Beowulf and Paradise Lost’s Epic themes Essay

Epic is generally a long narrative poem on a serious and great subject, in a style that is highly important, and centers on a hero whose actions depend on the fate of a tribe, a nation, or the human race as a whole. Such epic poetries as Milton’s Paradise Lost and the famous Old English poem Beowulf, which was translated into the new English , are both somewhat different and yet similar in many ways. We are aware of the fact that Beowulf was passed down orally from generation to generation until it was written down, which follows the old style of epics, primary. Unlike Beowulf, Paradise Lost follows a little of the primary traditions but with its own twist and is in the secondary family group. Also, pastoralism was important in the Renaissance literature such as Marvell’s The Garden, which is closely related to Paradise Lost. Generally, Pastoral writers deal with the lives of shepherds in the rural life and typically compare the happiness and pureness of a simple life a nd the corruption and sadness of the city. Most characters in pastoral poetry are often used to convey the author’s social and moral believes. It is incredible, to say the least, how closely one can compare poetry that comes from such diverse and unique cultural and historical backgrounds. Also, it is very interesting how these authors change or attempt to change the genre that they are working with specially that of Milton and Marvell. In comparing and contrasting the epics of Beowulf to that of Paradise Lost, one must consider the significance of the epic characteristics and hero examples displayed, and also observe how pastoral themes can come into play with an epic such as Paradise lost in comparison to Marvell’s poem The Garden. Essentially, an epic poetry has different characteristics that any â€Å"epic† poem has to fall under; it is a long narrative poem in great style, presenting characters of high position in a sequence of events, their expansion of maturity in different episodes, and overcoming obstacles. We can see that epics first took shape from the work of various unknown poets; an example of this is Beowulf, which we don’t know much about the writer. This kind of style in poetry breaks into two different groups, the primary and the secondary. Primary is usually a folkloric style and secondary appeals more to the later generations and is more artistic; we can clearly understand that Beowulf is in the primary group while Paradise Lost in the secondary group. Furthermore, epics, primary and secondary, both share a group of common characteristics, which are: the hero has an impressive physique, is very important to an ethnic group, national or international, and is historically important. Also, the setting is greatly important as well because it covers nations, the world, or even sometimes the universe. Additionally, the action requires a heroes’ courage. Moreover, supernatural forces such as god, his angels, and the evil-doers all are caught up in the middle of the action and intervene from time to time. Last but not least, most epic characters are in high positions like kings, princes, noblemen, members of the upper classes, and sometimes godly beings or Ghosts. In the Epic of Beowulf, Beowulf himself overcomes many obstacles and tests. To briefly examine this, Beowulf and a strong warrior make a bet to see who can stay in the water the longest. However, the most important and the most interesting one is the hardship Beowulf endures is in the battle between him, Grendel and his mother, the evil-monsters. As a result, Beowulf has been declared as a great epic poem simply because of the various characteristics it clearly possesses. Additionally an epic consists of a hero who is great and larger than life, predominately. Beowulf is, without a doubt, a perfect example of this hero because of the amazing acts of heroism he accomplishes. Epic characters are very good with and give numerous speeches that bring about the past or, more importantly, the speaker’s characteristics. Beowulf does not give many, but for the little he gives, we learn a great deal about his character traits. However, Paradise Lost’s Satan, who is not the hero of the poem, but the main character, uses speech as one of the main powers he posses to overcome the obstacles that lay before him, which is to ruin mankind. Moreover, Milton’s Paradise Lost, is a retelling of the biblical story of the creation of man. Similarly, this poem has the characteristics of an epic poetry because of its very long, detailed, narration, which is the story of the origin of Satan and the fall of mankind. The poem revolves around Adam and Eve in the Garden of Eden: the focus is mainly on how eve when tempted by Satan who directs her to disobey God’s rule and ate from the forbidden tree of knowledge. At first he was called Lucifer, an angel in heaven who rebelled against God, and was finally sent to hell with his followers. So basically, Paradise Lost is an epic poem, which, in fact, holds a universal human interest. Paradise Lost is obviously theological, but Beowulf, regardless of its lack of Christian references, also deals allegorically with matters of the Christian religion: the monsters symbolize evil, unleashed, surrounding the human nature to bring destruction and chaos to them. Also, by seeing epic as pastoralism, Milton integrates epic elements of Christian believes to human’s spiritual struggle. In addition, the two great pastoral poets of the Renaissance, John Milton and Andrew Marvell, both used many pastoral elements in their work. Milton used pastoral elements in several of his works, especially in Books 4 and 9 of Paradise Lost. In Paradise Lost, Milton is less concerned with pastoral landscapes and lost paradises than with a â€Å"paradise within.† Furthermore, the way Milton describes nature is that it is generally uncontrollable and that man civilize them. Milton’s description of the garden and Adam’s and Eve’s duties within it indeed proves this viewpoint. Also, Satan’s entrance into the garden shows both the ordinary and civilized characteristics of the world can be altered by evil. In comparison, Marvell’s poem The Garden, the speaker accepts the garden as a happy state to experience as a treat within. Marvell seems to turn away from society as whole in favor of nature. He particularly shuns the company of women, as he clearly favors the beauty of the trees more than the beauty of women. All in all, we see that through Beowulf, Paradise Lost, and The Garden, the authors intentionally try to change the genre that they are working with and add a style of their own, which, in general, are very interesting. Although the authors of both Beowulf and Paradise Lost follow the characteristics of an epic poem, however both their main characters are different, one is an evil-doer who brings destruction and chaos to mankind and the other being a great hero, who brings to an ends of the destructions being done to his people and land. Also, we observed that the Pastoralism in both Paradise Lost and The Garden are different in many ways as well.

Funding Health Care Services Essay

Health Care Services Recommend How Ambulatory Services Should Be Funded There are many businesses like ambulance services that are private. Their fees are collected by the person that is using the service to be transported to the doctor or the use of their insurance they use to assist with their services. The community also provides some of the services and they are supported by taxes. In some cases, this is very rare. The hospital provides some of the ambulance services which are paid for by their insurance company or the patient for the service that is rendered at that time. In the community where I live, the patient is charged for the ambulance service regardless if someone gets on the ambulance when they arrive at the home. But the service is always community based. This is how the ambulatory service is paid for rather than it getting paid for by our tax dollars. It also depends on the business, county, and state we live in each day. Services provided by the county and state are services paid for by tax base. There is also the use of private ambulance services, or just the use of completely volunteer ones. The use of first responders is funded by the county and the state. At the same time, one can use a private separate ambulance service to assist with the injured person and transporting them. Recommend How Continuum of Long-Term Care Services Should be Funded I recommend that in order to deal with the complicated nature of long-term care, alternative solutions need to be considered. The reality is that the population who is in need of long term care has to consider all of their basic health and human needs met for all the decades of their life. This is an expensive reality. With the expanding population of individuals who qualify for long term care, there needs to be a feasible plan in place in order to ensure the viability of long term services without leaning on limited tax payer and/or government funds. My suggestion is to increase the requirement for pre-graduate internships and/or clinic experiences for students who are seeking advanced degrees in the long-term care services field. These include; medical assisting, nursing, professional counseling, social work, a physical rehabilitation. According to Mulvey, in the US, Medicaid is a government program that will pay for certain health services  and nursing home care for older people. In most states, Medicaid also pays for some long-term care services at home and in the community. Eligibility and covered services vary from state to state. Most often, eligibility is based on income and personal resources. Individuals eligible for Medicaid are typically not in the condition or capable of aging in pla ce, and Medicaid’s expenses are primarily concentrated on nursing home care. The current requirement for these programs before graduation is in the range of 9-12 months of unpaid or low-paid service. If this service graduation requirement were to increase to 18-24 months this would provide many more entry level, yet qualified, individuals the opportunity to provide care for those who are seeking a multitude of services at a fraction of the cost of current programs. The basis for funding should be a combination of government subsidized funds, acknowledging the inherent sympathy that the United States was founded, along with private donations. If the cost of services can decrease, the available funds can stretch further to be able to support additional individuals who require long term care. Recommend How Mental and Behavioral Health Services Should be Funded Mental disorders and mental health problems are treated by a variety of caregivers who work in diverse, relatively independent, and loosely coordinated facilities and services-both public and private (Williams ;amp; Torren, 2010). I recommend that they appoint staff from the Department of Mental Health to develop and put into practice a joint plan to create a continuum of care for elder adults with behavioral health needs based on the Community Support Program (CSP) model. This plan of action should summarize objectives, goals, timeframes, action steps, and a research/evaluation component. It should also make available guidelines for written agreements on local collaboration, which it should include how to decide cross-system disagreements. I also think that resource allocation o should be a main focus. With this being said, this would lay the groundwork for the systems integration needed to create the continuum of care. Next, I recommend that they establish committed funding for services to elder adults with behavioral health needs for the county and state. This already exists for the care of the children. There should be a level of flexibility in order to develop a group of services perceptive to the needs of the individual of the adults. As of now, the state has not funded mental health. I recommend that at least one geriatric pilot project be included in the budget. The project should require integration of the behavioral health and aging systems. I think that this would really be a vital step in addressing the needs of the geriatric population which is really underserved today. Once this is set up, it is my recommendation that the state set aside more money for this funding each year. On the local level, community mental health should make behavioral health services for older individuals a main concern in its yearly plan for the distribution of reinvestment dollars. I also recommend that they require that all medical and nursing students be trained in identifying behavioral health issues, treatment modalities as they relate to the older adults, and the referral processes.

Gsm Specification & Air Interface

[pic] WHAT IS GSM GSM: GSM (Global System for Mobile Communications: originally from Groupe Special Mobile) is the most popular standard for mobile telephone systems in the world. The GSM Association, its promoting industry trade organization of mobile phone carriers and manufacturers, estimates that 80% of the global mobile market uses the standard. GSM Specifications-I RF Spectrum GSM 900 1. Mobile to BTS (uplink): 890-915 MHz 2. BTS to Mobile (downlink):935-960 MHz 3. Bandwidth: 2* 25 MHz GSM 1800 1. Mobile to BTS (uplink): 1710-1785 MHz 2. BTS to Mobile (downlink) 1805-1880 MHz 3. Bandwidth: 2* 75 MHz GSM Specification-II 1. Carrier Separation : 200 KHz 2. Duplex Distance : 45 MHz 3. No. of RF carriers : 124 4. Access Method : TDMA/FDMA 5. Modulation Method: GMSK 6. Modulation data rate: 270. 833 Kbps ADVANTAGES OF GSM: 1. GSM uses radio frequencies efficiently & due to the digital radio path the system tolerates more intercellular disturbances. 2. The average quality of speech achieved is better than in existing analogue systems. 3. Data transmission is supported throughout the system. 4. Speech is encrypted & subscriber information security is guaranteed. . Due to the ISDN compatibility, new services are offered compared to analogue systems. 6. International roaming is technically possible within all the countries concerned. 7. The large market toughens the competition & lowers the prices both for investments & usages. GSM SPECIFICATIONS The main idea behind the GSM specifications is to define several open interfaces which then are limiting certain parts of the GSM system. Because of this interface, openness the operator maintaining the network may obtain different parts of the network from different GSM network suppliers. Also when an interface is open it defines strictly what is happening through the interface & this in turn strictly defines what kind of actions/procedures/functions should ne implemented between the interfaces. STRUCTURE OF GSM: [pic] GSM Specifications: Before looking at the GSM specifications, it is important to understand the following basic terms: * Bandwidth —the range of a channel's limits; the broader the bandwidth, the faster data can be sent * Bits per second (bps) —a single on-off pulse of data; eight bits are equivalent to one byte * Frequency —the number of cycles per unit of time; frequency is measured in hertz (Hz) Kilo (k) —kilo is the designation for 1,000; the abbreviation kbps represents 1,000 bits per second * Megahertz (MHz) —1,000,000 hertz (cycles per second) * Milliseconds (ms) —one-thousandth of a second * Watt (W) —a measure of power of a transmitter Specifications for different personal communication services (PCS) systems vary among the different PCS networks. Listed below is a description of the specifications and characteristics for GSM. * Frequency band — the frequency range specified for GSM is 1,850 to 1,990 MHz (mobile station to base station). * Duplex distance —The duplex distance is 80 MHz. Duplex distance is the distance between the uplink and downlink frequencies. A channel has two frequencies, 80 MHz apart. * Channel separation —The separation between adjacent carrier frequencies. In GSM, this is 200 kHz. * Modulation —Modulation is the process of sending a signal by changing the characteristics of a carrier frequency. This is done in GSM via Gaussian minimum shift keying (GMSK). * Transmission rate —GSM is a digital system with an over-the-air bit rate of 270 kbps. * Access method —GSM utilizes the time division multiple access (TDMA) concept. TDMA is a technique in which several different calls may share the same carrier. Each call is assigned a particular time slot. * Speech coder —GSM uses linear predictive coding (LPC). The purpose of LPC is to reduce the bit rate. The LPC provides parameters for a filter that mimics the vocal tract. The signal passes through this filter, leaving behind a residual signal. Speech is encoded at 13 kbps. GSM Subscriber Services There are two basic types of services offered through GSM: telephony (also referred to as tele services) and data (also referred to as bearer services). Telephony services are mainly voice services that provide subscribers with the complete capability (including necessary terminal equipment) to communicate with other subscribers. Data services provide the capacity necessary to transmit appropriate data signals between two access points creating an interface to the network. In addition to normal telephony and emergency calling, the following subscriber services are supported by GSM: * Dual-tone multi-frequency (DTMF) —DTMF is a tone signaling scheme often used for various control purposes via the telephone network, such as remote control of an answering machine. GSM supports full-originating DTMF. * Facsimile group III —GSM supports CCITT Group 3 facsimile. As standard fax machines are designed to be connected to a telephone using analog signals, a special fax converter connected to the exchange is used in the GSM system. This enables a GSM–connected fax to communicate with any analog fax in the network. * Short message services —A convenient facility of the GSM network is the short message service. A message consisting of a maximum of 160 alphanumeric characters can be sent to or from a mobile station. This service can be viewed as an advanced form of alphanumeric paging with a number of advantages. If the subscriber's mobile unit is powered off or has left the coverage area, the message is stored and offered back to the subscriber when the mobile is powered on or has reentered the coverage area of the network. This function ensures that the message will be received. * Cell broadcast —A variation of the short message service is the cell broadcast facility. A message of a maximum of 93 characters can be broadcast to all mobile subscribers in a certain geographic area. Typical applications include traffic congestion warnings and reports on accidents. * Voice mail —This service is actually an answering machine within the network, which is controlled by the subscriber. Calls can be forwarded to the subscriber's voice-mail box and the subscriber checks for messages via a personal security code. * Fax mail —With this service, the subscriber can receive fax messages at any fax machine. The messages are stored in a service center from which they can be retrieved by the subscriber via a personal security code to the desired fax number. Supplementary Services GSM supports a comprehensive set of supplementary services that can complement and support both telephony and data services. Supplementary services are defined by GSM and are characterized as revenue-generating features. A partial listing of supplementary services follows. * Call forwarding —This service gives the subscriber the ability to forward incoming calls to another number if the called mobile unit is not reachable, if it is busy, if there is no reply, or if call forwarding is allowed unconditionally. Barring of outgoing calls —This service makes it possible for a mobile subscriber to prevent all outgoing calls. * Barring of incoming calls —This function allows the subscriber to prevent incoming calls. The following two conditions for incoming call barring exist: baring of all incoming calls and barring of incoming calls when roaming outside the home PLMN. * Advice of charge (AOC) —The AOC service provides the mobile subscribe r with an estimate of the call charges. There are two types of AOC information: one that provides the subscriber with an estimate of the bill and one that can be used for immediate charging purposes. AOC for data calls is provided on the basis of time measurements. * Call hold —This service enables the subscriber to interrupt an ongoing call and then subsequently reestablish the call. The call hold service is only applicable to normal telephony. * Call waiting —This service enables the mobile subscriber to be notified of an incoming call during a conversation. The subscriber can answer, reject, or ignore the incoming call. Call waiting is applicable to all GSM telecommunications services using a circuit-switched connection. Multiparty service —The multiparty service enables a mobile subscriber to establish a multiparty conversation—that is, a simultaneous conversation between three and six subscribers. This service is only applicable to normal telephony. * Calling line identification presentation/restriction —These services supply the called party with the integrated services digital network (ISDN) number of the calling party. The restriction se rvice enables the calling party to restrict the presentation. The restriction overrides the presentation. * Closed user groups (CUGs) —CUGs are generally comparable to a PBX. They are a group of subscribers who are capable of only calling themselves and certain numbers. AIR INTERFACE In cellular telephone communications, the air interface is the radio-frequency portion of the circuit between the cellular phone set or wireless modem (usually portable or mobile) and the active base station. As a subscriber moves from one cell to another in the system, the active base station changes periodically. Each changeover is known as a handoff. A cellular connection is only as good as its weakest link, which is almost always the air interface. Radio-frequency (RF) circuits are subject to many variables that affect signal quality. Factors that can cause problems include: * Use of the handheld phone set or portable wireless modem inside buildings, cars, buses, trucks, or trains * Proximity to human-made, steel-frame obstructions, especially large buildings and freeway overpasses * Abundance of utility wires that can reflect radio signals and/or generate noise that interferes with reception * Irregular terrain, particularly canyons and ravines * Inadequate transmitter power in phone set or wireless modem Poorly designed antenna in phone set or wireless modem In addition to these variables, some cellular networks have inadequate coverage in certain geographic areas. Usually this is because there are not enough base stations to ensure continuous communications for subscribers using portable (handheld) phone sets. As a network evolves, more base stations may be installed in a given region, and in that case, this problem will dim inish with time. Conversion of a network from analog to digital can result in dramatic improvement.

