How Do You Define Success?

Success is defined differently by different people. For some, success means becoming rich, for others reaching high social position. Everyone has his / her own definition of success. Depending on how you see the world, your definition of success will differ from others. However, achieving success is far from easy. Depending on the definition of success, it can be achieved through many ways and come in different forms. Nonetheless, whether small or big, success in any form carries the same worth as long as people continue to strive for it.There are many different ways to achieving success, you should just consider which way is the most appropriate for your desired results. Perseverance also plays a role, if you are willing to put in the effort; you will achieve more success and thus will be more satisfied in the end. To achieve success you should never give up. There is no use in just waiting for wishes and dreams to come true. Success can only be achieved if people learn from their m istakes.You never come close to success unless you experience failure. Believe me; you can embrace success if you only believe in yourself and your abilities. Moris Meterling said, â€Å"People are born of their thought, so think positively. † In short, no matter what situation you are involved in, in order for your goal to be achieved, you must always give your best effort, persevere, learn from your mistakes and believe in yourself. The most important thing to remember is that all you achieved is only to your benefit.

Budgeting Policy in Managing a Business

Budgeting is one of the fundamental concepts in managing a business and it is often up to the budgeting policies that the managers decides upon that will conclude where the company is going to make it in the industry or not. The budgeting policy a company decides upon will show the top management team where the money is being spent and, even more importantly, it will show the team prior to the spending actually occurring. If we refer to the four management functions (organizing, planning, directing and controlling), budgeting covers all four of them. Indeed, a responsible manager will be able to apply all four functions in what the budgeting policy is concerned. First of all, the top management will need to determine what the company's budget for the future period of time will be. This will need to take into consideration both the company's possible revenues during this time and the expansion strategy that the team has decided upon. It may be the case that the management team has designed an expansion on the market that will take up more of the resources than otherwise. While this may be the case, the spending must be determined by realistic plans and future achievements. Second of all, the top management team needs to organize the portfolio of projects and the investments it wants to develop in the subsequent period of time. Organizing the portfolio of projects also refers to determining (1) which projects of the portfolio will be done and (2) with what priority. Before the actual spending and investing begins, the company needs to have a organized set of future spending steps. The planning functions intervene in terms of properly determining the evolution of projects' costs in the period to come. Budgeting helps plan projects' costs so that we don't arrive at a situation where the company's finance is overwhelmed by costs during a period of time. In terms of directing, budgeting ensures that the funds are used where they are most necessary. Directing also refers to leading and the budgeting policies are direct means by which the top management leads within the company. Finally, the controlling function is essential in budgeting policies and strategies. Indeed, the controlling function ensures that the budget and the budgeting policies, previously established and decided upon, are fully respected. There is no point in having a healthy financial system within the company, corresponding to a well-planned budget, if this budget is regularly underestimated or overspent. The controlling function will keep track of projects' cost evolution, track down any inadvertence's that may appear and correct them in time. As we have seen from those previously presented, the budgeting function within the company is not only intrinsically linked to management, but the main functions of management are also reflected in a company's budgeting policies. It is essential, as pointed out, that the company properly analyzes what its sources are, how much of them it is willing to spend and, additionally, what future results and added value the investments will bring at a certain point in the future, in terms of the rate of return. A healthy budgeting strategy will lead to a healthy financial situation of the company and a solid development strategy for the future. Budgeting should be where every company strategy should begin.

Compensation practices & organizations Essay

Through the use of compensation practices, organizations effort to both reward and motivate diverse types of behavior. Compensation practices comprise pay and benefits, and contemporary total compensation approaches expand the definition of compensation to comprise a variety of favorable outcomes experienced by the employee (Milkovich & Newman, 2002). As of the importance of pay to employees, compensation and benefit programs can provide as a major indicator of possible discrimination in the organization. However, pay policies can also be used to lessen discriminatory behavior and encourage diversity. Though potential race and age discrimination in compensation is a significant concern, most of the applied and research attention has been aimed at sex related issues, particularly comparable worth and pay equity (Treiman & Hartman, 1981). Organizations can lessen the negative effects of their compensation practices by auditing their policies and then, based on the results of the audits, distill their procedures to eliminate bias, and where necessary, regulate the pay of minority group members. The type of audits that organizations can engage in will correspond to the three major theories, approaches, or techniques used in significant pay discrimination. The three major approaches or types of audit are (a) an equal pay audit, (b) a pay equity audit, and (c) an analysis of across-the-board problems. Employee and Labor Relations The National Labor Relations Act of 1935 ( NLRA) specifically stated that the National Labor Relations Board (NLRB) was empowered to remedy unfair labor practices by the issuance of cease and desist, and reinstatement and back pay orders, and by ordering affirmative action in effectuating the policies of the NLRA. Though the NLRB’s authority is limited by the statutory requisite that its orders should effectuate the policies of the NLRA and should be remedial, not punitive, the principle is one of governmental flexibility and authority to need affirmative acts by a party who has violated the law, so that an unlawful act is efficiently remedied. Such affirmative acts include, inter alia, the employment of individuals who were not hired or were fulfilled for discriminatory reasons, and, in cases linking unfair labor practice strikes, the reinstatement of striking employees yet where the discharge of striker replacements would be necessary. Interestingly, there is little or no evidence that the use and principle of affirmative action in the NLRA framework had any bearing on or resemblance to the use of those words in the context of favored treatment of minorities and women. For employee, performance appraisal can be conceptualized as an organized description of an individual’s job-relevant strengths and weaknesses that is their job performance. Though job performance data can be obtained either objectively (hard criteria) or judgmentally (soft criteria), the term â€Å"performance appraisal† is characteristically used in the context of, albeit not limited to, the latter. Performance evaluations can result in discriminatory outcomes via two mechanisms, (a) poor or ineffective appraisal or rating practices and (b) intentional distortion resulting from motivational and political factors. Concerning the former, two strategies have traditionally been advocated to address the problems with judgmentally based performance data: rating scale development and rater training. The results of rating scale comparisons indicate that format modification alone does not result in much improvement in performance evaluations (Woehr & Miller, 1997). Though, frame-of reference training, which emerged from the social cognitive approach to performance appraisal, appears to be quite effectual as a rater training approach to increasing the accuracy of ratings (Woehr & Huffcutt, 1994). In addition to rater training, job analysis must serve as the basis for constructing the appraisal instrument and the appraisal process so that employees are appraised only on job-related factors. Conclusion EEO and affirmative action in its classic form is mandated for companies entering into agreement with the federal agencies by executive orders 11246 and 11375. Yet the term has come to signify a much broader range of policies. Affirmative action has become a blanket term that refers to any number of active policies approved by organizations to remedy the effects of discrimination. In spite of of the multiplicity of affirmative action program types, however, the perception of affirmative action remains comparatively undifferentiated. In particular, many continue to associate affirmative action with quotas. There seems to be a widespread assumption that affirmative action is little more than favored selection based solely on demographic group membership. The objective of this paper has been to review and confer HR practices that can be used to achieve diversity in organizations. Practices pertaining to staffing and human resource development discussed in terms of reducing negative effects resultant from these practices and altering the behaviors of organizational members by these practices to lessen discrimination and increase diversity. References †¢ AARP (1993). How to recruit older workers. Washington, DC: Author. †¢ Arvey, R. D. , Gordon, M. E. , Massengill, D. P. , & Mussio, S. J. (1975).Differential dropout rates of minority job candidates due to â€Å"time lags† between selection procedures. Personnel Psychology, 28, 175-180. †¢ Avery, D. R. (2003). Reactions to diversity in recruiting advertising—Are differences Black and White? Journal of Applied Psychology, 88, 672-679. †¢ Delahoussaye, M. (2001). Leadership in the 21st century. Training, 38, 50-59. †¢ Doverspike, D. , & Arthur, W. Jr. (1995). Race and sex differences in the reactions to simulated selection decisions based on affirmative action. Journal of Black Psychology, 21, 181-200.

Ford Motor Company Essay Example | Topics and Well Written Essays - 5250 words

Ford Motor Company - Essay Example This report will give a comprehensive analysis of the external and internal factors and aspects that has lead the company to crisis. The first part of the analysis demonstrates a summary about the company and its problems in general. From the analysis in the second part it is found that poor management and decision making is the biggest problem of Ford. Ford is also loosing the market edge on Hybrid and Small cars segment. A fish bone diagram is used to represent the various challenges that have lead to the loss of profitability for Ford. The analysis helped to arrive at the issues which are management, competition, recession and quality. Excessive family control and poor decision making are the major management issues. Similarly, competition from Japanese car makers and other small and hybrid car makers are the major competition lead issues. Low demand and rippling effects of the recession are the recessionary issues. Finally product defects and recalls following that are the qualit y issues that affected ford. The analysis had also put forward various other solutions that will help the company to come back to profitability. Huge reduction of the family’s stake in the business is among the primary solution for Ford. The later part of the report describes a detailed cost benefit analysis for arriving at the right decision for the company. Some of the alternatives solutions available for Ford are as follows: invest huge in R&D, expand the market, develop more small cars, gradually exit the stake from other auto companies, invest in strategic alliances, gradually increase the marketing expenses, emphasize the message of quality. ... Ever since its inception Ford has acquired and sold many of the big brands in the industry. Jaguar & Land Rover and Volvo are the leading ones among them. Following the crisis that hit the company and which almost lead to their failure, it has to restructure itself thoroughly. As a part of it, Ford even discontinued its Mercury brand. Ford was one of the pioneers of ‘Mass Production’ concept. Ford introduced the assembly line system in the automobile production that enabled the roll-over of large number of cars within limited time. The Model T was the first Ford model to undergo assembly line production. â€Å"When the United States became involved in World War I (April 1917), the Ford Motor Company placed its resources at the disposal of the government.† (Funding Universe, 2011) Following the retirement of Henry Ford in 1918, the company’s operations were looked after by his son Edsel Ford. Ford faced the first financial problems in 1921 when the company h ad $58 million in debt and the company had only $20 million with them to meet this. But the various strategic moves that involved sales of maximum automobile and only through cash, reduction of inventories by one third, and various other cost reduction techniques helped them to increase cash inflow. Within no time Ford raised around $87 million which gave them a surplus amount even after meeting all its debt obligations. â€Å"The vision of Ford Motors is to become the world’s leading consumer company for automotive products and services. The mission statement of Ford is to that they are a global family with a proud heritage passionately committed to providing personal mobility for people around the world.  We anticipate consumer need and deliver outstanding products and services that improve people's

