A path breaking research in the area of Metrics used in IT industry Paper

A path breaking in the area of Metrics used in IT industry and its effectiveness- Developing new metrics for measuring - Research Paper Example Scope becomes sufficiently measured through observation of the changes required during the implementation process. This paper explores the various metrics utilized in assessment of the efficacy in implementation of these unique IT projects. TABLE OF CONTENTS ABSTRACT 2 TABLE OF CONTENTS 3 INTRODUCTION 4 METHODOLOGY 4 Planning 5 Controlling 6 DATA COLLECTION AND ANALYSIS 6 FINDINGS 9 Project metrics 10 Metrics in IT projects 11 Cost 11 Time 13 Scope 15 CONCLUSION 16 REFERENCES 18 INTRODUCTION The information technology industry represents a unique characteristic for development projects aimed at providing improved technologies, both in software and hardware sectors. The planning process for the projects remains an essential component for minimizing project failure ultimately assuring success. Poor management of IT projects remains the highest cause of project failures within the industry. It is estimated that this accounts for 54% failure with technical challenges causing 3% (Gulla, 2012). Proper management begins with development of proper plans during the initial project stages. The evaluation process seeks to make an assessment of the project progress during implementation. ... The process will be broken down into different stages which shall follow each other. The waterfall methodology being utilized shall be as indicated in the chart below. Measurement of the various metrics involved in the project will be undertaken following completion of each stage and relevant actions taken, based on the results of performance indexes. Figure 1the waterfall methodology Planning The project planning aspect involves the development of a plan providing guideline towards undertaking a desired development project. This marks the beginning stage of any project being implemented. The element of undertaking sufficient planning remains fundamental in assuring success, or causing ultimate project failure. The planning process involves provision of various aspects of the project, commonly through estimations. These estimations provide guidelines during implementation; hence their accuracy remains essential in assuring success. The provided estimates must remain reflective of act ual figures, with minimal discrepancies. During the project evaluation process, the actual figures become measured against the provided project estimates, established during the planning stages. Poor planning remains the fundamental cause for most project failures. While the planning phase remains fundamental in ensuring success, the numerous aspects involved within the planning phase contribute towards successful implementation. Individuals involved in the planning phase of any projects should ensure that the plans suffice the project requirements. This serves in eliminating and minimizing continuous changes during the project implementation phase. The planning phase should provide a

Save the planet by cutting down on meat That's just a load of bull Essay

Save the planet by cutting down on meat That's just a load of bull - Essay Example In contrast, transport makes up just 13% of the world’s greenhouse gas footprint. Moreover, cows turn out methane gas is 23 times as damaging as CO2. Furthermore, livestock rearing takes up 30% of the earth’s surface. In light of this, Johnson suggests that Dr.Pachauri was perhaps right for being anxious about emissions of methane gas from livestock. Johnson affirms that although Dr.Pachauri’s scrutiny was spot on; his proposition to cut down on meat was ridiculous. Additionally, Johnson (2008) argues that while shunning meat consumption by humans would notably result in decreased methane output; Dr. Pachauri’s recommendation is mistaken as it ignores the pertinent issues at the heart of every environmental problem that presently afflicts the world. Some of these issues include: deforestation, destruction of species, the 1.3 billion people whose livelihoods are reliant on agriculture as well as the persistent human population boom. Currently, the world’s population is about 6.72 billion and anticipated to rise to 9 billion by 2050. Cows are not the problem; people eating the cows are the problem. Additionally, Johnson also reminds the UN of its historic role which entails: campaigning against global overpopulation, family planning championing for female emancipation, and all the real solutions to world’s intolerable and excessive population boom. In support of Dr. Pachauri’s proposition that meat production puts more GHG’s than the earth’s entire transport network, Smith et al. (2007, p.501) suggests that agriculture discharges considerable amounts of GHG’s (such as methane-CH4, nitrous oxide-N2O and carbondioxide-CO2) into the atmosphere. CH4 is generated when organic matter putrefies in anaerobic circumstances, especially from fermentative digestion by ruminant farm animals, from stockpiled droppings. This confirms that Dr.Pachauri is perhaps right for being anxious about methane gas emissions from livestock. On the

Strategic planning and Implementation Essay Example | Topics and Well Written Essays - 3000 words

