Frankenstein Appearance and Acceptance - 1412 Words

centerbReliance on Appearance and Dependency upon Acceptance in Mary Shelleys Frankenstein and Todays Modern World./b/center br brOne of the main themes in Mary Shelleys Frankenstein is the importance of appearance and acceptance in modern society. In todays society, and also in the society of Frankenstein, people judge one often solely on their looks. Social prejudice is often based on looks, whether it be the color of someones skin, the clothes that a person wears, the facial features that one has and even the way one stands. People make snap judgments based on these and other considerations and they affect the way that they present themselves to one, and also the way that the treat the judged person. In Frankenstein the†¦show more content†¦Numerous accounts of hate of the monster just because of his frightful appearance follow this, including the villagers throwing rocks and driving away the monster (Shelley 91), the crushing blow to the creatures emotions when Felix drove him away (Shelley 119-120) and final straw before the creature turned against humanity, when the man shot the monster after h e had saved a girls life (Shelley 126). How very little has changed since then! Today when one is driving in our own fair city, Prince George, one sees a native man late at night and automatically assumes that he is a drunk. Or perhaps on seeing an older woman in high fashion dresses, one soon thinks he stuck up solely on her looks. In a more extreme example, think of the movie The Elephant Man where an extremely disfigured man tried to fit into mainstream society and ends up in a carnival, and later as a medical showcase. But deep inside Jerry Merrick, as the elephant man was then called, is an ideal citizen, caring and virtuous. Lastly closer to home, in any given public high school, one instantly and almost unknowingly classifies students into separate categories of Prep, Pothead, Jock, Cowboy, Skater, Slut, Goth, and other classifications as well. If one tries getting acquainted with these people, it is often find that they are, like Frankensteins monster, are very nice people. br brOne moreShow MoreRelated Appearance and Acceptance in Frankenstein and the Modern World1351 Words   |  6 PagesAppearance and Acceptance in Frankenstein and the Modern World       One of the main themes in Mary Shelleys Frankenstein is the importance of appearance and acceptance in modern society. In todays society, and also in the society of Frankenstein, people judge one often solely on their looks. Social prejudice is often based on looks, whether it be the color of someones skin, the clothes that a person wears, the facial features that one has and even the way one stands. People make snap judgmentsRead More Themes of Shelleys Frankenstein Essay1421 Words   |  6 Pages Mary Shelley discusses the themes of birth and creation, appearance and the necessity of companionship, love and acceptance in her novel Frankenstein. The themes that are explored in Frankenstein are relevant to today’s modern world. Shelley challenges readers by endorsing and confronting attitudes and values in her text through the events, circumstances and outcomes that take place in the novel, thus causing the reader to reflect upon their own lives and in turn the society a round them. ShelleyRead More Mary Shelleys Frankenstein - Victor Frankenstein is to Blame1046 Words   |  5 PagesVictor Frankenstein is to Blame Can an intense appetency for the pursuit of knowledge result in fatal consequences? In most situations when a strong desire is present consequences are seldom taken into consideration. In the novel, Frankenstein, Victor Frankenstein pursues knowledge in an obsessive manner that blinds him to the possible effects. Victor Frankenstein is the primary cause of his creatures desolation. Indeed, Victor Frankenstein is at fault for the creatures isolation andRead MoreMary Shelleys Frankenstein and Ridley Scotts Blade Runner Essays877 Words   |  4 PagesMary Shelley’s Frankenstein and Ridley Scott’s Blade Runner Comparison and Contrast Introduction Mary Shelley’s Frankenstein and Ridley Scott’s Blade Runner are two story lines created in a different era, Frankenstein being an early published novel on the creation of an experimental monster that longs to have a normal existence whilst Blade Runner is a more modern take to a future society where there have been genetically engineered robots named ‘replicas’ that are in appearance indistinguishableRead MoreFrankenstein, By Mary Shelley1703 Words   |  7 Pagesbeloved to the point where there’s numerous acclaimed novellas being published. Among those works such as Mr. Hyde and Dr. Jeckyll, resides Frankenstein; the story tells of immoral actions, a forbidden goal, and downfall of the protagonist, Victor Frankenstein. To the stupendous story, Victor’s position contributes in the Satanic hero archetype way. The work Frankenstein, which was written by Mary Shelley, included heroes that are antagonist characters amongst many other literary dev ices that possibly mayRead MoreIs Humanity Really Frankenstein s Monster?1619 Words   |  7 Pagescan be easily masked, and are therefore often overlooked. Three 19th century novels, Frankenstein, Sherlock Holmes: The Sign of Four, and The Strange Case of Dr. Jekyll and Mr. Hyde reveal both physical and mental qualities of monstrosity through the characters and demonstrate how these qualities relate to one another. Victor Frankenstein’s creation, the nameless creature in Mary Shelley’s novel, Frankenstein, displays countless characteristics of physical monstrosity; he is described as â€Å"ugly†Read More Frankenstein Essay701 Words   |  3 Pages nbsp;nbsp;nbsp;nbsp;nbsp;In her novel Frankenstein, Mary Shelley explores a wide range of themes concerning human nature through the thoughts and actions of two main characters and a host of others. Two themes are at the heart of the story, the most important being creation, but emphasis is also placed on alienation from society. These two themes are relevant even in today’s society as technology brings us ever closer to Frankenstein’s fictional achievement. nbsp;nbsp;nbsp;nbsp;nbsp;FirstRead MoreMary Shelley And James Whale : Advantages Of Communication912 Words   |  4 Pages Mary Shelley and James Whale illustrate the advantages of communication in Frankenstein using opposite approaches. The characterization of the creature in Shelley and Whale’s texts demonstrate the underlying effect of incompetent verbal expression through his inability to form relationships. In Whale’s film, removing the humanistic qualities of the creature by enabling his speech highlights the complexity of the character Shelley provided through communication. Without vocal recognition, decipheringRead MoreThe Monsters of Lusus Naturae by Margaret Atwood and Frankenstein by Mary Shelley743 Words   |  3 PagesMargaret Atwood. It is a story about a girl who had to deal with her appearance because she was different from the other family members. While Frankenstein, is story written by Mary Shirley. It is story about a hideous monster that was crea ted by Victor Frankenstein, and left him to wander all alone in the world. Shelley in Frankenstein and Atwood in Lusus Naturae, wrap their stories around two characters whose physical appearance are similar to one another (Mays 289). Both the stories deal with charactersRead MoreAnalysis Of Gris Grimly s Frankenstein And My Related Text993 Words   |  4 Pagestext Gris Grimly’s Frankenstein and my related text Shaun Tan’s ‘The Red Tree’, identity is never illustrated as static. But what is identity? Identity is the way that someone sees themselves, or the way that someone perceives others. It is an idea that, in the core text and related text, does not stay the same. Changing identity is a key element in both the graphic novel and picture book, as the characters develop over time and they discover their true selves. In Frankenstein (published in 2013