Planning for Success A Product Launch Event Essay

Planning for Success A Product Launch Event - Essay Example Lastly, the report will evaluate the importance of post-event analysis and review for future planning of product launch events. The technological industry and in particular the mobile phone industry is very competitive and it is characterised with continuous innovation and product development, therefore to remain competitive within the industry, a company has to engage in continuous research and development in order to come-up with products that meet customers’ needs and surpass their expectations (Lattanzi et al. 2006). This present report is about Nokia, which is a Finnish Multinational Communications and Information Technology Company, which in the recent past has experienced a decline of its’ market share because of stiff competition within the market especially from rival companies such as Apple and Samsung (Saylor, 2012). As a response to the current competition at the market, Nokia manufactured the Nokia Lumia 920 and Nokia Lumia 820, which have distinctive features that other Smart phones do not have. The two new Nokia products have launched in other countries but they are yet to launch officially in South Africa. This report therefore will document on the planning and reviewing of the marketing event that will be held in South Africa. The report will state on how Nokia will use the launch event to create awareness about the two new products and even try to generate huge sales for the two new products during their launch. According to the writings by Steinbock (2010), in the past Nokia has taken a back seat in the Smartphone industry mainly due to the intensive competition that comes from other giant such as Apple and Samsung. The company is betting or pegging high hopes on the new products that include the Nokia Lumia 920 and Nokia Lumia 820 to revamp its position as the market leader in the Smartphone industry. Thou, the two new products were officially

Non-Molestation and Occupancy Orders and Ancillary Relief Essay

Non-Molestation and Occupancy Orders and Ancillary Relief - Essay Example Further details are set out below. Non-Molestation Order In order to put a stop to your husband’s violence, you are at liberty to apply to the courts for a non-molestation order under Section 42 of the Family Law Act 1996 (as amended).1 There is one pre-condition necessary for applying for a non-molestation order. The order can only be in respect of associated persons.2 Associated persons are described by Section 62 of the Family Law Act 1996 and include any number of domestic relationships including spouses.3 Therefore you and John are associated persons. Moreover, should you apply for a divorce the court can make a non-molestation order in the course of family proceedings. Either way, the court can make the order irrespective of whether or not you apply for a divorce or whether or not there are any other family proceedings.4 In deciding whether or not a non-molestation order is appropriate the court will examine all of the facts and circumstances of the case including the ne ed to ensure your well-being, health and safety. In this regard, the resulting order will have the effect or ordering John to stop the violence and may also order him to avoid doing anything else that amounts to abusive behaviour or harassment.5 Essentially, a non-molestation order may refer to specific acts of violence or harassment or abusive conduct or it may be expressed in general terms.6 A non-molestation order may be for a fixed period or made until further notice.7 We would suggest that since you are sure you want to file for a divorce that you file for a divorce and seek a non-molestation order as interim relief with a view to having the order open until further notice. According to Section 42(8) of the Family Law Act 1996, once family proceedings are withdrawn or dismissed, the non-molestation order ceases to be effective.8 The consequences of Section 42(8) should not be of concern to you, since the divorce proceedings will only be withdrawn or dismissed if you either reco ncile with John (in which case a non-molestation order would not be necessary) or if it is established that the grounds for a divorce are not substantiated (in which case there was no need for a molestation order in the first place). Regardless, a non-molestation order will provide you with significant safety since a breach of the order is a criminal offence for which John faces a term of imprisonment for up to five years.9 Occupation Order Obviously, you may want to ask John to vacate the matrimonial home, but the problem with that is that since he is a co-owner under a tenancy in common, he has the right to come back and occupy the home at any time.10 This is because pursuant to Section 30 of Part IV of the Family Law Act 1996, both spouses have the right against eviction or exclusion from the family home unless an occupation order is obtained under sections 33-38 of the 1996 Act.11 By virtue of Section 33, as an associated person with an interest in the family home as a result of the tenancy in common, you have a right to apply for an occupation order as a means of putting a stop to John’s violence against you.12 An occupation order will make an order for you to either occupy the home or part of it or order John to vacate the home or part of it.13 In making the order the court will take account of the â€Å"

Mid Essay Example | Topics and Well Written Essays - 500 words

Mid - Essay Example Petrarch is known as the â€Å"Father of Humanism† because he was the one who theorized that â€Å"language was the key to learning and a window to the human soul† (Woods). In short, he was the one who first realized the interplay between language and the human being. For Petrarch, if only the human being can use language effectively, we can know ourselves and the world better and we can serve others better as well. Petrarch was also the first to theorize on the need to know the theoretical and practical purpose of human life in order that one may live well and happily (Woods). Petrarch, however, endured the Black Death because a woman whom he had met in his youth, Laura de Noves, died of Black Death, and of whom Petrarch could only write, â€Å"her soul, as I believe, returned to heaven, whence it came† (Petrarch on the Plague). Women were excluded from the history of our culture because â€Å"our tradition tells us†¦that philosophy itself [including history], and its norms of reason and objectivity, exclude everything that is feminine or associated with women† (Witt). Moreover, society is simply biased against women as it promoted the â€Å"negative characterization† of women or anything pertaining to the feminine aspect (Witt). Our culture and cultural heritage therefore have been not only biased against women and once did not recognize many of the rights that they freely exercise now. The passage actually comes from William Shakespeare’s play As You Like It, Act 2, scene 1, 12-17. This means that the speaker is sick and tired of the pretense that he experiences from the world around him. He seems to have been forced to adopt this insincerity ever since and that everytime he adopts this worldview, he suffers â€Å"adversity† in his life. However, without this adversity, he would not have realized the good thing that such adversity would bring him – the â€Å"precious

Internalism Essay Example | Topics and Well Written Essays - 1500 words

Internalism - Essay Example These factors can be fundamentally motivating. Internalists from the motivational background have a belief that there exists an internal connection that is necessary to be put into consideration between an individual’s conviction that something has to be done and the motivation as well to the intended purpose which can be labeled as X (Fischer&Mark 252). This philosophical concept when looked at in an ethical manner, then an individual should have committed to their desires or the goals that they would like to achieve. When taking an example that Peter, a young boy would like to be involved in drug use as used by fellow students in class, Peter has the internal reason to take the drugs as he wants to feel what the rest of the students usually feels when they are taking such like drugs. For an internal’s, Peter has all the reasons as to why he would like to be involved in drug taking but in an ethical perspective view of the internalist, Peter knows that it is wrong to commit such like crimes and he ought not to be involved in taking drugs like the rest of the students indulging in such(Schaubroeck 26). In the contemporary epistemology, internalism based on justification entails that there should be a justification for any action that is undertaken by any individual’s mind. A belief should highly be connected to the subject’s consciousness. Internalism can be distinguished in two sections. These include internalism based on knowledge and internalism that is based on justification and this should be distinguished well. Based on the judgment on justification, this is the most widely accepted form of internalism and is based on the conscious mind of an individual. Based on knowledge, conditions are distinguishable when established on beliefs and the knowledge that is upheld on a particular state of mind of an individual (Hawthorne 215). It is thus important to note that, internalism is can

British Petroleum (BP) and its corporate Image Term Paper

British Petroleum (BP) and its corporate Image - Term Paper Example Every company needs a market and a public where to sell its products. This would only be possible if the company is known to the public, and they have a picture in their minds regarding it. This picture has to be positive; otherwise it could cost the company. A positive image increases a company’s credibility. This image is somewhat build through advertising, where the company portrays itself. Such advertising is not sales-oriented, but takes the help of the public relations department to promote a better reputation and name-awareness of the company. Corporate advertising uses strategies to build a sense of buoyancy and fascination among the consumers’ as well as the others in the industry. The whole company is advertised and branded, not just the products and services. Corporate image is an amalgamated psychological image, which continues to change, according to the firm’s products, strategies, media coverage and other events. The corporate image is a public opi nion of the company, and does not necessarily echo the company’s actual image, size or position. Corporate image is flexible and can change unexpectedly. It could go from best to worst, in hours, because of any scandal or any news, even fake, that found its way into the media, and that highlights a negative aspect of the firm. For example, in the 1990s The Food Lion supermarket faced a scandal that accused the store of unhygienic practices, which was a fraud; but the store was forced to withdraw from the  Houston,  Oklahoma,  Louisiana, and  Dallas/Fort Worth Metroplex  markets, which it had recently entered, because of bad publicity. Or it could go from worst to good overnight, by a feature printed in the Wall Street Journal, or any other newspaper; written by a reporter who was impressed by your services. It is very unpredictable. Companies use advertising techniques to improve their depiction. Brands represent a philosophy; for example The Apple Computer Company has survived a lot of ups and downs, regarding its corporate image. Apple appealed to those computer users who were innovative and creative, who wanted to see themselves as unique and free-spirited people. Apple also faced complains and criticism for its iPhone 4, where there was a connectivity problem. Apple refused to accept that it was a technical error, instead asked the consumers that iPhones have to be held differently. Nowadays, the public relations departments are also involved in positive corporate image building. CORPORATE IMAGE AFFECTS BUSINESS SALES Corporate image helps consumers remember your company. How will people buy your products or services if they are not even aware that your company exists. According to the Gallup Poll, companies today are only 16% responsible, as compared to the 70% in 1968 (Argenti 5). In business, what matters most is what the public thinks and beliefs; and the public trust is what must be upheld and should not be broken. (Argenti 11) The pu blic trust in global companies is going in negative numbers. The statistics have been calculated by subtracting the percentage of distrust from the percentage of trust, expressed by the public during surveys. This shows that the public no longer trust the global companies, to upheld their rights and cater to their needs. (Argenti 15) Companies having good standing are more likely to achieve and maintain their status and public trust in

Hepatitis B Essay Example | Topics and Well Written Essays - 250 words - 1

Hepatitis B - Essay Example In addition, 18% of the Hepatitis B patients diagnosed in the country contacted the virus because of handling the already infected patients who were at home. As such, this study suggests that it is possible to control the infection and spread of the disease through encouraging responsible sexual behavior, especially a campaign advocating for behavioral change, as well as undertaking appropriate education for the care givers so that they can handle infected patients at home without the risk of infection. Therefore, the state of Philadelphia undertakes a number of risks due to the exposure from the relative of Hepatitis B, thereby instrumental to consider the variables involved. As such, it is imperative for the state to undertake measures to prevent the acute of chronic Hepatitis B, alongside making efforts to eliminate the transmission of the disease within the Philadelphia community, especially through administration of appropriate vaccination (Hepb,