Strategic planning and Implementation - Essay Example Facing the competitive landscape where industry is mostly undifferentiated, Speedy Hire Plc has successfully employed the differentiation strategy. This is because of the fact that industry offer products which are generic in nature and compete mostly on non pricing factors. Considering these external dynamics, Speedy Hire Plc is employing the differentiation strategy in order gain competitive advantage. Speedy Hire Plc works in an environment which is very competitive in nature and almost serve all the segments of society. A close analysis of the target market and all the stakeholders of the company would suggest the following list of stakeholders in the company – considering both the internal and external environment of the company: In its essence, SWOT analysis is a very simple tool of assessing the strengths, weaknesses, Opportunities and threats of the organization. However, deep down its one of the strongest strategic tools which if applied correctly can provide many strategic insights into the company’s internal and external environment. One of the basic assumption behind the development of SWOT as a tool is that it assumes that managers can plan the alignment of firm’s resources with its environment (Novicevic, et al, 2004). Developed in late 1950’s. The ANSOFF matrix is one of the most important tools for business to decide upon their growth strategies. (www.mindtools.com,2008). It provides a quick and simple way of deciding upon the growth strategies while working into any industry or sector. However, there are various arguments against ANSOFF Matrix as the basic means of addressing the growth of the business. The main argument that is often put forward is the basic difference behind the dynamics of the small and large business. ANSOFF Matrix does not take into account different dimensions of dynamics behind

Huck Finn in Education Essay Example for Free

Huck Finn in Education Essay For education to serve its purpose of helping students develop an understanding of themselves and the world around them, it must provide uncensored information and ideas. Mark Twain’s The Adventures of Huckleberry Finn undoubtedly supports that goal of education. The classic novel discusses issues regarding society’s greed and cowardice through a young boy’s, Huck Finn, perspective. Huck Finn is born into the American, white south during the mid 1800s when slavery and racism towards blacks was the norm. He is influenced by his surroundings to believe that slavery is right. The â€Å"civilized† adults dictate to him the nature of blacks as property. However, as a rebellious adolescent, Huck runs away from his home and journeys down the Mississippi river with a black slave named Jim. Across this adventure, Huck develops a different set of morals from his culture and slowly comes to view Jim as a person and a friend. America’s past white, southern culture is a testament to the gruesome reality of society’s ability to institutionalize its selfish nature. Mark Twain emphasizes in a genuine manner the ignorance of America’s slave-holding past and the importance of questioning the morals of society and as such, the novel The Adventures of Huckleberry Finn is worthy of belonging in compulsory education. Unlike many other novels, The Adventures of Huckleberry Finn delivers an unromanticized depiction of the racist, white south and slavery in the early part of American history. As seen through his characters, Mark Twain is not afraid to show the true nature of racism present in the 1800s. One of the most unsympathetic characters in the book is Pap, Huck Finn’s drunkard and abusive father. Pap’s dialogue contains the image of the thoughts of the average racist southern man in America during that era. In one instance, Pap says: Oh, yes, this is a wonderful govment, wonderful. Why, looky here. There was a free nigger there from Ohio – a mulatter, most as white as a white man. He had the whitest shirt on you ever see, too, and the shiniest hat; and there aint a man in that town thats got as fine clothes as what he had; and he had a gold watch and chain, and a silver-headed cane – the awful- est old gray-headed nabob in the State. And what do you think? They said he was a pfessor in a college, and could talk all kinds of languages, and knowed everything. And that aint the wust. They said he could VOTE when he was at home. Well, that let me out. Thinks I, what is the country a-coming to?