Market Research Proposal Example | Topics and Well Written Essays - 2000 words

Market - Research Proposal Example This necessity also entails multiple other concepts of marketing that encompasses the techniques based on which the factors related to customer dissatisfaction are identified and apprehended in an effective manner (Pearson Education, Inc., 2010). In relation to the above context, the proposal will be mainly designed for gathering the viewpoints of the customers in determining their satisfaction level towards the purchase made in relation to the selected product of ‘Cornish pasty’. In this proposal, multiple outcomes that project the emergence of customer complaints concerning the above product from domestic as well as international levels will also be evaluated. If seen from a logical perspective, it can be stated that the rise within the compliant levels amid the customers towards the selected product might impose greater level of threat to the business process of the company involved in manufacturing the product in the business markets of the UK (Cornish Pasty Association, 2015). Thus, with this concern, an attempt has been made to explore the reasons as to why there has been an increase in the percentage of complaints associated with this specific food product and also determine the nature of the customers’ complaints. Considering the above stated aspects, the proposal will also lay utmost focus on accumulating customers’ feedback relating to taste, quality, price and design of the product. From a theoretical perspective, it can be affirmed that the decrease within the interest levels of the customers eventually minimises the scope of developing multiple other products of similar category and also the revenue attainment opportunity. Rest apart, another credential objective of preparing this proposal is to focus upon collecting credential information regarding the potential changes that the customers intend to see within this product. Further part of the proposal will mainly encompass preparing two specific types of

Luxury vehicle Essay Example for Free

Luxury vehicle Essay 1. Cadillac introduced it’s new luxury SUV that is called the Escalade, and they had no idea in what direction it would lead to. To their surprise, it becomes a instant classic and the most popular truck on the market. They weren’t set out to target a specific customer base, they just wanted to keep up with the SUV craze. They saw other companies putting out similar vehicles, so they wanted to dip into that market. Once it released, it seemed to become a staple in the hip hop community, sports world, and for regular customers looking for a luxury SUV. It became most prominent however in the hip hop and sports cultures. You see tons of athletes arriving to the games in their escalades, and a lot of hip hop artists have them featured in their music videos. For some reason, it just excelled in the market, and there is really no particular reason for it. It could be because of how unique it looks, the luxurious features, or just off the time it was released. The music and sports industry started to boom so there was a lot of money to be spent and the Escalade was the newest and hottest item on the street. 2. The Escalade became so popular I believe for the power it represents. I feel that if you own a Escalade, you have a sense of power in a way. Whether it shows that you have money, a sense of style, or anything else, it just brings off a certain type of vibe. It shows some type of boldness as well, because you think of personality when you think of an Escalade. When you look at one, you notice first how the shiny grill stands out and just how luxurious the car is. I think in a way Cadillac has extended its appeal because now a lot of the Cadillacs feature the shiny grill. You also see its influence on other vehicles, because a lot of competitors base their models off of it and try to make some similarities. 3. Other companies have a lot to learn from the Escalade. If they do it right, maybe they can become the leader in luxury SUVs. It’s all about whom you have to endorse your product and how you market it out to the public. Cadillac know it has many endorsers that are famous and widely known throughout the world. When you have people of that magnitude openly using your products, you gain a tremendous amount of recognition. Also, before you come up with a new concept or design, you should allow potential customers to see the product to see if it would be something they would like. If you market your product correctly, there is a good chance that it will be successful just like the Cadillac Escalade. Case Study Cadillac is one of the most popular vehicle brands in the United States to this date. As Americans, we tend to treat it differently because it is the luxury brand of our Country. Since it is an American made car, we take a sense of pride in it, and owning one is something special. In 1998 there started to be a craze for mid size SUVs, and just like every other vehicle company, Cadillac had some thoughts in mind. They released their brand new line of the Cadillac Escalade, a large luxurious SUV. When they originally released it, they felt that their market would be traditional customers, but boy, where they wrong. In fact, it was the complete opposite. The Escalade seemed to become nationally recognized when it was constantly featured in hip hop videos, commercials, and the sports industry. While Cadillac didn’t intend to get into those specific markets, I’m sure they aren’t complaining because of how much recognition it gave them. However, it does seem to brush off a certain bad image when you see it featured in some of those ways. When you see a Escalade in a hip hop video that has drugs, half naked women, and curse words, it may rub some of your other customers off. It can be seen as a gang car, and you certainly don’t want to be driving one of those in certain areas. A regular family can be in the market for a SUV, but they may get a negative vibe from the Escalade because it may come off as being too â€Å"hood† or â€Å"ghetto† for them. I’m not too sure how a car can gain that characteristic, but I understand by it being featured and abused in certain ways, it can portray a negative image. Cadillac can feature their products in certain ways, and be able to be seen as a positive vehicle that is made for everybody. They can limit their exposure in hip hop videos if they feel that is necessary. When you see certain commercials you notice that the brand symbol is blurred out. If Cadillac saw this as a dilemma, they can gain access to have their emblems blurred out in rap videos that feature bad behavior. They can still gain national recognition by more of a formal type of commercial. This way, you do not offend any particular race, and show that the vehicle is suitable for people of all ages, color, and race. Cadillac has become on of the mot powerful and influential car brand, that I feel they don’t need to do too much to market themselves. They already have a tremendously large market.

Electronic Commerce Essay -- Ecommerce E-commerce

Electronic commerce   Ã‚  Ã‚  Ã‚  Ã‚  One of the fastest growing industries today is electronic commerce. Almost anything can be purchased, traded, or sold all via the Internet. A person sitting in their living room dressed in pajamas on a rainy Saturday morning in mid December can hookup to the internet and place their bid on a new chess set for the holidays without ever setting foot in the department stores. They can pay for it with their credit card through a secure transaction and have it delivered right to their door in a couple of days for less than they could get it retail. An article by Jan Thomas said that the electronic commerce industry is booming and that it has grown at an alarming rate of over 2000 percent since last year. She continued to say that she predicts that it will continue to grow at an even faster rate, as more and more products become available online and that knowledge of Internet commerce is really happening. (34)   Ã‚  Ã‚  Ã‚  Ã‚  One of the major reasons that this industry is booming is because purchasing over the Internet has been made very easy compared to the traditional way of shopping. Ordinarily a consumer will take the kids and pile in the family car and head to the local shopping mall. Once they get there they will find what they are looking for only to be told by the rude, pushy sales person that it is out of stock. After they get pushed into something other than what they came for they will wait in a line similar to that of Space Mountain at Disney World....