Theoretical Model Respiratory Motion †Free Samples to Students

Question: Discuss about the Theoretical Model for Respiratory Motion. Answer: Introduction: Mastectomy does not guarantee complete cure for early breast cancer patients; instead it increases the chance of recurrence because some tumor might remain in the chest wall. In such situation, radiation therapy is regarded as a targeted treatment option to kill or reduce the number of those cancer cells, which may remain even after surgery (McGale et al., 2014). External radiation therapy is most commonly given to patients after mastectomy. However, respiratory motion has been found to cause severe error during the radiation therapy. Respiratory motion leads to displacement of the tumour location and localizing the tumor in the chest wall becomes difficult in such cases. Another issue is that respiratory motion during irradiation leads to overdosing of normal tissues and underdosing of the tumor tissue or cells (Lewis Jiang, 2009). One report gives evidence regarding the issues in patient after the breast cancer radiotherapy. Link was found between radiation therapy and high risk o f breast cancer and lung problems. The study was done with 40, 781 women diagnosed with early stage breast cancer and they randomly assigned to radiation therapy and surgery or surgery alone. The follow up study after 10 years revealed that 20, 345 women died and the other 6, 064 had no breast cancer recurrence. However, compared to women treated without radiation therapy, women with radiation therapy were most likely to be diagnosed with lung cancer and heart disease. This is linked to the high amount of radiation exposure to lungs and heart during radiation therapy and a technique was needed that reduced the exposure rate to the lungs and heart of breast cancer patient (Taylor et al. 2017). Use of deep inspiration breath hold (DIBH) has been recognized as a technique to minimize irradiation of cardiac structures without compromising target coverage. Although no clinical studies has demonstrated the effectiveness of the technique in reducing morbidity, however it has been found to decrease dose to cardiac structure. In case of left sided breast cancer patient, the mean heart dose should not be greater than 4Gy (Yeung et al., 2015). Hence, adjusting dose limit through DIBH minimizes the risk of ischemic heart disease due to radiotherapy. Respiratory movement always remain a challenge in radiotherapy. Lot of research has been done to develop a technique that reduce the dose of radiation to normal cell (heart dose) in breast cancer patients (Giraud Houle, 2013). To control the effects of respiratory motion during radiotherapy, the respiratory gating technique has been regarded as a solution to protecting the normal cells and managing respiratory motion. These techniques used five techniques to mitigate the respiratory motion effects. This includes using breath hold technique, forced shallow breathing technique, respiratory gating technique and tracking techniques. The main advantage of integrating respiratory movement into treatment planning is that it leads to geometric precision and dosimetric improvements (Giraud Houle, 2013). The main goal of the respiratory gating technique is to separate the target area and heart as far as possible and the process of maximum inspiration promotes delivery of high dose to the breast wall and chest tissue and reduce the heart dose (Nissen and Appelt, 2013). Many studies studied the benefits of deep inspiration breath-hold (DIBH) technique for management of respiratory motion. The DIBH is the technique of making the patient inspire to a threshold limit and then holding that limit of inspiration until the delivery of radiation therapy. This leads to lower exposure to the heart and adequate coverage of the breast wall (Latty et al., 2015). A broad range of literature exists regarding the benefits of DIBH technique in the management of respiratory motion. However, there is lack of literature regarding the diverse role of DIBH in relation to left sided breast cancer patient. Future research on understanding the role of DIBH for breast cancer radiotherapy is necessary specially for life sided breast cancer patients because such patients are at increased risk of cardiac abnormalities such as ischemia, congestive heart failure and coronary artery disease. DIBH is specifically targeted for left sided breast cancer patients because it maximizes the gap between heart and chest wall and reduces the cardiac dose (Mc Parland et al., 2015). The review and critical appraisal of specific articles related to DIBH application for treatment of left sided breast cancer patients will help in categorizing different roles of DIBH in reducing the risk of cardiac complication as a result of overdose due to respiratory motion. To get access to research articles related to the role of DIBH in breast cancer radiotherapy, the article will be searched from MedLine, CINAHL, Cochrane Library and Google Scholar. The main criteria for searching the article was that the article must be published between 2006 to 2017 and English language must be used in all articles. The method of setting the data helped to filter the articles and the search term further ensured that relevant literature related to the topic has been retrieved. The primary search term included DIBH, DIBH for breast cancer patient, management of respiratory motion by DIBH and role of DIBH in managing respiratory motion in breast cancer patient. The main search strategy was to start with broad search terms first such DIBH and management of breast cancer radiotherapy and then find unique articles specific to the purpose of study. The articles were first screened on the basis of the title of the study and then by analysing the abstracts. On this basis, about 40 articles related to the topic were retrieved. However, after the analysis of the content of the articles, some articles were excluded because it did not focused on breast cancer patient or no insight was given regarding the role of DIBH for management of respiratory motion. Hence, the search strategy led to final retrieval of about 12 articles. Finally the critical appraisal of the article is done by means of thematic analysis approach. This literature review presents the role of DIBH in managing respiratory motion breast cancer radiotherapy by means of thematic analysis process and categorization of roles into different themes. The research study by Keall et al. (2006) discussed about the role of DIBH in managing respiratory motion in left sided breast cancer patients. The study gave an insight into the magnitude of respiratory motion and the radiotherapy specific problems caused by the respiratory motion. Secondly, the technique to effectively manage respiratory motion during radiotherapy was explained by the researcher. The main