Management discussion and analysis of McDonald Company (MD&A) Essay

Management discussion and analysis of McDonald Company (MD&A) - Essay Example McDonald Company is a US based company and has branches worldwide. The company has opened several branches in order to reach out to an ever growing number of customers in other countries. The company aims in opening the branches are to achieve long-term goals, which are maximization of profits and competitiveness in the market (Connolly, 2007 P. 109). When the company has several branches, it is at a better stage of producing products at low cost of production and, therefore, maximizing their profits. In addition, opening several outlets means that other companies will not imitate the company’s product and implement them in their own countries. This enables the company to stay relevant in the market since their products will be unique due to lack of competition. Reference Connolly, B. M. (2007). International Business Finance. New York, NY: Taylor & Francis Fried, G., Shapiro, J. S. & DeSchriver, T. (2008). Sport Finance-2nd Edition. New York, NY: Human Kinetics. Question 2 I choose to take an overview of the Management Discussion and Analysis of McDonald Company (MD&A). There are several fascinating things to learn from the company. First, The Company perceives itself as a franchisor and assumes franchising is significant to providing great, locally pertinent client experience as well as driving profitability. Second, McDonald’s revenues include sales by Organization-operated restaurants as well as fees from restaurants managed by franchisees Third, the firm is operated as separate geographic sections.... A, NJ: Pascal Press Question 3 Coast leadership, differentiation, as well as, focus strategies are applicable separately regarding any organization or environment. Any attempt to combine as well as reconciling the three strategies would lead in organizations being stuck along the way. The main reason why the three may not work together is because they differ on various dimensions and brings different requirements. These include resources, industry arrangement, skills, control procedures as well as management method. However, both cost leadership and differentiation strategies are unable to coexist in some firms while reconcilable in other industries. According to various studies done by scholars on manufacturing firms, it is clear that differentiators also engaged variables commonly linked to cost leadership strategy (Brigham et al, 2011 P. 87). Cost leadership strategy on the other side, also showed characteristics normally associated with differentiators. It suggests that there are no pure strategies and that both differentiation, as well as cost leadership, must be taken into consideration. McDonald company is one of American firms that have utilized differentiation strategy. The strategy calls for the creation of both product and service, which offers exclusive attributes, which are treasured by customers. The company learnt that the parent based there purchasing decision mostly on price. The McDonalds marketing executive, therefore, did what was seen as ingenious. They attached a $.50 toy in several of their products including the hamburger, French fries as well as coke. They went ahead, named the product a happy meal, and marketed it to the children. The industry knew that some clients visit its stores only to take a short break from their days work and not

Discuss the major problems facing elderly in China and how does the Essay

Discuss the major problems facing elderly in China and how does the government solve these problems - Essay Example Facts and discussion presented in this paper are basically meant to illuminate the reality of the claim that â€Å"the old people in China are having grave socioeconomic problems due to the increasing rate of old population and the Chinese government is profoundly concerned about this issue.† In my opinion, this state or claim is unequivocally based on a factual and reality-based approach, which is backed up by authentic research reports that are discussed in this paper. 2. Major problems faced by the old Chinese community: It is mentioned in (Chinese Culture, 2011) that the population of old people over 60 years of age is about 128 million which suggests the existence of one old Chinese over 60 years in every ten people, and this rate of old population is the largest in the whole world. (Central News Agency, 2007) claims that the rate of old population is thought to increase up to 400 million in 2037. Naturally, the grave socioeconomic scenarios experienced are bound to be mo re exploiting and destructive with the growing number of old citizens. It is suggested by Wenfan (cited in Chinese Culture, 2011) that most of the problems are resulting from the shattered family structure. In old times, old parents used to be the utmost responsibility of their mid aged children and they always took great care to look after their myriad psychological and financial needs along with encouraging them to share the same house. Now, with excessive competitiveness and increased materialistic approach, meaning of relationships is getting fast forgotten with the result that none of the kids remain behind with their parents. (LaFraniere, 2011) mentions that more than half of the old Chinese population lives separately because younger generations are moving away from their old parents. Shortage of money is the biggest problem that the old Chinese population has to deal with and this problem is potentially capable of bringing with itself myriad critical psychological pressures. 3. Better accommodation facilities for old people ensured at governmental level: The accommodation problems are worth mentioning that were quite significant in the past but are gradually lessening now. With urbanized lifestyle getting famous in the adult children, they are increasingly worried by the heavy burden of their parents. That is why they choose to live separately at their own places. They are themselves found too preoccupied with their own problems, let alone coping with the needs of the old parents. Therefore, more and more old Chinese people are left alone and they deserve better and cheaper accommodation facilities. It is mentioned by (Xiao, 2011) that â€Å"few overseas enterprises have invested in China's vast market for care of the elderly.† Affording the best old houses was not imaginable for the elderly people a few years back, but now more and more old Chinese people reportedly return from abroad so that they can spend the rest of their lives in their own country. Efforts made at governmental level have brought a noticeable change. â€Å"The thought of returning home and purchasing a house to spend their remaining years has attracted an increasing number of Chinese people who are currently living abroad.† (Overseas Chinese Network, 2009). More combined and strengthened efforts from the families, the local communities,

Nature versus Nurture Essay Example | Topics and Well Written Essays - 1500 words

Nature versus Nurture - Essay Example erived from the review of the theories, it has been observed that deciding whether the behavior of exhibited by human are genetic or learned is quite difficult. Nevertheless, it has been clearly observed that the impact of environment on the behavior of human being is largely apparent in many of the theories conducted in the filed of human growth and development. Human growth and development is an integral part of human life cycle. In order to describe the human growth and development, it is extremely important to acquaint with the concept of development. In this regard, development is a conception of continuous process. It is also describes that the growth and development is a periodical process, which changes over the time as human beings are matured. The process of growth and development helps human to think logically and perceive things rationally which will influence human to maintain all the responsibilities towards the society. The development process starts when a child is born and continues throughout the life (Ruffin, 2013). With this concern, the easy analyzes the seven theoretical perspectives of human growth and development and draws three inferences explaining on going debate of Nature versus Nurture related to lifespan. The human growth and development is a conception, which mainly depends upon several theoretical approaches. In order to explain the importance of the theoretical approaches it has been stated that the theories mainly works as a supportive factor to judge the world with the proper logic as well as in a balanced way. Besides, there are several theories that help people to understand that process of development of human personality as well as the nature and reasons behind the behavioral approach of a human. The theoretical approaches of human growth and development also describe the influence of human action on the environment. It has been also describes that the several theories are based on critical approaches of social and

Marketing Management Essay Example | Topics and Well Written Essays - 3000 words - 1

Marketing Management - Essay Example The company employs about 55,000 people in over 200 countries around the world. In India, Cadbury has been operating for more than 55 years as Cadbury’s India, a wholly owned subsidiary of Cadbury’s Schweppes. It has been ranked 5th in he FMCG sector in a survey conducted by Business World magazine (Scribd, 2009) In India, the company caters to three main segments: 1. Chocolates – Cadbury’s are the market leaders in India in this segment with over 70% market share. The leading brands in this category include the Dairy Milk, Crackle, Fruit & Nut, Temptations, 5 Star, Perk & Celebration Gift Boxes. The company has been able to change the cultural habits of the Indian that has traditional not eaten chocolates (Leahy, 2009). While the company has about 70% share of the chocolates market and about 15% of the food drinks market in India, as far as the sugar confectionery is concerned, Cadbury’s share is a mere 4% share in this category (Value Notes 2009). The sugar confectionery category contributes mere 12% to the company’s revenue and the company is not expecting any major success in the short run. Competitive brands such as Hershey’s of the US are tying up with well known brands such as Godrej in India (Gopalan, 2007). This would give tough competition to Cadbury’s. This report would evaluate the marketing mix of Cadbury’s in India and recommend the marketing mix to augment the sales of sugar confectionery in the Indian market. The confectionery industry is highly competitive in any market and each company has to compete with many multi-national, regional and national brands (Scribd, 2009). Competition revolves around taste, quality, price, packaging and advertising and promotional programs. Globally the chocolate confectionery market is very strong but the sugar confectionary market is fragmented. The Indian sugar confectionery market includes products such as sweets, jellies and