Financial Statement Analysis Essay

I. INTRODUCTION Financial analysis is the selection, evaluation and interpretation of financial data, along with other pertinent, to assist in investment and financial decision-making. Moreover, it is also the process of identifying financial strengths and weaknesses of the firm by properly establishing relationship between the items of the balance sheet and profit and loss accounts. When looking a specific company, the financial analyst will often focus on the income statement, balance sheet, and cash flows statement. One of the most common ways of analyzing financial data is to calculate ratios from the data to compare against those of other companies or against the company’s own historical performance. For example, return on assets is a common ratio used to determine how efficient a company is at using its assets and as a measure of profitability. This ratio could be calculated for several similar companies and compared as part of a larger analysis. Financial analysis converts raw information of financial statements in useful financial information. Only after financial analysis, we can use financial statements for decision making. This financial information is useful for planning for example; we can estimate our future ability of earning on advertising if we did financial analysis of our advertising expenses with direct return on the investment in advertising. Like this, we can do financial analysis of each and every item of profit and loss account, balance sheet and cash flow statement. II. STATEMENT OF OBJECTIVES This study aims to analyze the financial statement of Dr. Yanga’s Colleges, Inc and Far Eastern University for the periods of 2007 to 2011 using financial statement analysis. This analysis are to apprehend the information contained in financial statements with a view to know the weaknesses and strengths of the firm and to make a forecast about the future prospects of the firm thereby, enabling the analysts to take decisions regarding the operation of, and further investment in, the firm. To be more specific, the analysis is undertaken to serve the following purposes (objectives): * Assessment of Past Performance. Past performance is a good indicator of future performance. * Assessment of current position. Financial statement analysis shows the current position of the firm in terms of the types of assets owned by a business firm and the different liabilities due against the enterprise. * Prediction of profitability and growth prospects. Financial statement analysis helps in assessing and predicting the earning prospects and growth rates in earning which are used by investors while comparing investment alternatives and other users in judging earning potential of business enterprise. * Prediction of bankruptcy and failure. Financial statement analysis is an important tool in assessing and predicting bankruptcy and probability of business failure. * Assessment of the operational efficiency. Financial statement analysis helps to assess the operational efficiency of the management of a company. RESEARCH AND DISCUSSION Dr. Yanga’s Colleges, Inc. Dr. Yanga’s Colleges, Inc. (DYCI) started as a non-sectarian secondary institution. It was established in 1950 as the Francisco Balagtas Academy (FBA). In 1987, the name of the institution was changed to Dr. Yanga’s Francisco Balagtas Colleges (DYFBC). Through the years, the school has been an integral part in the formation of many young men and women of Bulacan, metamorphosing into successful practitioners in their various fields of interest. In 2001, the name of the institution was changed again and became Dr. Yanga’s Colleges, Inc. Dr. Yanga’s Colleges, Inc. (formerly Dr. Yanga’s Francisco Balagtas Colleges, Inc.) was registered with the Securities and Exchange Commission on April 2001, primarily to own, operate, maintain, or otherwise administer a school or colleges of any nationality providing therein education in different courses. Far Eastern University.The Far Eastern University, Incorporated (the University or FEU) is a domestic educational institution founded in June 1928 and was registered and incorporated with the Securities and Exchange Commission (SEC) on October 27, 1933. On October 27, 1983, the University extended its corporate life for another 50 years. The University became a listed corporation in the Philippine Stock Exchange on July 11, 1986. The University is a private, non-sectarian institution of learning comprising the following different institutes that offer specific courses, namely, Institute of Arts and Sciences; Institute of Accounts, Business and Finance; Institute of Education; Institute of Architecture and Fine Arts; Institute of Nursing; Institute of Engineering; Institute of Tourism and Hotel Management; Institute of Law; and Institute of Graduate Studies (PSE website). In November 2009, FEU entered into a Joint Venture (JV) Agreement to establish a joint venture company (JVC) for culinary arts. The registration of the JVC was approved by the SEC on May 7, 2010. In 2010, the University established the FEU Makati Campus (the Branch) in Makati City. The Branch started its operations in June 2010 (PSE website). III. FINDINGS/ANALYSIS FINANCIAL RATIOS Financial ratio analysis is the calculation and comparison of ratios which are derived from the information in a company’s financial statements the level and historical trends of these ratios can be used to make inferences about the company’s financial condition, its operation and attractiveness as an investment. There are four categories of ratio used in financial statement analysis. These are: (1) Liquidity Ratio(2)Activity Ratio(3)Leverage Ratio(4)Profitability Ratio This part of the study is organized the calculation and comparison of ratios of Dr. Yanga’s Colleges, Inc. and Far Eastern University using the four categories of financial ratios. Specific ratios for each category are also presented and analyzed 1. Liquidity ratio. Which measure a firm’s ability to meet cash needs as they arise. * Current ratio. The current ratio indicates a company’s ability to meet short-term debt obligations. The current ratio measures whether or not a firm has enough resources to pay its debts over the next 12 months. This ratio shows the current assets available to cover current liabilities at the balance sheet date. There should be a reasonable buffer of current assets over current liabilities as an indicator of the ability of the firm to pay its debts as and when they fall due. As presented, the current ratio of FEU is insignificantly increasing, which could mean more current assets may still be invested in other wealth-generating activities. This implies that FEU has to revisit its capital budgeting initiatives. As to the current ratio of DYCI is generally decreasing which has 4.36 in 2007 that reflects inefficient working capital management to 1.56 by 2011 which falls into a healthy mark of business current assets and liabilities that indicate both account are well functioning and helpful to the operation. * Quick or acid-test ratio. The quick ratio is a measure of a company’s ability to meet its short-term obligations using its most liquid assets (near cash or quick assets). Quick assets include those current assets that presumably can be quickly converted to cash at close to their book values.As a supplement to current ratio, quick or acid-test ratio aims to show the more liquid current assets available to pay the more immediately payable liabilities. With reference to current assets, FEU has its quick asset for the year 2010 of 2.26 and 1.92 for the year of 2011. The acid test ratio of FEU is steadily decreasing from 2007 to 2011 which could be interpreted as a deterioration of liquidity.While quick ratio of DYCI is same as their current ratio decreases because the only current assets they have arecash and cash equivalent and trade receivables which are both included in the quick assets. DYCI is less liquid than their previous. * Working Capital to total assets. Working capital to total assets ratio is useful while evaluating the company’s level of liquidity. Working capital measures a company’s ability to cover its short term financial obligations by comparing its Total Current Assets to its Total Assets.FEU’s working capital to total assets shows that from 0.57 in 2007 has its increased up to 4.26 in 2011 which indicates a positive sign, showing that FEU’s liquidity is improving over time. While DYCI has decreased its working capital to total assets between years 2007 with 0.21 down to 0.08 in 2011 that indicates the company may have too many total current liabilities, reducing the amount of working capital available. * Cash-flow liquidity ratio. Cash-flow liquidity ratio measures how well a company can handle its Short Term Debt with its cash and other liquid assets. It seems like quick ratio of FEU has become inconsistent with considerable decline in the liquidity ratio. This just confirms the discussion presented in the current ratio portion that not all current assets of FEU fall under the immediately realizable current assets when needed to pay off maturing debts. In the financial ratio of DYCI the cash flow liquidity ratio is unstable where it goes from 2.44 in 2007 it went down to 1.72 by 2008 and escalate to 2.36 and 3.57 by 2009 & 2010 but drastically recede during 2011 to 2.71 it shows that DYCI can provide cash payment to its short term obligation. 1. Activity ratio. Which measure the liquidity of specific assets and efficiency of managing assets. * Trade Receivable turn-over. Trade Receivable turn-over measures how many times a company’s accounts receivable have been turnover into cash during the year.FEU’s converted trade receivables into cash 3.14 times in 2011, low from 20.17 in 2007. The turnover if receivable doesn’t improve which may indicate a not do good quality of receivable and no improvement of the firm’s collection and credit policies. While the DYCI has a 41.92 times in 2011, up from 26.09 times in 2007. The receivable has improved and this may indicate better quality of receivable and improvement of the firm’s collection and credit policies. Generally, a high turnover of DYCI is good because it could indicate efficiency in the collection of receivable, but a very high turnover may not be favorable because it may indicate that credit and collection policies are overly restrictive. * Average Collection Period. This helps evaluate the liquidity of accounts receivable, the ability of the firm to collect from the customers.The ratio for FEU, indicate that during 2011, the firm collected its accounts in 116 days on average. No improvement over the 18 days collection period in 2007. This is one of the main reasons why it has significantly higher current assets.While the DYCI’s financial ratio reflects that decreased their average collection turnover by 5 days from 14days in 2007 to 9days by 2011 which signifies that there’s an excellent credit term management and falls into outstanding receivables. Hence, cash is circulating wellalthough out the operations that generates revenue.FEU has the longest collection period. Whether the average of 18 days taken to collect an account is good or bad, it depends on the credit terms FEU is offering. * Working capital turn-over. Working capital turn-over measures how well a company is utilizing its working capital to support a given level of sales. FEU’s financial ratio shows that working capital turnover in 2007 with 2.04 down to 1.07 in 2011 indicates a decreasing ratio which is a low ratio that FEU is investing in too many accounts receivable to support its sales, which could eventually lead to an excessive amount of bad debts and obsolete inventory. On the other hand DYCI has a working capital turnover between year 2011 with 17.11 and 9.62 in 2007 that means a high, or increasing Working Capital Turnover is usually a positive sign, showing the company is better able to generate sales from its Working Capital. But an extremely high working capital turnover ratio can indicate that DYCI does not have enough capital to support it sales growth. This is a particularly strong indicator when the accounts payable component of working capital is very high, since it indicates that management cannot pay its b ills as they come due for payment. * Asset turn-over ratio. Asset turn-over ratio measures how efficiently a company’s assets generate revenue For FEU, the total asset turnover has decreased relative to the industry. As reflected in the financial ratio of asset turnover in 2007 with 0.58 times that there is no improvement primarily in 2011 with 0.49 times. Like DYCI also has no improvement on their asset turnover ratio like FEU. The year 2007 and 2011 the ratio is low from 1.41 down to 0.84. But similar to the previous financial ratio, as a rule of thumb, to be considered effective, it should be at least 0.30 times. Using this, it can be said that the two firms both FEU and DYCI keep an effective mechanism on utilizing their total assets. * Capital intensity ratio. Capital intensity ratio measure of a firm’s efficiency in deployment of its assets.As reflected on the financial ratio of FEU. The capital intensity in 2007 was 1.72 and has an improvement with 2.05 in 2011. So FEU’s capital intensity ratio is high, it is said to be capital intensive. Like DYCI also a high ratio in 2007 with 0.71 up to 1.19 in 2011. This means that both firms have to make a significant investment in assets relative to the amount of sales revenue those assets can produce. Hence, FEU is more capital intensive than DYCI 1. Leverage ratio. Which measures the extent of a firm’s financing with debt relative to equity and its ability to cover interest and other fixed charges. * Debt ratio. Debt ratio measures the proportion of all assets that are financed with debt.Total debt includes all current liabilities and long term debt. Creditors prefer low ratios because the lower the ratio, the greater the cushion against losses in the event of liquidation. As presented, in 2007 with a 0.15 down to 0.12 in 2011 it seems like FEU will be highly favored because they have the lowest ratio and lower the risk. On the other hand DYCI will also be highly favoredbecause of its 0.89 in 2007 up to 0.91 in 2011. They both have the lowest ratio and indicate lower the risk because they didn’t have reached the generally considered maximum ratio of 50%. To much debt would pose difficulty in obtaining additional debt financing when needed or that credit is available only at extremely high rates of interest and most onerous terms. * Debt to equity ratio. Debt to equity ratio measures the riskiness of the firm’s capital structure in terms of relationship between the funds supplied by the creditor and the investor.As reflected from the financial ratio of FEU. FEU’s debt to equity ratio has increased between 0.88 of 2011 and 0.85 0f 2007, implying a slightly riskier capital structure. On the other hand the financial ratio of DYCI’s debt to equity ratio decreases from 0.11 in 2007 and 0.9 in 2011 which implies a no risk capital structure. 1. Profitability ratio. Which measure the overall performance of a firm and its efficiency in managing assets, liabilities, and equity * Operating Profit Margin. A ratio used to measure a company’s pricing strategy and operating efficiency.FEU’s operating profit margin doesn’t have an improvement because of its 34% in 2007 down to 26% in 2011. This is unfavorable because it indicates the ability of the company that there is no control in operating expenses while sharply decreasing sale. Unlike the operating profit margin of DYCI is consistently in equal level which is 1% in 2007 until 2011 with 1% as well. * Cash Flow Margin. Cash flow margin is cash from operating activities as a percentage of sales in a given period.FEU’s cash flow margin between 0.32% in 2011 decreased from the operating margin of 0.43% in 2007. On the other hand the DYCI’s cash flow margin in 2011 of 0.21 was higher than the operating margin. This indicates a strong positive generation of cash. The performance in 2011 represent a solid and impressive improvement over 2005 which is -0.01 when the firm failed to generate cash from operations and had a negative cash floe margin. * Rate of Return on Assets (ROA). It gives an idea as to how efficient management is at using its assets to generate earnings.This ratio measures efficiency with which assets are used to operate the firm. As a rule of thumb, a higher return on total assets is preferred since lower ROAmay mean higher degree of leveragetherefore higher interest expense and lower net income. Referring to financial ratio of FEU between 2011 from 2008 FEU consistently showed the highest ratio than DYCI with 1% in 2011. * Rate of Return on Equity. It gives an idea as to how efficient management is at using its assets to generate earnings. This ratio measures the rate of return on common shareholders’ investment. This is considered as the most important accounting ratio as this has something to do with the DuPont equation. As a rule of thumb, the higher the ROE, the better since low ROE but high ROA may mean that the firm is using greater debt. Reflected inthe financial ratio of FEU between the year 2007 to 2011 is inconsistently showed the highest ratio than DYCI with its low ratio of 7% in 2007. Summary of Financial Statements Analysis of FEU and DYCI Short-term liquidity and Activity Short-term liquidity and activity analysis is of particular significance to trade and short-term creditors, management and other parties concerned with the ability of a firm to meet near-term demand for cash. Both FEU and DYCI’s current and quick ratios are insignificantly decreasing indicating a deterioration of short-term liquidity. On the other hand the cash flow liquidity ratio of both firms doesn’t improved and has become inconsistent with considerable decline in the liquidity ratio. The average collection periods for accounts receivable of FEU doesn’t improved. There is no improvement that may be the result of poor day-to-day credit management or such temporary problem concerned by a depressed economy. While the DYCI decreased their average collection turnover by 5days which signifies that there is an excellent credit term management and falls into outstanding receivables. Presently, there appears to be no major problem in DYCI’s short-term liquidity position but FEU seems that there is a problem in average collection period that must have been improved. Long-term Solvency The debt ratios for FEU and DYCI shows a steady decreased in the use of borrowed funds. Total debt has decreased relative to total assets implying a slightly riskier capital structure. Given the decreased level of borrowing, the times earned and fixed charged coverage improved slightly in 2011. These ratio should however be monitored closely in the future particularly if the both firms continues to expand. Operating Efficiency and Profitability FEU and DYCI both decreased from 2007 to 2011 that means inefficient utilization or obsolescence of fixed assets. The assets turnover in 2011 of both firms also decreased implying that the company is not using its assets optimally and no progress traceable to improved management of receivables. Operating profit margin of FEU doesn’t have an improvement, unfavorable and manage to improve its operating margin in 2011 principally due to the ability of the firm that there is no control in operating expenses. Unlike DYCI that is in the stable level from 2007 to 2011. Referring to financial ratio of FEU and DYCI both firm increased considerably in 2011. These ratios measure the overall success of the both firm in generating profits from its investment and management strategies. Conclusion: It appears that Far Eastern University and Dr. Yanga’s Colleges, Inc. doesn’t have any major problems and is well proportioned for future growth but FEU must improve their average collection period. Close monitoring the firm’s management of receivables is important considering the size of the company’s capital tied up. The both firm should however be cautious of the increased risk associated with debt financing. IV. RECOMMENDATION The analysis of the Dr. Yanga’s Colleges Inc., financial statements shows that there is no consistent ratio on the increase of their comprehensive income unlike the Far Eastern University who maintains the increase of their profit. Therefore, it is advised that a stronger and more effective policy shall be developed and implemented regarding the ratio of the revenue and all expenses. When it comes to their cash every end of the year, Dr. Yanga’s improve better than FEU. For the past 5 years, FEU keeps on decreasing their cash on hand. It is observed and analyze that FEU’s cash on hand decrease, while their account receivables increase. So, the expected cash to be use in the entire year was still receivable that affects their accounting plans. It shows that FEU has a weak credit and collection policy, so it is advised to focus on those credit accounts, and also in accepting creditors and promissory notes. As reflected in the financial ratio of Far Eastern University and Dr. Yangas colleges, Inc. there is no major problems for both firms and is well proportioned for future growth. However the Far eastern University has a problem in their average collection period. Therefore, possessing a lower average collection period is seen as optimal, because this means that it does not take a company very long to turn its receivables into cash. Ultimately, every business needs cash to pay off its own expenses. In that case it is advised that FEU must improve an excellent credit term management to fall into outstanding receivables. Hence, cash is circulating well although out the operations that generates revenue.