†(35) Pap’s words clearly show the hatred he has towards blacks and his belief of white supremacy. He finds the idea of a black man, even a half black man, having the right to vote, a stable job, and an education, absolutely repulsive. This prejudicial perspective of Africa Americans was as common as the modern belief that slavery is wrong. In fact, though slavery in the United States was abolished after the Civil War, the intrinsic racism in America would not be truly called to question until the mid to late 1900s, more than a century later. The inability of white Americans to come to terms with black rights is a portrayal of the wrongs of society. Society is not perfect and young members of society should understand that in order to later on change society for the better. Education in America should provide insight to the hardships of African Americans, and the struggle of Jim living in a society filled with minds like Pap exemplifies the struggle and history of Black Americans. Furthermore, in Pap’s statement is the word â€Å"nigger†. Throughout the entire novel, Mark Twain controversially used the derogatory term over 200 times. Many feel that the use of â€Å"nigger† causes the book to be unacceptable in compulsory education. However, a more accurate view would be that the word â€Å"nigger† is not used in the novel for the purpose of demeaning blacks; rather the word is used to make the story accurate to the time. Words get their meaning from the intent of the speaker. Twain’s intent was not for the word to criticize blacks as it is well known that Mark Twain was an advocate against slavery and racism. He used the word because back in the 1800s, the normal word for slaves was â€Å"nigger†. By using the word, Twain painted a realistic picture of the southern culture of America. Although other books exist that discuss the nature of slavery without the term, for example, Uncle Tom’s Cabin, books like Uncle Tom’s Cabin are not as effective of delivering a view of the past. In Uncle Tom’s Cabin, the slave Uncle Tom is unrealistic for a slave of the time period. He speaks in an educated manner, and his obsession with religion turns him into an allegorical religious figure. Uncle Tom’s characterization takes away from the true battle of slavery in the south. On the other hand, Jim in Huck Finn is characterized more realistically. He speaks in a lower class way, and his journey with Huck for freedom depicts slavery and racism in that era. The book does not hide the sad truth of bigotry and the dehumanization of African Americans. Instead the book highlights it and educates students the history of American slavery. Moreover, the character of Huck Finn goes through a journey that expresses the important idea of an individual going against society’s rules to act on an unhindered set of morals in order to do what is right and good. Young teens often end up conforming to society in order to fit in. This conformity creates a loss of new and innovative ideas. Twain poses an important lesson of individuality and questioning society. Huck Finn is a boy living in a world where all his adult guides would tell him that befriending a black man and helping free a slave would be completely immoral. Born in such a culture, Huck accepts the view as the truth. Black people are bad. His conformity can be seen when he says: â€Å"Conscience says to me What had poor Miss Watson done to you, that you could see her nigger go off right under your eyes and never say one single word? What did that poor old woman do to you, that you could treat her so mean? I got to feeling so mean and so miserable I most wished I was dead (91). Instead of pitying Jim’s status as a slave, Huck pities Miss Watson for losing a slave. This illustrates slavery’s prominence and integration into society, along with Huck’s own ignorance and inability to shake off society’s influence. Society’s strong grasp on Huck is similar to modern pop culture’s grasp on teens. Every day, the media bombards the youth of America images of what is right and wrong. Sometimes society gives off the wrong message. For example, the attitude towards rape in America is society being wrong and the youth following the rape culture without questioning. Students should learn from this novel to stand up for their conscience as Huck does as the story progresses. Through involvement with Jim, Huck discovers Jim’s humanity. This discovery of blacks being human just like whites leads Huck to a higher moral understanding. Huck writes: â€Å"It was a close place. I took . . . up [the letter I’d written to Miss Watson], and held it in my hand. I was a-trembling, because I’d got to decide, forever, betwixt two things, and I knowed it. I studied a minute, sort of holding my breath, and then says to myself: â€Å"All right then, I’ll go to hell†Ã¢â‚¬â€and tore it up. It was awful thoughts and awful words, but they was said. And I let them stay said; and never thought no more about reforming†(207). When Huck tears the letter up, he is actively going against society and the white southern culture. This change is a depiction of not only the message of fighting society’s corruption, but also of Twain writing his opposition to slavery and racism. He calls out from his narrative for people to strip away their cultural influences. The influence of society can be harmful and slavery is a prime example. The whole of the south fought to uphold slavery, when today, the thought of legal slavery in the US is unthinkable. Mark Twain’s novel educates people to stand up for freedom from societal influences. The Adventures of Huckleberry Finn is a classic American piece of literature that should be part of compulsory education. The book contains a strong message and a realistic portrait of the time era. Mark Twain does not cover up information. He narrates it in a compelling story. Students learn from this novel the flaws of society and the importance of questioning ideas through a young boy and slaves’ adventure away from slavery and societal rules.