finding of this study related to the role of DIBH in breast cancer radiotherapy was that the technique reduces respiratory tumour motion and modifies the internal anatomy of the thoracic system to protect normal tissues from harm. However, the efficacy of the treatment was found to be limited by level of patients compliance to the procedure. This was because majority of patients in the research setting were found inefficient in performing the respiratory manoeuvre in a proper manner. Despite highlighting this limitation, the strength of the study was that it gave idea regarding im proving the efficacy of DIBH technique by pulmonary function test and starting a simulation series to analyse the discomforts faced by the patients during performing the DIBH technique. The core limitation was that radiation delivery related limitations were also found in the study which may limit the generalizability of the research data. Another literature was found to be very specific to the purpose of this literature review as it studies about the dosimetric and clinical benefits of DIBH for breast cancer radiotherapy. The quality and validity of the paper was further strengthened by comparing DIBH with free breathing technique. To evaluate the clinical benefits of DIBH during the radiotherapy, eight left sided breast cancer patients were taken and supervised to conduct breath hold technique during radiotherapy (Bruzzaniti et al., 2013). The data and outcome was evaluated by acquiring CT scans both with and without breath hold technique. After this procedure, the dose volume histogram and volume of heart and lung irradiated to specific dose was analysed. The study findings showed that application of DIBH led to 16% reduction in mean dose of lungs and 20% reduction in iiradiated pulmonary volumes (Bruzzaniti et al., 2013). Hence, the study gave the implication that patient training is an important component for succ essfully using the DIBH technique during treatment. In this study, the supervision of patients during the procedure resulted in reduction in irradiated lung/ heart volume. Stranzl Zurl, (2008) has also emphasized on reducing the heart volume in the irradiation field to reduce the dose delivery and protect normal tissues. Therefore, DIBH has been found to be effective in managing respiratory motion issues if patients receive adequate training in performing the procedure. However, the limitation of the DIBH approach as mentioned by the researcher was that this process requires a more complex set up and time needed to complete the radiation therapy increased in applying this technique for breast cancer patients. The research by Vikstrm et al., (2011) also presented the dose related advantage of utilizing DIBH technique for breast cancer patient. Many studies have documented about cardiac disease and pulmonary complications during breast irradiation in patients. Hence, the researcher investigated about the role of DIBH in reducing cardiopulmonary doses. The study participants included seventeen patients with early breast cancer and referred for adjuvant radiotherapy. This study was also consistent with the study by Bruzzaniti et al., (2013) as the DIBH plan was found lower cardiac and pulmonary doses during radiotherapy. Therefore, it gives validated evidence that DIBH technique reduces the radiation dose to the heart and lung tissues for tangential breast irradiation. However, there are limitations to this study because the dose reduction was obtained by restricting planning target volume coverage. Despite this limitation, the implementing DIBH technique is easier in clinical practice compar ed to other technique in radiotherapy. Advantage of DIBH related to patient outcome and compliance with the procedure Cardiac complication has been regarded as major complications in breast radiation therapy. Considering the efficacy of the DIBH technique in reduce irradiated heart volume and increasing lung sparing, Cervino et al., (2009) evaluated about the improvement in reproducibility of the technique by means of visual coaching. To analyze whether video coaching enhances patients compliance with the procedure or not, the left breast cancer patient were asked to conduct DIBH with and without visual coaching. The variable of measurement in this research was the reproducibility and the stability of the technique with and without visual feedback. The results of the study proved that the visual coaching improves the reproducibility of the technique and the compliance with correct DIBH technique in patient. Hence, this research gave idea regarding the process that is needed to improve the efficacy of DIBH technique for breast cancer patient. Therefore, this form of visual coaching will lead to healt hy tissue sparing and improved target coverage for patient. Radiation treatment is indispensable to the treatment and management of malignancy and carcinogenic conditions. However, as commented by Lattyet al. (2015), radiation treatment can have a number of positive and negative effects on the longevity and survival rate of an individual. Recent studies have revealed that high doses of radiation exposure to the left breast could be related to increased rate of cardiac morbidity and mortality. The deep inspiration breath hold technique helps in regulating the amount of cardiac morbidity due to radiation exposure (McGale et al. 2014). As commented by Koivumki et al. (2016), the radiation therapy to the left breast has long been a concern with respect to the adverse effects the same upon the longevity and recuperation rate of a patient. The deep inspiration hold breathing has been found to be effective in controlling the doses of radiation exposure to the left breast. This could be further supported with the help of relevant figures and statisti cs, which presents significant decrease in the cardiac mortality rate from 1.21 to 1.08 between 1973-1982. The DIBH technique adopts the patient to a specific and controlled set of radiation. This helps in reducing the anxieties in the patients regarding the contradictions attached with a certain procedure. There is a number of breath hold methods which could be utilized for the provision of controlled and tested levels of radiation doses for the treatment of high malignancy in breast cancer suspects. There are pre-dominantly two theories and methods covering the DIBH methods over here such as the spirometry- based active breathing coordinator (ABC) and the video based real-time position management (RPM).The ABC device was developed by a Michigan based hospital and had been under active scrutiny since its inception. The model had been found to possess a huge number of perks along with deficits which has been addressed accordingly. The device consisted of a mouth piece attached to a spirometer, where the nose of the patient had been blocked to divert the passage of oxygen only through the device. The spirometer is connected to a computer, enabling the radiologist to keep a tab over the patients inspiration level. Once, the threshold level is reached, the pinch valves in the device closes automatically. As asserted by Kraan Admiraal (2016), such controlled measure helps in assuring that exhalation and inhalation of the patient outside the threshold level is controlled tightly. However, as argued by Sayan, Hopkins, Heimann (2016), the ABC device is aggressive in nature and could paramount to increased levels of anxiety