Gay and Lesbian Adoption essays

Gay and Lesbian Adoption essays In 1942 a baby was born in a Chicago hospital named John Wayne Gacy. He came from what seemed like a normal family. He grew up with his two sisters, his mother, and his father. However, it was not known by anyone that Gacys father was both verbally and physically abusing him. This would ultimately affect Gacy for the rest of his life. In 1968 Gacy was indicted by the a grand jury allegedly committing the act of sodomy with a young teenage boy, and sent to prison for ten years. Gacy spent only 18 months in jail and was set free on parole. It was the start of Gacys killing spree that would last over ten years. He raped and killed in all, up to 33 young teenage boys. Gacy was not a suspect for any of the missing children until 1980. When the police searched Gacys house, they found 28 bodies buried in his house. Of the bodies found, 27 were buried in his crawl space. The other four victims were found later in local rivers. Throughout Gacys trial, he was said to show no emotions of regret or sympathy. John Wayne Gacy is still considered one of the most dangerous and famous serial killers of all time. My primary diagnosis of John Wayne Gacy is that he suffers from schizophrenia. There are many symptoms that make up schizophrenia, and two of them are clearly seen in Gacy. One positive symptom of schizophrenia is having extremely inappropriate emotions or actions. Gacy had very strange emotions. He enjoyed raping young teenage boys and then killing them. His actions were bizarre as well. The act of rape and murder are inappropriate. Also being able to bury and live with over 25 dead bodies is very unusual as well. Another symptom clearly seen in Gacy is his flat and unemotional personality. At the trial, Gacy seemed to be lapsed into flat affect. This means that he was in a zombie like state, showing absolutely no emotion at all. He had no regret for the crimes he committed. ...

Reparations in The United States Essay Example | Topics and Well Written Essays - 2500 words

Reparations in The United States - Essay Example According to the study  the life challenges the African American are facing today are because of slavery, and the life they underwent during slavery.  This is because they were taken from their homes in Africa, and abused in America by a regularity that ruined the structure of their families, as well as destroying the individual. When the American decided to end slavery,   the African   American were left with nothing, denied education, segregated making them experience a lot of economic challenges. Compared to the Europeans, the African American remained disadvantaged in the society, and it is said that they are likely to remain like that until the government compensates them.From this essay it is clear that the provided welfare and affirmative action, as well as other effort established to address socio economic challenges of the African Americans have been too small.These efforts have failed because the society has failed to tackle the main challenge affecting the African American people. This is because of racism and discrimination they present to the African American people.  To some extent the social welfare programs were established   for good intentions. However, have largely contributed to the isolation of the African American people, and further destroyed the African American society. Furthermore, the established programs only benefited other people leaving out the African Americans.   Ã‚  ... Compared to the Europeans, the African American remained disadvantaged in the society, and it is said that they are likely to remain like that until the government compensates them.7 3 The provided welfare and affirmative action, as well as other effort established to address socio economic challenges of the African Americans have been too small.8 These efforts have failed because the society has failed to tackle the main challenge affecting the African American people. This is because of racism and discrimination they present to the African American people.9 To some extent the social welfare programs were established for good intentions. However, have largely contributed to the isolation of the African American people, and further destroyed the African American society. Furthermore, the established programs only benefited other people leaving out the African Americans.4 Supporters for reparations noted that, reparations were not going to promote dependence. However, they were going to offer the African American people an opportunity to develop their own economic foundation and become independent.10 According to McCarthy, reparations were meant to restore past injustices, to amend the harms imposed, and to socialize their victims. This is because several existing African Americans went to isolated schools that had limited resources. In other circumstances where they went for higher education, then it was upon them to choose a black collage or not attend college at all.11 The African Americans experienced discrimination in job appointments, and they experienced poor access of information. They were categorized as second class citizens in the United States. McCarthy noted that this reparation took two forms the collective compensation and collective

Research Skills for Marketing Essay Example | Topics and Well Written Essays - 1250 words