Catherine II was Russia’s first ruler, who was considered as enlightened

Catherine II was Russia's first ruler, who was considered as enlightened. As a child growing up in Germany, she was given an enlightened education. She enthusiastically read ‘enlightened' literature, and soon became a disciple of the enlightenment. As Empress she continued to read the works of Locke, Montesquieu, and Voltaire. Although it is widely accepted that Catherine II was an enlightened despot, it has also been argued that she did nothing more than allow the continuation of policies that had began in the reign of Peter I; â€Å"Although she claimed to be an enlightened despot, Catherine II did no more than continue the policies of her predecessors. † Another argument as to why Catherine didn't carry out more enlightened reforms was due to her not wanting to make these enlightened reforms; the policies that Catherine II adopted were not adopted because of her beliefs, and/or her desire to create an ‘enlightened society', but were instead taken out to maintain her power, and to satisfy her vanity. Historians like Harris claim that Catherine only appeared to be enlightened to enhance her reputation with the philosophes. This view is also taken by R. Charques, who states that the â€Å"enlightenment in Catherine was not much deeper than her vanity; despotism on the other hand was implicit in her ambition. â€Å"1 There has also been the case that Catherine had recognised the danger of going too far and/or too fast. She had experience the downfall of her husband for doing just that. As H. Nickelson puts it â€Å"No despot was ever more subtly aware that politics is the art of the possible and that everything can be lost if a states mangoes too far, or too fast† Another valid argument is that Catherine became more conservative, and less willing to change the laws of Russia, on the lines of the enlightenment, as she got older, and had come to realise the scale of problems which faced Russia. The enthusiasm with which she began her reign soon faded as the reality of Russian backwardness and it's intolerance to change sank in. Harris sums up this point: â€Å"she coarsened with the exercise of power, her early idealism was abandoned as she learnt to understand the complexities of the Russian situation, and thus her enlightenment was only skin deep† A Key limitation to her ‘enlightening' Russia was the role that the nobility played in supporting and maintaining her power. Although the aristocracy were glad to be rid of the ‘insane' Peter III, Catherine had no claim to the throne. Many in Russia believed that she should only be regent for her son Paul, or that the ex Tsar Ivan IV should be re appointed. However with the support of the nobility Catherine could retain power for herself. But without the support of the nobility there was always the danger of the army who had so easily placed her on the throne could just as easily displace her. With all these limitations on her power Oppenheim asks: â€Å"would she attempt to put into practice some of her modern ideas about which she had read, or would she continue to govern Russia in the traditional mannor. â€Å"4 Since the death of Peter I, the nobles had slowly begun to increase their powers. Their compulsory state service, which Peter I had set up, was firstly cut to twenty-five years in the reign of Anna, and later in the reign of Peter III it was completely abolished, for that of hereditary peers, thus securing the role of the nobility in Russian society. Immediately after the death of Peter I there was an attempt by some nobles to restrict the power of the crown, via a supreme secret council. Cowie claims, † It consisted of six members drawn from the old and the new nobility. It's powers included complete control of legislation, but it aroused such opposition from the nobility that these had to be restricted. â€Å"5 It is clear to see that the nobility then were powerful enough to attempt to limit the autocracy, which Peter I had established. However their own class opposed them, which left the councils power restricted. The supreme council tried some years later to limit the power of the monarchy. Upon the nomination of Anna as Empress, she was presented with a document that she had to sign in order to be crowned. This document would have allowed the nobles to have a share in how the state was run. â€Å"This would have been to turn her into a constitutional monarch. â€Å"6 Cowie also agrees with this statement; â€Å"If put into practice these proposals would have replaced Russian autocracy by an oligarchy. â€Å"7 However the document didn't carry the mass support of the nobility. Again the nobility, which had the power to initiate a constitution, also had the power to stop its implementation. The ‘constitutional rights' they requested in 1730 were more restrictive on the crown than those they had asked for in 1725, which supports the idea that the nobles had increasingly gained power after the death of Peter I. In 1730 the Privy Council itself went against the wish of Empress Catherine I (who had nominated her daughter Elizabeth if Peter II should die) and instead choose and crowned Anna Duchess of Courland. Not only was central government under more influence from the nobility, but local government too was rapidly falling back into the hands of the nobility. During the reign of Peter II the nobles who ruled on behalf of the boy- tsar, began to take back some powers in local government which Peter I had taken away. As Harris Puts it † if Peter II had lived long, all of the work Peter the great had done would have been undone. â€Å"8 Cowie also argues this point; â€Å"the reign of this boy czar was a triumph for the conservative nobility. † After the death of the Empress Elizabeth in 1762, Peter III became Tsar, and Catherine became his Tsarina. During his short reign Peter managed to alienate the Russian nobility in particular the guards and the army. He even antagonised the church and the senate. Dukes claims, â€Å"the guards could still make an empress or break an emperor. â€Å"10 He goes on to say that Catherine had the support of these valuable guards and could control them through Orlov, her lover at the time, and that she used this power to overthrow her husband Peter III. Madarianga agrees with Duke's statement, she claims that â€Å"Catherine's many friends in the army joined in a plot to dethrone Peter III, and seized power with her full approval and participation†11 During the coup of 1762 the support of the nobility ensured the quick and efficient disposition of Peter III, which according to Oppenheim was virtually bloodless, and an easy victory for Catherine, in which the crown was practically offered to Catherine. Oppenheim the claims that the experiences of a poor ruler like Peter III meant that â€Å"Catherine could only expect to retain as long as she able to demonstrate that she was an effective ruler. This argument has also been supported by Lentin; â€Å"as such she remained permanently dependant on the good will of the nobility who could dethrone her as easily as they had raised her up. â€Å"13 I too agree with both Lentin and Oppenheim, as Catherine's first priority was to safeguard her own position, because those who had enthroned her could just as easily dispose of her. Harris on the other hand claims that Catherine could rely on the devotion of those who had gotten her in to power, and also on the fact that Russia was accustomed to an autocracy, and therefore would not have had to worry about appeasing the nobility. I disagree with this claim, although Catherine could rely on the devotion of the conspirators she still had to maintain the support of the rest of the nobility. As Lentin writes â€Å"It was after all, for antagonising the nobility that her husband and her son each met his death. â€Å"14 Catherine had watched the downfall of Peter III, and wasn't going to make his mistakes. On coming to power Catherine had inherited a nation whose workforce was predominantly conscripted. The serfs worked for the nobles, and although in theory Catherine was against serfdom, she knew few nobles would support her in any move to free the serfs. Oppenheim claims that Catherine knew that â€Å"abolishing or even reducing serfdom would entail enormous social upheaval and violent protests from the nobles; and that she lacked the administrative machinery and armed forces to enforce such a reform against their wishes. â€Å"15 Princess Dashkora also tells of the noble's unwillingness to emancipate the serfs she wrote, â€Å"a noble would have to be out of his mind to voluntarily surrender the source of his own prosperity. Madarianga disagrees with Oppenheim she says that Catherine is criticised â€Å"for giving away thousands of free peasants to her favourites and public savants, thus enserfing them†. This view is also taken by Harris who claims that the Russian occupation of the Ukraine â€Å"brought with it the oppressions of state power, taxation, forced labour and serfdom†17 Lentin takes neither views he instead takes the view that the circumstances prevented Catherine from helping the serfs not the nobles; â€Å"The gulf between noble and serf was had grown too wide for Catherine to bridge it. Faced with such an impasse she could do nothing. â€Å"18 I agree with both Harris and Madarianga because Catherine introduced serfdom to parts of her empire where it did not exist, where the nobles would not have pushed for it. On her own estates and lands the condition of the serf also worsened. By the end of her reign over a million people were enserfed by Catherine. Catherine was brought closer to the nobility in 1773-75, during the Pugachev revolt. Lentin states that the revolt made the â€Å"autocracy and the nobility wield together in a common self defence. â€Å"20 Harris also suggests that the Pugachev revolt aligned Catherine with the nobility; â€Å"her autocracy had been shown to rest squarely upon the support of the nobility. Stephen Lee has commented that the Pugachev revolt was an important stage in her reign, which made her see the extent of Russia's problems. This is said to have forced her to abandon radical social reform, and instead maintain the existing social structure. Oppenheim has also claimed that the Pugachev revolt made Catherine more dependent on the nobility â€Å"the revolt undoubtedly increased social division and made both Catherine and the nobles aware of their dependence on each other. â€Å"21 The Pugachev revolt prompted Catherine to declare that she was â€Å"an aristocrat, it is my duty, and my profession. † The Pugachev revolt showed Catherine that she needed the nobility to maintain peace, stability, law and order. Thus at this point much of her enlightened were abandoned in order to appease the nobility and to reward them. The Pugachev revolt showed the need for a more efficient local government, as Pugachev's early successes were due to poor local administration. Catherine changed Peter I' system of government, which brought the nobility under the central government, to a system which enlisted the co-operation of the nobility in the running of local government. This gave the nobles the authority to govern the provinces in co-operation with central government. Harris sums up this point â€Å"Central government was recruiting from the nobility; they appointed the nobility to be governors and councillors, and the latter ruled the provinces in co-operation with the local nobility. â€Å"22 Oppenheim argues that Catherine had not given away any significant power away in the reforms of 1775 â€Å"since it was still the governor appointed by her who made all the noteworthy decisions at a local level. â€Å"23 Treasure sums up Oppenhiem's point â€Å"skilfully Catherine presented the with the semblance of government†¦. She preserved the real power for those she chose the governors. † I agree with Treasure that Catherine retained the real power herself, while appearing to appease/ give in to the nobles. The reforms of 1775 bound the nobles to the crown closer than ever before. The reforms of 1775 led directly to the charter of the nobility 1785. â€Å"Her recognition of the shared interests of Tsar and the nobles was made explicit in the charter of the nobility. â€Å"24 The charter established the social pre-eminence of the nobility, and recognised them as a privileged caste with defined rights. Harris claims that â€Å"by recognising the privileges of the nobility, her own autocracy was left unchallenged, and with the support of the nobility she made Russia the dominant state in Eastern Europe†25 Oppenheim takes the viewpoint that â€Å"to her the charter meant that there was a firm legal basis for the social structure in Russia, instead of the archaic social system of Peter the great. For a ruler intent on giving Russia an enlightened and rational system of government this was a necessity. â€Å"26 Alexander claims that the charter didn't increase the power of the nobility it merely confirmed in law the power they already had. I agree with Harris that the charter had aligned Catherine with the nobility. Any threats of a coup by the noble receded. The nobles had received what they wanted, secured privileges and status. Catherine had ensured that she retained all significant power. As Oppenheim puts it â€Å"The nobles now worked as willing junior partners of state, instead of unwilling servants of Peter I. Catherine II's achievements in her reign were coniderable. However she is often critised for being insincere e. g for not bring about the sweeping reforms that she had advocated at the start of her riegn. Many of her critics question just how genuine Catherine really was. Many historians now believe that Catherine wasn't a true disciple of the enlightenment, but instead used the principles of the enlightenment to advance her own popularity, and to satify her own vanity. Lentin supports the idea that Catherine wasn't a genuine enlightened despot. He goes as far to say that Catherine was a hypocrite, who used â€Å"enlightened slogans as amask to conceal unenlightened policies†27 Harris supports the notion that Catherine was not truly an enlightened despot, but was instead concerned with her reputation with the philosophes and Western Europe. He tells us that Catherine was at great pains to show herself as an apt pupil of the disciples. Oppenhiem also agrees with Harris that her policies contradicted many of her writings. The Nakaz in particular was hypocritical, designed purely to impress the western philosophes. This helps to explain why very few of her ideals which shehad once read about were ever put in to practice. In some cases Catherine actually did the opposite to what the enlightenment proposed. Catherine made Russian society even more unfair. She cemented the privileges of the Russian nobility in law. As Shennen puts it â€Å"The liberties of the nobles constituted the liberties of a state or class and had significance precisely because other segments of the population, notably serfs, did not share them†28 On the other hand Blackwood suggests that Catherine was a genuine reformer, however the problems that faced Russia prevented her ideas from becoming a reality. James White supports Blackwoods claim, and he writes â€Å"altogether it is fair to describe Catherine as almost certainly enlightened in her wishes. 29 Andrews sums up both Blackwood and white's argument; â€Å"Catherine was evidently influenced by the ideas of the philosophes but the size of Russia, the political power of the nobles and her own programme of conquest all prevented their being put into practice. † I personally agree with the argument that Catherine was genuinely ‘enlightened', and that the reason why she couldn't incorporate enlightened reform into Russian law was the complexities of the Russian situation. Catherine herself put this predicament well, when she wrote to Diderot; â€Å"With all your great principles which I understand very well, one would make fine books but very bad business. You forget in all your plans of reform the diference in our positions; you only work on paper which endures all things, but I poor Empress, work on the human skin which is irritable and ticklish to a very different degree. † â€Å"The most important reason why Catherine II could not achieve her enlightened ambitions was her dependence on the nobility. † To what extent do you agree with this view?

