.54 years and the female lives 67.56 years. Iraq is ranked 119th in life expectancy. They are ranked 126th in infant mortality rates with a rate of 62.49 deaths for every 1,000 live births. Iraq has a literacy rate of approximately 60%, with the male population having a rate of 70.7% and the female population having a rate of 45%. They are ranked 145th. The Iraqi people speak, read, and write in many different languages. The official language of Iraq is Arabic. Other languages spoken are Kurdish, Assryian, and Armenian. The total land area of Iraq is 422,162 sq. km., with a population density of approximately 122 people per sq. mile. While most Iraqi people live in a desert climate, where the winters are mild and cool, and the summers are hot, dry, and cloudless, along the northern mountainous region they experience cold winters with occasional snow that melts and causes extensive dama...