What were Peron's economical and political polices and why did they Essay

What were Peron's economical and political polices and why did they fail† - Essay Example d economic steps taken by the Peron’s government and there is a so called de-peronizing process in the country to reverse the damage done by the regime. There were major issues involved on the social, political as well economical scale which are considered as failed steps taken by the regime. This essay will look into the reasons behind the failure of economic as well as political policies initiated by Peron during his two regimes and their overall impact on the Argentinean economy and the Latin America as a whole. The structure of this essay will be in such a way that it will first discuss the political history of Argentine just before the era of Juan Peron followed by the Political rise of Peron and then how and what was done on the economic front which made Peron as one of the charming and progressive leaders of Latin America and finally it was explored as to why the Economic as well as Political reforms undertaken by Peron can be considered as failure. In discussing the Political history of the Argentine, we will be focusing on the period of the first half of the 19th century but before the overtaking of Peron of the Argentine government. This period will be analyzed in order to explore the political thought of Peron’s time when finally achieved the throne of Argentine government for the first time in 1946. The Political history of Argentine remained much of a troubled history as it has witnessed much trouble and instability in its political as well as social arena despite having such great potential. It is largely considered that the political problems of the country was much due to its own people rather than inflicting trouble from external forces.(Watkins,1996)1. Historically, Argentine has remained an oligarchy under one party rule. However due to Oligarchy, there was a widespread opposition to the rule too as it was perceived that the Oligarch was pursuing their own class interests therefore there was a growing dissent within the middle class

Road to Independence Revolution Essay Example for Free

Road to Independence Revolution Essay â€Å"War is when the government tells you who the bad guy is. Revolution is when you decide for yourself.†(Unknown) In the case of the American Revolution, the colonists decided for themselves and truly believed in the cause. The Colonists knew that â€Å"change† had to take place because of the unfair treatment they experienced. The American Revolution was a time where Colonists fought for what they believed in, independence, and when they broke away from England. Boycotts, holding Congresses, and forming patriotic groups were the three most effective actions Colonists took, that led to the American Revolution. The boycotts were an effective action the Colonists took, leading up to the Revolution. During the boycotts, Colonists refused to buy British and European goods in order to protest against the British acts. Aware of the growing opposition, Parliament repealed all the Townshend Acts, except the one on tea. As a result, Colonists ended their boycotts, and started to trade with British merchants again. Few years later, the Continental Congress decided to boycott all British goods and trade. No British product could be brought into or consumed in the colonies, and no colonial goods could be shipped to Britain. To protest the Stamp Act, thousands of Americans refused to buy British and European goods. They also signed nonimportation agreements in which they pledged not to buy or use goods imported from Britain. As a result of boycotts, the Parliament canceled the remaining acts. In addition to the boycotts, Colonists also formed Congresses. Debating Proposals at the Continental Congresses led to the American Revolution. The colonial leaders need to unify the colonies against the British policies, led to the formation of congresses. The first congress was the Stamp Act Congress, assembled in October 1765. The Stamp Act placed tax on almost all printed materials in the colonies everything from newspapers and pamphlets to wills and playing cards. All printed materials had to have a stamp, which was applied by British officials. In October representatives from nine colonies met in New York at the Stamp Act Congress. They sent a petition to the king declaring that only colonial institutes shoul d be allowed to apply taxes. In March 1766, Parliament gave in to the colonists’ demands and repealed the Stamp Act. In September 1774, 55 men sent as delegates from all colonies except Georgia, to the city of Philadelphia for the First Continental Congress. These men had come to establish a political body to represent American interests and challenge British control. In this Congress, the delegates called to repeal 13 acts stating they violate the colonists rights. In addition, they voted to boycott all British goods and trade. One major decision was to endorse the Suffolk Resolves, which called the people of Suffolk Country, Massachusetts to fight against the redcoats. These armed groups were called militias. On May 10 1775, the Second Continental Congress assembled. That was the first Congress in which independence was discussed. It authorized the printing of money, and set up a post office. It also established committees to communicate with Native Americans and with other countries. Most important, the Congress created the Continental Army to fight against Britain in a more organized way than t he colonial militias did. The Congress chose George Washington to be the Army’s commander. The Second Continental Congress began to govern the colonies. King George III refused to receive the Olive Branch Petition a formal request; it assured the king of the colonists desire for peace. In addition to Congresses, colonists also formed patriotic groups to fight against Britain. Forming patriotic groups was an effective action that led to the American Revolution. Patriots formed two groups to fight against the redcoats, the Committees of Correspondence and the Sons of Liberty. The Son of Liberty was formed to protest the Stamp Act. In 1772, Samuel Adams formed the Committees of Correspondence to form communication between colonies of bad acts by British troops. The Committees of Correspondence spread throughout the colonies, bringing together protesters from all over the colonies. It also circulated writings about British injustice. Colonial leaders used news of the killing in the Boson Massacre as propaganda information designed to influence opinion -against British. As time went by, the group grew much larger than the nine people it started out with. The forming of patriotic groups helped to fight against the redcoats. These patriotic groups, like the Liberty, made Britain colonial officials nervous. Forming these patriotic groups was a major step in gaining Independence. Boycotts, holding Congresses, and forming patriotic groups were the three most effective actions Colonists took leading up to the American Revolution. The Boycotts were an effective action the Colonists took, leading up to the Revolution. Debating Proposals at the Continental Congresses led to the American Revolution. Forming patriotic groups was an effective action that led to the American Revolution. A spirit of Independence became obvious early in the history of the American people. Far from the established rules and limitations they had faced in their home countries, the new settlers began to make their own laws and develop their own ways of doing things.