Lung Cancer Essays - RTT, Lung Cancer, Free Essays, Term Papers

Lung Cancer Essays - RTT, Lung Cancer, Free Essays, Term Papers Lung Cancer Lung cancer is not just one disease but rather a group of diseases. All forms of cancer cause cells in the body to change and grow out of control. Most types of cancer cells form a lump or mass called a tumor. Cells from the tumor can break away and travel to other parts of the body where they can continue to grow. This spreading process is called metastasis. When cancer spreads, it is still named after the part of the body where it started. For example, if breast cancer spreads to the lungs, it is still breast cancer, not lung cancer. Another word for cancerous is malignant, so a cancerous tumor is referred to as malignant. But not all tumors are cancer. A tumor that is not cancer is called benign. Benign tumors do not grow and spread the way cancer does. They are usually not a threat to life. A few cancers, such as blood cancers (leukemia), do not form a tumor. Most cancers are named after the part of the body where the cancer first starts. Lung cancer begins in the lungs. The lungs are two sponge-like organs in the chest. The right lung has three sections, called lobes. The left lung has two lobes. It is smaller because the heart takes up more room on that side of the body. The lungs bring air in and out of the body, taking in oxygen and getting rid of carbon dioxide gas, a waste product. The lining around the lungs, called the pleura, helps to protect the lungs and allows them to move during breathing. The windpipe (trachea) brings air down into the lungs. It divides into tubes called bronchi, which divide into smaller branches called bronchioles. At the end of these small branches are tiny air sacs known as alveoli. Most lung cancers start in the lining of the bronchi but they can also begin in other areas such as the trachea, bronchioles, or alveoli. Lung cancer often takes many years to develop. Once the lung cancer occurs, cancer cells can break away and spread to other parts of the body. Lung cancer is a life- threatening disease because it often spreads in this way before it is found. Lung cancer is the leading cause of cancer death for both men and women. During the year 2000 there will be about 164,100 new cases of lung cancer in this country. About 156,900 people will die of lung cancer: about 89,300 men and 67,600 women. More people die of lung cancer than of colon, breast, and prostate cancers combined. Lung cancer is fairly rare in people under the age of 40. The average age of people found to have lung cancer is 60. If lung cancer is found and treated by surgery early, before it has spread to lymph nodes or other organs, the five-year survival rate is about 42%. However, few lung cancers are found at this early stage. The five-year survival rate for all stages of lung cancer combined was 14% in 1995, the last year for which we have national data. A risk factor is something that increases a person's chance of getting a disease. Some risk factors, like smoking, can be controlled. Others, such as a person's age, can't be changed. Smoking is by far the leading risk factor for lung cancer. More than 8 out of 10 lung cancers are thought to result from smoking. The longer a person has been smoking, and the more packs per day smoked, the greater the risk. If a person stops smoking before lung cancer develops, the lung tissue slowly returns to normal. Stopping smoking at any age lowers the risk of lung cancer. Cigar and pipe smoking are almost as likely to cause lung cancer as cigarette smoking. There is no evidence that smoking low tar cigarettes reduces the risk of lung cancer. Nonsmokers who breathe the smoke of others also increase their risk of lung cancer. Non- smoking spouses of smokers, for example, have a 30% greater risk of developing lung cancer than do spouses of nonsmokers. Workers exposed to tobacco smoke in the workplace are also more likely to get lung cancer. There are other risk factors for lung cancer besides smoking. People who work with asbestos have a higher risk of getting lung cancer. If they also smoke, the risk is greatly increased. The type of lung cancer linked to asbestos, mesothelioma, often starts in the pleura. This

Online Quiz System Case Essay Example

Online Quiz System Case Essay Example Online Quiz System Case Essay Online Quiz System Case Essay Quiz takers will use their surname and password to login and take the quiz. The questions must at least be 20 items with topics on PH and Myself. Upon login, they can take the quiz and see their score after. Display of score includes the raw score and its equivalent percentage. Using the database, quiz takers can register, view, search, and edit their data. A report on the summary of quiz takers and their scores must be displayed. (For adman access only. See access levels below. ) 2. The proponents must present their systems in a group of a maximum of 5 members.. 3. Other features: provides user-friendly interface create your own home page alteration on all fields is required, meaning users can not have erroneous inputs Ease of use. System must be very easy to use. The user interface is clean and natural even to beginners. Other additional features or display may or may not be included like: display of correct answers, total wrong and right answers, etc. Administrator can add questions to the quiz. 4. Access levels: Administrator all access to features like, viewing of the report of all quiz takers and their scores, add/register/edit/search users, and all other pertinent roles or rights.