Evaluating Strengths and Weaknesses of Reason as a Way of Knowing Essay Example for Free

Evaluating Strengths and Weaknesses of Reason as a Way of Knowing Essay This paper that I am writing on is a piece of paper; that is undeniable fact. Hundreds of years of development and definition also back up this statement as do any scientific experiments carried out upon it in an effort to prove that this piece of paper is indeed a piece of paper. Yet through reasoning the fact that this is a piece of paper can be disputed and even proved wrong. Reason seems like an excellent way to work out the world around us. It uses all of the facts available to come up with a suitable hypothesis which can be tested and either proved or disproved through experimentation. This is the foundation of science, which is what the majority of people would trust. So anything proved through scientific means is therefore and irrefutable fact. Of course, in every experiment write up there is an acknowledgement that the data collected might not be completely accurate or that the interpretation of results might be wayward but again this is perfectly reasonable. It is reasonable to assume that despite your best efforts you may have got the answer wrong and another answer, no matter how unlikely, may be correct. As well as reason being proved by scientific experiment it can also be proved by historical fact. For example, it is undisputable fact that on 30th May 1431 Joan of Arc was burned at the stake. That cannot be argued with, it was that date and will always be that date no matter what happens in the future and every history text or website would agree with that fact. So it is therefore illogical to start claiming that Joan of Arc died last week as historical facts, which are perfectly reasonable, tell us otherwise. However, does reason really help us in our quest for knowledge or is it a poor way of finding out about the world? Despite much scientific investigation and historical knowledge there are many questions in the world that are left unanswered and unexplained. These questions are sometimes fundamental to life itself. For example, how are we conscious beings that can interact with the world beyond purely animal instincts? This question could possibly be explained by the electrica l impulses in the brain that form our thoughts but how can we have developed into any kind society purely through electrical impulses? In this case, using reason to explain what is happening almost seems unreasonable as the potential answer seems not to be able to completely cover the question. After all, if it is only electrical impulses, then what need is there for a person to be able to be able to create a symphony with an orchestra? As well as reason not being able to answer some questions there are some problems with following logical arguments. Logical fallacies are the main example of this. This is where through looking at two or more facts a conclusion is drawn which is false. For example: Cake is food, food is tasty, and therefore cake is tasty. However, this is obviously not true as whilst some cake may be tasty, perhaps even the majority; this does not mean to say that all cake is tasty. After all a burnt cake is not that tasty! Also not only is the conclusion false the two facts through which the conclusion is derived can also be said to be false. After all, any cake that I bake should not be classed as food and not all food is tasty. This statement is far too general and is a large problem with logical fallacies as they generally come to a wrong conclusion, both through the ignorance of other factors as well as the fact that often the facts are not completely accurate in the first place. Lateral thinking is also something which at first seems illogical yet (often) in hindsight becomes logical. It is creative thinking which does not merely follow the most logical steps to reach an answer. For example a suggested solution to the Arab-Israeli conflict in the Middle East was to ship vast amounts of Marmite to the area. This seems utterly senseless, as surely holding talks and making agreements between the two sides would be the best steps forward. However, on examining the idea further it becomes logical, if creative! In the typical diet of people in the Middle Eastern area there is a lack of zinc due to the main diet of unleavened bread. This lack of zinc creates aggression. Marmite contains a lot of zinc and therefore could be used to solve the problem in the Middle East. Whilst this solution does not seem reasonable it would work and so shows that reason is not always the best policy. There is also a difference in opinion between what people may think is logical and illogical. Many people in the world take illogical decisions and believe illogical knowledge. Or they seem to do so. Religion is a major factor in many people’s lives and it affects many of the things that they think and do. Due to this people may make a decision that seems illogical to secular people which is perfectly logical to religious people. This brings up the question of; what is reason? After all if two different decisions about the same thing are made and are both reasonable to those people it begs the question of whether or not reason itself can be defined. Is reason just a matter of opinion or is there a yardstick by which all reasonable decisions can be made. If we look back at the British Empire one of the purposes of that was to; â€Å"Make the world England† rather then to respect what other cultures thought and did. In many small islands in the Far East a warrior culture was common and often tribes would fight each other for prestige rather then for anything else. However, to the British this seemed barbaric, yet without it the culture fell apart. For them it was reasonable for this to take place, the knowledge they had seemed to point to the fact that this was a good thing. But not for the British who had a very different opinion through the knowledge that they had acquired. To conclude reason as a way of knowing has both strengths and weaknesses. The weaknesses are that a difference of opinion means that people will reason differently too making it an irregular method of making decisions and acquiring knowledge. Reason may also not be the best policy as more creative solutions may be better which can be derived through latera l thinking. Also logical fallacies call into question the validity of reason as they produce false results through logical steps. As well as this we cannot answer some fundamental questions through reason. However, reason is often the best way that we can make decisions in the world. Scientific experiment and historical knowledge are two very good examples of how reason cannot be changed and is therefore very valuable as it allows us to have consistency with our knowledge. Of course religion means that some inconsistency comes into play with our knowledge but on the whole reason is often the best policy.