The Ukiyo-e Wood Block Print during the Edo Period Essay Example for Free

The Ukiyo-e Wood Block Print during the Edo Period Essay Mention Moronobu, and to the mind’s eye appears a procession of vigorous, picturesque figures, all the motley citizenry of old Edo (Tokyo); the magic name of Harunobu evokes slender, ethereal girls, as lovely and fragile as the first frost of winter; Utamaro, Hokusai, Hiroshige – each name stands for a unique and arresting kind of beauty, whether of voluptuous femininity, masculine strength, or scenic grandeur. These men, and several dozen more, represent the ultimate glory of ukiyo-e. The ukiyo-e masters mark a fitting conclusion to the long and glowing tradition of classical Japanese art. Like the era which nurtured it (the Edo Period from 1600 to 1868), ukiyo-e represents a unique development in Japan, the growth of a great renaissance based upon a largely popular foundation, whereas the earlier high points of Japanese civilization had been forged largely by the aristocracy or the priesthood. That such popularization did not result in vulgarization is one of the wonders of the world of art. This was the consequence, in part, of the innate sense of restrained form and color harmony of the Japanese populace as a whole. At the same time the determined efforts of an enlightened group of artists, artisans, publishers, connoisseurs, and patrons ensured that ukiyo-e standards would always remain several degrees above the level the populace considered acceptable. Politically and socially this was a feudal, almost totalitarian age; the masses accepted the voice of authority in most of their social activities. In their arts, too, they were willing to follow the lead of a loosely bound group of style dictators, much as women have sometimes followed Paris fashions in our own day. The result was two centuries of ukiyo-e woodblock prints, a continuous flow of high quality which was both the reflection and the arbiter of popular taste. And while one may give most of the credit for this phenomenon to the masters who directly produced ukiyo-e, one should not underestimate the power of the populace which supported it. What was even more critical than their taste was the inner need they felt for possessing fine art of their own. What makes the phenomenon of ukiyo-e even more curious is the fact that the Japanese populace was primarily obeying aesthetic instincts, rather than consciously anticipating the unique art form is was to support for such a long period. In general, this paper discusses the development of ukiyo-e during the Edo Period. It starts by describing the city – its city layout, population, warrior culture, and court culture – a major subject of ukiyo-e at that time. This is followed by the origins of this art form, themes and motifs, and techniques. The final part of this paper explains why such wood block prints became so popular in the Edo Period. The City of Edo The great majority of ukiyo-e were produced and marketed in the city of Edo. These prints were bought for the purchasers own enjoyment or to be taken back to the provinces as souvenirs for friends and family. Mass production of ukiyo-e first took place in Edo during the Kyoho period (1716-1736). Ukiyo-e emerged from a social milieu that centered on publishers and groups of cultured individuals who lived in the shitamachi area, particularly around Nihonbashi. From the middle of the eighteenth century, a time when Edo was becoming the cultural center of Japan, this area functioned as the hub of cultural activity not just of Edo but of all Japan. When Tokugawa Ieyasu (1542-1616) came to Edo in 1590, he inherited little more than the vestiges of a castle built long before by Ota Dokan (1432-1486). With the implementation of Tokugawa political rule, this sleepy, historic area was destined to become the capital of all Japan. By the start of the eighteenth century, roughly one century after the establishment of the Tokugawa bakufu, the city of Edo already boasted a population of around one million inhabitants. The appearance of a city of such size was an event unprecedented in Japanese history (Matsunosuke, 1997). In the 1660’s the location of daimyo residences in Edo was in fact a miniature version of the position of the various daimyo within the country as a whole. By such means, the bakufu shrewdly stationed the forces of the tozama and fudai daimyo houses in ways that worked to its advantage. The bakufu governed the daimyo with an iron hand. Until the time of the fifth shogun, the bakufu frequently ordered fief transfers or confiscations (Tamotsu, 1961). As a result, daimyo residences were often moved within the city. Incessant changes in city planning also required construction of new wards or forcible relocation of old ones, giving the number of residences the bakufu bequeathed to its vassals, calculated at five-year intervals. Many characteristics of the city of Edo were the result of demographic factors (Matsunosuke, 1997). Building the metropolis had required a tremendous number of individuals with traditional skills and knowledge: house builders, plasterers, tatami makers, carpenters, tailors, armorers, surveyors, draftsmen, scholars, and legislators. Anyone with an outstanding ability sought his fortune in Edo. Competition was fierce, and fighting instincts surged to the fore. The majority of the Edo population was male. Male apprentices and clerks staffed the Edo branches of provincial stores. Most of these men returned to their home area after finishing their stint in Edo. Male laborers were required by daimyo for constructing Edo branches of local shrines and family temples. Samurai stationed in Edo were of course also exclusively male. In addition, Edo boasted a huge population of priests. Masterless samurai (ronin) and the self-styled street knights known as kyokaku contributed greatly to conflicts in the city. With the end of civil wars and with the peasantry under tight administrative control, ronin could no longer ramble freely about the villages. They too began to search for new forms of employment. A few members of this vast population went abroad; but many more slipped into Edo to become merchants, craftsmen, flute-playing monks (komuso), or kyokaku. The warrior population contributed much to the uniqueness of Edo. A large number of bannermen (hatamoto) – direct vassals and guardsmen of the bakufulived in the environs of the castle. A system of alternate attendance (sankin kotai) required daimyo and their retainers to spend alternate years in the capital and at their domains. Daimyo wives and children resided permanently in the capital. Thus at any given time, a large part of the military force of the nation was stationed in Edo. No matter how distant a daimyos domain lay from Edo, he took part in regular grand processions between his home area and the capital. The concentration of warriors in the city stimulated the emergence of a unique Edo economy. The presence of a large stratum of newly enfranchised warrior nobles required the procurement of a tremendous quantity of consumer goods (Matsunosuke, 1997). Supplying such goods was the responsibility of official merchants and artisans who streamed to the capital from all parts of the country. Edo thus became a consumer capital. Forced to live in the city, the daimyo, along with their retainers and families, enthusiastically set about developing their own culture. Both the ancient Kyoto court traditions and the warrior culture of the Kamakura bakufu (1185-1333) developed rapidly among the aristocratic warrior stratum. The habits and lifestyle of the daimyo and the high-ranking officialstheir food, housing, and clothing, their furnishings and utensils, even their styles of seating and deportmentwere in fact all warrior-style variations of the ancient customs, practices, and etiquette of the Kyoto court. Principles of warrior rule governed the rank or status of individuals and families in the feudal hierarchy. Rules were drawn up stipulating the forms a daimyo was required to follow. Social rank determined the shape and size of a daimyos Edo residence, the scale of his processions, and the kind of vehicles, furnishings, and clothing he was allowed to use. Distinctions of feudal rank were displayed to be immediately visible. These included the colors and designs of clothing, styles of architecture and materials used in buildings and gardens, and the methods and ingredients employed in manufacturing various goods consumed by the warrior. Even the borders of straw floor mats (tatami) in Edo castle varied according to the rank of the officials who sat on them. For this reason feudal culture – at its most typical, Edo warrior culture – Is often said to be a predominantly visual culture (Matsunosuke, 1997). Since attempts to strengthen ones military prowess was sure to evoke displeasure from the bakufu, many warriors instead built huge gardens or absorbed themselves in leisure pursuits. Within three or four generations, both the daimyo and the shogun were no longer country bumpkins: they had become a true upper-class nobility in both name and deed. Vestiges of gardens as they existed at Edo daimyo residences can still be found in Tokyo today. Examples include the Korakuen of the Mito house, the Hama Rikyfi of the Kofu Tokugawa, and the Rikugien at the Komagome villa of the daimyo Yanagisawa Yoshi- yasu. These parks, as well as maps of ponds and gardens at residences of the Togoshi Hosokawa, show that construction took place on a grand scale. Residents of such estates could enjoy leisurely strolls within the grounds or ride in pleasure boats on the large ponds. At such villas the Edo warrior nobility sought to revive the cultural life of Heian-period courtiers, who valued natural beauty and lived in natural surroundings. Origins of Ukiyo-e It is rare indeed for a single word to express within itself the changing concepts of an age. â€Å"Ukiyo† is such a word: in medieval Japan it appeared as a Buddhist expression which connoted first â€Å"this world of pain†, with the derived sense of â€Å"this transient, unreliable world† (Lane, 1962). Etymologically it thus meant â€Å"this fleeting, floating world†. However, for the newly liberated townsman of the seventeenth-century Japanese renaissance, â€Å"floating world† tended to lose its connotations of the transitory world of illusion, to take on hedonistic implications and denote the newly evolved, stylish world of pleasure – the world of easy women and gay actors and all the pleasures of the flesh (Lane, 1962). By the time the suffix -e (meaning â€Å"pictures†) had been added to form the new compound ukiyo-e (â€Å"floating-world pictures†) around the year 1680, this hedonistic significance had become predominant in the expression. Thus the subject of our book, ukiyo-e, meant something like the following to the Japanese of the age which engendered it: A new style of pictures, very much in vogue, devoted to depicting everyday life, particularly fair women and handsome men indulging in pleasure, or part of the world of pleasure -pictures, as often as not, of an erotic nature. But what brought about this new development in Japanese art, this revolutionary shift from the overworked themes of classical tradition to those of the workaday world? To understand the origin of the ukiyo-e, it is necessary to look far back into the past. The disruption of the period of the northern and southern courts in the fourteenth century followed by the Chinese renaissance in the fifteenth had meant a real break with ancient traditions. A reaction to the intervening Chinese school could not begin to set in until late in the Muromachi period. In addition, the unsettling wars of the period created a mood in which new ideas could arise, and in which the populace seems to have been less restrained socially than during the rigid Tokugawa regime. Art reflected its environment in the gradual emergence of genre paintings. While the new style did not strictly follow the narrative attitude of the Yamato-e scroll tradition, it was also far removed from the ethical approach of the Kano masters towards figure subjects (Paine and Soper, 1955). The style originated in the old capital of Kyoto, and among the works of the Kano artists who lived there are to be found some which depict and emphasize the contemporary scene in preference to an ennobling idealism. The new spirit was stimulated by Hideyoshis talent for spectacular display. This lowly but heroic figure liked to impress people. The great fete or tea-party at the shrine of Kitano in 1587 introduced a novel kind of popular entertainment. For the occasion Hideyoshi had placards set up in Kyoto, Nara, Osaka, and Sakai inviting all to come irrespective of class or wealth. At the tea-party Hideyoshis treasures were ostentatiously exhibited. The next year he gave a great flower viewing party at the temple of Daigoji (Paine and Soper, 1955). The popular art of the period deals with masses of people, as though these joyful occasions had also impressed the artists. The following section describes ukiyo-e themes and motifs, which explains why the art was popular during the Edo Period. Ukiyo-e Woodblock Technique Ukiyo-e prints were produced as a result of the collaboration of the artist, the publisher, the master carver, and the printer’s shop. However, it was the artist who received credit for the piece in the end. First, publishers would start the procedure by engaging artists to design a print or sequence of prints. The artists may have a background on traditional styles of painting or they may have learned from style of other ukiyo-e masters while having training in the workshop (Fauntleroy, 1989). Many ukiyo-e artists were commissioned to produce novel compositions to embellish interiors of households or design customized surimono (greeting cards) for clients who could afford the lavishness of unique works of art. Once the artists had prepared hanshita-e (drawing), the precise size of the print for publishing, they would trace the outlines of hanshita-e on a piece of thin paper using black ink. The traced version would be relayed to master woodcutters, who would then translate the artist’s brushed composition into a board of wood using scrapers, chisels, and knives. They used fine-textured and very hard wood to make sure that even the most elaborate parts of the design imprinted in relief would last the pressure of hundreds of other printings. Then, master cutters would put the tracing face down on the wooden board. They would then carve away all wood from the surface excluding that indicating the outlines of the drawing of the artists. Since a design imprinted in relief will create a reverse image when put into print, wood cutters reversed tracing to come up with an image similar to the original conception of the artists. A registration mark was carved beyond the perimeter of the composition in the lower right-hand part of the board (Fauntleroy, 1989). The key block would then be sent to printers, who would finish a number of black-and-white impressions, approximately the quantity of colors to be used in the final print. They did not use a mechanical press familiar to European printers because it lacked the pressure needed for wood block impressions; rather the printer applied physical strength to the woodblock, paper, and baren. Then, the proofs would be sent back to the artist, who would inspect the wood block impression and indicate colors to be used. The proofs would be sent back to the woodcutting shop. After the completion of the carving, the key and color blocks would be turned over to the printers. Following the printing of the first color, the paper would be placed on top of a second block inked with a special color; this process would continue throughout the series of color blocks (Fauntleroy, 1989).