in the patient. There are a number of limitations with the DIBH devices, as the device gets interlocked with the linear accelerator. Therefore, the radiologist is required to manually control the inhalation and exhalation levels of the patient (Stranzl Zurl, 2008). The, the ABC device however, shows good and effective control over the rates of respiration limiting the amount of pulmonary tissue damage (Hong et al. 2016).On the contrary, the RPM system monitors the images through an infrared camera mounted on the wall of the infrared unit, which is further supported by the surrounding infrared lights. In this respect, the device auto controls the valves regulating the inhalation and exhalation rates of the patients based upon the threshold level. The DIBH procedure is less aggressive in nature and therefore helps in reducing the patient grievances during the delivery of the required treatment (Volpe et al. 2015). Moreover, the system is linked to the linear accelerator and automatically triggers the beam during the scanning process in case the breathing of the patient falls below the threshold level. Therefore, the system is much more efficient in the sense that the radiologists dont have to manually control the settings compared to other conventional devices (Hong et al. 2014). However, studies and recent evidence have shown that both RPM and the ABC reduce the impact of radiation on the heart of the patients. However as argued by Kathpal et al. (2014), the implementation of the DIBH is largely dependent upon the participant organization and is accompanied with huge investment cost. Limitations of the application of the model There are a number of limitations of the DIBH model which hinders the incorporation and the implementation of the model within the hospital set up. As commented by Giraud Houle (2013), lack of knowledge regarding the applicability of the model along with lack of adequate amount of infrastructure can prevent the implication of the emergent technology in the treatment of breast cancer patients (Keall et al. 2006). Additionally, high installation and maintenance charges often prevent the hospices from installing the model. Moreover, lack of skills in the health care professional used to the conventional methods of treatment can affect the health care plan and processes related to designing of effective and less painful treatment procedures for the ones with breast cancer. Additionally, coping up with the anxieties present in the patients regarding the current methods and the affectivity of the emergent medical procedures remains a debatable topic (Latty et al. 2015). A number of challenges have been faced in the conducting of the literature review. Some of the gaps could be attributed to the availability of insufficient amount of journals articles specifically for left sided breast cancer patients. The DIBH being a recent medical intervention, comprehensive research and evaluation is not available yet. Therefore, lack of peer reviewed articles along with less availability of direct information from the medical professionals was a challenge. Additionally, lack of sufficient time for the conduct of the thorough research was also a limiting factor. Some of the relevant articles were published in language other than English resulting in accessibility issues. Moreover, some of the articles were priced thus making accessibility an issue for those articles. The lack of knowledge and transparent communication process can affect the end result of a treatment procedure. There was lack of articles which evaluated the experienced of left sided breast cancer patients after using DIBH. This would have given greater idea about the benefits of DIBH for health outcome. As commented by Cervino et al. (2009), the inculcation of effective communication procedures can help in the establishment of the desired results. However, as per the ethics standards and guidelines the necessary and relevant information need to be shared with the support service users (Giraud Houle, 2013). The effective implementation of the DIBH methods implied that the level of pulmonary tissue damage caused by adverse effects of radiation could be controlled. Several studies and findings have pointed at the negative outcomes of high doses of radiation on the health and longevity of the patient availing the particular services. Therefore, inculcation of such methods can help in achieving speedy recovery of the patients along with producing a positive impact on the health outcome. There has been huge amount of correlation between the radiation overdoses and cardiac morbidities (Vikstrom et al. 2011). However, one of the major challenges encountered over here is the patient compliance and agreeability with the procedures. The development of DIBH could help in carving out new niches by implementing advanced technologies for the treatment of breast cancer. There are a number of contradictions attached with high amount of radiation exposure to the left breast of the patients. Therefore, implementation of the deep inhalation breathing program could be useful in controlling the amount of radiation exposure. However, lack of sufficient knowledge regarding the handling and management of the DIBH instruments along with huge infrastructural costs involved can hinder the outcomes of the process. Moreover, such therapies might act as a research base for designing more efficient and minimally invasive diagnostic tools and interventions for management of chronic illness in patients. Additionally, such interventions could be possibly used for controlling the radiation hazards associated with highly sophisticated diagnostic methods and tools such as Magnetic Resonance Imaging (MRI). Conclusion: The current assignment focuses on the aspect of DIBH model on addressing the perils associated with radiation overdose and its effect on the long terms cardiac conditions and well being of an individual. Therefore, the implementation of the DIBH model could be developed further for providing effective treatment and care to the patient receiving the radiation therapies. However, there are a number of limitations of the application of the model .This is mainly attributable to the lack of knowledge and proper skills in the health care professionals regarding the relevant measures which hinders the rate of success of the concerned methods and design. Additionally, lack of standard policies and compliance measures can affect the progress of the method within the current scenario. References Bruzzaniti, V., Abate, A., Pinnar, P., DAndrea, M., Infusino, E., Landoni, V., ... Strigari, L. (2013). Dosimetric and clinical advantages of deep inspiration breath-hold (DIBH) during radiotherapy of breast cancer.Journal of Experimental Clinical Cancer Research,32(1), 88. Cervino, L. I., Gupta, S., Rose, M. A., Yashar, C., Jiang, S. B. (2009). Using surface imaging and visual coaching to improve the reproducibility and stability of deep-inspiration breath hold for left-breast-cancer radiotherapy.Physics in medicine and biology,54(22), 6853. Giraud, P., Houle, A. (2013). Respiratory gating for radiotherapy: main technical aspects and clinical benefits.ISRN Pulmonology,2013. Hong, J. C., Rahimy, E., Gross, C. P., Shafman, T., Hu, X., James, B. Y., ... Soulos, P. R. (2017). Radiation Dose and Cardiac Risk in Breast Cancer Treatment: An Analysis of Modern Radiotherapy Including Community Settings.Practical