Working with Allied Health Professionals

Working with Allied Health Professionals This work is a reflective piece based on my experience of working within a multi-professional group setting. I will be using the model by Gibbs model (1988) to aid my reflection and present my account. Although I will be contemplating how the group performed as a whole, ultimately I aim to guide my own learning, thus aiding my preparation for future similar situations. Task Description Once strategically placed within an inter-professional group of students, we were asked to work as a team to develop an IPL strategy for the pre-registration training of Allied Health Professionals. Our efforts were to be centred on creating a twenty minute presentation based on our idea to our AHP peers. This was carried out over a week, with our presentation was expected to be given on Friday afternoon. Our Implementation of the Task and Personal Thoughts We first assembled and became acquainted with each other on Monday morning. Initial introductions and group communication were aided by a simple but effective exercise to assist preliminary group collaboration. This activity was fun, and valuable in helping us begin to establish the group relationship, and personally extinguished any uncomfortable feelings which I may usually have in a situation like this. I also felt confident that this particular group of individuals worked well together and at this point I had no concerns about the task ahead. Subsequently, we were given our main task. Although I felt that there were some very valid and intelligent thoughts brought forward during our brainstorming, I began to worry that there were perhaps too many which differed somewhat, and that as a group we were not using our time efficiently. In addition, people could not agree on the simplest practicalities, which I felt was unhelpful. The group met again on Wednesday morning, with each individual bringing their contribution of research to share. We discussed a possible structure to the presentation, although as the meeting went on it became clear that there were unquestionably some conflicting views on what our approach should be. At this point, I began to feel doubtful that the group was capable of decision-making, and started to feel anxious about our assignment. In addition, I felt that one particular member of the group seemed to feel strongly about their own outlook on the task, and that perhaps they were slightly negative regarding other ideas, unhelpful for the overall morale of the group. The following day we met in a skills lab to take some photographs for our presentation, which was successful. This was followed by a short discussion, where some of the members of the group voiced their concerns that they had lost track of how the group would present. It was then disclosed that one particular idea had been developed outside of the meetings and that there was no need to be concerned, which made me feel excluded from the decision-making. As a result, I resolved to prevent my thoughts becoming too negative by concentrating on my particular research and presentation role, accepting the decision made. On the day of the presentation, we met up beforehand and rehearsed using our amalgamated slides. I was pleasantly surprised about how the whole thing flowed, and felt relieved. The group as a whole also seemed reassured. Evaluation Individual Performance I believe that I tried my upmost to show commitment to the group and its task, and to give support when necessary. This is reflected in the peer evaluations that I received after the task was over. At the same time, I also tried to keep the group focused and remind them of time constraints. Nonetheless, I have come to realise that I was anxious and distrustful that the group would not be able to finish the work that had been set. Because of my unease of the groups relatively slow progression, I think that I subliminally withdrew from the group in that I was only confident in my own individual component of the work, deciding to stop being concerned with the overall work. One of the manners of conflict identified by John Hunt (1987) is unhelpful flight behaviour (psychological, physical or symbolic withdrawal), which blocks and inhibits group work. In my opinion this describes the negative way in which I acted, which on reflection was likely detrimental to group effectiveness. Group Performance I think our final presentation artefact was successful, reflected by the unexpectedly positive feedback which we received. I found this surprising, because of the amount of conflict and lack of decision-making that went on during the process. Charles Handy (1993) is of the opinion that although groups collaboratively produce fewer ideas than individual brainstorming, the quality of the ideas is superior in that they are more thought through and better evaluated. Even though our proposal is not what I would have gone for individually, I have come to realise that collaborative ideas are of sound quality and should not be distrusted. Despite our conflict, I realise that with regards to ethical concerns all of us were extremely understanding of certain members individual needs. For example, instances where it was necessary to consider child care issues whilst deciding meeting times were all taken into account, with everyone being very considerate and accepting. I appreciate that acting fairly and in a reasonable way to each other is critical, as agreed by the first of the four ethical principles drawn up by Beauchamp and Childress (1995): Respect for autonomy. However, in my opinion it is important to recognise that group effectiveness seemed to break down as the week went on. Aspects contributing to this included conflicting ideas, poor decision-making and lack of time for healthy group development. I firmly believe that the latter was especially damaging to our group communication. The groups decision-making was so meagre that individual members of the group had no choice but to take initiative and make decisions without the entire groups permission. Although I felt that this represented group decision-making failure, in hindsight it probably saved us from ultimate failure of the task. Analysis and Reflection of my own and my groups performance Within this section are a few key elements that I regard as being important aspects of this experience to learn from: Team-working In my opinion, there were some very good aspects within our team-working, taking into account our ultimate success. Spears (1992) describes the METHODS model, which uses an acronym for its seven concepts. I have thought about this with regards to my group experience, and feel that the team worked well in carrying out individual research, then coming together to educate each other to provide the necessary sustenance to produce the presentation. In addition, I think the team came up with exciting although challenging ideas that took the theme a creative step further, when a more demure approach would have been acceptable. Hence in my opinion, we achieved the Dream element of the model, taking the time to be imaginative. However, I think more effective team-working would have been possible if we had set clear goals to be met in our meetings, which would have avoided anxiousness and confusion. In addition, I think we would have benefitted from some outside feedback to improve our working and reduce conflicts. Furthermore, although many creative ideas were put forward, some were unfortunately met by some negative attitude damaging to the innovative environment. On reflection, I think that our group would have undoubtedly benefitted by planning our work using the METHODS model. In particular, I will definitely strongly advise my future groups to use goal-setting to encourage improvement, to gain feedback throughout and to optimise team success by encouraging innovation rather than cynicism. Decision-making I think that the groups decision-making was poor due to a combination of the large number of ideas, avoidance of conflict, and lack of planning and organisation. Although in my opinion lots of ideas can only be positive, group meetings lacking structure and orientation meant that this large amount of suggestions made things confusing, hence positive decisions were impossible to achieve. As observed by C. Handy (1999 p.173), the decision-making procedure could be by authority, majority, consensus, minority or no response. During our group work, the only decisions made were negative, via a minority or no response process. I think that this is because we failed to decide upon an appointed decision-making method during the early stages of group development. In my opinion, the role that I played within my group experience affected the decision-making negatively, in that I was so concerned the task would not be completed, I avoided conflict and went along with the strongest voice in the group. Looking back, my thinking was to try to aid progression, as I thought that further conflict would slow things down further. Works by Hall (1971) includes advice for good decision-making, for example the recommendation that group members should avoid changing their minds merely to avoid conflict, and to actively seek out differences of opinion. This is something I will take with me and implement in future situations. From this reflection, I have learnt that forward planning is key. For example, an authoritative leader should be appointed from the beginning, as should a method of decision-making. In addition, meetings should be planned and well structured, with goals set to be met by the end of each one. Diversity and Difference Current theory by Cox (1993) states that although diversity in groups often leads to disagreements, it also means more productivity than with a group which is more homogenous, including a higher level of creativity and innovation. In my group experience, there was some definite heterogeneity within group members characteristics, including different personalities, attitudes, and in turn influence and group integration. I think that this was the cause of the conflict that occurred, although as I have already mentioned, the group did collaboratively produce a vast range of ideas and importantly was successful in its end goal. I believe that although conflict would have been absent had there been less diversity, so would have the quantity and quality of imaginative ideas. To reflect upon my group role, I will use Holm and Stevensons prompt questions (1994): What was my role in this situation and was I comfortable? Belbin (1981) noted that if any of the eight team roles is absent or inadequate, the overall team will be off-balance. Prior to meeting my group, I carried out a Belbins Team Roles Questionnaire, finding that typically I am an Implementer and Teamworker. In retrospect, whilst I was part of this particular group, I believe that I took on a different role. Although I remained an Implementer, in my opinion I acted more as a Completer-finisher than a Teamworker, considering my anxiousness that the group was inefficient and that the task may not get done on time. I believe my role changed to facilitate the groups progression and even out an imbalance. This change did cause me to feel slightly uncomfortable, mainly due to the unease associated with it. How did others act? Were the actions appropriate? Looking back, I think that in particular there were too many team workers. The group regarded the conflict and tension that had occurred as negative, and people were keen to avoid this as much as possible. Although our actions were appropriate given our situation and the task at hand, things may have been implemented in a more effective and planned way. From this reflection, I have come to realise that some diversity (although associated with disagreement) is positive, and ultimately necessary for good productivity. Additionally, although each team role is associated with some negative aspects, all are crucial for good team-working. I will bear all this in mind in future, and will no longer shy away from some healthy conflict. Management of power and conflict When the group met after each individuals research, there was some tension and disagreement over the groups priorities, and the method by which the task should be carried out. As conflict continued pressure mounted, not helped by time constraints of the room booking. The Tuckman stages of group development (1965) describe part of the Storming stage as the group beginning to settle disagreements and setting priorities, however this was unachievable due to lack of time available. As a result of this situation a clear leader surfaced, providing much needed structure and clarity. She listened to everything that all had to say, somehow having the ability to create an innovative environment whilst simultaneously bringing some degree of organisation into the proceedings, precisely what the group was actively looking for. She also had huge confidence in the group as a whole, emitting positivity and confidence, vital to the needs of the team at the time. Although the storming stage was not entirely complete, the norming stage commenced because of this newly-found structure. Even so, as I have described disagreements were not all entirely resolved. This resulted in tension and some continuing conflict being present within the group throughout the rest of our time together. This was unfortunate, as one particular member of the group began to interpret some of the discussion as being a personal attack, thus becoming defensive. However, I am pleased to say that on the day of the presentation we managed to set aside all hostility and presented our work proudly together and as a team. From this analysis element, I have come to realise that time should be made for healthy group development to allow time for conflict resolution. Clinical Reasoning One of the CAIPE principles of effective Interprofessional Education (2002) is to respect the contribution of each professional within the patient care pathway. As a group, I think we demonstrated this, as there was much amicability in considering each others needs, responsibilities and alternative responsibilities in order to reason meeting times and the amount and type of individual work each person took on. It was reassuring to realise that this is possible within interprofessionals. One of the thoughts behind interprofessional learning is that it enables professionals to learn with, from and about each other to improve collaboration and the quality of care. In terms of my own personal experience of the group work I think I have certainly significantly enhanced my knowledge of other healthcare professionals alongside the undertaking of the task. This module has allowed me to further appreciate the value of the IPL activities that are in place as part of our learning, for example the observation of MDT meetings. I appreciate that my learning would benefit from developing my clinical reasoning skill set further, and I have identified this as an essential area for my professional development. Conclusion The conclusion is a fundamental part of the Gibbs model of reflection, prompting reflection on what else I could have done. To aid this, I shall continue to refer to a selection of Holm and Stevensons reflection questions: How could I have improved the situation? By easing my anxiety in having more trust in my peers and in the group as a whole, my personal experience would have been much more positive. In addition, forward planning, for example the setting of goals and early decisions as to how the group will work would have been beneficial. Do I feel as if I have learnt anything new about myself? I have become aware that I am able to be flexible according to the needs of my group in the role that is required of me. I see this as a positive concept, as during my time as a healthcare practitioner, I will come across a diverse range of situations, where malleability will be key. Has it changed my way of thinking in any way? I have come to realise that individuals are diverse in their characteristics, attitudes and beliefs, and appreciate that this diversity is very positive within a group setting. I have also come to realise that a degree of conflict is good for productivity and creativity (although time must be allocated for any conflict to be resolved). Action Plan Attend a successful team worker course to work on my group skills. Find ways of relieving anxiety, by perhaps attending a course on this. Strongly suggest use of the METHODS model during future group scenarios to aid effective team-working. Strongly propose to decide on a decision-making procedure early on in a future group situation. Actively make time for healthy group development. Ask for relevant and professional feedback to be given to the group throughout. Try out different reflection models for different experiences to help me determine which are most useful for my own personal learning and to aid me in becoming a successful reflective practitioner. Participate in as many IPL activities as possible to develop my clinical reasoning skills.