4 Creative Ways to Advance Your Career

4 Creative Ways to Advance Your Career There’s no worse feeling in the world for a job hunter than finding the perfect position but being eliminated from consideration simply because you fail to meet one requirement. There may be some ways around these â€Å"must-haves,† but in most cases failure to meet the job description - or even one small component of it - can remove you from the running. Instead of taking a chance on it happening again, cover your bases by padding your resume with one or more of these four sought-after skills. 1. Basic CodingWhile a weekend-long program in basic coding won’t land you a job as a software engineer, it will round out your resume. Sites like Codeacademy offer free lessons in a range of programming languages, including PHP, HTML, Python, Javascript, CSS and others. Each lesson is short, powerful, and delivers just what you need to add â€Å"Programming† to the â€Å"Skills† section of your resume.2. Public SpeakingTen percent of people love public spe aking, 10 percent are terrified of it, and the remaining 80 percent are somewhere in the middle - they know it’s not going to be very fun, but they also know they’ll survive the experience.Aside from helping you pass the â€Å"good communication skills† requirement part of a job description requirement, there’s another important reason the majority of people should work on this skill: why would you want a job when you can merely tolerate a major aspect of it? Comfort with public speaking won’t just land you a job; rather, it will continue to be a useful skill throughout your life.Coursera’s â€Å"Introduction to Public Speaking† course is free, always open, and delivers useful instruction and plenty of opportunities for practice through its public speaking curriculum, including a series of videos totaling 18 hours, videos, and peer assessments.3. Graphic DesignGraphic design skills are highly desirable for a wide range of positions, particularly with the growth of social media, digital technology, and ever-popular infographics. While fudging knowledge of Adobe Photoshop, InDesign or Illustrator on your resume can lead to catastrophic results - particularly if you’re called upon to demonstrate your knowledge or experience - it is possible to learn the basics on your own.For example, Adobe offers tutorials designed to help everyone from novices to experts expand their skill set, while online education website Lynda’s â€Å"Photoshop CC Essential Training† offers the training you need to feel comfortable working with Photoshop.4. Website BuildingAn increasing number of employers are requesting that candidates include links to personal websites along with their application materials. Don’t have one of your own? Unfortunately, this may indicate a lack of initiative and/or the inability to keep up with 21st century expectations.Rather than risking coming off as unmotivated, take advantag e of classes aimed at helping beginners acquire the knowledge they need to to build their own websites. The Muse’s â€Å"Your Guide to Building a Personal Website That’ll Land You a Job,† offers the perfect starting point.The best part of many of these web courses and tutorials? Many are taught during a single day or weekend so you can increase your job marketability without investing significant additional time or expense. Your resume will thank you for it.

ORGANISATIONAL BEHAVIOUR AND DEVELOPMENT Essay Example | Topics and Well Written Essays - 1500 words

ORGANISATIONAL BEHAVIOUR AND DEVELOPMENT - Essay Example Each theory has three important aspect of communication i.e. sender, receiver and message. According to Roberts (2007) â€Å"Change is a multifaceted phenomenon, yet regardless of the paradigm adopted, there is agreement among all writers about change: it is hard, and generally more complex than anyone first anticipates.† Managing change is directing resources to the direction of goals. It involves all the concerned people from the organisation. It is a calculative and structured process of dealing with known changes. Change management is the process requires proper communication and coordination with all the related departments. There are various issues involved in change management process. Change management is always a planned approach of an organisation. Change management process will be successful when there is maximum involvement of the collective effort of the people. The risk of failure of implementation is identified and strategy is developed to deal with the same. The human aspect of change is the primary aspect of the change management in the organisation. This is depended on the industrial psychology. There are various angles to the process like change management. The process should be multi-disciplinary. It should touch all the aspects of the organisation with a focus on the fundamental of the human resource management issues. The new procedures, policies and change in the organisation processes, process and strategic procedures have various risk of the resistance. People when work together form groups. These groups can be formal and informal. Groups have certain norms. The members of a group are likeminded in various issues and approaches. They have commitment for each other. The group communicate through some language to each other. The language becomes the basic tool of keeping the information regarding the norms and expectations of the

Strategic Marketing Planning of S&W and Makatume Assignment

Strategic Marketing Planning of S&W and Makatume - Assignment Example The high consumer demand gives the opportunity to the company to charge higher prices, be better placed in retailers' shelf space and have co-op advertising. Weaknesses = its costs are high since its old production plants are in urban areas whereas labor costs are high. Another weakness is that there is a market confusion between it's professional and consumer tools. The distributors, on the other hand, feel that the company has abused its market position. A further weakness is that S&W is not present in the fast-growing cordless segment. Opportunities = Makatume is locked into lower voltages so there is enough space for S&W to enter the high voltage space. There is also space for the lower voltage market since apart from Makatume, the other players are small companies (domestic and foreign niche competitors). Makatume's position was also due to the favorable exchange rates but the exchange rate forecast for the next years is not that favorable. Threats = Makatume has a good reputation in tradesmen for its professional tools. Makatume follows an aggressive strategy and its aim is to become the No2 player in the US market. It has also a dominant market share in the growing cordless segment. The primary step will cost reduction so as S&W can become more competitive and survive competition from cheaper producers such as Makatume and the Chinese. The production plants through offshoring should move to countries where labor costs are lower. However, S&W should take care that the quality of products manufactured in foreign plants should be equivalent to the ones produced locally. The old production plants, on the other hand, could be used for other business purposes (e.g. premises) or at least they could be rent.Another weakness is the market confusion for consumer and professional tools. Since S&W advertises heavily then it can make a clear positioning of the above tools in its advertisements. There should be market researches done prior and post the advertising campaigns which will check the degree of confusion in the minds of consumers.  

Evidence-Based Practice Projects Coursework Example | Topics and Well Written Essays - 250 words

Evidence-Based Practice Projects - Coursework Example Literature focus identifies the essential information to be shared (Melnyk & Fineout-Overholt, 2011). The approach also helps medical practitioners to share information efficiently as well as evaluate end products in researches. Quantitative research is considered as the best method to be applied in literature focus. Many clinicians use this method to validity study findings thus meeting the core principles of Evidence-Based Practice. Quantitative studies are flexible as it creates room for the analysis of two independent variables (Melnyk & Fineout-Overholt, 2011). For instance, in the clinical study of hypertension, a clinician may choose to analyze the causes of the disease by studying why one group is diagnosed with the ailment while the other is not. The method can be evaluated through population response after presenting the outcome of a medical research to the general public. EBP posters can be used to showcase the result of a quantitative study research practice on a certain disease to the general public (Forsyth et. al, 2010). The aim of this approach would be to analyze public response in order to evaluate the validity of quantitative study research practice. EBP posters are effective to use when aiming to reach a multitude of people (Forsyth et. al, 2010). Clinical canceling can also be used to reach many people with the aim of determining the validity of a quantitative research study. Quantitative research is an effective approach in disseminating EBP as it fosters simplicity in clinical practice to practitioners.

Introduction to Professional Nursing Practice Essay - 1

Introduction to Professional Nursing Practice - Essay Example The other appropriate measure, which head nurses ought to ensure, encompasses avoiding incidences of nurses’ shortage (Subramanian &Vinoth, 2012). Since this is what results to excessive workload on the part of nurses for they end up serving many patients beyond what their both physical and psychological endurance can adequately support. Shortage of nurses in hospitals is a major cause of Burnout whose early signs encompass stress and irritability that signify an overworked nurse. Therefore, nurses ought to learn how know themselves and their limitations (Gagnon, 2008). Moreover, nurses are supposed to maintain a healthy lifestyle by fitting enjoyable leisure activities in their daily lives. This will help in reducing stress. Furthermore, nurses’ training is to put other peoples care before them (Walter, Plaumann & Awa, 2010). This intervention normally enables them learn how to take care of themselves and not to mistake self-care as being selfish but as a way of energizing as well as maintaining one’s emotional and physical stamina. In post cases, this comes with enhancing interpersonal and social relationships with friends and family, which is via healthy communication (Elder, Evans & Nizette, 2009) Elder, Evans & Nizette (2009) in their study have clearly shown how burnout syndrome is an ethical issue and that all nurses have a moral obligation to take the necessary steps to reduce burnout in themselves. This is because, as seen above, burnout syndrome is an undesirable state due to the nurses’ interaction with patients and its effects it on immediate colleagues. Mainly, these associations act as influential organizations towards promoting health mostly comprising of registered nurses. This is through lobbying government and other respective authorities towards availing appropriate working environment for nurses, which will in turn lead improved medical care. Their focuses

Report Essay Example | Topics and Well Written Essays - 1750 words - 6

Report - Essay Example Recently, Oxfam International is operating its supportive functions approximately in over 90 countries around the world (Oxfam International, 2014). In this report, the objective is to identify the contribution of the Oxfam International in relation to the issues of climate change in the society. At the same time, the report intends to identify the values and interests of Oxfam International. Moreover, the report will also critically analyze the advocacy viewpoint of the Oxfam International in relation to various scenarios. Finally, the report will also highlight a supportive view regarding the contribution of the organization. According to the viewpoint Pettengell (2010), during the early 21st century, the issue regarding climate change had become one of the most critical aspects, which has influenced several difficulties and challenges in the society such as poverty and health care related issues (Pettengell, 2010). In this regard, rationally it can be asserted that climate change has initiated larger threats across the entire world. Moreover, it has affected the capacity and response of the poor in the society, which has influenced the poor citizens in an adverse manner. In this context, it can be claimed that climate change has affected the subsistence of crops due to vulnerable outer temperature ranges around the world. At the same time, erratic rainfall has also changed the seasonal pattern and monsoon of the entire globe, which has negatively affected the agricultural cycles all around the world. As an effect, farmers are struggling to produce expected amount of crop. On the other hand, due to frequ ent climate changes the level of sea water is rising around the world, which is also indirectly affecting the productivity of crops, due to presence of high proportion salt in the water (Pettengell, 2010). These are the identified adverse effects that climate changes have on the environment and the society at large. According to the report published