Radiation Oncology. Kathpal, M., Sun, K., Malmer, C., Ninneman, S., Wendt, S., Hughs, G., ... Tinnel, B. (2014). Deep inspiration breath hold (DIBH) with electromagnetic surface transponder confirmation of chest wall (CW) position during radiation for left breast cancer. Keall, P. J., Mageras, G. S., Balter, J. M., Emery, R. S., Forster, K. M., Jiang, S. B., ... Ramsey, C. R. (2006). The management of respiratory motion in radiation oncology report of AAPM Task Group 76.Medical physics,33(10), 3874-3900. Koivumki, T., Heikkil, J., Vnnen, A., Koskela, K., Sillanmki, S., Seppl, J. (2016). Flattening filter free technique in breath-hold treatments of left-sided breast cancer: The effect on beam-on time and dose distributions.Radiotherapy and Oncology,118(1), 194-198. Kraan, B., Admiraal, M. (2016). PO-1026: Setup accuracy of DIBH for breast treatment with a simultaneous integrated boost.Radiotherapy and Oncology,119, S497. Latty, D., Stuart, K. E., Wang, W., Ahern, V. (2015). Review of deep inspiration breath?hold techniques for the treatment of breast cancer.Journal of medical radiation sciences,62(1), 74-81. Latty, D., Stuart, K. E., Wang, W., Ahern, V. (2015). Review of deep inspiration breath-hold techniques for the treatment of breast cancer.Journal of Medical Radiation Sciences,62(1), 7481. https://doi.org/10.1002/jmrs.96 Lewis, J. H., Jiang, S. B. (2009). A theoretical model for respiratory motion artifacts in free-breathing CT scans.Physics in medicine and biology,54(3), 745. Mc Parland, N., Nica, L., Soo, J., Menna, T. (2015). Deep Inspiration Breath Hold for left-sided breast cancer: experience from the patients perspective.Journal of Radiotherapy in Practice,14(3), 228-235. McGale, P., Taylor, C., Correa, C., Cutter, D., Duane, F., Ewertz, M., Gray, R., Mannu, G., Peto, R., Whelan, T. and Wang, Y., 2014. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Nissen, H.D. and Appelt, A.L., 2013. Improved heart, lung and target dose with deep inspiration breath hold in a large clinical series of breast cancer patients.Radiotherapy and Oncology,106(1), pp.28-32. Sayan, M., E Hopkins, W., Heimann, R. (2016). Deep Inspiration Breath-hold (DIBH) Technique to Reduce Cardiac Radiation Dose in the Management of Breast Cancer.Current Cancer Therapy Reviews,12(1), 2-14. Stranzl, H., Zurl, B. (2008). Postoperative irradiation of left-sided breast cancer patients and cardiac toxicity.Strahlentherapie und Onkologie,184(7), 354-358. Taylor, C., Correa, C., Duane, F.K., Aznar, M.C., Anderson, S.J., Bergh, J., Dodwell, D., Ewertz, M., Gray, R., Jagsi, R. and Pierce, L., 2017. Estimating the risks of breast cancer radiotherapy: evidence from modern radiation doses to the lungs and heart and from previous randomized trials.Journal of Clinical Oncology,35(15), pp.1641-1649. Vikstrm, J., Hjelstuen, M. H., Mjaaland, I., Dybvik, K. I. (2011). Cardiac and pulmonary dose reduction for tangentially irradiated breast cancer, utilizing deep inspiration breath-hold with audio-visual guidance, without compromising target coverage.Acta Oncologica,50(1), 42-50. Volpe, T., Margiasso, R., Saleh, Z., Kuo, L., Hong, L., Ballangrud, A., ... Tang, X. (2015). A Comparison of Three Planning Techniques for Bilateral Reconstructed Chest Wall Patients Undergoing Deep Inspiration Breath Hold (DIBH) Breast Irradiation.International Journal of Radiation Oncology Biology Physics,93(3), E616-E617. Yeung, R., Conroy, L., Long, K., Walrath, D., Li, H., Smith, W., ... Phan, T. (2015). Cardiac dose reduction with deep inspiration breath hold for left-sided breast cancer radiotherapy patients with and without regional nodal irradiation.Radiation Oncology,10(1), 200.

The Nature of Costs Essay Example

The Nature of Costs Paper The costs are really incurred in order to be able to hunt ducks and would be the same Whether one, two, three, or a dozen ducks ever actually sol All Of the costs, with the possible exception of the costs of the shotgun shells, are basically fixed with respect to how many ducks are actually bagged during any one hunting trip. 3. In a decision of whether to give up hunting entirely, more of the costs listed by John are relevant. If Bill did not hunt, he would not need to pay for: gas, oil, and tires; shotgun shells; the hunting license; and the whiskey, In addition, he loud be able to sell his camper, equipment, boat, and possibly pickup truck, the proceeds vehicle would be considered relevant in this decision, The original costs to these items are not relevant, but their resale values are relevant. Exercise 13-10 (continued) These three requirements illustrate the slippery nature of costs, A cost that is relevant in one situation can be irrelevant in the next. None of the costs-? except possibly the cost of the shotgun shells-?are relevant when we compute the cost of bagging a particular duck; some of them are relevant when we compute the cost of a hunting trip; and more of them are relevant when we insider the possibility of giving up hunting. We will write a custom essay sample on The Nature of Costs specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The Nature of Costs specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The Nature of Costs specifically for you FOR ONLY $16.38 $13.9/page Hire Writer PROBLEM 13-18 Dropping Retaining a Flight ALL I Profits have been decreasing for several years at Pegasus Airlines. In an effort to improve the companys performance, consideration is being given to dropping several flights that appear to be unprofitable. IA typical income statement for one round-trip Of one such flight (flight 482) is as follows: The following additional information is available about flight 482: I I Members of the flight crew are paid fixed annual salaries, whereas the flight assistants are paid based on the number of round trips they complete. I I One-third of the liability insurance is a special charge assessed against flight 482 because in the opinion of the insurances Company, the destination of the flight is in a high-risk area. The remaining Vivo-thirds would he unaffected by a decision I Tit drop flight 482, The baggage loading and flight preparation expense is an allocation to ground crews salaries and depreciation of ground I equipment, Dropping flight 482 would have no effect on the companys total baggage loading and flight preparation expenses, Lifting 482 is dropped, Pegasus Airlines has no authorization at present to replace it with another flight. I Aircraft depreciation is due entirely to obsolescence Depreciation due to wear and tear is negligible. Dropping flight 482 would not allow Pegasus Airlines to reduce the number of aircraft in its fleet or the number of flight I crew on its payroll. I I Required: I Prepare an analysis showing What impact dropping flight 482 would have on the airlines profits. I The airlines scheduling Officer has been criticized because only about Of the seats on Pegasus flights are being Filled compared to an industry average of 60%. The scheduling officer has explained that Pegasus average seat occupancy I could be improved considerably by eliminating about 10% of its flights, but that doing so would reduce profits. Explain how I latish could happen. Contribution margin lost if the flight is 2,950) flight is discontinued: promotion Fuel for aircraft discontinued I Flight costs that can be avoided if the Flight IS 750 15,800 1 Liability insurance (1/3 x $4,200) Salaries, flight assistants 1 ,400 | 11,500 Overnight costs for flight crew and assistants | 300 | 9,750 | I (3,200) Net decrease in profits if the flight is discontinued The following costs are not relevant to the decision: I Salaries, flight crew will not change. I I Depreciation of aircraft I Liability insurance (two-thirds) insurance is unaffected by this decision. I Baggage loading and flight preparation cost that will continue even if the flight is I discontinued. I Operating Income I I lancers or (Decrease) 514,000 1 ,so | 12,950 expenses: Salaries, flight crew Flight promotion Ticket revenue 4,000) 1,050 | (12,950) Fixed annual salaries, which Consists. I Two-thirds of the liability This is an allocated Problem MM (continued) I Keep the Flight Drop the Flight I Variable expenses Contribution margin I I Less flight 11,800 1750 I Depreciation of aircraft 1,550 11,550 4,200 preparation | 2,800 I Fuel for aircraft 5,800 11,400 11,700 Overnight costs for flight crew and I Liability insurance Salaries, flight assistants Baggage loading and flight 300 1 7,600 I lastings at destination I I Total flight expenses | 7. 