Impact Of Volcanic Activity On The Environment

Impact Of Volcanic Activity On The Environment The research examines the impact of volcanic eruption on the environment and on society. The work aims at exploring four different types of volcanic eruption, the negative and positive impact of volcanic eruption and the health and safety measures during and after volcanic eruption. A total of thirty questionnaires were sent out to friends, staff and students of Cambridge education group, twenty responded with useful information which has influenced the content of this research. The questions includes, have you ever experienced volcanic eruption in your country, the positive and negative impact of volcanic eruption. The comment they made within the defined range was critically analysed by the author by making reference to secondary sources .It was found that the eruption in Iceland was a composite volcanic eruption which lead to closure of several airports around the world. Volcanic eruption has a devastating effect on our society and could lead to loss of lives, income and properties. iv INTRODUCTION The name volcano has its origin from the word Vulcan, a god of fire in Roman mythology. Most people instantly think that a cone shaped mountain with smooth steep slopes, perhaps with a snow covered peak and a ring of smoke rising skyward. The description is accurate but applies to only one type of volcano which is the stratovolcano. Although there are other types that differ in many ways from stratovolcano, some volcanoes are composed of long, gentle slopes often covered with fertile soil while some have no vertical structure instead composed of a depression hundreds of yards deep and extending over several miles. The shape of volcanic structure is clear indication of the type of activity carried on by the volcano .A volcanoes type of activity is also related to the chemical and physical properties of magma produced. Mauro R(2003) 1.1PRODUCT OF VOLCANISM Volcanism in Iceland results from divergent plate movement across the Mid-Atlantic Ridge and excessive production of magma in the North Atlantic Mantle plumeà ¢Ã¢â€š ¬Ã‚  Freysteinn (2006) The product of volcanic eruption are lava, gases and fragmented material such as ash which is derived from molten rock called magma .Magma is a molten matter of silicate composition. Silicon is the main constituent of most minerals and rock in the Earthà ¢Ã¢â€š ¬Ã¢â€ž ¢s crust and also contains dissolved gases which is less dense than solid rock and tends to work it way upwards through fissures .lava is a magma that has erupted at the surface.The term lava applies both to the molten material and to the rock that forms after magma has cooled and hardened. Schminike ( 2004) 1.2 BACKGROUND OF STUDY In the 9th century AD, the Vikings settled in Iceland and established a council that documented its first historical volcanic eruption .The heroic tale was written in the 12th and 13th centuries after a third of the population died from smallpox and in 1783-1784, Laki eruption killed a-fifth of the remaining population by famine. Iceland gained sovereignty from Denmark in 1981 and completed independence in 1944 Recently,the Eyajallajokull volcano which is known as the iseland-mountain underglacier, situated in the southern Iceland erupted spectacularly on the 14th of April 2010 ,after having been dormant for almost 5000years .During this eruption ,the subglacial eruption produced a large ash plumes that drifted over Europe and forced an unprecedented closure of airspace in Europe and other countries .The Iceland owe its existence to a large volcanic hot spot sitting on a mid-ocean ridge .The plate boundary between the American and Eurasian tectonic plate crosses Iceland from the south to the north and spreading process can be directly measured and observed on land .Chimu (2010) 1.3AIMS AND OBJECTIVES Volcanic eruption in Europe can cause severe damage in localized areas. This can be seen in Iceland, a country prone to volcanic eruption. Volcanic eruption has the ability to irreparably damage plant and animal ecosystems and also human social environments. This report seeks to explore the types of volcano, the positive and negative impact of volcanic eruption. This report will also show the health and safety measures during and after volcanic eruption. 2 2.0 LITERATURE REVIEW The Authors below has discussed the phenomenon on the previous volcanic eruption on different locations. This has been incorporated by the author in view of the recent volcanic eruption in Iceland. According to Grattan et al (1991) historical document from A.D ,1783 demonstrated that volcanic gases emitted in an eruption in Iceland did have a severe effect on both the physical and human environment within Europe. The Laki volcanic eruption in southern Iceland in 1783, resulted to high release of haze which were felt all over Iceland .The damaging effect led to destruction crops and vegetation, cultivated crops and vegetation were burnt and withered by acid precipitation. Caseldine (2009) Mount Pinatubo is a volcano that stands 5770 feet, which is located in Philippine along the coordinates 15oN,1200E. The eruption in Mount Pinatubo on the 15th of July was the second largest most violent volcanic activity in the twentieth century after being dominant for over 500 years .The action led to the release of nearly 20 million tons of pyroclastic debris which actually resulted to the destruction of more than 200,000 acre of land and also gave rise to major casualties and damage.This includes the death of more than 700 people and destruction of more than 200,000 homes. Yacove ( 2003). In the morning of May 18th ,1980 Mount St Helens erupted a pyroclastic material which constituted a hot pumice and ash. Approximately 400 meter of the mountainside blew outward that morning. About 60 square kilometres of the neighboring valley was filled with debris.The explosive eruption of Mount St Helens caused the death of over 50 people .Allan (2003 ) Kilauea is lacated between the southeast and it is the spot where all active volcanoes in the entire Hawaiian chain occurred,perhaps the world`s most active volcano . Kilauea`s frequent eruption makes the crater a great study site for volcanologists. In Hawaiian tradition Kilauea is also the home of Pele,the Hawaiian volcano goddess. During the nineteenth century the eruption occurred more often and have contributed to the Kilauea`s reputition, both as a geologic site of wonder and as spiritual site of significance to some residents of Hawaii Allan( 2003) The stramboli volcano in Italy is archytype for strambolian activity (carniel and lacop 1996) another feature of this volcano is the presence of continous volcanic tremor (Ripepe and Gorder1991) .About twice a year the volcanic eruption that occurred showed paroxysmal activity that effected tourist visiting the volcano( Jaquet and caniel 2001) 3 3.0 METHODOLOGY This research has been conducted by the author through the use of primary and secondary sources .Primary data were achieved by survey, interviewing people both verbally and online on the account to the recent volcanic eruption that occurred in Iceland and previous eruption in other countries. A total of thirty questionnaires were issued out to students, tutors, administrators and an expert on the field of structural geology. The information received were critically analysed and incorporated into the report. Secondary sources were evaluated from two different research trends which are quantitative and qualitative analysis. These analysis were established by making reference to books from the library, journals, articles and also e-books such as goggle scholar ,goggle books were utilised .Data collected from these material were re-examined by comparing, evaluating both information from primary and secondary data 4 4.0 VOLCANISM The frequency, magnitude and kind of volcanic eruption are likely to change in the future. The earth has been formed about 4.6billion years ago with consistent occurrence of volcanic eruption. Each year about one-tenth of the active volcanoes on earth erupt. One in every six of the active volcanoes on earth has led to loss of lives and properties as a result of this activity , cities and region has been devastated. Disastrous volcanic eruptions are characterised by rapid onset of their climatic phase and by a wide variety of eruptive behaviour and effects. High and low temperature particularly mass flows of different types, such as debris, avalenche, pyroclastic flows and debris flows but also including atmospheric transport of ash for hundreds of killometres ,during a dynamic eruptions, huge masses of gasses are released into the stratosphere ,forming aerosol that globally effect the climate and the ozone layer for years.Volcano are certain to increase in future the reason are manifold. Schimike(2004) 4.1. CAUSES OF VOLCANIC ERUPTION A volcano is composed of three basic elements. A vent through which volcanic material erupt. A conduit which is the passage that allows magama to reach the surface of the earth and a reservoir or magma chamber deep in the earth crust. All volcanic eruption are not alike, some eruption are quiet with lava slowly oozing from a vent .Other eruption are very violent with lava and other materials being injected hundred miles into the air. Gases from within the earth interior mix with huge quantities of dust and ash and rise into the air as a great dark clouds that can be seen from many kilometres away. Some dark coloured lava is thin and runny and tends to flow as well. Explosive eruption are caused when lava in the vents hardens into rock.Steam and lava build up under the rocks when the pressure of the steam and new lava becomes great, a violent explosion occurs as a result of internal pressure within the rock.Gases and rock shoot up through the opening and spill over or fill the air with lava fragments.A volcanic eruption have been known to knock an entire forest ,furthermore an erupting volcano can trigger tsunamis,flashfloods,earthquakes,mudflow and rockfalls. After Floyd (2000) 4.2 TYPES AND COMPOSITION OF VOLCANOES There are different kinds of volcanoes which are classified based on the shape of the volcano ,the materials they are built of and the way the volcano erupt .The author will explain four different types of volcano which are grouped as: 1. Strato volcanoes 2. Cinder cones volcanoes 5 3. Shield volcanoes (which are also called shields) 4. Lava dome volcanoes 3.2.1 strato volcanoes The stratovolcanoes are also known as a composite volcanoes. Magma moves to the surface from its source miles below the crust and often changes in composition. There are different types of magma which are associated with different types of volcanoes. Basaltic magma, which comes from deep within the mantle undergoes little chemical changes during the process of volcanism. During this process some amount of fluid allows the magma to let-off its gas safely. The resulting landforms are cinder cones and shield volcanoes. In stratovolcano,magma`s chemical composition may change to a more viscous type.The chemical composition will eventually be responsible for the creation of volcanic rocks which are different from basalt.The three most common rock types found in strato volcanoes ,with variations in their composition are rhyolite,decite and andesite.Andesite has similar composition to basalt but has more percentage of silica content than basalt ,however Rhyolite on the other hand ,is more i dentical in composition to its parent rock while Decite is the middle in terms of composition. The rock types serve a purpose in composite eruption because it tells geologists the source of magma and the phase of eruption. The composite volcano are composed of virtually all the material a volcano can eject from a vent and the materials discharged piles up to form steeply sloping cone of the volcano. Prisciantelli (2004) 4.2.2 CINDER CONE VOLCANOES Cinder cones are one type of volcano or volcanic landform. They are associated with subsurface contact which amounts to their volatility.Magma on the top of a chamber is loaded with gas during the process of volcanic activity.The pressure from the gases subsequently necessitate to the explosiveness of the eruption while at the bottom of the chamber the pressure is less and magma tends to flow through a break in the cone. Furthermore when gases are thrown in the air during eruption the lava shatters and hardens to small cinders and ash which piles up around the vent. In addition the cinder cones are usually steep-sided and the top of the cone has a bowl shape which are small in size. The typical behaviour of a cinder cone is an eruption from a vent in the earth, concurrently, cinders are being accumulated to form the cone ,followed by a possible break at the base of the cone from which lava flows. The cinder is used for construction and also seperated by snowplows during winter to improve driving on icy roads.Prisiantelli(2004) 6 4.2.3 SHIELD VOLCANOES The shield volcanoes are another type of volcanic structure but are much broader than cinder cones, generally covering large areas. Lava constantly flows through the vent and they do not produce cinders, ash like the cinder cone volcanoes. The shield volcanoes are not as explosive and destructive as composite and cinder cone volcanoes .However they are harmful to anyone they come in contact with and also their lava flow covers a wider range of distance .The lava has multiple flows while one is hardening the other tends to begin and run over the top of the initial flow. In this manner, the volcano builds outward into a broad slope, its structure is high and wide and often covers many mile during this activity. The slope is more gradual than that of the composite or cinder cone volcano. Shield volcanoes has a similarity with that of the cinder cones in terms of basalt lava composition. The rock type of the shield volcano is andesite and the fluid flow is different from the basaltic flo w. Pisiantelle(2004) 4.2.4 LAVA DOMES VOLCANOES Lava domes volcanoes are less common and are also known as volcanic domes and plug domes which are steep-sided, bulb-shaped mountain that forms when viscous felsic magma and occasionally intermediate magma, is forced toward the surface. When pressure below the chamber is great , the felsic magma tends to move gradually. This is as a result of the sticky magma that are contained in a chamber. Some cited examples of a lava domes volcanoes was an occurrence in Washington which began in the year 1980 on Mount St. Helens. A number of lava domes were buried in the crater of Mount St. Helens and most of these were destroyed during subsequent eruptions. Since 1983, Mount St. Helens has been characterised by occasional growth and renewed eruption in 2004.More so in June 1991, a lava dome in japan, the unzen volcanoe collapsed under its own weight which caused debris to flow and also hot ash that killed 43 people during the eruption. The lava domes eruptions are among the most violent and destructive. In 1992 on Mount Pele on the island of Martinique, viscous magma accumulated at the highest point of the Pele and eventually pressure increased until the side of the mountain blew out with a huge explosion which led to the high discharge of dense cloud of pyroclastic materials and a glowing cloud of dust called the Nuee ardante (glowing cloud in French).The explosion also led to swirling cloud of white-hot ash and gases with an internal temperature of 700 degree celsius that consumed everything in its path. Subsequently, Nuee ardent passed through 7 St.Pierre within two or three minutes ,followed by a firestone as an ignitable material which burned and exploded. Approximately 28,000 resident of the city died during this action. According to Wicander (2008) 8 5.0 THE IMPACT OF VOLCANIC ERUPTION ( CASE STUDY:ICELAND VOLCANO 2010) Iceland has a high concentration of active volcanoes due to unique geological conditions. There are about 130 mountains of volcanic origin,18 of which have erupted since the colonization. A high amount of volcanism is concentrated along the plate boundary ,which runs across the island from the southwest to the north west. In the south and southwest regions of the island we find the Hekla, Eldgja and the Laki craters, also the Arafajokull and Snafellsjokull. Eyjafjallojokull is situated to the north of skoger and to the west of Myradalsjokull .Hooper (2010) Geologist explain the high concentration of volcanic activity in Iceland by a combination of the island position on the mid-atlantic ridge and volcanic hot spot underneath the Eurasian and North American plates. More so Icelandic eruptions are famous for their massive volume of erupted ashes and for vast lava outflows. The most common type of volcanoes are the composite volcanoes which spread over vast areas of the country and usually arranged in chains. Over the last 500years Iceland`s volcanoes have ejected about one third of the total global lava output ,although the Laki volcano in southern Iceland which erupted in 1783 and was classified as the largest erupted lava since the Iceland`s colonization .The most recent volcanic eruption in Iceland began on the 14th of April at the Eyjafjallokull mountain .Geologist explained during the eruption ,that the activity of the volcano increased incessantly, spewing a plume of ash which was approximately 5.3 miles high into the atmosphere. Thousands of flights were cancelled with millions of travel plans affected. During the incidence it was estimated that shutting down the United kingdom`s airspace alone for a week incurred lost of over 100 million pounds. More so business plans and those involved in importation and exportation of goods were disrupted. Th e global cost of the disruption, resulted in a loss of billions of pounds.Hooper (2010) 5.2 PRIMARY ANALYSES Questionnaire survey detailed in the report will help to influence some of the content of this report, other influences will be interviews both verbally and online. Although it was difficult to draw conclusions from some of the responses particularly the open-ended response. This investigation was carried out on friends lectures and also on students and staff of the Cambridge education group ,between 4th July to 11th July 2010 A total of 30 people were advised to fill in a questionnaire and out of the 30 people ,the number of responses from both online and paper questionnaire at the time of this research totalled 20 and out of the people that responded 18% were males while 12%,were females. The age-group of these participants ,27% were under 40 whereas 3% were above 40. Question 8,on the questionnaire was, have you ever experienced volcanic eruption in your country. A total of 27% partakers said No, while 3% said yes. Furthermore , question 10 was ,do u think that volcanic activity has a negative impact on the economy of a country. 30% of the respondents said yes and there reasons were, it can affect business activities by giving rise to delay on production services and that volcanic eruption may defer tourist and cause a lot of damages to properties ,vegetation and livelihood. Smoke haze will cause or necessitate delays both on residents and visitors going for tourism and other important activities . Most airports might likely to be shut-down during this activity. More so most manufacturing industries that rely on importation and exportation will put a halt on their activities there by affecting income generation and revenue for the government and private sector as a whole. Question 12 , was about the positive impact of volcanic eruption.27% of the respondents said that volcanic eruption, only has negative impact whereas 3% out of the respondents who said Yes, provided information within the defined range. The comments they made were that ,many years after volcanic eruption it could aid tourism and also produce interesting geographical and historical features. Furthermore,ash which is a product of volcanism enriches the soil when it is being deposited at the surface of the earth. In addition new rocks are formed from magma and can be used for infrastructural development. The analysis is shown on table 2 5.3 FINDINGS The preceding chapters focused on the origin ,composition and types of volcanoes. More so, on the procedures and analyses of primary data to meet the requirement of the author. This chapter will analyse further on the negative and positive impact of volcanic eruption on society in relation to primary analyses. This has been achieved through secondary sources. Depending on the type of eruption and its location, volcanic eruptions has overwhelming effects through a number of displays. The negative impact includes, the high release of haze during eruption ,which leads to destruction of crops and vegetation from acid precipitation.Caseldine( 2009). Pyroclastic resulting from eruption and can cause ample damage depending on the size of the layer deposited. A Thickness which is less than 1mm will act as irritant to lungs and eyes and also lead to closure of airport due to the potential to aircraft and contaminate water within the area. While a layer of ash with thickness between 1-5mm will cause minor damage to buildings and blocking air filters. This can also lead to electricity cuts due to conductivity of wet ash. A layer of ash which is about 5 -10mm will destroy crops and pastures, causing light weight buildings to collapse and also effect rail transport through signal failure. After Gottsamann (2008) Furthermore,a cited example of the negative impact was the eruption in Laki which is located in southern Iceland in the year 1983 .When lava poured out from a total of 135 newly opened cratars, it was estimated that during this eruption some half billion tons of 11 toxic gases was expelled into the atmosphere and killed over 16,000 people and slughter about 60% of cattle in island. After Gottsamann (2008). Volcanic eruption deposit materials (ash) on the surface of the earth and after a long period of time due to physical and chemical changes ,the ash provides nutrient to the surrounding soil. Volcanic soils are potentially fertile as the ash can contain trace element beneficial to the growth of plant .This can relatively encourage high population and intense agriculture within the area. Volcanoes are often located in region where there is high agricultural production. Volcanoes, provides strikingly natural beauty which can attract tourist .An example demonstrated is the volcanic eruption which occurred between 1963-1965 in costa rica ,called the Irezu volcano. The eruption was reported to be responsible for 4.3% increase in the number of tourists between 1963-1964 . Indirect economic benefit can also be initiated in response to the indications or threat of imminent volcanic eruption. Further example, was the volcanic activity that took place at Rabaul papua , New Guinea between 1983 a nd 1985 which led to a number of improvement to infrastructure on that location.This includes advancement of air-strips, road and bridges ,water and power supplies ,health facilities and communications .However during this growth ,food production increased as a number of people cultivated food gardens outside the danger zone.After Gottsamann ( 2008) 12 6.0 HEALTH AND SAFTY MEASURES DURING AND AFTER VOLCANIC ERUPTION WHAT TO DO DURING VOCANIC ERUPTION 1. During volcanic eruption,it requires immediate evacuation to a safer location ,rock debris ,lava flows and ash will make the area around the volcano dangerous to anyone that stays 2. If instructed to evacuate follow the directions of the authorities. 3. Evacuate to an area upwind and higher ground .Flash floods, mud and poisonous gases will accumulate in low lying areas 4. If you are unable to evacuate ,seek shelter indoors and make sure all windows and doors are locked to keep ash out . 5. Store all vehicles and equipment inside a garage and leave them, until the eruption has ended. 6. If you must go outdoors use goggle to protect your eyes and use a face mask or hold a damp cloth over your face to aid breathing. 7. Avoid falling volcanic ash ,cover your mouth and nose and wear long-sleeves to avoid irritation or burns on the skin. 8. If you are in a vehicle keep the engine switched off. Avoid driving when ash is falling heavily as driving will stir up more ash that may clog your vehicle`s engine. Bickley (2010) WHAT TO DO AFTER VOLCANIC ERUPTION 1. Minimise your movement and keep all windows and doors closed. 2. Always ensure the safety of yourself and your family before responding to the needs of others. Do a headcount to make sure the members of the family are safe and sound. 3. Check for injuries,do not attempt to move seriously injured person unless they are in immediate danger of death or further injury. 4. Drive slowly and carefully with your lights on. 5. Remove ash from your roof,more than ten centimetres of ash may be enough for your roof to collapse. 13 6. Hose down outside with a little water to dampen the ash .This helps to keep it from blowing around. Bickley (2010) 14 7.0 CONCLUSION In the assessement of the impact of volcanic eruption on the society and environment ,it was found that volcanic eruption are not alike ,some are quiet while some are violent ,This action depends on the internal pressure exerted on lava. The pressure necessitates gases and rocks to shot up through a vent and conduit and fill the air with lava fragments. It can be seen that the recent volcanic eruption in Iceland on eyjafjallolojokull province was a composite volcanic eruption which has ejected about one third of the total global lava output over the past 500years .The recent volcanic activity in Iceland occurred within a month and resulted to a loss of billions of pounds around Europe. The sudden violence of volcanic eruption causes catastrophe and devastation on the environment .This includes destruction of buildings, crops and vegetation. Could also lead to flight and vital activity delayed The findings also indicate that volcanic eruption has more negative impact on our society and these could affect income generation and revenue for the government and private sector.