Introduction to Professional Nursing Practice Essay - 1

Introduction to Professional Nursing Practice - Essay Example The other appropriate measure, which head nurses ought to ensure, encompasses avoiding incidences of nurses’ shortage (Subramanian &Vinoth, 2012). Since this is what results to excessive workload on the part of nurses for they end up serving many patients beyond what their both physical and psychological endurance can adequately support. Shortage of nurses in hospitals is a major cause of Burnout whose early signs encompass stress and irritability that signify an overworked nurse. Therefore, nurses ought to learn how know themselves and their limitations (Gagnon, 2008). Moreover, nurses are supposed to maintain a healthy lifestyle by fitting enjoyable leisure activities in their daily lives. This will help in reducing stress. Furthermore, nurses’ training is to put other peoples care before them (Walter, Plaumann & Awa, 2010). This intervention normally enables them learn how to take care of themselves and not to mistake self-care as being selfish but as a way of energizing as well as maintaining one’s emotional and physical stamina. In post cases, this comes with enhancing interpersonal and social relationships with friends and family, which is via healthy communication (Elder, Evans & Nizette, 2009) Elder, Evans & Nizette (2009) in their study have clearly shown how burnout syndrome is an ethical issue and that all nurses have a moral obligation to take the necessary steps to reduce burnout in themselves. This is because, as seen above, burnout syndrome is an undesirable state due to the nurses’ interaction with patients and its effects it on immediate colleagues. Mainly, these associations act as influential organizations towards promoting health mostly comprising of registered nurses. This is through lobbying government and other respective authorities towards availing appropriate working environment for nurses, which will in turn lead improved medical care. Their focuses

Index funds and their investment policy Essay Example | Topics and Well Written Essays - 1000 words

Index funds and their investment policy - Essay Example Unlike index funds, actively managed funds aim to reach results, which exceed whole market results or some of its components. It's important for their managers to select the stocks, necessary to buy, correctly, and also to define exactly the best selling/purchasing moment. Unlike actively managed funds, which aim to reach results, which exceed whole market results or some of its components (it's important for their managers to select the stocks, necessary to buy, correctly, and also to define exactly the best selling/purchasing moment), index funds demonstrate more passive investment strategy. Index funds invest assets to some basic asset classes, each of them characterized by its own flights and drops. That's why combinations of investing into funds, based on various indexes allow reaching some balance, reducing the risk and increasing invested money return. There are five five members, who represent Standard & Poor's and the ASX. They set policy, determ index composition and administer the indices in accordance with the S&P/ASX index methodology. The investment policy includes adding, removing or by-passing any company or during the selection process. And what about the portfolio investment... An index addition generally will be made only if an index vacancy is created by an index deletion. The Index Committee determines S&P/ASX index additions based on historic analysis of a stock's market capitalization, free float, and liquidity. The Fund is a style-based fund that seeks to provide a total return that is broadly in line with the S&P/ASX 200 Index (excluding listed property trusts) before taking into account Fund fees and expenses. The Fund is targeting a grossed-up dividend yield that is 1% above that of the index. Grossed-up dividend yield is calculated taking into account both cash dividends and associated franking credits. Surely, the Committee analyses every merger, spin-off, acquisition, or scheme of arrangement. Index funds are popular among investors thanks to their wide portfolio diversification, low expenses and high efficiency from taxation point. 2. ASX200 composition determining and it's changing. There are indexes for some certain market branches (municipal, technological, financial etc.), regions and states and even different investment styles. For instance, "growth" indexes are composed from the stocks of the companies, which are waited to demonstrate fast profit growth tempos, while "cost" indexes - from the stocks, which can be undervalued on the base of financial results or company assets. The S&P/ASX 200 Index is recognized as one of the leading investment benchmarks for the Australian equity market. The index represents the 200 largest and most liquid publicly listed entities in Australia. The S&P/ASX 200 Index provides investors and fund managers with an effective benchmark for Australian equity performance, as it offers a broader representation of the Australian market. What companys' stocks are included in ASX 200 list The

John Locke Essay Essay Example for Free

John Locke Essay Essay John Locke, a philosopher of the Age of Reason and the Enlightenment, greatly influenced the American revolution and the French revolution. His beliefs were the social contract, natural rights, and the right of revolution. One of John Lockes beliefs was the social contract. A social contract can be either a written or unwritten agreement between a government and its people. Social contracts usually contain a basic set of laws and agreements explaining how the country should be run. Examples of a Social contract are the US constitution and the Declaration of the Rights of Man. John Locke was a huge influence for both of these documents. Locke also believed that every person has natural rights. A natural right is a basic right that every citizen should be born with. Locke said that everyones natural rights were the right to â€Å"life, liberty, and property. † These natural rights have been quoted and used many times in history. Thomas Jefferson was influenced by this while writing the Declaration of Independence, saying that all men are created equal and that they have the right to life, liberty, and the pursuit of happiness. Lastly and most importantly, Locke believed in the right of revolution. The right of revolution is the belief that if that a government does not meet the basic needs and wishes of its people, then the people have the right to revolt and overthrow that government. Examples of this are the American and French revolutions. The Americans revolted against England because they failed to grant them the basic rights stated in their social contract, saying no taxation without representation. The French revolted against their government because King Louis caused the countries economy to be almost non existent and most of the country had nothing to eat. Both these revolutions led to the rise of democratic nations. John Locke is one of the most influential people in history. His beliefs has influenced the formation of many countries, including our own. His ideas have be restated and reused throughout history, and still influence people today.