850 | 9,750 .NET operating loss I $ (4,650) I $ (7,850) 2. The goal of increasing the seat occupancy could be obtained by eliminating flights with a lower-than-average seat occupancy. By eliminating these flights and keeping the flights with a higher-than-average seat occupancy, the overall average seat occupancy for the company as a whole would be improved. This loud reduce profits in at least two ways. First, the flights that are eliminated could have contribution margins that exceed their avoidable costs (such as in the case of flight 482 in part 1). If so, then eliminating these flights would reduce the companys total contribution margin more than it would reduce total costs, and profits would decline. Second, these flights might be acting as feeder flights, bringing passengers to cities where connections to more profitable flights are made. I PROBLEM 13-20 I Dropping or Retaining a Segment 102 I I Jackson County Senior Services is a nonprofit organization devoted to roving essential services to seniors who live in their loon homes vitamin the Jackson County area. Three services are provided for seniors-?home nursing, meals on wheels, and I housekeeping. In the home nursing program, nurses visit seniors on a regular basis to check on their general health and to I I perform tests ordered by their physicians. The meals on wheels program delivers a hot meal once a day to each senior enrolled I I in the program. The housekeeping service provides weekly housecleaning and maintenance services. Data on revenue and expenses I LIFO the past year follow: I The head administrator of Jackson County Senior Services, Judith Minima, is concerned about the organizations finances and Considers the net operating income of $5,000 last year to be razor-thin. (Last years results were very similar to the results LIFO previous years and are representative of what would he expected in the future. ) She feels that the organization should be I building its financial reserves at a more rapid rate in order to prepare for the next inevitable recession, After seeing the I above report, Ms. Minima asked for more information about the financial advisability of perhaps discontinuing the housekeeping program. The depreciation in housekeeping is for a small van that is used to carry the housekeepers and their equipment from job to Elf the program were discontinued, the van would be donated to a charitable organization. None of the general administrative overhead would be avoided if the housekeeping program were dropped, but the liability insurance and the salary Of the program I I administrator would be avoided. I Should the housekeeping program be discontinued? Explain. Show computations to support your answer. I I Recast the above data in a format that would be more useful to management in guessing the long-run financial viability of the Various services. 1. No, the housekeeping program should not be discontinued. It is actually generating a positive program segment margin and is, of course, providing a valuable service to seniors. Computations to support this conclusion follow: I I Contribution margin lost if the housekeeping program is dropped avoided: Insurance I I Program administrators salary I Fixed costs that can be II Liability | 37,000 | 52,000 whole Decrease in net operating income for the organization as a Depreciation on the van is a sunk cost and the van has no salvage value overhead is allocated and none of it would be avoided if the program were dropped; thus it is not relevant to the decision.

Profile of World War II Colonel General Ludwig Beck

Profile of World War II Colonel General Ludwig Beck Early Career Born at Biebrich, Germany, Ludwig Beck received a traditional education before entering the German Army in 1898 as a cadet. Rising through the ranks, Beck was recognized as a gifted officer and was tapped for staff service. With the outbreak of World War I, he was assigned to the Western Front where he spent the conflict as a staff officer. With the German defeat in 1918, Beck was retained in the small postwar Reichswehr. Continuing to advance, he later received command of the 5th Artillery Regiment. Becks Rise to Prominence In 1930, while in this assignment, Beck came to the defense of three of his officers who were charged with distributing Nazi propaganda on post. As membership in political parties was forbidden by Reichswehr regulations, the three men faced a court-martial. Angered, Beck passionately spoke on behalf of his men arguing that the Nazis were a force for good in Germany and that officers should be able to join the party. In the course of the trials, Beck met and impressed Adolf Hitler. Over the next two years, he worked to write a new operations manual for the Reichswehr entitled Truppenfà ¼hrung. The work earned Beck a great deal of respect and he was given command of the 1st Cavalry Division in 1932 along with a promotion to lieutenant general. Eager to see German prestige and power returned to prewar levels, Beck celebrated the Nazi ascent to power in 1933 stating, I have wished for years for the political revolution, and now my wishes have come true. It is the first ray of hope since 1918. With Hitler in power, Beck was elevated to lead the Truppenamt (Troop Office) on October 1, 1933. Beck as Chief of Staff As the Treaty of Versailles prohibited the Reichswehr from having a General Staff, this office served as a shadow organization that fulfilled a similar function. In this role, Beck worked to rebuild the German military and pushed to develop new armored forces. As German rearmament moved forward, he was officially titled Chief of the General Staff in 1935. Working an average of ten hours a day, Beck was known as an intelligent officer, but one that often became obsessed by administrative details. A political player, he worked to expand his posts power and sought the ability to directly advise the Reich leadership. Though he believed that Germany should fight a major war or series of war to restore its place as a power in Europe, he felt that these should not occur until the military was fully prepared. Despite this, he strongly backed Hitlers move to reoccupy the Rhineland in 1936. As the 1930s progressed, Beck became increasingly concerned that Hitler would force a conflict before the military was ready. As a result, he