Quality of Life in Cervical Cancer Patients in India

Quality of Life in Cervical Cancer Patients in India Abstract Introduction: Cervical cancer is the most frequently diagnosed cancer among women in India. Understanding quality of life (QOL) in women undergoing chemo-radiotherapy for cervical cancer. It will help in introducing interventions for better care and outcomes in these women. This study assessed the QOL before and after chemo-radiotherapy in cervical cancer patients. Methods: This follow up study was undertaken at Dr. B.R.A Institute Rotary Cancer Hospital(IRCH), AIIMS, New Delhi, India. Sixty seven newly diagnosed women with advanced cervical cancer (stage 2b to 4b) were included to assess the change in QOL after treatment . Structured questionnaires on Quality of Life (The European Organization for Research and Treatment of Cancer, EORTC QLQ-C30 and EORTC QLQ-CX24) were used. QOL was assessed before initiation and after 6 months of treatment. Results The mean age of women at the time of detection of cervical cancer was 52.28 ±11.29 years (Range 30-75 years). Squamous cell carcinoma was found to be the most common cell type (97%). Six months survival was 92.53% The mean global health score of cervical cancer patients after six months of treatment was 59.52, which was significantly higher than the pre treatment score of 50.15 (p=0.00007). Physical, cognitive and emotional functioning (p Conclusions Recommendations QOL of newly diagnosed cervical cancer patients significantly improved following chemo-radio therapy. Enhancement was also demonstrated on three of the five functional scales of EORTC QLQ-C30. To further improve QOL, interventions focusing on social and psychological support and physical rehabilitation may be needed. Keywords: Cervical cancer; Quality of Life; Chemo-radiotherapy INTRODUCTION Cervical cancer is a major public health problem in many developing countries. Besides contributing significantly to mortality rates, it leads to the loss of productive life due to prolonged disability.1The absolute burden is expected to increase in future unless effective preventive measures are undertaken. Globally, cervical cancer is the fourth most common cancer in women with nearly 528,000 new cases reported in 2012.2 Nearly 85% of the global burden occurs in the less developed regions, where it accounts for almost 12% of all female cancers. High-risk regions, with estimated (Age standardized rate) ASRs over 30 per 100,000 include Eastern Africa (42.7), Melanesia (33.3), Southern (31.5) and Middle (30.6) Africa. There were an estimated 266,000 deaths from cervical cancer worldwide in 2012, accounting for 7.5% of all female cancer deaths.2 Cervical cancer is one of the leading cancers among Indian women with estimated 123000 new cases and 67477 deaths in 2012.2Cancer is preventable and curable if detected at an early stage.The five year survival rate of cervical cancer when diagnosed at the earliest stage is 92% and the combined 5 year survival rate of all stages is71%3. It is currently believed that the persistent infection with one of the 15 oncogenic types of Human papilloma virus (HPV) is the central and necessary cause of almost all cervical cancers and its precursor, cervical intra epithelial neoplasia (CIN). A proportion of CIN, if not detected and treated, progress to invasive cervical carcinoma over a period of 10-20 years owing to the effect of other cofactors.4,5Unfortunately, despite the availability of methods for prevention and early diagnosis, many women in India have never been screened for cervical cancer. Though the diagnosis and treatment of cervical cancer has been developed, there are important consequences from the disease and its treatment among survivors, especially the impact on quality of life (QOL).Somefunctional disorders occur following therapies such as surgery, which involves the female genital anatomy affecting directly their perception of body image and sexual functions; radiotherapy which could damage the vaginal mucosa and epithelium; and chemotherapy which could induce various adverse effects like nausea, vomiting, diarrhea, constipation, mucositis, weight changes and hormonal changes. Variouspsychological factors including low self-esteem, changes in self-image, beliefs about the origin of cancer, marital tensions, fears and worries can affect the patients.6 Need to measure QOL has become important due to broadening concept of measuring health status beyond traditional indicators such as mortality and morbidity.Assessing QOL is potentially valuable in identifying pa tients’ problems and discovering the challenges and planning for the health systems. Taking into account the impact of early screening methods on long term survival of cancer patients, studies assessing QOL and its related factorshave become critical.Limited studies have been done to evaluate QOL among cervical cancer survivorsdiagnosed in advanced stages. This studyassessed the QOL in such patients before