Student :: essays research papers

A summary of Into The Wild Through reading Into The Wilds, I have resented a lot of emotions mostly anger. I have never thought that such person would stand in greater instance in relationship to the environmental movement like McCandless until causing his own death. What sense then can we make of this tragedy, and I do believe the death of Chris McCandless was tragic. It is tragic because he confused isolation with solitude. If one seeks escape for its own sake and runs away from the world only because it is intensely unpleasant, then one will not find peace and one will not find solitude. Chris McCandless seemed to be running away, away from people, friends, institutions, and most significantly from living in right relationship with others. He began to turn away from friendships and companions, to espouse unpopular causes and to speak out at every opportunity against oppression and government intervention. He set out on a journey of self-discovery and independence by traveling to the deserts of many states . He walked away from the comfortable surroundings of his home, his family, and his friends, intending to live a solitary life in the desert because he determined that mainstream society does not hold a place for him. And him who went "into the wild" on a journey of self-discovery and illumination, was particularly unique in the attempt to find himself in the wilderness because even he abandon everything such as money clothers and more he realized that he needed those in the deserts in order to survive. During his odyssey, McCandless met and lived with several people whom he considered to be friends. Although he rarely took their advice or accepted any material gifts from them, he seems to have left a lasting impression. To Ron he wrote the following: We just have to have the courage to turn against our habitual life style and engage in unconventional living . . . you don't need me or anyone else around to bring this

Multiple Sclerosis Essay -- Health Medical Medicine Essays

Multiple Sclerosis The primary objective of this paper is to raise fundamental questions in regards to multiple sclerosis, and to explore possibilities that attempt to answer these inquiries. Second, the prospective outcome is to provide a solid knowledge base for which my peers may begin to understand the relationship between multiple sclerosis and neurobiology and behavior. The first question to address in the general schema of this essay is: What is Multiple Sclerosis? Multiple Sclerosis also commonly referred to as MS is considered an autoimmune disease that affects the central nervous system (CNS). The key to understanding MS is to recognize its relationship to the human immune system. The immune system is an intricate network of specialized cells and organs that defends the body against attacks by foreign agents also known as antigens such as bacteria, viruses, fungi, and parasites. To the contrary, in the case of multiple sclerosis, the connection between the immune system and the body is interrupted when the immune system identifies itself, particularly the white matter of the central nervous system as a foreign body, and consequently destroys the myelin. The myelin is a fatty tissue composed of rich protein and lipids that protect and insulate the nerve fibers, which serve to carry out electrical impulses. The central nervous system is made up of the brain, spinal cord, and optic nerves; thusly MS affects several areas of the human anatomy. Multiple Sclerosis could be described as the loss of myelin in multiple locations throughout the body, which then exposes the nerve fibers and leaves scaring called sclerosis. The next question that should be addressed is: What are the principal functions of myelin? In... ...of living with this disease, instead of at its mercy. First, one needs to acknowledge the existence of the disease. Second, an individual should allow time to process the idea of living with the disease. Third, one should become an active agent in fighting the disease by becoming informed. Fourth, a person should be willing to make adjustments, which may alter one's lifestyle. In conclusion an individual should not be afraid of multiple sclerosis, but dare to live a fulfilling life. Bibliography 1)http://www.nationalmssociety.org 2)http://www.ninds.nih.gov/health_and_medical/pubs/multiple_sclerosis.htm 3)http://www.undestandingms.com/ms/articles/cognitive.asp For further information check out 4)http://web.lexis-nexis.com/universe/document?_ 5)http://www.docguide.com/news/content.nfs/NewsPrint/ 6)http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?

Condoleezza Rice Essay -- Biography Biographies Essays

Condoleezza Rice Not many people can add the position of National Security Advisor to their list of achievements, especially if those people are women. Condoleezza Rice, however, can place the accomplishment right up there with being a previous member of President Bush’s foreign-policy team, and tenured professor and provost in the political science department of the prestigious Stanford University. Rice is well known for her knowledge on Russian history and current events. After growing up in Birmingham, Alabama during a time of racial segregation, Rice soon went on to graduate from the University of Denver at the age of 19 (she skipped two grades), where she became an expert in the issues of the Soviet Union. She also received two advanced degrees in political science. With a master’s degree from the University of Notre Dame and a doctorate from the University of Denver’s Graduate School of International Studies, she soon found herself a provost and professor at Stanford, only to be drawn away by a life in politics. In Washington, D.C., Rice worked on nuclear strategic planning with the Council on Foreign Relations fellowship at the Joint Chiefs of Staff. After returning to Stanford, she soon found herself back in the political spotlight. President George Bush, in 1989, trusted Rice to the point of allowing her to aid in Russian policy and relations. Rice became the director of Soviet and East European affairs with the National Security Council, special assistant to the president for national security affairs and senior director for Soviet affairs in the National Security Council. In essence, Rice helped Poland receive needed reforms, as well as helped with policies between the United States... ...ck and female, the world suddenly takes notice. â€Å" There aren't too many females in this business, she was really an exception in this almost 100-percent-male crowd -- which may be one of the reasons she earned the reputation of being tough," said Sergei Rogov, director of the Russian Institute of U.S. and Canada Studies in Moscow, who has known Rice for nearly two decades. Condoleeza Rice has been a member on the boards of directors for the Charles Schwab Corporation, the William and Flora Hewlett Foundation, the Chevron Corporation, the University of Notre Dame, the International Advisory Council of J.P. Morgan and the San Francisco Board of Governors. She also has invested time working on various political books, such as â€Å"Germany Unified and Europe Transformed,† â€Å"The Gorbachev Era,† and â€Å"Uncertain Allegiance: The Soviet Union and the Czechoslovak Army.† Condoleezza Rice Essay -- Biography Biographies Essays Condoleezza Rice Not many people can add the position of National Security Advisor to their list of achievements, especially if those people are women. Condoleezza Rice, however, can place the accomplishment right up there with being a previous member of President Bush’s foreign-policy team, and tenured professor and provost in the political science department of the prestigious Stanford University. Rice is well known for her knowledge on Russian history and current events. After growing up in Birmingham, Alabama during a time of racial segregation, Rice soon went on to graduate from the University of Denver at the age of 19 (she skipped two grades), where she became an expert in the issues of the Soviet Union. She also received two advanced degrees in political science. With a master’s degree from the University of Notre Dame and a doctorate from the University of Denver’s Graduate School of International Studies, she soon found herself a provost and professor at Stanford, only to be drawn away by a life in politics. In Washington, D.C., Rice worked on nuclear strategic planning with the Council on Foreign Relations fellowship at the Joint Chiefs of Staff. After returning to Stanford, she soon found herself back in the political spotlight. President George Bush, in 1989, trusted Rice to the point of allowing her to aid in Russian policy and relations. Rice became the director of Soviet and East European affairs with the National Security Council, special assistant to the president for national security affairs and senior director for Soviet affairs in the National Security Council. In essence, Rice helped Poland receive needed reforms, as well as helped with policies between the United States... ...ck and female, the world suddenly takes notice. â€Å" There aren't too many females in this business, she was really an exception in this almost 100-percent-male crowd -- which may be one of the reasons she earned the reputation of being tough," said Sergei Rogov, director of the Russian Institute of U.S. and Canada Studies in Moscow, who has known Rice for nearly two decades. Condoleeza Rice has been a member on the boards of directors for the Charles Schwab Corporation, the William and Flora Hewlett Foundation, the Chevron Corporation, the University of Notre Dame, the International Advisory Council of J.P. Morgan and the San Francisco Board of Governors. She also has invested time working on various political books, such as â€Å"Germany Unified and Europe Transformed,† â€Å"The Gorbachev Era,† and â€Å"Uncertain Allegiance: The Soviet Union and the Czechoslovak Army.†

Heraldic Code of the Philippines Essay

â€Å"Don’t walk in front of me, I may not follow; don’t walk behind me, I may not lead; Just walk beside me, and be my friend†. I have one such good friend who walks beside me and who extends his hand, when I am about to slip and fall. He is my greatest asset in life, which I treasure more than anything else in this world. He is my best friend. My best friend is Tom Sangma. We come from the same neighbourhood. Our houses are situated close to each others. Both Tom and I are of same age and belong to more or less same economic background. In fact, what has cemented our friendship deep is that our families have been close to each other for a long time. My father and his father were classmates. My mother’s best friend is Tom’s mother. Another reason, which probably helped us to become good friends, is that we have grown together. We have spent our childhood days playing, fighting, learning, and enjoying together. My memory of sweet bygone days of the past is a nostalgic memory of happy days spent together in Tom’s company. Today Tom and I study in Class X in a reputed school in the town. We generally go to school together and have been lucky enough to be studying in the same class for the past ten years and more. Tom has many excellent qualities of heart and mind. His simplicity, smartness, neatness, intelligence, straightforwardness, cool temperament, pleasant behaviour, gentle ways, dutifulness, etc. have made him one of the most liked and popular students in the school. Tom’s sweet temperament is his greatest quality. He never hurts others or speaks ill of others. He has a charming personality. For several years consecutively, he has been given the ‘Best Student’ award in the school. Despite my best efforts I have never managed to reach his level. Yet I never feel jealous of him. Because he helps me more than anybody. He tries to do all he can to make me come up to his level. He never goes to any function or party or film without me. I do the same for him. Whenever I am sick, he is the first to come and see me. There is no function in my home without his presence. The same is true in his house as well. All these have combined to make our friendship deep and lasting. The best trait that I admire and like most in my friend is his disciplined life. He would not do anything that goes against accepted norms or decency. He gets up on time, does his homework always, attends school regularly, respects his teachers and elders and never indulges in unhealthy ways such as, smoking, taking alcohol, idling away time, skipping classes etc. His principle of ‘duty first- enjoyment second’ is something that I find difficult to follow, yet try to imitate. He corrects me whenever I commit any mistake. For me he is a source of inspiration, support and also a role model to imitate. I am ever grateful to the almighty for having given me such a good friend. I cherish it as my greatest treasure. I am sure our friendship will grow deeper and deeper in the years to come. I wish everyone had such friends in life. One cannot describe the thrill and the joy of journeying together in life, sharing its ups and downs, rainbows and thunders and Good Fridays and Easters. It has to be experienced.