Psychological Impact of Newly Diagnosed Lung Cancer

Psychological Impact of Newly Diagnosed Lung Cancer CHAPTER ONE Introduction The concern addressed in this dissertation is to explore the psychological impact on a newly diagnosed lung cancer patient. Patients with lung cancer normally experience variety of distress symptoms, many of which begin prior to diagnosis and continue throughout the course of the disease and the treatment, which adversely affects the functional status and quality of life (Julkunen et al, 2009). The experience of lung cancer is not limited to only the victims but may equally have wide-range impact on families physical and emotional well-being. Therefore it is essential to critically assess the extent of this psychological impact of lung cancer on the patient. This topic is properly examined in context of a critical literature review approach. The approach has adopted the traditional method which is considered appropriate for the purpose of this piece of work. This method involves a critique, summary and synthesis of a body of literature after which a conclusions is drawn, (Coughlan,et al. 2008). According to Crombie (1996), the purpose of writing a literature review is to convey to readers the knowledge and ideas which have been established on the chosen topic, and explore the strength and weaknesses. This helps to identify gaps and inconsistencies in the literature. Gomm et al, (2000) stated that the purpose of a review is to analyse critically a published body of knowledge through summary, classification, and comparison of prior research studies, reviews of literature, and theoretical articles. A further consideration for the literature review will not merely be a descriptive list of materials obtained, or a summary of relevant resource s, but rather to provide the framework of the research investigation and summarise the literature studied in order to develop the research study (Brink and Wood, 2001). A brief description of the anatomy and physiology of the lungs will be discussed to enhance proper understanding of the topic. Pathophysiology, aetiology and epidemiology of lung cancer will be outlined. The methodology will be described including a brief description of the models and strategies adopted in conducting the review. The review of 10 peer review papers are presented in chapters using critical appraisal tools to evaluate the strengths and limitations of the research papers. Both qualitative and quantitative primary research papers will also be used. Limitations of the literature and the process of the review will be identified. The dissertation will be structure in the following way: Chapter 2 will explore the background information about lung cancer by examining the pathophysiology, aetiology, and epidemiology, pathogenesis, treatment and evaluation of the disease. It also considers the rationale behind the chosen topic. Chapter 3, Research Methodology, outlining the various strategies employed to gather and analyse the sources of data. Chapter 4, Psychological distress: anxiety, depression, desire for hastened death, feeling of guilt and hopelessness. Chapter 5, Discusses the impact psychological distress has on quality of life of newly diagnosed lung cancer patients. Chapter 6, Summary of findings of the literature reviewed. Chapter 7, Limitations of the literature reviewed. Chapter 8, Limitations of the whole literature reviewing process. Chapter 9, Conclusion and Recommendations, distils the key points and relates them to proper management of lung cancer. It also proposes a number of recommendations to tackle the problems identified above. CHPTER 2 Lung cancer 2.1 Introduction The study is to identify the psychological impact of newly diagnosed lung cancer on the patient. Lung Cancer is a disease that begins in the tissue of the lungs. To better understand lung cancer, it is vital to understand the anatomy and physiology of the lungs. 2.2 Anatomy and physiology of the lungs The lungs are two cone-shaped structures positioned on either side of the heart. In the mediastinum. They are sponge-like organs that are part of the respiratory system. During breathing, air enters the mouth or nasal cavity and travels down the trachea. The trachea, divides into two smaller tubes: the right bronchus and the left bronchus. The right bronchus enters the right lung and the left bronchus enters the left lung. The right and left bronchus branch into bronchioles. These bronchioles end in tiny balloon-like air sacs called alveoli. The alveoli are where oxygen, carbon dioxide, and other substances are exchanged between the lungs and the blood stream. (Gould, 2006). Pathophysiology, aetiology and epidemiology of lung cancer Lung cancer is a term, which covers a collection of several different forms of malignant tumour arising in the lungs and in the major airways (The Royal College of Physicians, 2005). There are two major types of lung cancer, non-small cell and small cell. Non-small cell lung cancer (NSCLC) arises from epithelial cells which is the most common type of lung cancer. Small cell lung cancer begins in the nerve cells or hormone-producing cells of the lung. The term small cell refers to the size and shape of the cancer cells when seen under a microscope. According to (McCance and Heuther 2005) the non-small cell lung cancer (NSCLC) accounts for about 80% of all lung cancers. There are different types of NSCLC, these are: Squamous cell carcinoma (also called epidermoid carcinoma). This is the most common type of NSCLC. It forms in the lining of the bronchial tubes and is the most common type of lung cancer in men. Adenocarcinoma. This is found in the glands of the lungs that produce mucus. This is the most common type of lung cancer in women and also among people who have not smoked. Bronchioalveolar carcinoma. This is a rare subset of adenocarcinoma. It forms near the lungs air sacs. Recent clinical research by Scullion and Henry (1998) has shown that this type of cancer responds more effectively to the newer targeted therapies Large-cell undifferentiated carcinoma. This cancer forms near the surface, or outer edges, of the lungs. It can grow rapidly. The small cell lung cancer (SCLC) as (MacCance and Huether, 2005) puts it, accounts for about 20% of all lung cancers. Although the cells are small, they multiply quickly and form large tumors that can spread throughout the body. Smoking is almost always the cause of SCLC. Lung cancer begins when cells in the lungs grow out of control and form a tumor. A tumor can be benign (noncancerous) or malignant (cancerous). A cancerous tumor is a collection of a large number of cancer cells that have the ability to spread to other parts of the body. A lung tumor can begin anywhere in the lungs (Muers et al, 2001). According to Hughes and Pride (1999), once a cancerous lung tumor begins to grow, it may or may not shed cancer cells. These cells can be carried away in blood or float away in the natural fluid called lymph, which surrounds lung tissue. Lymph flows through the lymphatic vessels that drain into lymph nodes. Cancer cells metastasise when it leaves its site of origin and moves into a lymph node or to a far away part of the body through the bloodstream. The location and size of the initial lung tumor, and whether it has spread to lymph nodes or more distant sites, determines the stage of lung cancer. The type of lung cancer and stage of the disease determine what type of treatment is needed. The staging system describes the extent of the disease at the time and therefore provides a basis for treatment and prognosis. The staging systems as described by McCances and Huether, (2006) are based on the following: The size of the primary tumour (T); The extent of regional lymph nodes (N); and The spread of the tumor (M). Lung cancer is the most common form of cancer in the UK, resulting in 36,000 deaths each year (DOH, 2007). Lung cancer is the leading cause of cancer motality in the UK: In every 15 minutes, a new diagnosis is made with approximately 40,000 fresh cases every year (NICE, 2009). It remains the most frequent of all malignant diseases and the one with the poorest prognosis. 80 percent of effected people die within a year (DOH, 2007). Lung cancer continues to rise and is now very high in women as well as men (Hamer et al, 2008). Many epidemiological studies have assessed the extent and nature of problem in the UK, (Blackler et al, 2007) report that lung cancer occurs in people who smoke. This is supported by further research from the United States of America, including other comprehensive study conducted by Scullion and Henry (1998) that the risk of lung cancer is higher in persons who begin smoking early, continue for many years, and are considered heavy smokers. However (Gould, 2006) posited that people who dont smoke can also develop lung cancer, although this is much rarer. This confirms (McCance and Huethers, 2005) statement that people who have been in prolonged or close contact with asbestos have a higher risk of lung cancer, especially if they smoke. Lung cancer is rarely diagnosed in people younger than 40 most cases occur in people over the age of 60. 2.3 Pathogenesis, Treatment and Evaluation The treatment of lung cancer is based on the size and location of the tumor, whether the cancer has spread, and also the persons overall health. There are four basic ways to treat lung cancer: surgery, radiation therapy, chemotherapy, and targeted therapy (NICE, 2005). Treatment options differ for each individual and may depend on other factors such as age, physical condition, and other medical problems. The goal of Surgery is to remove the part of the lung where the tumor is isolated. Chemotherapy is to kill rapidly dividing cells in the body, including cancer cells using drugs. It is the main treatment for people with small cell lung cancer. In many people, chemotherapy will enable them to live for longer, with better control of symptoms. (NICE 2009) Chemotherapy may be given on its own, or before radiotherapy. Sometimes chemotherapy and radiotherapy are given at the same time; this is known as chemoradiation. Targeted therapy is a treatments designed to target cancer cells in more specific ways, usually involving the mechanisms that cause cancer cells to grow or divide (DOH, 2007). The diagnosis of lung cancer becomes a crisis in victims life when experienced, confronting them with changes in identity, role, and social interactions and presenting them with an uncertain future (Waller and caroline, 1996). Kemp (1999) posited, the psychosocial distress can interfere with the patients healthcare and diminish his or her health and functioning. Many patients who face cancer diagnosis that require physical effects of treatment appear to experience emotional difficulties, including anxiety and depression. Equally, patients with untreated depression or anxiety may be less likely to take their cancer medication and maintain their health. Moreover they may withdraw from family or other social support services which may affect the treatment outcome. 2.4 Rationale The rationale for the choice of topic was based on a desire to understand the psychological impact of lung cancer on the patient. Often the physical effects of the cancer disease and treatment are focused more on the curative effort. Therefore, it is important for the health-care team to address psychological effects, that cancer patients normally encounter that can greatly affect their sense of well-being. Nursing is expected to deliver high quality care that is effective in promoting health and well being (LoBiondo-Wood and Haber, 2006). Evidence-based practice is a key strategy in the development of modern health services and crucial to the development of nursing practice (Parahoo, 1997). Evidence-based care as Brink and Wood (2001) suggest and supported by (Carnwell 1997), is the conscientious use of current best evidence in making decisions about the care of individual patients or the delivery of health services. The successful completion of the review will investigate primary r esearch. In doing so this may act as an additional information source for healthcare professionals and as a basis for further enquiry. Chapter 3 METHODOLOGY 3.1 Aims and research questions Against the background of the foregoing explanation, it is desirable to identify the psychological distress associated with lung cancer and how it affects the patient. The questions the review seeks to address/answer are 1. What are the psychological reactions of newly diagnosed lung cancer patients? 2. How do these psychological reactions affect physical and psychological wellbeing of theses patients? 3. What interventions can be used to address these psychological reactions of newly diagnosed lung cancer and manage them effectively? 3.2 Parameters for the literature search The chosen method is a systematic literature review of both qualitative and quantitative research in the study area. A systematic literature review as defined by (Parahoo, 1997) is a summary of research that uses explicit approach to perform a thorough literature search and critical appraisal of existing body of published knowledge to identify the valid and applicable evidence. It is a means of managing very large volumes of information to identify evidence on which recommendations can be made (Holloway and Wheeler, 2002). Studies were used if they included adults (age 45 +) who have been newly diagnosed of lung cancer. 3.3 Inclusion Criteria This review included literature published from the year 1999 onwards All papers published in English Language only. Primary research directly related to the topic and Published research articles only. 3.4 Exclusion criteria Primary research not directly related to the topic Unpublished research articles Articles published before the year 1999 Other people were involved also, people from the specialist cancer services and the librarians whose help was invaluable in developing a search strategy and in sourcing and retrieving papers. 3.5 Literature searching strategies The search was completed using electronic databases. These were the Cochrane Library, CINAHL, British Nursing Index, Northampton Full Text [emailprotected], Proquest, Medline, and PsycInfo. The Cochrane Library was searched initially to see if a similar study had been done. The other data based were then searched from 1999-2009. Medline is a nursing and medical database. It is known to be incomplete (Markinson, 2002) however (Tagney and Haines, 2009) demonstrated that a search on MEDLINE is likely to produce most of the appropriate papers because it publishes articles from a worldwide source. The hospital library service was used to find studies which were not available in full text form on the internet or locally held journals. Not all could be located; however this potentially could be a source of bias. In discussing the problems and importance of incomplete retrieval of papers, (Chalmers and Altman, 1995) argue that trials that are difficult to locate tend to be smaller and lower methodological quality than trials that are easily accessible. The key words used to search the database were LUNG CANCER, DIAGNOSIS, DEPRESSION, CANCERS, PSYCHOLOGY, PSYCHOLOGICAL INTERVENTION, MEN, ANXIETY, ANGER, SADNESS, FEELING OF GUILT OR REGRET and PATIENTS FEELINGS. The nature of the study necessitated the use of very general terms such as lung cancer, and psychology. Sensitivity was chosen rather than specificity in the selection process and this meant that the search initially uncovered a large number of papers unrelated to the study. The result of the search was initially screened by reading the abstract online and retrieving the relevant ones using the inclusion and exclusion criteria. The studies which were retrieved were screened again to make sure they fulfil all the criteria required to be used for the review. To avoid bias, this study used methods outlined by Aveyard (2008). The methods were simplified for people who are new to or have little experience in doing a literature review. As suggested by (Cutcliffe and Ward, 2003) met hods used in systematic reviews reduce the potential bias of the review. 