and after treatment with chemotherapy and radiotherapy. MATERIALS AND METHODS This was a follow-up study conducted atDr. B.R.A Institute Rotary Cancer Hospital(IRCH), All India Institute of Medical Sciences, New Delhi.67 female patients who were diagnosed with cervical cancer attending IRCH between 1st January 2014 and 30th June 2014 were recurited. The inclusion criteria were all women who were newly registered and diagnosed cases of cervical cancer of any histological type and advanced cancer stages (2b to 4b). Critically ill patients, those not willing to give informed consent and those who underwent surgery and did not require radiotherapy and chemotherapy were excluded. All consecutive cervical cancer patients fulfilling the inclusion criteria during the six month period were eligible for recruitment. Quality of life of the study subjects was assessed using the questionnaires developed by the European Organization for Research and Treatment of cancer (EORTC) QLQ-30 and EORTC QLQ-CX24.7-11 a) EORTC QLQ- CX30 The EORTC QLQ-C30 is a questionnaire developed in 1993 to assess the quality of life of generic cancer patients. It has been translated and validated into several languages including Hindi and has been used in numerous studies worldwide. These questionnaires have been undergone extensive testing in multicultural and multidisciplinary research settings, and have been confirmed to be a reliable and valid tool. The EORTC QLQ C-30 questionnaire comprises of 30 questions assessing functioning viz. physical, role, cognitive, emotional, social; symptoms viz. fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulty; and a global health status score which assesses the overall QOL. b) EORTC QLQ-CX24 EORTC Quality of Life Group has adopted a modular approach to QOL assessment for overcoming the limitations of generic tool and for disease specific treatment measurements. Consequenty, modules specific to tumor site locations, management modality, or a QOL dimension have been developed that are administered in addition to the core questionnaire. The EORTC QLQ CX-24 is a complementary questionnaire specific for cervical cancer patients that consists of 24 questions categorized as functional scales viz. body image, sexual activity, sexual enjoyment, sexual/vaginal functioning and symptom scales viz. symptoms experience, lymphedema, peripheral neuropathy, menopausal symptoms and sexual worry. Both the tools utilize a 4-point response scale namely â€Å"Not at all†, â€Å"A little†, â€Å"Quite a bit† and â€Å"Very much† to assess each functional or symptom item, and a 7-point response scale to assess global health status ranging from very poor to excellent. These study instruments were administered to patients at baseline and again at 6 months to ascertain changes in QOL after treatment. Institutional Ethics Committee (IEC) approval was obtained from All India Institute of Medical Sciences (AIIMS), New Delhi prior to initiation of study. Prior to enrollment, written informed consent was obtained from patients after detailed explanation about the study. Patient confidentiality was assured and the study participants had the right to abstain from participation without affecting on the quality of care being provided to them. Statistical analysis Data analysis was performed using Statistical Package for the Social Sciences (SPSS) version 18.Qualitative data was expressed in proportions while mean and standard deviation were calculated for quantitative data. The student’s t test and Chi square tests were used for comparing the characteristics of the study participants and the quality of life scores before and after chemo-radiotherapy. The scoring of the questionnaire data was performed according to the scoring manual. All scores were transformed to a 0-100 scale. For the functional scales, a good function was indicated by higher scores. For symptom scales, more severe symptoms were indicated by a higher score.10Ap-valueunder 0.05 wasconsidered statistically significant. RESULTS This study included 67 patients of advanced cervical cancer who met the eligibility criteria. Six deaths were reported during the course of study and 5 patients were lost to follow up. The final sample that was analyzed consisted of 62 patients and the quality of life was assessed in 56 patientsThe mean age of study participants was 52.28 ±11.29 years (Range 30-75 years).Squamous cell carcinoma was the most common cancer (97%) while remaining 3% patients were diagnosed with adenocarcinoma/ adenosquamous carcinoma. Majority (53.73%) of the study subjects were in stage 3b, 40% in stage 2b and remaining in stage 3a and 4a. Metastasis was present in only one patient.Combination of radiotherapy and chemotherapy was the most common (77.67%) modality of treatment. Nearly 12% of the study subjects were treated only by radiotherapy while another 10.45% cases received radiotherapy after surgery. Palliative treatment was given to four patients Six months survival among