Diagnosis On Stomach Cancer Survival Health And Social Care Essay

Stomach Cancer is one of the 20 most common malignant neoplastic diseases in the UK. Survival from tummy malignant neoplastic disease has been increasing in the past 30 old ages, nevertheless at that place remains to be survival differences between different socio-economic categories. The endurance in more disadvantaged categories has remained lower than endurance from the more flush categories ( this difference is known as the want spread ) and more so important in males. Methods: A complete dataset of 70370 malignant neoplastic disease patients that was formed from the malignant neoplastic disease register dataset and merged with Hospital Episode Statistics ( HES ) dataset. The extra jeopardy patterning attack was used ; utilizing the construct of flexible parametric patterning with restricted three-dimensional splines was used to predict net endurance from tummy malignant neoplastic disease. Consequences: The net endurance was found to differ between different want classs, where cyberspace endurance was lower in the most disadvantaged category and the highest in the most flush category. The net endurance was found to be higher in females than males and was found to be about twice every bit much in patients who had surgery. Decision: It was found that although net endurance about doubled in patients who had surgery, the want spread still remained. However farther analysis which include phase and class of malignant neoplastic disease would assist in placing whether this want spread is in fact important after taking into history such variables. Table of Contentss Care Form 53GlossaryDCO – Death Certificate Merely EHR – Excess Hazard Ratio FP – Fractional Polynomial GOR – Government Office Region HES – Hospital Episode Statisticss IMD – Index of Multiple Deprivation MAR – Missing At Random MI – Multiple Imputation TVC – Time changing constituent DF – Degrees of freedom ONS – Office of National Statistics HES – Hospital Episode Statisticss AIC – Akaike information standard BIC – Bayesian information standard1 Introduction1.1 Biology and Symptoms of Stomach CancerCancer is a disease which causes unnatural growing of cells which start to split and reproduce uncontrollably and in some instances these cells can metastasise. This growing in cells occurs many old ages before the malignant neoplastic disease can be detected. The cancerous cells lose legion indispensable control systems due to mutant in the cistrons of normal cells. When human cells reproduce, mutant can go on by opportunity, nevertheless a figure of different mutants occur before malignant neoplastic disease cells are formed. There are three cistrons which can do malignant neoplastic disease cells ; transforming genes ( besides known as ‘cancer cistrons ‘ which are unnatural and do the cells to multiply or duplicate ) , tumour suppresser cistrons ( cistrons which stop the cells multiplying nevertheless if damaged halt working hence cells become cancerous ) and DNA fix cistrons ( cistrons which repair other damaged cistrons nevertheless if damaged so mutants can non be repaired and therefore when the cell multiplies and divides it copies the mutants ) . ( 1 ) Stomach malignant neoplastic disease is the malignant neoplastic disease that occurs in the tummy and is besides known as stomachic malignant neoplastic disease. There are a figure of different types of tummy malignant neoplastic diseases. The most common type of tummy malignant neoplastic disease is known as glandular cancer of the tummy which starts in the secretory organ cells of the tummy liner, the secretory organ cells so produce stomach fluids and mucous secretion. Other types of tummy malignant neoplastic disease include ; Squamous cell malignant neoplastic diseases ; formed in the squamous cells ( skin cells that are between the secretory organ cells which form the tummy liner ) ( 2 ) . Lymphoma of the tummy ; really rare and is a different type of malignant neoplastic disease in which white blood cells ( lymph cells ) become cancerous cells and can non assist support the organic structure like normal white blood cells ( 2 ) . Gastrointestinal tummy tumor ( GIST ) ; a rare tumor which grows from the cells of the connective tissue which uphold the variety meats of the digestive ( GI ) piece of land and can be both cancerous and non-cancerous ) ( 2 ) . Neuroendocrine tumor ; are rare tumour which grows in the tissues that produce endocrines in the digestive system and can be cancerous and non-cancerous ( 2 ) . The early symptoms of tummy malignant neoplastic disease are non-specific and include dyspepsia, sourness and belch, experiencing full Oklahoman and hence ensuing in loss of weight, shed blooding in the tummy which can do anemia and hence doing fatigue and paler tegument. Other symptoms include purging, blood coagulums, hurting in the upper venters or hurting under the chest bone and trouble in get downing. Symptoms of the advanced phase of the malignant neoplastic disease, include blood in the stool and development of fluid in the venters ( 3 ) . There are no testing programme for tummy malignant neoplastic disease in the UK, nevertheless tummy malignant neoplastic disease is the most common malignant neoplastic disease in Japan and hence a showing programme is used which involves a Ba repast x-ray followed by endoscopy.1.2 Stomach Cancer Incidence, Survival & A ; MortalityCancer is a cardinal wellness issue in the UK, where a one-fourth of all deceases are due to malignant neoplastic disease and one in three people develop malignant neoplastic disease at any point in their lives. Cancer is more common in older people where more than 75 % of deceases occur in people over 65, nevertheless it can develop at any age. The incidence rate of malignant neoplastic disease has increased by 20 % in males and 40 % in females since the mid-1970 ‘s ( 4 ) . Stomach malignant neoplastic disease was found to be the 9th most common malignant neoplastic disease amongst work forces and the 14th most common amongst adult females in the UK in 2008 ( 5 ) . Around 7610 new instances of tummy malignant neoplastic disease were diagnosed in the UK in 2008, 4923 instances among work forces and 2687 in adult females with an overall incident rate of 8.6 per 100,000 individuals. In Britain the incidence rates for both males and females have more than halved ; from about 30 per 100,000 in 1975-1977 to about 13 per 100,000 in 2006-2008 in males, and from about 14 per 100,000 in 1975-1977 to about 5 per 100,000 in 2006-2008 ( 5 ) . The rate increased quickly for people above 60 old ages to about 140 per 100,000 in work forces and 67 per 100,000 in adult females aged 85 and over in 2008 ( 5 ) . Survival from tummy malignant neoplastic disease progressively progressed in patients diagnosed in 1996-1999 compared to patients diagnosed in 1971-1975, peculiarly due to quicker and earlier sensing and diagnosing, and betterment in intervention ( 6 ) . In England and Wales ; the one twelvemonth endurance more than doubled in patients diagnosed in 1996-1999 compared to 1971-1975. The 5 twelvemonth endurance were about three times higher in patients diagnosed in 1996-1999 compared to patients diagnosed in 1971-1975 ( 6 ) . The mortality rate of tummy malignant neoplastic disease decreased by about 70 % in both males and females over the last 30 old ages in the UK. The tendency of mortality was similar to the tendency of incidence as the mortality rate was found to be higher in males than females across the UK in 2008 ( 7 ) . The different types of intervention for tummy malignant neoplastic disease include surgery, radiation therapy, chemotherapy and biological therapy. Combinations of the interventions are besides normally used such as chemotherapy and surgery in state of affairss where it is non possible to take a localized malignant neoplastic disease wholly as it has spread and hence chemotherapy is used to first shrivel the malignant neoplastic disease plenty to surgically take it ( 8 ) .1.3 Hazard FactorsMore than 70 % of all tummy malignant neoplastic disease instances are diagnosed in developing states ( 9 ) . Older people, males and people belonging to the most disadvantaged socio-economic position have a higher hazard of tummy malignant neoplastic disease ( 10 ) . Other hazard factors include ; smoke, intoxicant, weight, household history, exposure to radiation, business and Helicobacter Pylori ( 10 ) . Helicobacter Pylori is a bacterial infection that has higher prevalence in developing states and in people who have a low socio-economic position. In a survey of instances in 2010, it was found that 32 % of tummy malignant neoplastic disease instances were associated with infection of the bacteria. In other surveies it has besides been found that get rid ofing Helicobacter pylori may help in forestalling tummy malignant neoplastic disease ( 10 ) . There is uncertainness about the association of holding tummy malignant neoplastic disease and an unhealthy diet. A few surveies have found that a higher consumption of fruits and veggies is associated with cut downing the hazard of tummy malignant neoplastic disease, nevertheless other surveies such as the EPIC survey found that a Mediterranean diet reduces the hazard of tummy malignant neoplastic disease. Another survey found that pickled veggies increase the hazard of tummy malignant neoplastic disease in Nipponese and Koreans ( 10 ) . Family history of tummy malignant neoplastic disease increases the hazard of acquiring the disease, nevertheless some of this addition may be environmental, as some surveies showed grounds of increased hazard in partners of patients ( 10 ) . The EPIC survey found that physical activity reduced the hazard of tummy malignant neoplastic disease and have a protective consequence, nevertheless other surveies provide no grounds of such and hence farther research needs to be carried out to supply important grounds ( 10 ) .1.4 Socio-economic InequalityThe endurance between want classs varies well for tummy malignant neoplastic disease ; with flush patients holding higher endurance rates compared to strip patients as shown from a figure of surveies worldwide. Mitry et Al. ( 11 ) analysed tummy malignant neoplastic disease informations from England and Wales malignant neoplastic disease registers and found a statistically important ‘deprivation spread ‘ ( i.e. the difference in endurance between flush and disadvantaged categories of patients ) in survival analysis in work forces diagnosed between1986-1999. Another survey carried out in the Netherlands found that the hazard of deceasing was lower after seting for possib le confounders in flush patients compared to deprived patients ( 12 ) . A survey in Japan besides looked at the association between socio-economic position and tummy malignant neoplastic disease endurance by analyzing the endurance of patients by their business. There was grounds of disparity in endurance by business after seting for possible confounders and this was chiefly due to ulterior diagnosing of tummy malignant neoplastic disease amongst the lower businesss ( 13 ) . The want spread in endurance has widened for male patients diagnosed in the 1996-1999 compared to those diagnosed in 1986-1990. Mitry et Al. ( 11 ) showed that the want spread for both annual endurance and five-year endurance has widened steadily and significantly from 1986 to 1999 for tummy malignant neoplastic disease and that that the want spread in work forces is likely to go on broadening. In England There were grounds of socioeconomic inequality in tummy malignant neoplastic disease incidence, it was reported that incidence remained unchanged in the flush groups, nevertheless incidence decreased by 31 % in deprived work forces and by 47 % in disadvantaged adult females higher in West Midlands, England between 1986-2000 ( 14 ) . Many suggestions were put frontward to explicate the beginning of the want spread in malignant neoplastic disease endurance, and three chief factors were suggested ; phase of diagnosing, biological features of the malignant neoplastic disease, host factors and consequence of intervention, psychosocial factors, and intervention received, medical expertness and malignant neoplastic disease showing ( 15 ) .1.5 Aims & A ; AimsThe net ( comparative ) endurance in a population of malignant neoplastic disease patients is their endurance from the malignant neoplastic disease of involvement in the absence of other causes of decease. The comparing of net endurance in the UK by want class suggests a important broadening want spread in males ( 11 ) . The purpose of this undertaking is to look into whether the widening want spread in work forces was due to work forces in the deprived group non profiting from healing surgery. The phase at diagnosing will besides be studied to look into the possibility of deprived work forces diagnosed at a ulterior phase compared to affluent work forces. Datas from the eight regional malignant neoplastic disease Registries of England over the period 1997-2006 will be examined. This dataset will be linked to the Hospital Episode Statistics from which information on intervention will be derived, to analyze survival tendencies and estimate net endurance of patients with tummy malignant neoplastic disease after seting for sex, age, want spread, intervention and phase of disease at diagnosing. Net endurance will be estimated utilizing an extra jeopardy theoretical account. From the extra jeopardy theoretical account, all cause mortality will be modelled as the amount of the extra ( cancer-related ) mortality jeopardy and the expected ( background ) mortality. Net endurance will hence be calculated as the ratio of the observed ( all cause ) endurance to the expected ( background ) endurance. The background mortality/survival will be defined utilizing life tabular arraies from the general population. The life tabular arraies will be merged utilizing age, sex, twelvemonth of issue, GOR ( Government Office Regions ) and want class to the malignant neoplastic disease dataset. Net endurance by want class will foremost be estimated to find if there is any grounds of socio-economic inequality in malignant neoplastic disease endurance in the analysed period 1997-2006. An analysis will so be carried out, seting for confounders such as age, sex, intervention, and phase of malignant neoplastic disease.2 Materials and methodsThis chapter will supply description of the informations used in the undertaking and the statistical methods applied to predict net endurance from tummy malignant neoplastic disease by want category. The construct of flexible parametric patterning with restricted three-dimensional splines will be used to take into history differences in mortality by age, sex and intervention are discussed in item. All statistical analysis was carried out utilizing STATA 12.1 ( 16 ) .2.1 DatasThe UK is known to hold the most extensive/complete malignant neoplastic disease enrollment systems in the universe ( 17 ) . Presently there are eight malignant neoplastic disease registers in England. The malignant neoplastic disease registers in England collect information on clinical informations such as phase and type of malignant neoplastic disease, decease certifications which are forwarded by the Office of National Statistics ( ONS ) and demographic information such as day of the month of birth, day of the month of diagnosing, sex ( 18 ) . Information such as the malignant neoplastic disease class, phase and intervention are largely uncomplete. furthermore information on infirmary admittances and co-morbidity is frequently unavailable. Further information on malignant neoplastic disease patients can be obtained from the Hospital Episode Statistics ( HES ) . The HES is a database apparatus to include informations and information on all admittances in NHS infirmaries since 1989. Since 2003, the HES database has besides included and stored information on outpatients. The information in the HES are extracted from clinical instance notes. clinical instance notes include more elaborate descriptions of the clinical informations such as class and phase of malignant neoplastic disease at diagnosing, intervention received and co-morbidity. The malignant neoplastic disease register and HES database can be merged ( 19 ) utilizing the patients NHS figure and cardinal information day of the month of birth. Once the malignant neoplastic disease register and the HES database are combined, an independent cheque on the quality of the information is carried out every bit good as betterment in the completeness of the informations aggregation ( 19 ) . The patients acknowledged through decease certifications are followed up by their enrollment officers from their several regional malignant neoplastic disease registers to happen out the topographic point of intervention and therefore the patients ‘ infirmary & A ; instance notes. However this is non equal for some patients as they may non hold been provided any secondary attention ( hospitalization/clinics ) and therefore these patients are referred as decease certification merely ( DCO ) ( 20, 21 ) . Analysiss will be carried out on anon. informations from the eight malignant neoplastic disease registers in England on tummy malignant neoplastic disease diagnosed during 1997-2006. The patients identified suited for the analyses were merged in progress with their several patient records from the HES database from which information on intervention was extracted. Demographic information which included day of the month of birth, sex, Government Office Region ( GOR ) , day of the month of malignant neoplastic disease diagnosing and morphology were given for each patient. Information on the abode ZIP code at diagnosing and critical position ( dead, alive or emigrated ) were found from the Office of National Statistics for each patient. However as there was no information available the socio-economic position of each malignant neoplastic disease patient, utilizing the ZIP code ; the abode at diagnosing of each malignant neoplastic disease patients was identified and hence a want mark based on the abode was allocated to each patient. Five want classs ( from 1 ‘most affluent ‘ to 5 ‘most deprived ‘ ) were classified utilizing the income sphere mark of the 2004 Index of Multiple want ( IMD2004 ) and each patient was hence assigned to their several class based on their want mark. The IMD is based on everyday administrative informations of the 34,378 Lower Super-Output Areas ( LSOAs ) in England. Carstairs index ( 22 ) was the index used antecedently. Comparing the IMD mark to the Carstairs mark, the IMD is based on a smaller geographical country and is non based the nose count informations and therefore can be updated on a regular basis without transporting out a new nose count. The IMD is normally updated every 3-4 old ages.2.2 Statistical Methods2.2.1 Relative Survival and Excess MortalityNet endurance can be used to mensurate malignant neoplastic disease mortality straight. It can besides be used to mensurate extra mortality of malignant neoplastic disease patients compared to the general population. Net endurance can be estimated utilizing