Acute Myeloid Leukemia: Causes and Treatment Strategies

Acute Myeloid Leukemia: Causes and Treatment Strategies Pathology Acute myeloid leukemia is a disease that primarily afflicts adults. The likelihood of being diagnosed with AML increases with age; the median age of diagnosis is 65 with very few cases reported in those under the age of 40 [4]. Several risk factors have been associated with increased incidence of AML including: Li-Fraumeni disease, Klinefelter’s syndrome, radiation exposure, chemotherapy, and chemicals (benzene, herbicides, etc) (See supplementary figure S.1) [4]. However, the initiation of AML is a multistep process and can be the result many different genetic aberrations [4][5]. Therefore, the aforementioned risk factors do not account for all cases of AML [4]. Acute myelogenous leukemia is the result of oncogene-driven accumulation of immature myeloblasts within the bone marrow [5]. Myeloblasts are progenitor cells, which will ultimately give rise to neutrophils, basophils, eosinophils, and mast cells (collectively known as the granulocytes) [6]. In AML, the genes that govern proper differentiation of myeloblasts into one of the aforementioned cell types are mutated. This prevents differentiation and leads to a buildup of myeloblasts within the marrow [5]. The clinical consequences of myeloblast buildup are marrow failure leading to low white-blood cell count, low red-blood cell count, and insufficient levels of clotting factors [5]. Therefore, clinical symptoms are depressed immune function, anemia, and continued hemorrhaging. The molecular pathogenesis of AML (and all cancers) begins with the acquisition of genetic abnormalities. There are two models that describe how these acquisitions arise. The conventional model of cancer cell initiation proposes that the cell gradually acquires certain mutations to genes involved in mitotic signaling (KRAS or APC) and tumor suppression (P53), thereby allowing the cell to divide uncontrollably [7]. However, Recent work by Stephens et al. [8] showed that multiple mutations can be induced in a â€Å"one off† event by the random shattering and re-ligation of one or more chromosomes [8]. They termed this event â€Å"Chromothripsis† [8]. Chromothripsis results in massive translocations and changes to copy number state, but is distinct from the conventional model of cancer cell initiation by the presence of large-scale inter-chromosomal rearrangements [8]. Thus, the chromothripsis model differs from its conventional counterpart in the time taken for the cell t o reach malignancy and the scale to which the genome is altered. Chromothripsis is observed in a portion of AML cases; Rausch et al. [9] found nearly half of the AML cohort showed chromosomal rearrangements consistent with chromothripsis [9]. This shows that, accumulation of the necessary mutations that drive AML may occur by more than one mechanism. By either mechanism of AML initiation, myeloblasts lose the ability to differentiate. The molecular pathogenesis commonly shows two frequent chromosomal aberrations – a translocation between chromosome 8 and 21, and an inversion of chromosome 16 [5]. These changes affect two genes crucial for myeloid differentiation (CBF1ÃŽ ± and CBF1ÃŽ ²) [5]. The effect of the inversion and translocation results in a gene chimera, which is translated into a protein that interferes with proper CBF1ÃŽ ± and CBF1ÃŽ ² function [5]. However, these specific chromosomal alterations are not observed in every case of AML. DNA-damage inducing agents like radiation or certain chemicals, may cause aberrations to chromosome 5 and 7, which has also been implicated in the initiation of AML [5]. This shows that there are several factors involved in proper myeloid differentiation and that interference to any of them may result in AML. Visual differentiation of healthy myeloblasts from leukemic myeloblasts can be challenging. Myeloblasts should contain 3 5 nucleoli, which are full of uncondensed chromatin [6]. Some leukemic myeloblasts may show more than 3 – 5 nucleoli [5]. Also, they do not normally contain granules, however, leukemic myeloblasts may have granules, which can serve as a potential marker for diagnosis [5]. It is important to stress that these morphological changes may not appear in all cases of AML. Therefore, prognosis is confirmed by the presence of greater than 20% myeloblasts in bone marrow biopsy [5]. Treatment There are different avenues for treating AML. Treatment may include supportive care (in advanced cases), chemotherapy, and stem cell transplantation. However, chemotherapy is the most common and effective method of treatment [3]. When medicinal chemists began isolating antibiotics produced from bacteria in search of potential leads for drug design, Aurelio Di Marco and his research team discovered a new species of bacteria, Streptomyces peucetius, within a soil sample they obtained from an area near Bari, Italy [10][11]. This new strain of bacteria was produced a compound that was efficacious as a chemotherapeutic agent against many tumors; the compound was later named daunorubicin and is now considered a key intervention administered to patients with AML [12]. Daunorubicin and doxorubicin are part of the class of antibiotics collectively known as the anthracyclines. Anthracyclines can cause cytotoxicity by different mechanisms depending on their intracellular concentration. As reviewed by Gerwitz [13], in vitro studies show there are several possible mechanisms for the anti-tumor effects of these agents including: Inhibition of DNA synthesis, free radical generation leading to either DNA damage or lipid peroxidation, inhibition of DNA topoisomerase resulting in helix super-coiling, DNA alkylation, and DNA cross-linking [13]. The induction of apoptosis was also mentioned as a mechanism of cytotoxicity, but it is likely that apoptosis is a byproduct of the aforementioned cellular stresses, rather than a direct consequence of anthracycline exposure [13]. It is important to note that these mechanisms were observed in vitro, and that in vitro conditions allow for exposure at concentrations that may greatly exceed in vivo concentrations [13]. Pharmacodynamics Although, daunorubicin and doxorubicin are thought to cause cytotoxicity by several different processes, their ability to bind to DNA and prevent DNA replication or transcription is considered to be the primary means of anti-tumor activity in vivo [13][14]. This is because replication is inhibited at anthracycline concentrations that can be reached in vivo following a standard dosage [13]. The two anthracyclines appear to intercalate preferentially to regions of DNA with select base-pair composition, specifically, regions with CGATCG sequences [14]. Rabanni, Finn, Ausio [15] suggest that intercalation stabilizes hydrogen bonds between the two strands of DNA [15]. This means that the energy required to separate the strands is higher, and cannot be achieved by DNA helicase [15]. Thus, strand separation is inhibited, preventing DNA replication and tumor cell proliferation. For both compounds, the chromophore portion (DCBA in fig. 1) of the molecule intercalates between complementary guanine-cytosine (GC)  base pairs on each side of the DNA double-helix (fig. 2). The compound is stabilized in this position by hydrogen bonds on either side of the molecule. The â€Å"D† side of the molecule is held in position with aid from a solvent atom (believed to be ionic sodium), which forms hydrogen bonds between oxygen 4 and 5 to  nitrogen 7 of guanine12 (fig. 2) [14]. The â€Å"A† side of either drug is coordinated by hydrogen bonds from oxygen 9 to nitrogens 2 and 3 of guanine 2 (fig. 2) [14]. As previously mentioned, all of these interactions occur between both daunorubicin/doxorubicin and C/G DNA sequences. However, the added hydroxyl group on C14 of doxorubicin creates an extra association. The hydroxyl appears to shift solvent molecules such that indirect interactions between itself and the phosphate backbone of DNA are created (fig. 3) [14 ]. This added interaction might explain the slightly higher in vitro affinity constant between doxorubicin-DNA (Ka = 1.610-5) as compared to daunorubicin-DNA (Ka = 1.210-5) (in vitro Ka determination performed at 37 °C in 10% fetal calf serum) [17]. Doxorubicin is more potent than daunorubicin. In the case of anthracycline induced inhibition of DNA strand separation, the potency and efficacy are directly related. The increased binding affinity of doxorubicin means that it will associate with DNA and prevent DNA separation at a lower concentration (See supplementary fig.S2). Therefore, pharmacological factors aside, it will be more potent and will prevent tumor cell proliferation at lower concentrations. Synthesis Doxorubicin is a semi-synthetic analog of daunorubicin. The daunorubicin producing bacteria, Streptomyces peucetius, was mutated to the doxorubicin producing subspecies Streptomyces peucetius subsp. caesius [18]. This mutated strain was found to carry an oxidizing cytochrome P450 isoform capable of hydroxylating the C14 of daunorubicin [19]. The gene that encodes this P450 is called doxA [19]. Although, this gene is crucial for doxorubicin production, its presence does not guarantee collectable quantities of doxorubicin (See supplemental figure S.2) [20]. Enzymes, such as dnrH and dnrX, may further oxidize or reduce the newly formed doxorubicin into other metabolites that do not have antitumor abilities [18]. Therefore, in order to make doxorubicin production sustainable, the down regulation of such genes is required to increase doxorubicin yield. Pharmacokinetics Despite their similar molecular structure, daunorubicin and doxorubicin have distinct pharmacokinetic properties. This section will begin by contrasting the differences in elimination, metabolism, and distribution. Bioavailability will not be contrasted because both of these agents are administered intravenously. The section will then conclude with a description of tissue distribution, intracellular distribution, and toxicity. Administration As already mentioned, both anthracyclines are administered via intravenous injection [21][22]. They should not be injected subcutaneously or intramuscularly due to the significant risk of tissue death at and near the injection site [23]. The exact dosage schedule for both daunorubicin and doxorubicin is dependent on several different factors including: age, health, pre-exisiting heart conditions, and renal functioning, therefore exact dosages vary among different patient populations. In terms of daunorubicin, dosage ranges between 30 and 45 mg/m2, whereas doxorubicin dosages range between 40 and 75 mg/m2 during the initial course of treatment [24][25]. Elimination Both compounds are eliminated from the plasma via urinary and biliary mechanisms [23]. However, a much greater proportion of a daunorubicin dose is excreted through the kidneys (14-23%) as compared to doxorubicin (5%), while a larger proportion of doxorubicin was reported to be excreted through the bowels (50%) compared to daunorubicin (40%) [23]. Daunorubicin and doxorubicin are considered to be high clearance drugs. They have a similar clearance value of 1-2 L/Kgà ¯Ã¢â‚¬Å¡Ã… ¸h [26]. The elimination of either drug, along with their metabolites, follows a triphasic decline in plasma concentration [23]. After a 60ml/m2 infusion of daunorubicin/doxorubicin, the plasma concentration/time graph shows that both drugs are eliminated with a similar rate (fig.3) [26]. However the Medsafe ® [23] datasheet for daunorubicin/doxorubicin reports that the plasma T1/2 for the first phase averages 45min daunorubicin and 12min doxorubicin, while the second phase is 18.5hrs daunorubicin, 3.3hrs doxorubicin. Metabolism The primary metabolites of daunorubicin and doxorubicin are daunorubicinol and doxorubicinol respectively. Because of their similar structures, the metabolism of either compound occurs in a likewise fashion. The enzyme most implicated in metabolism is NADPH (nicotinamide-adenine-dinucleotide-phosphate) dependent cytochrome P450 reductase [27]. This enzyme reduces the ketone at C13 to an alcohol to produce daunorubicinol and doxorubicinol [28]. These two products are believed to retain their cytotoxicity and are cleared from the plasma at a similar rate [28][29]. Another common metabolite for either compound is generated via reduction of the glycosidic bond by gycosidases. Glycosidic reduction results in removal of the amino-sugar that is bonded to C7 [28]. This reaction eliminates the anti-tumor capabilities of either compound [28]. Following removal of the amino-sugar, the remaining aglycone is demethylated and then undergoes phase II metabolism (sulfonation or glucuronidation) [23]. Phase II metabolism by sulfonation or glucuronidation increases plasma clearance and enhances elimination. Two other metabolites are listed in literature, 7-deoxydoxorubincolone and 7-deoxydoxorubinone, however the enzyme or enzymes that facilitate these reactions were not noted [30]. Two other enzymes metabolize both daunorubicin and doxorubicin under aerobic conditions, xanthine dehydrogenase and xanthine oxidase, and produce reduced semiquinones and oxygen radicals [31]. These radicals could provide added efficacy to the drug therapy. It has been suggested that advanced stage cancer cells exhibit high oxidative stress and that it may be advantageous to exploit this finding to preferentially and specifically attack and destroy them [30]. Under anaerobic conditions, xanthine dehydrogenase metabolizes doxorubicin to 7- deoxydoxorubicin aglycone, which has been found to be efficacious in the reduction of the drug’s toxicity [31]. Volume of Distribution Daunorubicin and doxorubicin localize in the tissues. The Vd for daunorubicin is 39.2 L/Kg, while the Vd for doxorubicin is 24.6 L/Kg [26]. This indicates that both compounds have high tissue distribution [26]. Although the addition of a hydroxyl group at C14 markedly reduces doxorubicin’s ability to distribute into the tissues (relative to daunorubicin), doxorubicin remains within leukemic cells for a longer duration than daunorubicin (fig. 5) [26]. Upon administration, daunorubicin accumulates within leukemic cells more rapidly than does doxorubicin (fig 5). This is likely because of the increased polar surface area brought on by the added hydroxyl group of doxorubicin, which hinders its ability to cross membranes. However, the added hydroxyl group provides increased binding affinity to DNA [17]. Therefore, it will not leave the cell as rapidly because it will remain bound to DNA [26]. Toxicity The clinical use of doxorubicin and daunorubicin may be limited by their similar inherent toxicity. It goes without saying that chemotherapeutics should not be administered to women who are lactating or pregnant due to significant health complications that can be incurred by the infant or fetus, respectively, therefore these drugs should not be considered in these populations [33]. The use of these agents in a long-term manner is cautioned due to their ability to cause cardiotoxicity [29]. Under aerobic conditions, the semiquinone radical that may be produced during metabolism undergoes redox cycling [27]. Accumulation of reaction oxygen species soon occurs and can cause cytotoxicity [27]. This is believed to account for tissue death in cardiac cells, and is one of the major implications of using the anthracycline class of anti-tumors agents [27]. The cardiotoxicity itself includes effects such as functional damage to mitochrondrial DNA, interference of cytochrome c oxidase, and dysf unctional lipid peroxidation [13]. Personalised Cancer Treatment: Known Markers in Treatment Personalised Cancer Treatment: Known Markers in Treatment Personalised cancer treatment – known markers and what they mean for treatment Contents (Jump to) Known markers and what they mean for treatment Overview Drug target markers Diagnostic and prognostic markers Meta description Keywords Copyscape Known markers and what they mean for treatment Overview Personalised, targeted and hormonal treatments all depend on genetic mutations that can be identified in cancer cells to be effective. These mutations are sometimes referred to as â€Å"markers†. The markers can manifest through over-expression, lack of expression or mutated expression of specific proteins. Some markers can be targeted using specific treatments whereas some can act as measurements for disease diagnosis, prognosis and treatment response. Drug target markers The genes listed below have all been associated in cancer, the majority of which can also be treated. (*) – Targetable genes and proteins that can also be measured to determine treatment response, cancer diagnosis and prognosis. Diagnostic and prognostic markers The following markers are all related to diagnosis, prognosis and treatment progress. Meta description Cancer markers can help with the diagnosis and treatment of cancer and can give access to targeted therapies. Keywords Cancer markers, genetic markers, diagnostic markers, drug target markers Copyscape Checked Sep 2014 CIGNPOST: KNOWN MARKERS AND WHAT THEY MEAN FOR TREATMENT © Cignpost Ltd 2014PAGE | 1 [EB1]If these are genes not proteins then they should be in italics Psychology Christianity: Five Views | Eric L. Johnson Psychology Christianity: Five Views | Eric L. Johnson Review of â€Å"Psychology Christianity- Five Views† by Eric L. Johnson. Title: Psychology Christianity Five Views Author: Eric L. Johnson Publisher: InterVarsity Press. (U.S.A.) 2000 Price:  £14.37 ISBN: 978-0-8308-2848-7 Introduction: In this book review, I intend to cover the following outcomes: evaluate psychological theories against biblical teaching, discuss the contribution psychology has to make to Christian counselling, assess the compatibility of psychology (research and psychotherapy) with Christian counselling and critical examination of psychological theories. About the editor Eric L. Johnson is a teacher, editor, author and director. He attended Toronto Baptist Seminary and proceeded on to Calvin College before going on to Michigan State University where he bagged his PhD. He is an academic psychologist and initially lectured for nine years at the Northwestern College in Minnesota teaching Christian worldview, psychology and theology. Johnson wrote â€Å"Foundations for Soul Care: A Christian Psychology Proposal† and contributed several articles for the Baker Encylopedia of Psychology and Counselling. He argued for the necessity of theology in counselling and psychological research. He is with the Journal of Psychology and Theology as an associate editor. Johnson edited a special issue of the Journal of Psychology and Christianity, entitled â€Å"Psychology within the Christian Tradition† in 1998. He made contributions in two books: â€Å"Christianity and Psychology: Four Views† and â€Å"God under Fire: Modern Scholarship Reinvents God† in addition to editing this book that I am reviewing. Johnson is currently the director of the Society for Christian Psychology and the Lawrence and Charlotte Hoover Professor of Pastoral Care at The Southern Baptist Theological Seminary in Louisville, Kentucky. About the Book Psychology and Christianity: Five Views, is divided into seven chapters and has three hundred and nineteen pages. It is a review and expansion of the first edition titled â€Å"Psychology and Christianity: Four Views†. This book essentially lends to give a precise understanding of human nature and this is an issue that has refused to go. In page 104, we see that Adams argues that the Bible is sufficient to understand human nature and there is nothing psychology can offer but there are opposing arguments. Freud cited in Chapman (2007:41) argues that religion is an illusion. However, Crabb cited in Lutzer (1998:72) argues that we can spoil the Egyptians; take the best of both Christianity and Psychology for our use and become more effective as long as they are not in conflict with the Bible because the Bible will always be superior. The Wesleyan Quadrilateral advocates that four factors (Scripture, Tradition, Experience and Reason) must be considered when reaching decisions. In view of all this on-going debates, Johnson tries in this book to advance the argument for a relationship between Psychology and Christianity, and address the issue of helping Christians to understand and grasp the nettle of psychology. In this edition, there is a fifth view which has been added to the first edition of four views. This fifth view is contributed by John H. Coe and Todd W. Hall and it is titled â€Å"A Transformational Psychology view†. The other four view contributors were still involved in this edition but with revised contributions. The authors put forward five different views of how Psychology and Christianity can be integrated. They are David G. Myers who deals with the levels of explanation; an integration view by Stanton L. Jones, biblical counselling view by David A. Powlison and Christian psychology by Robert C. Roberts co-authored by P.J. Watson. Johnson wrote the opening chapter discussing the history of Christian psychology and also the closing chapter which talks about gaining understanding through the five views put forward by the various authors. The authors gave very good account of themselves in their respective views. Every chapter is concise, well laid out and the thought flow pattern is quite consistent and credible. Content of the book Johnson sandwiches the five views in between two chapters that he authored. He started in this first chapter by looking at the history of Christians in Psychology. In this chapter, Johnson looks at a generic background of psychology but with special reference to how psychology is viewed today. He argues (page 10) that science is a gift from God and that the scientific revolution was initiated by mostly Christians. Some Christians have unreservedly incorporated modern psychology while others like (Bobgan Bobgan 1987) have out-rightly rejected it and called it â€Å"psychoheresy†. Johnson explained in this chapter about the neutrality of this book and that it is rather a picture of the views of the majority of Christians. The second chapter was by David Myers and it deal with levels of explanation. This chapter delves into the subject of human characteristics. This view recognises that Christian theology and Psychology are different and should be treated so but that both should combine well. Myers argues (page 49) that both vary especially in the methodology of research and so each should free to explore as they deem fit. He further argues (page 72-74) that scientific data has enabled him along with some other Christian thinkers to shift from their view of seeing homosexuality as a sin, to understanding the biological explanation of prenatal influences to brain differences especially also considering the fact that the Bible did not have much coverage on the subject matter. Stanton Jones wrote the third chapter which is on the integration view. He shares the same view as Myers; that both Christian theology and Psychology have something to contribute to each other and consequently should be integrated; an aspect that is contrary to Myers view that they should be separated. Christianity is God’s word and psychology is God’s work. Jones argues (page 101) that God’s sovereignty prevails over every facet of human life and that Christian psychologists should benefit from that. However, Jones also shares a common view as Myers with regards to the fact that the Bible does not address some issues adequately (page 101). Jones shares a personal testimony of the tension points that he struggled with in-between Christianity and Psychology. (103-104). Jones became more confused as he desired to be faithful to the Bible, yet, he could not argue with the result that he was actually learning a lot about human nature in Psychology and so through excl usion, he found himself blending both Psychology and Christian theology. The fourth chapter deals with Christian psychology and was co-authored by Roberts and Watson. They argue that understanding God which is revelation (general and special) should be the starting point for the development of psychological theories. These authors (page 155-156) argue that Christian sermons (using Jesus’ sermon on the Mount as an example) are aimed at helping people to live well; dealing with character and transformation of persons and that psychology also deals with how to live, and changing a person’s character with the aim of living well. They identify terminology as the only difference between both. They argue (page 157) that sermon conceptualises psychology. John Coe and Todd Hall co-authored this fifth chapter which deals with the transformational view. They set out, not to develop or defend a model but to shed light on their argument, (page 200) that psychology and Christianity are closely related and that psychology is only an expression of faith and love. This view is the view that has just been added in this edition making it five views. They argue (page 200) in favour of the process and methodology of psychology as a process to new ways of transforming people. This approach looks into the psychologist’s transformation (emotional and spiritual). David Powlison authored the sixth chapter which discusses a Biblical counselling view. He started with a very bold statement â€Å"Christian faith is a psychology†. Also that â€Å"Christian ministry is a therapy† These statements summarises his view. Powlison argues (page 245) that the Scriptures talks about thoughts and intentions of the heart. He further argues that God through the scriptures reveals how human beings should achieve their potentials and a clear change process of attaining such too. Powlison assumes a very new approach in his view; the approach is to delve into the meanings of the word â€Å"psychology† in the very context in which it is used. He argues (page 248) that obviously the meaning is relative. In a bid to drive home his argument, he develops sub themes; Psych 1 – 6. Psych 1 looks at how you work,; Psych 2 looks at the detailed knowledge of human functioning; Pych 3 looks at the competing theories of human personality; Psych 4 de als with the practical application to psychotherapy; Psych 5 looks at a system of professional and institutional arrangements and Psych 6 deals with a mass of ethos. Powlison was really keen on ensuring that his readers have a very clear understanding of his view and goes a step further with a case study as he argues (page 262) that looking at cases is the best way to understand psychological views including biblical counselling. Eric Johnson authored the seventh and closing chapter where he made reference to similar books that has multiple views on the same subject. According to him, this book helps to highlight the point that a group of people, and specifically Christians in this instance, have the same belief but varied perspectives even within the same belief. Johnson (page 293) uses Proverbs 12:15 to affirm that a wise man will be humbled, by that awareness of what he does not know. No one has absolute knowledge except God. He argues that because we are finite creatures, we are limited in terms of views but God is the omniscient observer. He further argues that the more views we are open to, the better our understanding will be, and he encourages his readers especially Christians to dialogue, engage, critique and integrate the strengths of these views as it will enhance their understanding and scope in other to develop their own â€Å"postformal synthesis† (page 309). There is something I found very fascinating about this book. I found out that each chapter have contributing responses from the perspective of the other authors highlighting the strengths and weaknesses of the particular view in light of their own view. My thought. I think that the writing style is easy to read and understand. The chapters are logically laid out and concise and the literary genre is prose. The subsequent contributions from diverse perspectives to each chapter are not common and made it all seem like a conference, answering most questions that readers could have raised. I am the pastor of my local church; I encourage members through prayers, teaching, preaching and pastoral care, based on the Scriptures. I have found myself at crossroads in some contemporary issues which are similar to the observations of Myers and Jones, where they have found the Bible silent on some issues and inadequately addressing some other issues. This is one of my reasons of studying Counselling, and a book like this has opened me up to differing views highlighting both strengths and weaknesses of those views. This review has been an eye opener for me. CONCLUSION In conclusion, I consider the book well-structured as Johnson sets the stage with the historical background and after taking the five views, he borders the book at the end, encouraging scholars to critically and constructively engage to progress the work. Finally, I observe that Johnson claims (page 10) that the book is neutral and that the views represent the collective views of a majority of Christians. This is a very good claim but it would have been very good if he had gone a step further to substantiate his claim with data. However, overall, I consider this book to be of immense value to any Christian psychologists irrespective of their chosen model; it will open them up to differing views even within the Christian community of Psychotherapists. . I identify with Stanton Jones who authored the Integrative view and I will recommend this book to anyone who is seeking a clearer understanding of the integrative model of counselling. References: Chapman, C.N. (2007). Freud, Religion, and Anxiety. USA: Lulu.com. Page 41 Lutzer, E.W. (1998) Pastor to Pastor: Tackling the Problems of Ministry. USA: Kregel Publications. Page 72 Peter Emordi Psychology of Christian Counselling COU2001 1