3.6 Method of Evaluation The literature is evaluated using Greenhalg T (1997) structure for evaluating qualitative research. (See appendix 2) This model was selected because most of the research was qualitative due to the nature of the selected topic. Anxiety and depression are difficult to measure because its an emotional response and therefore immeasurable. 3,7 Method of Analysis The research is analysed using a summing up approach as described by (Aveyard, 2008) which is adopted from the approaches given by Paterson et al (2001). This model was chosen because it facilitates the extraction of themes from research literature of a diverse nature. Again is suitable for people who are new to the literature review process. The themes generated are: Psychological distress: Anxiety, depression, feeling of hopelessness and the desire for hastened death. Effect of psychological distress on quality of life of people with newly diagnosed lung cancer. 3.8 Data handling method The data was stored and subsequently analysed using data storage system described by (Cormack, 2000) this system has two commonly methods of storing data: storage in original form, and storage using computer. The printed research papers were stored in a ring binder file and a memory stick was used to store computerised data. The purpose of data storage as LoBiondo-Wood and Haber (2006) puts it has three basic related purposes: to make sure that no data are lost; to ensure that information are obtained in a way which makes it reasonably accessible; and to ensure that the researcher is able to analyse the data. A separate note book was used to store references. 3.9 Resources required and sources identified Resources required are computers, various libraries, search engines, text books, stationary, supervisor, and librarian. Sources identified are internet and printed journals. CHAPTER FOUR THEME 1 Psychological distress: Anxiety, depression, desire for hastened death, feeling of guilt and hopelessness. Following exploration of the available and chosen research for this literature review, various themes have been identified. This chapter aims to discuss and explore the reviewed literature regarding the psychological distress of newly diagnosed lung cancer patients. It will discuss anxiety, depression, feeling of guilt and hopelessness which influence the disease-related factors on the desire for hastened death which have emerged from the data. Five studies (Akechi et al (2006), Turner et al, (2006), Wilson et al, (2007), (Rodin, et al 2009) and Mystakidou et al, (2008) will be examined using the methodology, discussions and analysis of the research to evaluate their findings. (See appendix 3 for research articles) In order for this to be achieved, the chapter has been divided into three sub-themes these are: Psychological distress. Anxiety and depression. Feeling of guilt/hopelessness and the desire for hastened death. There will be a small summary to conclude the chapter. 4.1 Psychological distress A cancer diagnosis can be viewed as a very stressful event for patients as they must adapt to the shock and uncertainty that such a diagnosis presents Fox et al (2006). As a result of life-threatening nature of cancer, psychological distress in cancer patients has been widely studied. Previous studies have indicated that 10-40% of cancer patients suffer from psychological distress (Skarstein, 1999). Vos et al, (2008) reported that 19% of lung cancer patients experienced depression between the time of diagnosis and initial treatment and 35% of them continued to experience the same disorder 6 months after. It is therefore vital to investigate the exact predictive factors of the psychological factors experienced by newly diagnosed lung cancer patients. The first research paper identified was conducted by Akechi et al (2006). The purpose of the study was to investigate longitudinal changes and predictive factors for psychological distress among newly diagnosed lung cancer patients. The study was conducted among 85 newly diagnosed advanced non-small cell lung cancer patients. Data were obtained in structured interview and validated self-report questionnaires. Psychological distress was evaluated using the Profile of Mood State (POMS) scale. This scale was developed by McNair et al., 1977. The POMS scale according to Akechi et al (2006) is a self-rating scale measuring six emotional sates (tension-anxiety, depression-dejection, anger-hostility, vigor, fatigue, and confusion) and total mood disturbance. It was hypothesized that a lower fighting spirit and a higher helplessness/hopelessness were significant predictors of total mood disturbances. Therefore initial psychological response after lung cancer diagnosis was the most relevant p redictor of subsequent psychological distress. Their findings indicate that initial mood disturbance after the disclosure of a diagnosis of cancer (shock and uncertainty) is the most relevant predictor for subsequent psychological distress and that early intervention beginning immediately after a diagnosis is one way of preventing and/or reducing subsequent psychological distress in lung cancer patients. Initial psychological response after cancer diagnosis seems to continue the subsequent illness trajectory for at least several months, although several dimensions of psychological response, including anxiety and depression, may decrease. In their words, the overall psychological distress does not decrease naturally in the usual clinical care setting. Their study has several methodological advantages as compared with other studies because the method used for collection and analysis of the data were clearly described in the study which confirms that the qualitative method used was appropriate for the study (Greenhalg, 2001). However it has several limitations and cautions must be used when interpreting its findings. First, it was stated in the methodology that the researchers were not able to obtain longitudinal data on approximately 40% of the potentially eligible subject at the time of the investigation (Akechi et al, 2006). This introduces the possibility of a selection bias (Crombie 1996). The absence of this longitudinal data mentioned demonstrate that individual level change over time could not be studied on 40% of the sample therefore the researchers could not obtain the longitudinal course of psychological distress of those people(Akechi et al, 2006). This indicate that the findings may be distorted by the bias, even though it seems to be very common and one of the most difficult issues that cannot be completely overcome in the studies focusing on advanced cancer patients. Secondly, of all, this study included up to 6 months follow-up after cancer diagnosis, the longitudinal course of patients psychological status thereafter is unclear. Six months after diagnosis may not be enough long time to evaluate the longitudinal course of distress experienced by advanced lung cancer patients. For example, a recent study, examining the course of psychological distress in metastatic breast cancer patients demonstrated that distress remained constant or declined during the illness trajectory; however distress significantly increased proximal to death (Hill et al, 2002). Considering the prognosis of advanced non-small cell lung cancer patients, it seems plausible that many dimensions of psychological distress, including anxiety and depression, may increase as death approaches. The convenience sampling method used also poses threat to the generalisation of the findings, because the study subjects consisted entirely of newly diagnosed advanced non-small cell lung cancer (NSCL) patients who visited one Thoracic Oncology Division in Japan. Since patients with other lung cancer types at other sites were not examined in the study, it remains unclear whether the results can be extrapolated to patients with other lung cancer types at other sites. Lastly, psychological distress after cancer diagnosis was the only significant predictive factor of subsequent psychological distress after cancer diagnosis. To the best of our knowledge, very few studies have addressed the predictive factors for psychological distress in lung cancer patients while several studies have investigated predictors for subsequent psychological distress in other types of cancers (REF). Edward and Clarke (2004) demonstrated that family functioning and patients illness characteristics were associated with anxiety and depression in newly diagnosed lung cancer patients. Consequently, because the follow-up period in this study was short and the sampling method used caution must be taken when interpreting the findings. 4.2 Anxiety and Depression Depression refers to an emotional disturbance marked by the cardinal symptoms of persistent and pervasive low mood and the loss of interest or pleasure in normal activities (Skarstein et al, 2000). McPherson (2004) defined anxiety as a feeling of apprehension and fear characterized by physical symptoms such as palpitations sweating, and feelings of stress. Depression and anxiety disorders are thought to be common in palliative cancer care ( Strutkowski et al, 2008). The first study identified was conducted by Turner et al, (2006). It was a prospective observational cohort study of patients undergoing palliative radiotherapy for lung cancer. The aim was to measure psychological distress and concerns before and after treatment using the Hospital Anxiety and Depression (HADS) and a concern checklist. Participants were selected randomly from radiotherapy clinics in various hospitals. Data were obtained from a group of 83 elderly patients (aged 75 and above) being treated with palliative radiotherapy for lung cancer, with a comparison group of 49 younger patients (aged 65 and under). They completed the HADS (Hospital Anxiety and Depression Scale) and a concerns checklist before and after treatment. The HADS according to Skarstein, (1999) is an instrument which rates anxiety and depression in patients with physical illness. It has two sub-scales, one assessing anxiety, and another evaluating depression. Anxiety and depression subscales of the HADS were scored using a score of 0-7 = normal, 8-10 = borderline, and 11-21 = probable case (i.e. likely to have the diagnosis of anxiety or depression confirmed after formal psychiatric assessment). The concerns checklist data were examined to provide median numbers of concerns identified by each patient group before and after treatment and, the changes over time were compared statistically. They hypothesized that majority of newly diagnosed lung cancer patients experience severe level of depression and anxiety. The result of the study shows that the 60% of young group and 40% of elderly group had anxiety. And 30% of young group and 60% of the elderly group had depression. The young group consistently ranked the illness, the future relating to the illness, family and their energy level as their major concern and the elderly group also ranked family and breathlessness as their major concern. This findings suggested that people of all ages have similar concerns and level of anxiety and depression whiles receiving palliative radiotherapy for lung cancer. A year after a similar study was conducted by Wilson et al, (2007). It examined depression and anxiety disorders in 381 patients who were receiving palliative cancer care. The study group consisted of 212 women and 169 men (age 26-93). Data was obtained through the development of a structured interview of symptoms and concerns. Depression and anxiety disorders were assessed with a modified version of the Primary Care Evaluation of Mental Disorders (PRIME-MD) clinician evaluation guide. The PRIME-ED according to Fox, (2006) provides a quick screening method for a wide range of mental health disorders. The findings of the study suggested that physical symptoms (such as pain and breathlessness) as well as issues about the illness itself and its treatment were more likely to have been addressed. Anxiety and depression were the frequent individual diagnosis. But there was no association between these disorders and the time to death. However it makes it more difficult to treat their physic al symptoms. The findings from these two studies suggest that depression and anxiety disorders are common in newly diagnosed lung cancer patients. However Turner et al (2006) suggested that people of all ages have similar concerns and levels of anxiety and depression while receiving palliative radiotherapy for lung cancer. Turner et als (2006) findings supported Wilson et al, (2007) because it also established that issues about the illness itself and its treatment outcome were the major concerns of the participants which influence anxiety and depression. However the two studies are limited to the method used. Turner et al (2006) clearly identified the data collection method used in the methodology. Patients completed the Hospital Anxiety and Depression Scale and the Concerns Check List. The questionnaire was completed by patients during their first visit for radiotherapy using touch-screen technology to record their responses. This method has been validated against paper questionnaire (Holloway and Wheeler, 2002). Some patients also used the paper version of the questionnaire. Data obtained from these two methods were compared in the analysis. Follow up was made during the next visit of patients to their outpatient appointment. Lung cancer specialist nurses were used for the collection of follow-up data. Where this was not possible, questionnaire, along side paid envelopes were sent directly to the participants. Those who returned completed questionnaires were sent a letter of thanks. On the other hand, Wilson et al, (2007) used a di agnostic interview which was a modification of a protocol that has been developed for the rapid screening of mental disorders in primary rather than palliative care. Although it has been used in previous studies in oncology settings, admittedly there is not enough strong body of validating research to support it use (Skarskein, 2000). Moreover Turner et als (2006) study was conducted in the United Kingdom while Wilson et al, (2007) was conducted in Canada. This could affect the interpretation of the findings because of the existing cultural differences and healthcare systems among these two countries. Conversely, in both papers the researchers achieved excellent sample sizes and responses (LoBiondo-Wood, 2006). Greenhalg (2001) stated that when examining studies it is important to distinguish whether the sampling strategy is appropriate for the design of the study and level of evidence provided by the design. Turner et al, (2006) selected a sample size of 191 patients undergoing palliative radiotherapy in radiotherapy centres in various hospitals. From this, 132 were recruited into the study, 83 elderly and 49 younger patients. Wilson et al, (2007) selected an eligible sample of 381 lung cancer patients receiving palliative care in eight sites across Canada. In both studies the researchers achieved excellent sample size and response rate. The sample sizes were large enough to give an accurate picture of what is going on (Greenhalg, 2001). Crombie (2008) stated that studies which use too small sample size often fail to detect clinically important effects. Moreover both studies used random sampling to recruit participants for the studie