cause specific or extra mortality. Net endurance utilizing the cause-specific attack can be used by measuring the cause of each decease, merely the deceases attributed to the malignant neoplastic disease are considered and all other causes of deceases are censored. The major disadvantage is that there is a strong dependance on the quality of decease records. Cause-specific endurance can be used to mensurate malignant neoplastic disease mortality straight and uses inside informations of all deceases, nevertheless the cause of decease in this instance is malignant neoplastic disease and is used in the malignant neoplastic disease mortality. This method requires the cause of decease to be accurate and exactly specified, nevertheless the cause of decease is non given in most instances. Indirect deceases such as deceases due to route accidents or deceases due to side-effects of medications/treatment alongside deceases due to malignant neoplastic disease are hard to sort. Furthermore, different diagnosticians will specify cause of decease otherwise depending on the state of affairs at clip of decease hence cause of decease may non be right defined. There are two methods of appraisal of the cause specific attack are Kaplan-Meier method and the Acturial method. Excess mortality is a method which accounts for malignant neoplastic disease mortality straight and indirectly without necessitating an accurate and precise specification of the cause of decease ( 23 ) . The extra mortality is derived as the difference in the ascertained mortality ( mortality due to all causes ) and expected mortality ( mortality due to non-cancer-related causes ) . Both extra mortality methods estimation malignant neoplastic disease mortality after seting for background mortality from assorted other causes and hence presumptively should give similar values. In world nevertheless this depends on how suitably premises are fulfilled for each several method, chiefly accurately documenting and stipulating the cause of decease for the cause-specific method and the truth of gauging the expected mortality for the extra mortality method ( 23 ) . Excess mortality is classified mathematically utilizing the jeopardy map at clip since diagnosing as. The jeopardy map is equal to the amount of the extra jeopardy due to stomach malignant neoplastic disease diagnosing and the expected jeopardy ( sometimes known as the baseline jeopardy, estimated utilizing external informations from the general population ) where is the covariates vector ( 24 ) . Equation ( 1 ) Net endurance ( Relative endurance ) is the survival corresponding to extra mortality, and is derived as the ratio of the ascertained endurance of the malignant neoplastic disease patients to the expected endurance estimated from the general population utilizing life tabular arraies. Equation ( 1 ) may therefore equivalently be written in footings of net/relative endurance as Equation ( 2 ) where and are the cumulative observed and expected endurance severally. The relation between the jeopardy map and expected jeopardy and cumulative observed and expected endurance severally, is given by and, and the net/relative endurance is so given as. ( 24 ) The jeopardy is assumed to be piecewise changeless over of follow-up clip ( changeless over little clip intervals ) in pattern and hence a short period such as a twelvemonth or less might be used at the start of the followup. If a longer period is used so the changeless jeopardy premise is violated and clip since diagnosing is non automatically adjusted for and is hence the uninterrupted map may be modelled as a measure map. A new covariate vector is derived by adding the covariate vector with the index variables where the index variables are generated for all intervals apart from the mention interval. A multiplicative map of the covariates in the signifier of is assumed to be the extra jeopardy and therefore equation ( 1 ) becomes Equation ( 3 ) or instead Equation ( 4 ) where the parametric quantity estimates when exponentiated can be inferred as extra jeopardy ratios ( EHRs ) . The jeopardies are assumed to be relative implicitly in equation ( 3 ) . By Introducing interaction footings of the follow-up clip and covariates in the theoretical account can be used for patterning non-proportional jeopardies. Excess mortality can be estimated utilizing assorted different methods, Different methods exist for gauging extra mortality, either utilizing a full likeliness attack ( 25 ) , or based on sorted informations incorporating one observation for each life table interval within a generalised additive theoretical account ( 25, 26 ) . Life tabular arraies provide information on endurance and give the chance of decease in the general population stratified by age, calendar twelvemonth, sex, want and authorities office part ( GOR ) . The life tabular arraies in England are based on the nose count informations and are hence updated every 10 old ages to demo alterations in life anticipation. In the analysis carried out for this undertaking the life tabular array used is stratified by sex, age, GOR, twelvemonth of issue, and IMD quintile. The Life tabular arraies from 1981-2010 were used. Life tabular arraies are based on mortality in the general population, which include the mortality due to stomach malignant neoplastic disease, but because decease due to malignant neoplastic disease is little compared to the general population, it does non impact net/relative endurance estimations in pattern Ederee et Al. ( 27 ) . The stpm2 bid in STATA was used to foretell comparative endurance. The timescale and failure were declared utilizing the stset bid, and the clip beginning for the analysis was taken to be the day of the month of diagnosing of each topic. The timescale was calculated in old ages and the extra mortality was modelled as the primary result of involvement as suggested in ( 23 ) .2.2.2 SplinesFrequently complex non-linear effects from uninterrupted variables e.g. age are modelled in arrested development theoretical accounts. There are many improved methods of patterning complex and non-linear effects. Splines is an easy manner of including an explanatory variable in a smooth non-linear manner. Mathematical maps which are sections of multinomials and joined together at points called knots are known as splines. To do the spline smooth, A figure of restraints which include limitations on the mathematical derived functions of the spline map are applied between next multinomial sections so that the curve is smooth at the knot. In general, splines can be generated utilizing multinomials of any grade. However three-dimensional splines are frequently used, in which each section can be written as a three-dimensional multinomial as three-dimensional multinomials normally model most curves right and are computationally easy to obtain. The smoothness status for a three-dimensional spline means that the spline map is uninterrupted i.e. the first and 2nd derived functions are uninterrupted everyplace and there are no leaps or interruptions in the spline. A three-dimensional spline with K knots may be derived mathematically in footings of K+4 parametric quantities in general as ( 28 ) : where the notation classifies the incline map, where if, and if and the knots are at places severally. Cubic splines behave ill at the dress suits when fitted to informations is less and the spline map may be susceptible to extreme value. A subset of three-dimensional splines where the spline map is additive before the first knot and after the last knot are known as restricted splines ( 28 ) . A restricted three-dimensional spline can be specified by K-1 parametric quantities for K figure of knots which is 5 less than a general three-dimensional spline. where the is defined as: With a logarithmically transformed clip variable, restricted splines are normally used to pattern the extra jeopardy. Knots can be anyplace on the log-outcome clip distribution, where the boundary knots at the first and last log-outcome clip.2.2.3 Flexible Parametric Survival ModelsRoyston and Parmar ( 29 ) foremost introduced flexible parametric theoretical accounts in the position of censored endurance informations. This method of patterning informations gave more flexibleness to the form of the jeopardy map in comparing to other parametric theoretical accounts e.g. the Weibull theoretical account for which the signifiers of the jeopardy map are limited. The flexible parametric theoretical accounts do non necessitate numerical incorporation and hence a cardinal advantage of such theoretical accounts is comparatively fast calculations. ( 30 ) The Cox theoretical account is the most common method of covering with censored informations, nevertheless flexible parametric theoretical accounts can cover with non-proportional jeopardies more expeditiously. In flexible parametric endurance theoretical accounts, clip is treated as a uninterrupted variable and hence unlike piecewise approaches the demand of dividing the time-scale is non needed ( 24, 26 ) . The big Numberss of excess parametric quantities which are required to be created so that time-dependent effects are incorporated in the piecewise attack are hence non required in this modeling attack and hence this reduces the computational clip and uses less computing machine memory particularly for big datasets. Alteration of the flexible parametric theoretical accounts have since been done for comparative endurance theoretical accounts ( 30, 31 ) A parametric theoretical account is defined as a theoretical account which can be identified in footings of a fixed set of parametric quantities ( , , †¦ ) . Restricted three-dimensional splines are fitted to the estimations of the log baseline jeopardy in a flexible parametric net/relative endurance theoretical account ( 30 ) . Equation ( 6 ) Transforming to the endurance graduated table Equation ( 7 ) where is the restricted three-dimensional spline map of with knots, and is the cumulative overall jeopardy. The log-likelihood map is obtained utilizing equation ( 6 ) and numerical methods are used to gauge the parametric quantities which give upper limit likeliness utilizing equation. Thus the endurance and hazard maps can be analytically estimated.2.2.4 Evitable DeathsA manner of infering extra hazard ratios is by ciphering evitable deceases ( 32-34 ) . The figure of evitable deceases is the figure of deceases due to stomach malignant neoplastic disease which could be avoided if the net endurance in all socio-economic classs would be the same as that of the most flush class after seting for the different features of each class. The expected figure of deceases due to all causes amongst a specific group of patients utilizing equation ( 2 ) is: where N is the size of the population, is the expected endurance at clip T and is the net endurance of the concerned group at clip T. In the general population, the predicted figure of all-cause deceases in a matched group is:.The premise of net endurance being the same as in a population being compared to is made ( in this instance the least disadvantaged ( flush ) category ) to deduce evitable deceases. The figure of evitable deceases are calculated by deducting the predicted figure of deceases due to all causes given the new comparative endurance from the predicted figure of deceases due to all causes given the original comparative endurance. The figure of â€Å" evitable † deceases represents postponed deceases which will happen subsequently and hence are really variable with the follow-up clip.2.3 Statistical AnalysisTo transport out the statistical analysis, informations were examined to vouch it ‘s dependability. Consistency cheques were besides carried to do certain informations was placed in the needed scopes. Datas from the Hospital Episode Statistics ( HES ) database were merged with the malignant neoplastic disease register informations, and information on intervention was obtained. patients whose records could non be matched to the HES database were excluded. Patients who had losing informations on variables such as GOR or IMD mark ( used to deduce want classs ) , which were used in unifying with the general population life tabular array to gauge the net endurance were besides excluded from the analysis. The patient distributions were examined by the chief explanatory variables on the information. To happen differences in want class, cross-tabulations of other variables ( such as intervention, GOR and malignant neoplastic disease registers etc. ) by want category were carried out. Net endurance by want category was estimated utilizing a flexible parametric theoretical account. This theoretical account did non affect any variables with losing informations and the stpm2 bid in STATA was used to cipher predicted net endurance. Expected chances of decease were estimated by unifying the life tabular arraies stratified by age, sex, want and GOR and twelvemonth of issue, to the malignant neoplastic disease dataset ( formed of HES merged with the malignant neoplastic disease register informations ) . The method of flexible parametric theoretical accounts utilizing restricted three-dimensional splines was used, as this method was computationally less ambitious and less clip consuming and a more accurate method of analysis. Using flexible parametric patterning with splines, interaction footings were fitted in the theoretical account. As extra mortality was predicted to differ non-linearly with age, hence interaction footings for age with splines were besides introduced. To prove the rightness of this method of analysis, both in footings of the procedure of utilizing splines and besides presenting the interaction footings of the theoretical account. Net endurance for up to 10 old ages was estimated and predicted by want category, seting for sex, intervention and age group. A new variable dividing the age with 5 splines was so created and used to do dummy variables for the restricted three-dimensional age splines variables. A restricted three-dimensional spline with 5 knots was used. To let for non-proportionality in the extra jeopardy for both twelvemonth ( twelvemonth of diagnosing ) spline and age spline variables, dummy variables for the interaction between both variables were generated. A figure of flexible parametric theoretical accounts were fitted for males and females individually. The first theoretical account was fitted with want and chief confounders such as the age splines and twelvemonth ( twelvemonth of diagnosing ) splines. A 2nd theoretical account with interactions between age splines and twelvemonth ( twelvemonth of diagnosing ) splines every bit good as utilizing all the variables from the first theoretical account. The 3rd theoretical account was fitted by including intervention ( as the association between intervention and want class was to be examined particularly in patients who had surgery ) in the best adjustment theoretical account out of the first two theoretical accounts. The theoretical accounts were re-fitted with clip changing effects with age merely and so with both age and clip of diagnosing. These theoretical accounts were compared for the best of tantrum utilizing the likeliness ratio trial. To happen out which grades of freedom ( DF ) for the baseline jeopardy produced the better adjustment theoretical account, the best adjustment theoretical account without the clip changing effects was fitted with 1 to 5 DF and so compared utilizing Akaike information standard ( AIC ) and Bayesian information standard ( BIC ) . The best fitting theoretical account with the DF for the baseline jeopardy was chosen to be the 1 with the smallest AIC and BIC. The same method was used to make up one's mind which DF for the varying effects was best used for the best fitting clip changing effects theoretical account. The scrutiny of evitable deceases was carried out to gauge and foretell the figure of evitable deceases at 1 and 5 old ages if endurance was the same in all want classs as the most flush class.3 Consequences3.1 Description of the malignant neoplastic disease register informationsFor the analyses to be carried out, a sum of 70,370 patients who were diagnosed with tummy malignant neoplastic disease during the period of 1997-2006, and were linked to the HES database. From the entire figure of patients, 1729 ( 2.46 % ) patients were registered via their decease certification merely ( DCO ) or had zero endurance ( day of the month of decease was the same as the day of the month of diagnosing ) . Zero endurances were included in the analysis by adding one twenty-four hours to the day of the month of decease, as excepting them would overrate the endurance, nevertheless it is known that DCOs seldom have a confirmed day of the month of diagnosing ( 21 ) . Of the entire figure of tummy malignant neoplastic disease patients, 45,580 ( 64.77 % ) were work forces and 24,790 ( 35.23 % ) of the patients were adult females. Table shows the figure of tummy malignant neoplastic disease instances by GOR. The largest absolute figure of tummy malignant neoplastic disease patients was in the North-West part and the smallest being in the North East part. Table: Proportion of tummy malignant neoplastic disease patients by Government Office Region Government office part Number ( % ) of patients North East ( A ) 5,157 ( 7.33 ) North West ( B ) 11,615 ( 16.51 ) Yorkshire and The Humber ( D ) 8,710 ( 12.38 ) East Midlands ( E ) 6,278 ( 8.92 ) West Midlands ( F ) 8,461 ( 12.02 ) East of England ( G ) 7,027 ( 9.99 ) London ( H ) 7,508 ( 10.67 ) South East ( J ) 8,878 ( 12.62 ) South West ( K ) 6,736 ( 9.57 ) The proportion of males to females and average age of tummy malignant neoplastic disease diagnosing were similar across all want categories, the highest mean age at diagnosing in the in-between want class ( 73.3 old ages ) and the lowest amongst the most disadvantaged group and the flush group ( 72.4 old ages ) , nevertheless this difference in mean age at diagnosing was non that large amongst want categories. The spread for age amongst all want categories was found to be similar due to the lopsidedness and standard divergence. The proportions of topics coming from each GOR by want category differed mostly. Figure: Percentage of patients by want categoryA clear monotonically increasing form was found in the per centum of people by want category, where there was a lower per centum of patients from the flush category and a higher per centum of patients from the disadvantaged category as shown in Figure 1. Figure: Percentage of patients having no intervention A tendency was seen in intervention. Figure 2 shows that the most disadvantaged group were less likely to have any signifier of intervention. The tendency in the per centum of patients having any intervention including surgery was found to back up the consequences from Figure 2, where the per centum of patients from flush to the most disadvantaged were 34.63 % , 34.30 % , 33.74 % , 33.02 % and 32.79 % severally. Table: Distribution of patients by Sexual activity Males Females Entire VariablesNitrogen%Nitrogen%Nitrogen%45,580 64.77 24,790 35.23 70370 100 Age group ( old ages ) 15-44 1,020 2.24 706 2.85 1,726 2.45 45-54 2,760 6.06 1,072 