those who could be followed up was 92.53%.The global health score amongst improved significantly after treatment (p= 0.00007). The mean global health score of cervical cancer patients following treatment was 59.52, which was significantly higher than pre-treatment values of 50.15. [Table1] The patients quality of life of patients in the functional scales comprising physical, role, emotional and cognitive functioning improved significantly after treatment of cervical cancer (p= 0.012, 0.044, 0.000026, 0.00062 respectively). There was no difference in social functioning score.Symptom like fatigue, pain and loss of appetite improved significantly, but no significant improvement was seen in nausea/vomiting, dyspnea, insomnia and constipation. Diarrhea worsened in the post treatmentphase (Table 1). There were significant changes in cervical cancer specific EORTC QLQ CX-24 module scores for cervical cancer patients [Table2].There was significant decrease in body image, sexual enjoyment and vaginal functioning after treatment, though sexual activity as a whole did not change significantly. Overall symptom experience showed significant improvement after treatment with score reducing from 25.70 to 12.55 indicating improvement (P=0.00001). There was no difference in symptoms reflecting peripheral neuropathy and menopausal symptoms after treatment On the other hand, sexual worry decreased significantly with the mean score declining from 60.28 to 17.02 after treatment. Overall health score and quality of life score improved significantly (p DISCUSSION Indicators of quality of life measure the impact of a disease and its treatment on a patient’s daily activities, behavior, perceived health and functional status. Quality of life indices, which focus on patient’s own perception of disease, provide further information that cannot be obtained solely from conventional clinical and functional measurements. Therefore tools to measure quality of life have been framed by various organizations for comprehensive assessment of patients under treatment. Many factors may contribute to QOL of women diagnosed with a gynecological cancer. In our study most common modality of treatment was combination of radio and chemotherapy. Radiation therapy damages the vaginal mucosa and epithelium which leads to decrease sexual functioning and pleasure. Additional side-effects of radiotherapy are nausea, vomiting, diarrhea and mucositis among others12. Our study compared the pre-treatment and the post-treatment QOL for advanced cervical cancer patients. The Global health score showed a significant increase after treatment making it apparent that quality of life improves after treatment. Similar results were also seen in a recent study published by Kumar S et al. (2014)13.In functional scales, all the items showed a significant increase after treatment including physical, emotional, cognitive and role except social functioning which was nearly same before and after treatment. This was in contrast to a study by Greimel et al. (2002)14, which showed that the global health status, emotional and social functioning remained low. This difference could be because of enrollment of all stages of cervical cancer in their study and the fact that majority of study subjects underwent surgery as a part of treatment modality. The symptom scale analysis revealed that there was a significant decrease in fatigue, pain, insomnia and appetite loss after treatment. This was in contrast with another study done by Klee et al. (2000)15in which pain, appetit e loss, nausea vomiting increased after 3 months of treatment. This variation could be because of differences in time gap between initiation of treatment and post therapy QOL assessment. Episodes of diarrhea worsened after treatment in the present study which may due to radiotherapy. Radiotherapy has been shown to be associated with diarrhea while constipation may be ascribed to injury to the parasympathetic nerves during surgerical interventions 15,16. Another study done by Tokzaharani S et al. (2013)17also showed scores were negatively associated with symptoms including short breathing, lack of appetite, nausea and vomiting, sleep disorder, peripheral neuropathy and menopausal symptoms. In our study, financial difficulties had not changed significantly after treatment. Other studies have shown that financial difficulties increased after treatment which can affect the QOL of the patients [Park S Y et al. (2007)18]. As the study subjects were being treated in a government supported institution, out-of-pocket expenses are likely to be low.This aspect of assessment becomes especially important in resources limited settings like ours. Sexuality is an important aspect in patients suffering from any gynecological cancer and thus a crucial determinant of QOL. In our study there was a significant decrease in sexual enjoyment and sexual and vaginal functioning score in EORTC QLQ CX -24 which was also demonstrated in the study conducted by