What is LinkedIn? Essay -- Website, Professionals, Networking

LinkedIn LinkedIn is a website specifically established for the professionals all around the world to network. The website allows people to search for business contacts, manage their professional identity, research firms, join industry groups and identify desired career opportunities. This website is also being leveraged by the brands and recruiters and many corporate profiles have been established on LinkedIn to recruit candidates and develop a pool of potential candidates through networking (Lewis, 2012). Is the organization doing well? Despite the increasing competition in the internet sphere, LinkedIn has been performing since its establishment in 2003. LinkedIn is always going to have the benefit of being pioneer in launching a website that targeted the specific niche of professionals for networking and recruiting. As of March 2012, LinkedIn was declared as the largest professional network on the internet with revenue of $522.2 million in 2011. By 2012, the website has more than 150 million members in over 200 countries. The success of LinkedIn can be determined from the fact that it is the first major U.S. social networking company that completed its initial public offering in 2011 by raising an aggregate of $270.2 million for general corporate purposes and working capital (Our Social Times, 2012). The main reason for the success of LinkedIn has been its ability to offer innovative products and services to all its members. The individual profiles and corporate profiles are provided with different range of products through which they can affectively leverage the potential of LinkedIn. The company has targeted all areas in the specific niche of professionals around the world and has diversified its portfolio to r... ...ed Marketer, February 2009, pp. 17-18. Steyn, P., Salehi-Sangari, E., Pitt, L. and Berthon, P., (2010). The SocialMedia Release as a Public Relations Tool: Intentions to Use Among B2B Bloggers. Public Relations Review, 36(1), pp.87-89. Thackeray, R., Neiger, B., Hanson, C. and McKenzie, J., (2008). Enhancing Promotional Strategies Within Social Marketing Programs: Use of Web 2.0 Social Media. Health Promotion Practice, 9(4), pp.338-343. Venkatesan, Rajkumar, Kumar V., and Bohling, Timothy, (2007). â€Å"Optimal Customer Relationship Management Using Bayesian Decision Theory: An Application for Customer Selection†, Journal of Marketing Research, 44(4), pp.579-594. Verhage, Bronis, (2010). Marketing Fundamentals. Noordhoff Uitgevers bv., Groningen. Ward, David, (2009). â€Å"Needs Seeded Strategies†, Journal of Applied Economic Sciences, vol. IV, iss. 3(9), pp.441-456.

The Writer and The Thought-Fox :: Comparative, Wilbur, Hughes

The metaphorical voyage found in Richard Wilbur’s â€Å"The Writer† and the experience described in Ted Hughes’s â€Å"The Thought-Fox† show events in which a journey of discovery is made. Though their theme and metaphors are vastly different, many parallels exist between their use of animals and their creation of sensorial imagery. In this way, the reader finds how the voyage of life and the flight of a bird are akin to the adventures of a fox; one can hope to direct fate, but we must let it run its natural course. â€Å"The Writer† begins with the speaker informing the audience that his daughter is â€Å"at the prow of the house† (1) where his â€Å"daughter is writing a story† (3) as â€Å"the windows are tossed with linden† (2). From the beginning of the poem, the speaker begins to deliver an extended metaphor of life’s voyage with the phrase â€Å"prow of the house† (1). Moreover, the speaker continues it throughout the poem with phrases such as, â€Å"Like a chain hauled over a gunwale† (6) or â€Å"I wish her a lucky passage† (Line 9) or â€Å"Beating a smooth course† (29). In addition to the metaphor, the Wilbur depicts precise imagery and a symbol for the audience to experience. One example of imagery is found in the line, â€Å"Where light breaks, and the windows are tossed with linden† (2). Not only does this line create a sense of confined—yet open—space, but the audience can easily imagine the sound and wave-like movements coming from the swaying linden trees. Another image created is two people anticipating the â€Å"starling† (19) to fly smoothly into the outside world as they watch the â€Å"sleek, wild, dark / and iridescent creature† (22-23) â€Å"helplessly from . . . through the crack of a door† (20). Lastly, Wilbur utilizes the form of a small fragile bird trying—repeatedly—to fly out of an unfamiliar room into the world. As the speaker’s daughter will have struggles during her life because situations are unfamiliar to her. Similarly, â€Å"The Thought Fox† establishes the physical setting very quick; the speaker is a room in which â€Å"something else is alive / besides the clock’s loneliness† (2-3) and where there is a â€Å"blank page† (4) where the speaker is imagining a forest at midnight. In doing so, Ted Hughes begins to create a metaphor of darkness with the phrase â€Å"midnight moment’s forest.† The darkness found in this forest represents the unknown bounds of the human imagination because the deeper one goes into darkness the further one â€Å"is entering [into] loneliness† (8). The Writer and The Thought-Fox :: Comparative, Wilbur, Hughes The metaphorical voyage found in Richard Wilbur’s â€Å"The Writer† and the experience described in Ted Hughes’s â€Å"The Thought-Fox† show events in which a journey of discovery is made. Though their theme and metaphors are vastly different, many parallels exist between their use of animals and their creation of sensorial imagery. In this way, the reader finds how the voyage of life and the flight of a bird are akin to the adventures of a fox; one can hope to direct fate, but we must let it run its natural course. â€Å"The Writer† begins with the speaker informing the audience that his daughter is â€Å"at the prow of the house† (1) where his â€Å"daughter is writing a story† (3) as â€Å"the windows are tossed with linden† (2). From the beginning of the poem, the speaker begins to deliver an extended metaphor of life’s voyage with the phrase â€Å"prow of the house† (1). Moreover, the speaker continues it throughout the poem with phrases such as, â€Å"Like a chain hauled over a gunwale† (6) or â€Å"I wish her a lucky passage† (Line 9) or â€Å"Beating a smooth course† (29). In addition to the metaphor, the Wilbur depicts precise imagery and a symbol for the audience to experience. One example of imagery is found in the line, â€Å"Where light breaks, and the windows are tossed with linden† (2). Not only does this line create a sense of confined—yet open—space, but the audience can easily imagine the sound and wave-like movements coming from the swaying linden trees. Another image created is two people anticipating the â€Å"starling† (19) to fly smoothly into the outside world as they watch the â€Å"sleek, wild, dark / and iridescent creature† (22-23) â€Å"helplessly from . . . through the crack of a door† (20). Lastly, Wilbur utilizes the form of a small fragile bird trying—repeatedly—to fly out of an unfamiliar room into the world. As the speaker’s daughter will have struggles during her life because situations are unfamiliar to her. Similarly, â€Å"The Thought Fox† establishes the physical setting very quick; the speaker is a room in which â€Å"something else is alive / besides the clock’s loneliness† (2-3) and where there is a â€Å"blank page† (4) where the speaker is imagining a forest at midnight. In doing so, Ted Hughes begins to create a metaphor of darkness with the phrase â€Å"midnight moment’s forest.† The darkness found in this forest represents the unknown bounds of the human imagination because the deeper one goes into darkness the further one â€Å"is entering [into] loneliness† (8).