Research Skills for Marketing - Essay Example The cost applied here also is very much important. The data sources applied here are primary data. The information are collected only through the primary data i.e., collecting direct information from the respondents. The research approaches include Observational Research: which is just observing the buying behaviour of the customer Survey research: This is done by conducting survey directly to the customers. Behavioral Data: by finding out the traces of the purchasing behavior in the store, scanning data The Research instruments include Questionnaire and by Qualitative measures The expectations can be identified by setting up the questionnaires and conducting analysis and by customer opinion. Sampling Plan is the sampling unit ie., who is to be surveyed, here men,women and children. The sampling size should be large so that the good analysis is done hence a sample of nearly 500 respondents are to be taken. The sampling procedure is the probability sample. The contact is done through mail Questionnaire, online interview and direct interview 3. COLLECTING INFORMATION: The information is collected through feed backs like questionnaires, interviews and surveys. 4. ANALYZING THE INFORMATION: The information is analyzed here through various techniques like tabulation, frequency distribution, averages, measures of dispersion and SPSS methods. The more the analysis the more the accuracy of results. 5. PRESENTING THE FINDINGS: The findings here were on the Arrangement of the products in the store. The cost of the products. The method of payments Products available. Methods of promotion. The service availed. 6. MAKING THE DECISION: Hence by conducting research in all these areas it is suggested to have a moderate price for the...Why the customers behave as this and what is the wrong found in the shop. The information is analyzed here through various techniques like tabulation, frequency distribution, averages, measures of dispersion and SPSS methods. The more the analysis the more the accuracy of results. 9. Esty, Katharine, Richard Griffin, and Marcie Schorr-Hirsh (1995). Workplace diversity. A managers guide to solving problems and turning diversity into a competitive advantage. Avon, MA: Adams Media Corporation.

ECO-FRIENDLY KEY PERFORMANCE INDICATORS IN PUBLIC PROCUREMENT Dissertation

ECO-FRIENDLY KEY PERFORMANCE INDICATORS IN PUBLIC PROCUREMENT - Dissertation Example This paper will adopt the conceptual model approach, framed by Yin (1989) in his research article. According to Yin (1989) conceptual models are necessary while conducting research work, especially in the context of framing a well-defined information and subsequent discussion and analysis. Quite often used when two phenomena are being compared and contrasted (in this case comparing and contrasting two procurement organizations, A and B), this approach requires that the researcher frame and organize the data into a modular format. This paper is in line with Yin’s theory of the resultant conceptual model, which though formulated primarily primary data, also allows for the mapping of a phenomenon and its subsequent theoretical analysis. In other words, this approach allows for the explanation of facts through theoretical analysis; the expansion of knowledge through the clarification of the relation between reality and theory; and most importantly, is ideally appropriate for a com parative analysis of two organizations (Yin, 1989). The nature and concerns of the current research have led to the determination of the imperatives of extensively exploiting the conceptual model approach. The research focuses on the critical analysis of two organizations, from the data collected during primary research. Organization A, a public sector entity, is a Public Procurement Organization; while Organization B, also a Public Procurement Organization belongs to a different Department. Primary data from both the organizations were collected through the process of extensive interviewing. 4.5.1 Qualitative Sampling When selecting samples for qualitative survey, a different set of priorities must be taken into consideration. Each conducted qualitative survey is almost similar to an individual scientific research. Here the sample size is not important, rather the set up of observable patterns in the data, is. According to Patton (1987), â€Å"The sample should be large enough to be credible, given the purpose of evaluation, but small enough to permit adequate depth and detail for each case or unit in the sample†. Qualitative samples tend to be studied in nature, rather than being random (Crabtree and Miller, 1999). Studied sampling, or criterion?based selection (Miles and Huberman, 1994) bases the selection of research and participants on certain specific features and characteristics that will enable the researcher to gather in?depth information on areas important for that particular research. This type of studied sampling is therefore strategic in nature (Crabtree and Miller, 1999), with scope for easy access to explore a situation and the participants, having only secondary importance. Typical case sampling, a particular type of purposive sampling, observed mainly in cases that are representative of a larger group selected for a detailed analysis, is relevant to the present study (Patton, 1987). Since qualitative research does not emphasize on stati stical data interpretation, there is no compulsion that samples must be of a sufficient scale for a researcher to arrive at a conclusion (Denzin and Lincoln, 2000). Sample sizes must be kept credibly small, in order to do justice to the rich evidence provided by the qualitative studies and to make best use of the resources available for intensive research analysis (Ritchie and Lewis, 2003). Within the context of the present study, sample size was primarily

Radioimmunoscintigraphy using Prostascint (Capromab Pendetide) Essay Example for Free