initially refused to write plans for the invasion of Austria in May 1937 as he felt it would provoke a war with Britain and France. Falling Out with Hitler When the Anschluss failed to cause international protest in March 1938, he quickly developed the needed plans which were dubbed Case Otto. Though Beck foresaw a conflict to eliminate Czechoslovakia and officially advocated for action in the fall of 1937, he retained worries that Germany was not prepared for a major European war. Not believing Germany could win such a contest prior to 1940, he openly began advocating against a war with Czechoslovakia in May 1938. As the armys senior general, he challenged Hitlers belief that France and Britain would allow Germany a free hand. The relationship between Beck and Hitler rapidly began to deteriorate aided by the latters preference for the Nazi SS over the Wehrmacht. While Beck lobbied against what he believed would be a premature war, Hitler chastised him stating that he was one of the officers still imprisoned in the idea of the hundred-thousand-man army imposed by the Treaty of Versailles. Through the summer Beck continued to work to prevent a conflict while also attempting to reorganize the command structure as he felt it was Hitlers advisors that were pushing for war. In an effort to increase pressure on the Nazi regime, Beck attempted to organize a mass resignation of senior Wehrmacht officers and issued instructions on July 29 that as well as preparing for foreign wars the army should be ready for for an internal conflict which need only take place in Berlin. In early August, Beck suggested that several Nazi officials should be removed from power. On the 10th, his arguments against war were relentlessly attacked by Hitler at a meeting of senior generals. Unwilling to continue, Beck, now a colonel general, resigned on August 17. Beck Bringing Down Hitler In exchange for resigning quietly, Hitler had promised Beck a field command but instead had him transferred to the retired list. Working with other anti-war and anti-Hitler officials, such as Carl Goerdeler, Beck and several others began planning to remove Hitler from power. Though they informed the British Foreign Office of their intentions, they were unable to prevent the signing of the Munich Agreement in late September. With the beginning of World War II in September 1939, Beck became a key player in various plots to remove the Nazi regime. From the fall of 1939 through 1941, Beck worked with other anti-Nazi officials such as Goerdeler, Dr. Hjalmar Schacht, and Ulrich von Hassell in planning a coup to remove Hitler and make peace with Britain and France. In these scenarios, Beck would be the leader of the new German government. As these plans evolved, Beck was involved in two aborted attempts to kill Hitler with bombs in 1943. The following year, he became a key player, along with Goerdeler and Colonel Claus von Stauffenberg, in what became known as the July 20 Plot. This plan called for Stauffenberg to kill Hitler with a bomb at the Wolfs Lair headquarters near Rastenburg. Once Hitler was dead, the conspirators would use the German reserve forces to take control of the country and would form a new provisional government with Beck at its head. On July 20, Stauffenberg detonated the bomb but failed to kill Hitler. With the plots failure, Beck was arrested by General Friedrich Fromm. Exposed and with no hope of escape, Beck elected to commit suicide later that day rather than face trial. Using a pistol, Beck fired but only managed to critically injure himself. As a result, a sergeant was forced to finish the job by shooting Beck in the back of the neck. Selected Sources World War II Database: Ludwig BeckJVL: Ludwig BeckGerman Resistance Memorial Center: Ludwig Beck

The Best IB Biology Textbooks, Reviewed

The Best IB Biology Textbooks, Reviewed SAT / ACT Prep Online Guides and Tips To achieve success in your IB Biology SL/HL class and on the exam, you need to find the best textbook for your learning style. In this article, I have collected and reviewed a list of the most recent IB Biology Textbooks (2013 or newer), as I don't recommend you studying with any older books, as they may be out of date. Who Is This Article For? This article is for IB Biology students who are serious about success in the classroom and on the IB Biology SL/HL papers. If you only plan on using the textbook for 5 hours of studying, the choice of book becomes less important. However, if you plan to use the textbook throughout the school year for study help as well as while preparing for the IB Biology exam, you should choose carefully. In this guide, I’ve divided the books into specific categories to help you make a knowledgeable choice. The Best IB Biology Textbooks We’re going to divide this into a few categories: Best Overall Textbook: A must have book as a part of your learning process, no matter your skill level or weaknesses. Best Textbook for Average Students:This book provides more in-depth explanations for those who need a little more assistance and struggled to understand the material when it was taught in class. Best Textbook for High Achieving Students:This book has the material to push the high achievers over the top by focusing on how to apply what you have learned in class to the exam, without repeating the details that you have already mastered. Textbook to Avoid:This book lacks certain material you need to succeed in class and on the exam. Best Overall Textbook This textbook is a must have as a part of your learning process, no matter your skill level or weaknesses. IB Biology Course Book: 2014 Edition: Oxford IB Diploma Program Price on Amazon: New $58.90, Used $37.18 Description: This is the go-to IB Biology textbook. Andrew Allott and David Mindorff are the only authors to work directly with the IBO to create their textbook, which means they truly understand what the IBO wants you to understand and what the IBO will ask you on the exam. They're also able to give you the most realistic practice problems that resemble the actual IB Biology papers.This textbook contains: detailed explanations on each topic in the SL/HL syllabus practice problems for each topic Pros: developed directly with the IB high-quality in-depth explanations realistic sample IB Biology questions organized logically, with practice integrated throughout inexpensive compared to other new textbooks Cons: this book does not give clear guidance on how best to customize its content for your needs doesn't contain study strategies or test strategies Best Textbook for Average Students This book provides more in-depth explanations for those who need a little more assistance and struggled to understand the material when it was taught in class. Biology for the IB Diploma Price on Amazon: New $83, Used $5 Description: This is textbook is the best for average students because it is the most detailed of all of the IB Biology textbooks, making use of annotated diagrams and pictures to explain complex processes. This book follows the IB Biology Syllabus: chapters are presented in syllabus order. Both Standard Level and Higher Level topics are covered, with Higher Level only topics clearly marked. The text is written in easy to understand language with all key IB Biology terms simply defined, and exam questions integrated throughout. Pros: high-quality in-depth explanations great for visual learners since it makes extensive use of