Audit plan †Accounts Receivable and Notes Receivable Audit Procedures Essay

1. Obtain an aged trial balance of individual customer accounts. Recalculate the total and trace to the general ledger control account. 2. Review the aging for large and unusual items. 3. Send confirmations to all accounts over $X. Select a random sample of all remaining accounts for confirmation. a.i.1.a.i.1.a. Investigate exceptions reported by customers. a.i.1.a.i.1.b. Perform alternative procedures on accounts that do not respond to positive confirmation requests. a.i.1.a.i.1.b.i. Vouch cash receipts after the confirmation date for subsequent payment. a.i.1.a.i.1.b.ii. Vouch sales invoices and shipping documents. 4. Evaluate the adequacy of the allowance for doubtful accounts. a. Vouch a sample of current amounts in the aged trial balance to sales invoices to determine whether amounts aged current should be aged past due. b. Compare the current-year write-off experience to the prior-year allowance. c. Vouch cash receipts after the balance sheet date for collections on past-due accounts. d. Obtain financial statements or credit reports and discuss with the credit manager collections on large past-due accounts. e. Calculate an allowance estimate using prior relations of write-offs and sales, taking under consideration current economic events. Notes Receivable 5. Review the bank confirmations, loan agreements, and minutes of the board for indications of pledged, discounted, or assigned receivables. 6. Inspect or obtain confirmation of notes receivable. 7. Recalculate interest income and trace to the income account. 8. Obtain written client representations regarding pledge, discount, or assignment of receivables, and about receivables from officers, directors, affiliates, or other related parties. 9. Review the adequacy of control over recording of all charges to customers (completeness)-audited in the sales transaction test of controls audit plan.

Respiratory Infections In Developing Countries Health And Social Care Essay

Respiratory infections are prevailing worldwide and are straight responsible for morbidity and a important proportion of mortality, particularly in kids. The most common respiratory conditions include acute respiratory piece of land infections, asthma, pneumonia and bronchitis. Acute respiratory infections ( ARIs ) continue to be the taking cause of acute unwellnesss globally and remain the most of import cause of baby and immature kids mortality and morbidity, which accounts for about two million deceases every twelvemonth and ranks as the first cause of disability-adjusted life-years ( DALYs ) lost in developing states. The populations who are at maximal hazard for developing a fatal respiratory disease are the really immature, the aged, and the immunocompromised. Upper respiratory infections are really frequent but are seldom dangerous. Lower respiratory infections are responsible for more terrible unwellnesss like grippe, pneumonia bronchiolitis, asthma and bronchitis which are t he taking subscribers to acute respiratory infections mortality ( WHO Acute respiratory infections update, 2009 ) . Acute respiratory infections continue to remain among the chief causes of child mortality globally. Even in the general population, they are the taking cause of acute morbidities. Hospital records from high mortality provinces of India show that up to 13 % of inpatient paediatric deceases are due to ARI. Harmonizing to recent WHO/UNICEF study, approximately 20 % of deceases in kids under five old ages of age are due to acute lower respiratory tract infections like bronchitis, bronchiolitis and pneumonia. ( Vashishth.V, 2010 ) . Respiratory diseases histories for a significant proportion of mortality all over India with the upper limit reported in the Central States and the lower limit reported in the North Eastern part of the state. Respiratory infections histories for the 2nd largest ( 22 % ) cause of deceases among kids aged below five old ages. ( Ministry of Health and Family Welfare, 2003 ) . Most of the disease load in rural India is due to the respiratory diseases like asthma, bronchitis, TB ( TB ) and pneumonia. In low income scenes these diseases are chiefly attributed with exposure to indoor pollution, solid-cooking fuels, hapless lodging, low nutritionary position and hapless healthful conditions 1. The association of respiratory upsets with geographical part may be important with population denseness, industrial and fabric pollutants, and baccy ingestion. ( Ramanakumar, 2005 ) . Wheezing is one of the commonest symptoms of respiratory diseases in kids. Epidemiologic surveies conducted worldwide have shown that 10 to 15 per centum of babies start to wheeze during their first twelvemonth of life, and around 25 per centum of kids less than five old ages of age nowadays to their clinicians with wheezing. ( Fakhouri, 2007 ) . Nebulized medicines are an built-in portion of direction of many respiratory diseases. Nebulizing a drug is a extremely effectual method of presenting drugs straight into the lungs in the signifier of aerosol atoms, provided with the right equipment and gas flow is used with the appropriate drug. This method of medicine disposal has an added benefit that it has minimum side effects compared with other manners of intervention. Nurses play an of import function in the disposal of medicine via a atomizer in any wellness attention puting. 1.1 Need for the survey: Respiratory attention patterns are altering, and pull offing respiratory diseases in kids is a existent challenge to the medical fraternity. Many clinical surveies have shown that O bringing and nebulization of bronchodilators via a gas driven jet atomizers play a cardinal function in the intervention of wheezing. Children differ from grownups in more than merely their size ; they have, for illustration, different external respiration form, respiratory rate, tidal volume and air passage construction. Nebulization is one of the easiest and most efficient ways to administrate respiratory medicines in kids. Beta agonist remains the most commonly prescribed medicine for wheezing in kids by respiratory baby doctors and general baby doctors likewise since they are proved to be the most effectual drug in the intervention of airway obstructor in kids. Despite the fact that nebulization of drug is an of import portion of intervention in assorted respiratory diseases, small attending has been paid to the efficiency of O therapy during nebulizations. The restraints in the handiness of high flow O cylinders and high cost of equipment bound the everyday usage of this technique in most primary wellness attention puting in developing states. 1.2 Statement of the Problem: A COMPARITIVE STUDY TO ASSESS THE EFFECTIVENESS OF NEBULIZATION WITH AND WITHOUT OXYGEN IN IMPROVING THE RESPIRATORY STATUS OF CHILDREN WITH WHEEZING IN A SELECTED HOSPITAL, COIMBATORE: Symptoms of respiratory diseases like wheezing affect the normal pneumonic map and impair the wellness of the kids. The purpose of the survey is to better the pneumonic map through nebulization with O. The cardinal intent defines the quality of wellness desired to consequence or sustain in patients and specifies particular duty in caring for patients. The cardinal intent of this survey was the betterment in respiratory position by nebulization with and without O. The 2nd construct is prescription for the fulfilment of cardinal intent. The prescription is directing to a directing activity that will most likely to take to fulfillment of cardinal intent. A prescription indicates the wide general action which is appropriate to the execution of the action. In this survey nebulization with and without O was used for kids with wheezing and 25 kids were assigned to each therapy. The therapies were given for 15-20 proceedingss with on-going appraisal of respiratory parametric quantities like respiratory rate, wheeze mark, O impregnation, abjurations and dyspnea class. The 3rd construct is worlds which include five constituents aa‚ ¬ † the agent, the receiver, the end, the agencies and the model. The agent is the practising nurse and is characterized by personal properties capacities, capablenesss and committedness and here research worker is considered as the agent. The receiver, the patient is characterized by personal properties and jobs and here the kids have jobs like wheezing, tachypnoea, abjurations and dyspnea. The end is the coveted result to accomplish. Reduction in respiratory ailments was considered as the end of this survey. The average comprise the activities and devices through which the practician is enabled to achieve the end. The scene of the survey was paediatric OPD of GKNM Hospital, Coimbatore which is a 530 bedded superspeciality infirmary. Oxygen and compressed air were used to ease the therapies and the technique of usage of devices was explained to parents and kids before disposal of therapies. The therapies were given for 15-20 proceedingss. The model consists of homo, environmental, professional and organisational installations and infirmary was considered as model.

Mark strand

So the poet I decided to do this on is Mark Strand. He was born in Canada in 1934 and grew up in different places in the United States. He studied at several universities including Antioch Ohio college, Yale, also the University of Florence on a Fulbright fellowship where he studied 19th century Italian poetry. When he was a child, he actually wasn't considered bright. He was a painter while studying at Yale, and a lot of people say that he creates a â€Å"painterly' image in his poetry because of the way he closely examines things.I found it really interesting that in an interview he said that he wasn't good with language as a child, and so the idea that he would one day become a poet would come as a huge shock for his family growing up. Strand felt deeply connected with the painter Edward Hopper. He wrote a book about his works, explaining the paintings in very expressive details. Strand definitely has a way of showing his passion for both art and poetry and combining the two.Hopp er was considered a very misunderstood, realist painter and Strand said that he eally connected with his â€Å"strangeness† and feels influenced by it. Strand's poetry has a very simple language to it. It sometimes borders on something beyond reality, in the way that he perceives the world. He wrote a lot of poems about dreams and disassociation from the world. He's written 14 books of poetry. He also writes a lot of life and death. Death, being what he considers the main point in lyrical poetry. What I really connect with Is the rhythm of this poem first of all.I actually enjoyed a ot of other poems by Strand but after we looked at Fishing on the susehanna river by Billy Collins, this intrigued me because it reminded me of that similar rhythm. I enjoy the repetition that things will always end but then continue to go on and return again. Theres this sadness in the earlier stanzas about how things Just stay the same, leave and come back again. The hopelessness of a mundane wo rld. In the end theres kind of a positive hopefulness where the people at the party don't think the night will end. They don't let it though the music stops. mark strand By Idramaqueenl