Radioimmunoscintigraphy using Prostascint (Capromab Pendetide) Essay Abstract   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Prostate cancer is one of the most common malignancies encountered among the men over the age of 65 years in the U.S. Proper treatment of patients with prostate cancer requires the determination of exact extent of cancer spread. Conventional imaging modalities like CT and MRI have proved to be of little use. Newer imaging modality involving radioimmunoscintigraphy using Prostascint has emerged as a useful diagnostic test for management of cases of carcinoma of prostate, particularly patients with localized disease and those showing evidence of recurrence following radiotherapy. Prostascint imaging serves as a reliable, noninvasive means of differentiating patients with organ-confined disease from those with metastatic spread to lymph. Following a positive Prostascint scan confirmatory studies (biopsy of involved sites) must be undertaken prior to initiation of a definitive surgical procedure. In the modern era, high quality fused images, using CT or MRI with Prostascint scans, obtained from using higher-resolution gamma cameras, have further increased the value of radioimmunoscintigraphy. However well designed randomized controlled trials in future are required to prove the exact clinical role of Prostascint imaging in cases of prostate cancer. Table of contents Introduction†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 Analysis of Prostascint Imaging†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.5 Applications of Prostascint imaging†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦6 Newly diagnosed patients with biopsy-proven prostate cancer.6 Patients with rising levels of PSA following prostatectomy†¦..7 Challenges associated with the use of Prostascint imaging†¦.†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.10 Safety and precautions†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.11 Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦13 References/ bibliography†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦l5 Radioimmunoscintigraphy using Prostascint (Capromab Pendetide) Introduction Prostate cancer is one of the most common malignancies encountered among the men over the age of 65 years in the U.S. During the year 2004, in the U.S 230,110 men were registered with the diagnosis of carcinoma prostate, whereas 29,900 died from it. (Jemal et al, 2004). Following the diagnosis of prostate cancer, one of the most important challenges for the clinician is to estimate the exact extent of the cancer (cancer staging) in order to undertake a proper treatment plan, which would be able to cure the cancer in its entirety in early as well as late cases. Information needed to stage prostate cancer depends upon tumor size, location, extra-prostatic extension, lymphatic involvement and distant metastases (Neal Kelly, 2004). In more than one third of cases of prostate cancer, by the time cancer is diagnosed, it has frequently involved the lymph nodes outside the pelvis, the most common ones being the periaortic lymph nodes (Neal Kelly, 2004). Treatment options and prognosis of localized cancer of prostate is different from the cases where the cancer has spread into the lymph nodes, contradicting the use of both surgery and radiotherapy, which works well for the localized disease. Hormone therapy and recently taxane based chemotherapy is used for the treatment of advanced disease (Neal Kelly, 2004). Presently the prediction of lymph node metastasis is not very accurate because, in the vast majority of cases, tissue examination for evaluating spread of cancer is based on biopsies involving a limited sample of the area with possible lymphatic spread. Conventional imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) for detecting soft tissue metastasis, suffer from many disadvantages, which limits their use for this purpose (Neal Kelly, 2004). Lymphography as a diagnostic modality for visualization of lymphatic vessels and lymph nodes, following injection of radio opaque material in a lymphatic vessel has also proven to be inaccurate (Wolfgang, 2003). Significant advancements in the field of medical imaging have enabled the accurate estimation of cancer spread to a large extent. One such imaging technology is radioimmunoscintigraphy with Prostascint, which would be discussed in this paper. Analysis of Prostascint Imaging Radioimmunoscintigraphy is a nuclear medicine imaging technique which detectsn  signal from a radio labeled antibody that recognizes prostate tissue (Wolfgang, 2003). The most commonly studied monoclonal murine antibody for this purpose is (7E11-C53), capromab pendetide conjugated with the linker-chelator glycyl-tyrosyl-(N, ÃŽ-diethylenetriamine-pentaacetic acid)-lysine commonly known as Prostascint. In the most commonly used type of radioimmunoscintigraphy, Prostascint which has been radio labeled with indium-111(In-111) is given, followed by nuclear medicine imaging or SPECT imaging (Keane, Rosner, Wingo, McLeod, 2006). The most studied target for prostate cancer is the prostate-specific membrane antigen (PSMA), a glycoprotein expressed by prostate tissue, which is produced both by benign and malignant prostate epithelial cells. However it is expressed more abundantly in patients with prostate cancer, hormone-refractive disease, and prostate cancer metastases (Keane et al, 2006). Thus