visuals organized according to the syllabus with IB exam questions integrated. very inexpensive to buy used compared to the other textbooks. Cons: doesn't contain test strategies or study strategies may be too detailed/feel redundant for high achieving students who have mastered the basics. Best Textbook for High Achieving Students This book has the material to push the high achievers over the top by focusing on how to apply what you have learned in class to the exam, without repeating the details that you have already mastered. HL Biology 2nd edition bookand SL Biology 2nd edition book Price for SL Textbook on Amazon: New $105, Used $34 Price for HL Textbook on Amazon: New $136, Used $50 Description: These textbooks are the most focused on IB exam success. Throughout the textbooks, IB Biology exam questions are provided from real past papers, along with advice for test success and on how to avoid common mistakes. These textbooks follow the organization of the newest IB Biology Syllabus and provide explanations using real-world examples as well as pictures. The accompanying eBook provides additional support with videos, animations, solved problems, and more. Pros: many realistic IB Biology exam practice questions, integrated with each chapter. in-depth online support with additional simulations, videos, and problems explained. provides test strategies Cons: may not be in-depth enough for some students, since the explanations expect you have some knowledge. Higher Level and Standard Level are separated into 2 books, so if you decide to switch into Higher Level late (after taking a year of IB Biology, which many schools allow), you would have to purchase another book. relatively expensive compared to the other textbooks. Textbook to Avoid This book lacks certain material you need to succeed in class and on the exam. Biology for the IB Diploma Coursebook Price on Amazon:New $61, Used $41 Description: This edition of the IB Biology Coursebook from Cambridge Press was developed using the newest IB Biology syllabus. It covers all of the core topics of the syllabus including some practice questions. However, it does not cover any of the options (Both IB Biology SL and HL have core topics your teacher must cover as well as 2 additional topics - known as the options - because your teacher gets to choose from 4 options - for a more in-depth explanation of the options, read our other article The Complete IB Biology Syllabus: SL and HL). The core topics are tested on Paper 1 and 2 of the IB Biology SL/HL Exam, and the options are tested on Paper 3. Pros: developed using the IB Biology syllabus focused review of IB Biology core topics including some practice questions. inexpensive compared to other new textbooks Cons: missing review of the options, which count for ⅓ of the IB Biology exam. This textbook is too expensive to spend money on when it is missing ⅓ of the material needed to succeed on the IB Biology exam. Other Free and Paid Study Resources Find other free IB Biology study resources in our other articles The Best IB Biology Study Guide and Notes for SL/HL and Where to Find IB Biology Past Papers - Free and Official.Also, check out our other article on The Best IB Biology Books, Reviewed to find additional paid study guides for IB Biology SL/HL. What’s Next? Trying to figure out what extracurricular you should do? Learn more about participating in Science Olympiad, starting a club, doing volunteer work, andjoining Student Government. Studying for the SAT? Check out our complete guide to the SAT.Taking the SAT in the next month? Check out our guide to cramming. Not sure where you want to go to college? Check out our guide to finding your target school.Also, figure out your target SAT score or target ACT score. Want to improve your SAT score by 160 points or your ACT score by 4 points? We've written a guide for each test about the top 5 strategies you must be using to have a shot at improving your score. Download it for free now:

A critical analysis of Uk Teaching standard 2 Essay - 1

A critical analysis of Uk Teaching standard 2 - Essay Example This means that the teacher needs to be aware of the capabilities of the pupils and their prior knowledge (McBer, 2012). From this, the teacher then builds a teaching plan to incorporate these capabilities and prior knowledge of the pupils. The teacher also has to guide his or her pupils on the progress made and focus on the needs that emerge, in the long run. This will enable the teachers to demonstrate knowledge and the overall understanding of the learning of these pupils and how it impacts on teaching. The teacher will also be in a position to take responsibility and a conscientious attitude towards their own work and their study. This mode of teaching is strengthened by the constructivist theory of learning. The theory indicates that learning starts with issues that revolve around the students trying to construct meaning. Thus, for the teacher to teach well, they have to understand mental models for the students to use to perceive the world and all the assumptions to support such models (Coe, 2014). Thus, students have to construct their own meaning not just memorising the correct answers. The teachers also have to demonstrate a good knowledge and understanding of the subject and the curriculum. The teachers have to exercise knowledge of relevant subjects and areas of the curriculum and foster and maintain the interest of the pupils on the subject and take care of their misunderstandings. The teachers should demonstrate a critical understanding of the developments in their subject and the areas of the curriculum that will be important in enabling a better understanding for the pupils (Trainees, 2012). It is important for the teachers to understand relevant concepts in the curriculum that will be beneficial for the oval understanding and knowledge of the pupils. The teachers must develop high level of literacy for the pupils and articulacy in addition to using correct Standard

Describe State Plans and discuss what must be demonstrated by the Assignment

Describe State Plans and discuss what must be demonstrated by the states, including the process, to be an approved OSHA State Plan - Assignment Example oved OSHA State Plan, first, a state must put the necessary measures and assure OSHA that within a period of three years, it will have implemented all the structural elements that are significant for an appropriate occupational and health program. Some of the elements that a state must put in place include; appropriate laws, regulations, procedures for setting up standards, enforcing the legislations, appeal of both the citations and penalties and lastly a state must have a sufficient number of enforcement personnel who are qualified. Once the state accomplishes the above requirements, it is eligible for certification. This signifies structural completeness of the overall plan (Government Institutes Inc, Government Institutes Research Group, 2007). Once the state indicates that it can be able to enforce standards independently, it enters into an agreement with OSHA. This agreement is referred to as operation status agreement. Lastly after the state has accomplished all the requirements by OSHA, it is accredited final approval which grants OSHA authority to cover and monitor all occupation safety and health safety of the state (Government Institutes Inc, Government Institutes Research Group,