Kumar S et al. (2014)13. Another study [Park S Y et al. (2007)18] stated that 40% to 100% individuals face sexual dysfunction after treatment. This is because cervical cancer and its treatment affect the same areas of the body which are involved in sexual response. Both chemotherapy and radiotherapy has been associated with sexual problems like dyspareunia, insufficient lubrication, anxiety about sexual performance. Beside this, psychological factors also have an important role in sexual behaviors, and we found that cervical cancer patients had more anxiety about sexual performance. Overall symptoms experience reduced significantly after treatment but lymphedema, peripheral neuropathy menopausal symptoms did not change significantly. In contrast, Kumar S et al. (2014)13demonstratedsignificant increase in these symptoms after treatment. In another study done by Frumovitz et al. (2005)19, frequency of menopausal symptoms increased and sexual functioning decreased after treatment. These symptoms may follow from oophorectomy or radiation damage to the ovaries. In our study patients had perceived poor body image after treatment. These results were similar to those reported by of Park S Y et al. (2007)18. In our study overall health score and quality of life score improved significantly (p It is suggested that further studies and interventions focusing on improving the QOL in survivors should be encouraged. Although, the overall QOL after treatment in cervical cancer survivors was good, treatment of related problems can further improve it. By detecting the problems associated with the quality of life after treatment of cervical cancer, health care professionals will be able to undertake intervention programs that will help to prevent or ameliorate specific problems and adverse effects. RECOMMENDATIONS Although this study revealed that patients with cervical cancer subjected to radiotherapy and chemotherapy are satisfied with their global quality of life, attention should be paid to certain dimensions like sexual functioning during post-treatment period. To further improve QOL, interventions focusing on social and psychological support and physical rehabilitation may be needed.

Love in Shakespeares Romeo and Juliet Essay -- Shakespeare, Romeo Juli

Love. In all its facets and colors, love is understood and accepted as a concept by even the most primitive cultures. But what is love? Many writers have debated this subject. Many works have been produced detailing the understanding individuals had of the concept of love.   Ã‚  Ã‚  The more accepted conception of love is usually found in Romeo & Juliet. Many people refer to it as love at first sight, in French, â€Å"le coup de foudre†, as if you had just been struck by a lightning bolt. This interpretation dates back to the courtly love tradition which manifested during the late Middle Ages, first through chivalry and then more openly among the nobility. In fact, many references to the courtly love tradition are found in the play, for example, Juliet's famous line: â€Å"I'll prove more true than those that have more cunning to be strange.† Here, Juliet is obviously talking about the other women, those who know to be coy.   Ã‚  Ã‚  The courtly love tradition is, however, best expressed in all the works I have chosen by â€Å"The Miller's Tale†, Chaucer's recalling of tales supposedly told in his time period. In this story, we witness the amorous liaison between Alyson, the carpenter John's wife, and Nicholas, a student of astronomy and courtly love. The lovers engineer a stratagem which will allow them to consume their passion without fear of retribution, but only after much insistence on the part of Nicholas.   Ã‚  Ã‚  Ã¢â‚¬Å"Then Nicholas began to plead his cause   Ã‚  Ã‚  And spoke so fair in proffering what he could   Ã‚  Ã‚  That in the end she promised him she would.†   Ã‚  Ã‚  It seems strange that, in both stories, there seems to be some resistance to the tradition of courtly love. Both stories were written during the Middle Ages, two hundred years apart. We can ... ....   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Everyone always thinks they hold the truth. The Word of God can be a convincing argument for those who rely on faith to survive. The word of man, however, makes a stronger point, as it demonstrates how foolish and artificial our beliefs can sometimes be, and how they can change and evolve with time.   Ã‚  Ã‚  Who is to say what love will be a hundred years from now? What will they write when they speak of us, of our own courtship rituals, of the looseness of morals we sometimes manifest? Will they see our behaviours as evil or good? Or will they see us as people who acted according to the values set in the culture in which we lived?   Ã‚  Ã‚  Or is it better not to think of the future, and just love each other, as we always have, regardless of everything else ? Works Cited: Shakespeare, William. Romeo and Juliet. London: Cambridge University Press, 1959.