4.32 3,832 5.45 55-64 7,277 15.97 2,663 10.74 9,940 14.13 65-74 14,990 32.89 6,087 24.55 21,077 29.95 75-84 14,992 32.89 9,031 36.43 24,023 34.14 85-100 4,541 9.96 5,231 21.10 9,772 13.89 Want 1-least deprived 7,033 15.43 3,497 14.11 10,530 14.96 2 8,169 17.92 4,226 17.05 12,395 17.61 3 9,241 20.27 5,160 20.81 14,401 20.46 4 10,399 22.81 5,723 23.09 16,122 22.91 5-most deprived 10,738 23.56 6,184 24.95 16,922 24.05 Treatment Surgery merely 7,718 16.93 4,347 17.54 12,065 17.15 Chemo merely 6,266 13.75 2,114 8.53 8,380 11.91 Radio merely 233 0.51 112 0.45 345 0.49 Surgery, wireless 135 0.30 77 0.31 212 0.30 Surgery, chemo 1,688 3.70 731 2.95 2,419 3.44 Chemo, wireless 114 0.25 37 0.15 151 0.21 Surgery, chemo, wireless 45 0.10 13 0.05 58 0.08 No intervention 29,381 64.46 17,359 70.02 46,740 66.42 Site C160 13,932 30.57 4,520 18.23 18,452 26.22 C161 643 1.41 290 1.17 933 1.33 C162 1,133 2.49 600 2.42 1,733 2.46 C163 2,276 4.99 1,746 7.04 4,022 5.72 C164 1,059 2.32 812 3.28 1,871 2.66 C165 3,268 7.17 1,688 6.81 4,956 7.04 C166 1,227 2.69 686 2.77 1,913 2.72 C168 460 1.01 250 1.01 710 1.01 C169 21,582 47.35 14,198 57.27 35,780 50.85 Government Office Region ( GOR ) A 3,223 7.07 1,934 7.80 5,157 7.33 Bacillus 7,367 16.16 4,248 17.14 11,615 16.51 Calciferol 5,466 11.99 3,244 13.09 8,710 12.38 Tocopherol 4,182 9.18 2,096 8.46 6,278 8.92 F 5,669 12.44 2,792 11.26 8,461 12.02 Gram 4,746 10.41 2,281 9.20 7,027 9.99 Hydrogen 4,745 10.41 2,763 11.15 7,508 10.67 Joule 5,802 12.73 3,076 12.41 8,878 12.62 K 4,380 9.61 2,356 9.50 6,736 9.57 Cancer Registry North & A ; York 7,455 16.36 4,431 17.87 11,886 16.89 Trent 5,277 11.58 2,799 11.29 8,076 11.48 East Anglia 3,148 6.91 1,474 5.95 4,622 6.57 Thames 9,368 20.55 5,202 20.98 14,570 20.70 Oxford 1,815 3.98 1,002 4.04 2,817 4.00 South & A ; West 5,876 12.89 3,063 12.36 8,939 12.70 West Midlands 5,975 12.43 2,790 11.25 8,456 12.02 North West & A ; Mersey 6,975 15.30 4,029 4.029 11,004 15.64 From Table 2, it can be clearly seen that the proportion of males and females were similar in the two youngest age group classs, nevertheless the proportion of males was more in the in-between two classs and the proportion of females was more in the oldest two classs. The distribution of the proportion of males and females was similar for all want, intervention, GOR and malignant neoplastic disease register classs. The proportion of males was about twice every bit many as females for site C160 and the proportion of females was more compared to males for site C169, nevertheless the proportion of males and females were similar for all other sites. A important factor in finding endurance is intervention, hence a trial was carried out to see if there was any difference between want classs in the proportion having any intervention compared to those non having intervention, and in the proportion having intervention affecting surgery compared to those undergoing no surgical intervention. Two logistic arrested development theoretical accounts were hence carried out, one for the proportion having any intervention and the other for the proportion having surgical intervention by want class, seting for age and twelvemonth of diagnosing, individually for males and females. After seting for confounder, the odds of acquiring any intervention for females in the most disadvantaged class were 0.88 times less than in the flush class ( p-value 0.009 ) . There was no difference in the odds of intervention in males between want classs. After seting for confounders, the odds having surgical intervention in males from the more disadvantaged classs was 1.18 times more than in the flush class ( p-value & lt ; 0.001 ) and no difference in the odds of having surgical intervention in females between want classs. The average age at diagnosing was 72.92 old ages. The mean overall follow-up clip of 1.57 old ages as shown in table 3. The per centum of patients who died by the terminal of the follow-up period was found to be 91.64 % of patients. Table 3 shows the average follow-up clip ( the norm clip until stomach malignant neoplastic disease patients are dead or censored ) and the per centum of those who died stratified by age group, want category and intervention. A really little difference was found in both overall mean follow-up clip and the proportion dead by the terminal of followup between males and females. The average follow-up clip was longer and the proportion of patients deceasing by the terminal of the followup was lower in younger topics. The average follow-up clip was longer and the proportion of patients deceasing was lower in the patients belonging to the most flush class, with both results demoing an diminishing tendency by diminishing want category. The average follow-up clip of patients having surgery, with either or both radiation therapy and chemotherapy, was longer than those patients who did non have surgery and the proportion death by the terminal of followup was smaller. This was chiefly due to the fact that chemotherapy and radiation therapy interventions were carried out on patients at the ulterior phases of the malignant neoplastic disease, whereas surgery was carried out earlier phase, nevertheless this may propose that patients who underwent surgery had a better endurance. Variable Average followup ( old ages ) % dead by the terminal of followupMaleFemaleOverallMaleFemaleOverall1.58 1.56 1.57 91.74 91.45 91.64 Age group ( old ages ) 15-44 2.63 2.95 2.76 80.39 74.50 77.98 45-54 2.47 2.55 2.49 83.62 80.78 82.83 55-64 2.25 2.51 2.32 85.83 82.58 84.96 65-74 1.76 1.99 1.83 90.43 97.93 89.70 75-84 1.13 1.29 1.19 95.96 94.59 95.44 85-100 0.62 0.64 0.63 99.10 99.14 99.12 Want 1-least deprived 1.76 1.80 1.77 89.95 89.33 89.74 2 1.65 1.58 1.63 91.46 90.91 91.27 3 1.56 1.52 1.54 92.14 91.98 92.08 4 1.48 1.50 1.49 92.36 91.94 92.22 5-most deprived 1.53 1.48 1.51 92.18 92.12 92.16 Treatment Surgery merely 3.41 3.70 3.52 77.52 74.76 76.53 Chemo merely 1.58 1.48 1.55 94.14 94.80 94.31 Radio merely 1.70 1.40 1.60 90.56 91.07 90.72 Surgery, wireless 3.82 4.67 4.13 76.30 61.04 70.75 Surgery, chemo 3.26 3.25 3.26 81.46 80.85 81.27 Chemo, wireless 1.84 2.02 1.89 92.11 89.19 91.39 Surgery, chemo, wireless 3.13 3.27 3.16 86.67 84.62 86.21 No intervention 0.99 0.94 0.97 95.64 95.82 95.71 Table 3: Average follow-up clip and % of patients who were recorded as holding died by the terminal of the follow-up period by sex3.2 Consequences from the more complex analysisThe simple flexible parametric theoretical account was fitted with want, age splines and twelvemonth splines variables. The grades of freedom for the baseline jeopardy were chosen utilizing the AIC and BIC consequences from Table 4. Table 4: Degrees of freedom for Baseline jeopardy and their AIC/BIC Baseline Hazard DF Model DF AIC BIC Male 1 16 92327.50 92467.13 2 17 87329.59 87477.95 3 18 86419.88 86576.97 4 19 86097.21 86263.03 5 20 85890.83 86065.38 Female 1 16 44135.45 44265.34 2 17 41201.07 41339.08 3 18 40783.54 40929.67 4 19 40686.45 40840.69 5 20 40568.31 40730.67 From Table 4, it can clearly be seen that the theoretical accounts fitted with 5 grades of freedom for the baseline jeopardy give the smallest AIC and BIC for both males and females and hence provide a better tantrum for the theoretical account. Although it seems best to utilize 5 DF for the baseline jeopardy, 3 DF will be used as the theoretical accounts with 5 DF are computationally intensive when clip changing effects are included. Table 5: Net endurance by want class at 1, 5 and 10 old ages unadjusted for intervention for males and females individually Net enduranceMalesFemales1-year endurance Most flush 0.36 0.38 2 0.34 0.35 3 0.33 0.34 4 0.32 0.33 Most disadvantaged 0.32 0.33 5-year endurance Most flush 0.16 0.19 2 0.14 0.16 3 0.13 0.16 4 0.12 0.15 Most disadvantaged 0.12 0.15 10-year endurance Most flush 0.12 0.15 2 0.10 0.12 3 0.10 0.12 4 0.09 0.11 Most disadvantaged 0.09 0.11 Consequences from the estimation of cyberspace endurance up to 1, 5, and 10 old ages after diagnosing, unadjusted for intervention, are shown in Figures 3-8 for males and females individually, and showed that there was a suggestion of a additive tendency across the want groups. Between the five want groups, 1-year predicted net endurance ranged from 0.32 to 0.36 for males and 0.33 to 0.38 for females. The 5-year predicted net endurance ranged from 0.12 to 0.16 for males and 0.15 to 0.19 in females. The 10- twelvemonth predicted net endurance ranged from 0.09 and 0.12 for males and 0.11 to 0.15 for females ( Table 5 ) . In general, the predicted cyberspace endurance scope had a somewhat higher lower limit and upper limit for females than males bespeaking that the predicted cyberspace endurance was overall better/higher in females than males. The estimated difference in endurance was 0.04 in males and 0.05 in females between the most flush and the most disadvantaged groups at one twelvemonth after diagnosing. At five old ages after diagnosing the estimated difference in endurance between the two groups was the same for males but decreased to 0.04 for females. A clear additive tendency was seen between one and five old ages after diagnosing. The tendency between the least disadvantaged and most disadvantaged classs remained up to ten old ages after diagnosing, although at ten old ages the endurance of the two most disadvantaged classs was the same. Table 6: Excess jeopardy ratio ( EHR ) of decease, adjusted for age and twelvemonth of diagnosing for males and females individually without seting for intervention and clip varying effects for patients diagnosed with tummy malignant neoplastic disease during 1997-2006 in England Males FemalesEHRP-value95 % CIEHRP-value95 % CIWant 1-Least deprived Baseline––Baseline––2 1.046 0.014 ( 1.009, 1.084 ) 1.072 0.006 ( 1.020, 1.128 ) 3 1.076 & lt ; 0.001 ( 1.039, 1.114 ) 1.082 0.001 ( 1.031, 1.136 ) 4 1.117 & lt ; 0.001 ( 1.079, 1.155 ) 1.118 & lt ; 0.001 ( 1.066, 1.172 ) 5-most deprived 1.142 & lt ; 0.001 ( 1.103, 1.181 ) 1.143 & lt ; 0.001 ( 1.091, 1.197 ) Splines 1 3.389 & lt ; 0.001 ( 3.349, 3.428 ) 3.383 & lt ; 0.001 ( 3.331, 3.436 ) 2 1.242 & lt ; 0.001 ( 1.230, 1.254 ) 1.262 & lt ; 0.001 ( 1.246, 1.278 ) 3 1.107 & lt ; 0.001 ( 1.101, 1.113 ) 1.098 & lt ; 0.001 ( 1.090, 1.106 ) Table 6 shows a comparing of the consequences of the flexible theoretical accounts for males and females individually. Comparing the consequences of males and females, the extra jeopardy ratio ( EHR ) of decease by want class was higher in general for females, although both analyses gave a additive tendency in EHR by want. For both males and females, the EHR of decease by want was statistically important indicating that the EHR differed for each want class compared to the most flush class. Therefore more disadvantaged groups had a higher extra mortality due to malignant neoplastic disease compared to the less disadvantaged groups. Age and twelvemonth of diagnosing were modelled as a non-linear effects, and were important in for the first three age splines for both males and females and were important for twelvemonth spline 1 and 4 in males and twelvemonth splines 1 & A ; 2 in females. Figure: Internet endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for males diagnosed with tummy malignant neoplastic disease during 1997-2006 in England. Figure: Internet endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for females diagnosed with tummy malignant neoplastic disease during 1997-2006 in England. Figure: Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for males diagnosed with tummy malignant neoplastic disease during 1997-2006 in England. Figure: Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for females diagnosed with tummy malignant neoplastic disease during 1997-2006 in England. Figure: Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males diagnosed with tummy malignant neoplastic disease during 1997-2006 in England. Figure: Relative endurance up to 10 old ages after diagnosing, by want class at diagnosing for females diagnosed with tummy malignant neoplastic disease during 1997-2006 in England. Table 7: Degrees of freedom for Time Varying Component ( TVC ) and their AIC/BIC with baseline jeopardy of 3 DF. TVC DF Model DF AIC BIC Male 1 23 86047.89 86248.62 2 28 86035.85 86280.22 4 38 85727.08 86058.72 5 43 85660.87 86036.14 Female 1 23 40628.06 40814.77 2 28 40590.59 40817.9 4 38 40504.96 40813.45 5 43 40515.35 40864.43 The flexible parametric theoretical account was fitted with want, age splines and twelvemonth splines variables and age splines as the clip changing consequence. The grades of freedom for the baseline jeopardy were chosen utilizing the AIC and BIC consequences from Table 4. From Table 7, it can clearly be seen that the theoretical account fitted for males with 5 DF for the clip variable consequence gives the smallest AIC and BIC, nevertheless the theoretical account fitted for females with 4 DF has the smallest AIC and BIC. Therefore either 4 DF or 5 DF can be used run the analysis for the clip changing effects and intervention. Further analysis was carried out utilizing 4 DF. Table 8: Adjusted extra jeopardy ratio ( EHR ) of decease for males and females individually seting for intervention and clip changing effects of age and twelvemonth of diagnosing for patients diagnosed with tummy malignant neoplastic disease during 1997-2006 in England Males FemalesEHRP-value95 % CIEHRP-value95 % CIWant 1-Least deprived Baseline––Baseline––2 1.080 & lt ; 0.001 ( 1.042, 1.120 ) 1.056 0.036 ( 1.004, 1.110 ) 3 1.111 & lt ; 0.001 ( 1.073, 1.150 ) 1.095 & lt ; 0.001 ( 1.043, 1.149 ) 4 1.167 & lt ; 0.001 ( 1.128, 1.208 ) 1.124 & lt ; 0.001 ( 1.072,1.179 ) 5-most deprived 1.195 & lt ; 0.001 ( 1.155, 1.236 ) 1.162 & lt ; 0.001 ( 1.109, 1.217 ) Splines 1 3.639 & lt ; 0.001 ( 3.593, 3.686 ) 3.783 & lt ; 0.001 ( 3.709, 3.859 ) 2 1.219 & lt ; 0.001 ( 1.206, 1.232 ) 1.243 & lt ; 0.001 ( 1.223, 1.264 ) 3 1.100 & lt ; 0.001 ( 1.093, 1.108 ) 1.112 & lt ; 0.001 ( 1.102, 1.122 ) Treatment No Surgery Baseline––Baseline––Surgery 0.327 & lt ; 0.001 ( 0.317, 0.337 ) 0.311 & lt ; 0.001 ( 0.298, 0.325 ) No Chemo Baseline––Baseline––Chemo 0.732 & lt ; 0.001 ( 0.711, 0.754 ) 0.826 & lt ; 0.001 ( 0.788, 0.865 ) No Radio Baseline––Baseline––Radio 0.755 & lt ; 0.001 ( 0.679, 0.839 ) 0.764 0.001 ( 0.653, 0.894 ) Age splines Age spline1 1.304 & lt ; 0.001 ( 1.285, 1.323 ) 1.295 & lt ; 0.001 ( 1.269, 1.322 ) Age spline 2 0.945 & lt ; 0.001 ( 0.931, 0.959 ) 0.938 & lt ; 0.001 ( 0.922, 0.956 ) Age spline 3 1.014 0.063 ( 0.999, 1.028 ) 1.019 0.048 ( 1.000, 1.039 ) Age spline 4 0.993 0.286 ( 0.980, 1.006 ) 0.980 0.028 ( 0.963, 0.998 ) Age spline 5 0.987 0.044 ( 0.975, 1.000 ) 0.999 0.896 ( 0.985, 1.014 ) Year of diagnosing splines Year spline1 0.923 & lt ; 0.001 ( 0.912, 0.935 ) 0.929 & lt ; 0.001 ( 0.914, 0.944 ) Year spline 2 1.016 0.012 ( 1.003, 1.028 ) 1.005 0.567 ( 0.989, 1.021 ) Year spline 3 0.988 0.041 ( 0.976, 0.999 ) 0.996 0.622 ( 0.980, 1.012 ) Year spline 4 1.025 & lt ; 0.001 ( 1.013, 1.038 ) 1.012 0.140 ( 0.996, 1.029 ) Year spline 5 1.003 0.630 ( 0.991, 1.015 ) 1.005 0.592 ( 0.988, 1.021 ) Table 8 shows a comparing of the consequences of the clip changing effects theoretical account seting for want, age at diagnosing, twelvemonth of diagnosing and intervention for males and females individually. Comparing the consequences from the male analysis with the female, the extra jeopardy ratio ( EHR ) for decease by want was lower in females in general, although both analyses gave a additive tendency in EHR by want. Comparing the EHR for both analyses to consequences from Table 6, it is clear that the EHR is lower when intervention and clip changing effects such as age and twelvemonth of diagnosing are taken into history. There was besides lessening in EHR for any intervention compared to no intervention ; nevertheless there was a big lessening in EHR of surgery compared to no surgery for both males and females. In both analyses, intervention with surgery was associated with increased net endurance compared to non-surgical intervention or no intervention. Age and twelvemonth of diagnosing were modelled as a time-dependent non-linear consequence, and were important for peculiar splines in both theoretical accounts. The additive tendency in want category remained and became more important, since the EHR in want classs for both males and females differed in comparing to the most flush group at the 5 % significance degree, as in the instance of the simpler analyses. Therefore more disadvantaged groups had a higher extra mortality due to malignant neoplastic disease compared to the less disadvantaged groups. The deficiency of an interaction term between want classs and splines in the concluding theoretical account suggests that the difference in comparative endurance between want groups did non alteration over the clip period of the survey. Figure: Internet endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for males seting for intervention and clip changing effects and diagnosed during 1997-2006 in England. Figure: Internet endurance up to 1 twelvemonth after diagnosing, by want class at diagnosing for females seting for intervention and clip changing effects and diagnosed during 1997-2006 in England. Figure: Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for males seting for intervention and clip changing effects and diagnosed during 1997-2006 in England. Figure: Internet endurance up to 5 old ages after diagnosing, by want class at diagnosing for females seting for intervention and clip changing effects and diagnosed during 1997-2006 in England. Figure: Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males seting for intervention and clip changing effects and diagnosed during 1997-2006 in England. Figure: Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for females seting for intervention and clip changing effects and diagnosed during 1997-2006 in England. Figure: Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males who had intervention affecting surgery, seting for clip changing effects and diagnosed during 1997-2006 in England. Figure: Internet endurance up to 10 old ages after diagnosing, by want class at diagnosing for males who had intervention affecting surgery, seting for clip changing effects and diagnosed during 1997-2006 in England. Table 9: Net endurance by want class at 1, 5 and 10 old ages adjusted for intervention and surgery for males and females individually. Males FemalesNet enduranceNet endurance from tummy surgeryNet enduranceNet endurance from tummy surgery1-year endurance Most flush 0.37 0.65 0.36 0.67 2 0.34 0.63 0.34 0.65 3 0.33 0.62 0.33 0.64 4 0.32 0.61 0.32 0.63 Most disadvantaged 0.31 0.60 0.32 0.63 5-year endurance Most flush 0.16 0.42 0.17 0.46 2 0.14 0.39 0.16 0.44 3 0.14 0.38 0.15 0.42 4 0.13 0.37 0.14 0.42 Most disadvantaged 0.13 0.36 0.14 0.41 10-year endurance Most flush 0.12 0.36 0.13 0.40 2 0.11 0.32 0.12 0.37 3 0.10 0.32 0.11 0.36 4 0.10 0.30 0.11 0.35 Most disadvantaged 0.10 0.30 0.11 0.35 Consequences from the estimation of cyberspace endurance up to 1, 5 and 10 old ages after diagnosing, adjusted for intervention and clip changing affects, are shown in Figures 9-14 for males and females individually, and showed that there was a sug