immunoscintigraphy is dependent on the degree of PSMA expression rather than the actual size of a metastatic lesion or the increase in the levels of PSA (prostate specific antigen). Applications of Prostascint imaging Prostascint (Capromab Pende ­tide) is commonly used as a diagnostic imaging agent, which shows significantly improved sensitivity for extra-prostatic cancer detection compared with conventional imaging modalities (Keane et al, 2006). According to the literature review by Keane et al, (2006), Prostascint, received Food and Drug Administration (FDA) approval in 1996 for its use as an imaging agent for the following purposes: (1) For the staging of patients, who have been recently diagnosed with histologically proven localized prostate cancer and are at a high risk for soft tissue metastases or (2) For the restaging of post prostatectomy patients with a rising PSA level. These applications of Prostascint have been described below in details: Newly diagnosed patients with biopsy-proven prostate cancer Prostascint imaging should be considered after a definitive diagnosis of localized prostate cancer, as proven by standard diagnostic investigations including chest x-ray, bone scan, CT scan, or MRI, which have been made prior to the initiation of definitive therapy in form of surgery or radiotherapy. Prostascint is not indicated in patients who are not at high risk for developing metastatic disease (Hinke et al, 1998). In fact it is especially administered to those patients who are at a high risk for pelvic lymph node metastasis as shown by an intermediate to high Gleason grade (a system for grading prostate cancer depending on the degree of differentiation of the malignant cells under a microscope) or by other diagnostic investigations carried out to evaluate the disease spread. In a study by Hinke et al (1998), scan positive extraprostatic regions, especially lymph nodes, following initial treatment, were histologically evaluated. The sensitivity and specificity of Prostascint imaging in   detection of extraprostatic disease was found to be 75% and   86% respectively, whereas the accuracy was found to be 81% and the positive predictive of Prostascint imaging in   detection of extraprostatic disease was found to be 79%. Thus, the study by Hinke et al (1998) shows that In-111 capromab pendetide (Prostascint) imaging has emerged as a promising diagnostic tool for detecting prostate cancer by having a significant impact on patient management through its detection of occult extra-prostatic disease in more than 50% of prostate carcinoma patients studied, and information regarding the presence of lymph node metastasis. It also shows that Prostascint imaging serves as a reliable, noninvasive means of differentiating patients with organ-confined disease from those with metastatic spread to lymph nodes and complements other modalities including prostate specific antigen (PSA), Gleason score, and clinical staging. Since Prostascint imaging can help predict the future involvement of lymph nodes in patients at high risk for extraprostatic disease it can therefore help in the selection of patients who may not benefit from definitive local therapy in form of surgery or radiotherapy. Patients with rising levels of PSA following prostatectomy Despite the ability of radical prostatectomy to eradicate prostate carcinoma, biochemical evidence of recurrent prostate carcinoma, in form of elevation in the serum PSA levels above the limit of detection may be seen in approximately 40% of patients, 15 years after they undergo surgery. The PSA test may become positive many years prior to a change in the bone scan or before the emergence of clinical evidence of recurrence (Neal Kelly, 2004). In more than 33% of cases the disease may recur locally in the prostatic fossa or regional lymph nodes or at distant sites. The presence of cancer recurrence requires further treatment in form of local salvage treatments or systemic therapy (Neal Kelly, 2004). Salvage therapy in form of external beam radiation may provide a therapeutic benefit only to those patients who have a localized recurrence. On the other hand, systemic therapy like hormonal therapy is usually recommended for patients with disseminated disease (lymphatic or metastatic spread) (Neal Kelly, 2004). Traditionally, most patients who show elevated serum levels of PSA post-surgically undergo a computed tomography (CT) scan of abdomen and pelvis or bone scintigraphy. The detection of tumor deposits on CT scans is size dependent i.e. the size of the tumor deposits should be more than 10–15 mm prior to detection. Further more, CT scan is not able to differentiate whether the lymph node is enlarged due to the presence of inflammation or metastasis (Neal Kelly, 2004). Thus the finding of radiographically enlarged lymph nodes is not diagnostic of carcinoma. Recurrence of prostate cancer after radiotherapy presents several challenges for the clinician regarding appropriate management. It is of utmost importance to identify correctly those patients with persistent localized disease and the potential to benefit from curative therapy (Keane et al, 2003). The localization of the extent of recurrent disease after radical prostatectomy is especially important for patients showing rising levels of PSA after prostatectomy and are being considered for salvage radiation therapy. However this is difficult with presently available techniques and may greatly influence subsequent clinical management (Raj, Partin, Polasiik, 2002). Prostascint imaging would greatly help in providing solution to this problem. Patients showing a positive result with radioimmunoscintigraphy, demonstrating that the cases with disease spread outside the pelvis can be spared inappropriate treatment, with radiotherapy, thus helps in reducing the associated morbidity and expense (Keane et al, 2006). Raj et al (2002) conducted a study to determine the use of indium- 111 labelled Prostascint imaging to detect recurrent prostate carcinoma radiographically in men with early biochemical evidence of failure (serum PSA levels less than or equal to 4.0 ng/mL) and tried to assess the minimum rise in serum PSA level, which would be necessary for imaging recurrent disease. Preoperatively, all patients had negative bone scans and negative lymph nodes on histopathological biopsy, and they did not undergo   any therapy including   hormonal ablation, chemotherapy, or radiation therapy preoperatively or postoperatively until the (111)In labeled Prostascint imaging was performed. The results of this study demonstrated that the Prostascint imaging is capable of detecting recurrent disease irrespective of level of serum PSA increase. Postive results on prostascint imaging were associated with significant increase in the probability of having recurrent disease. Furthermore 42.8% of patients demonstrated regional uptake in prostatic fossa with or without regional lymph nodes. Almost one-third of patients (30.6%) had local uptake only in the prostatic fossa. These results are in agreement with the known fact that one-third of prostate tumors that recur after prostate surgery occurs locally within the prostatic bed. Thus a positive Prostascint scan results can help classify the patients into two clinically useful categories, i.e.   those with local disease and those with distant recurrent disease, which are candidates for subsequent salvage treatment protocols. Challenges associated with the use of Prostascint imaging   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Imaging with indium In-111 capromab pendetide is technically challenging, requiring high degree of attention to anatomical details, which is not normally necessary with most nuclear medicine studies. The image quality of Prostascint imaging is observed to widely vary among different institutions depending on the method of image acquisition, the skills of the interpreting radiologist, and the resolution of cameras used for SPECT scanning (Wong, Turkington, Polascik, Coleman, 2004). Thus Prostascint imaging requires special training of the involved health care professionals in the field of nuclear medicine, utilizing this technique. Interpretation of the images requires the nuclear medicine physician to become familiar with detailed anatomy of the pelvis in order to read through the normal uptake patterns seen with this drug. On being given sufficient training and experience, the study can become routine for most nuclear medicine departments. Some of the limitations associated with the use of Prostascint scan include, relatively low spatial resolution and low detection efficiency of medium-energy collimators used in the past for detection of In-111 photo peaks; nonspecific localization of monoclonal antibodies in the blood, bowel, bone marrow, and prostate gland and lack of anatomic information on the part of the radiologist to localize accumulation of radiotracer (Wong et al, 2004). In order to improve upon the image quality, diagnostic accuracy and to discover a practical and efficient method of imaging, free from the above described problems, increasing degree of research has been done to improve image resolution. Over the past 5 years, significantly greater image resolution from improved camera technology and the use of co-registration to fuse functional images provided by radioimmunoscintigraphy with anatomic imaging scans such as CT or MRI (Wong, et al 2004). The fusion of these images helps in fusion of anatomical image (obtained on CT or MRI) and physiological image (obtained through Prostascint imaging), thereby considerably improving the resolution of fused image. Keane et al (2006) have reported an accuracy of 83% with fused images. The use of dual-head gamma cameras with a much higher resolution, to co-register the functional single-photon emission tomography (SPECT) image and an anatomic image (CT or MRI) has also made a dramatic difference in prostate cancer detection with the Prostascint imaging (Keane, (2006).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Wong et al (2004) conducted a study in which they tried to improve the diagnostic accuracy of this examination by using hybrid gamma camera–CT technology. Imaging was performed on a dual-head scanner with an integrated CT scanner built onto the same rotating gantry as the camera heads (for SPECT scanning). Wong et al reached the conclusion that evaluation of extraprostatic disease in the pelvis and lower abdomen may also be facilitated by the combined SPECT-CT images. However, the sample size of this study was too small to reach any definitive conclusion. In future, larger well designed, randomized controlled studies are required in order to definitely prove the advantage of this type of scanning in comparison to conventional Prostascint imaging. Safety and precautions Certain precautions which must be observed at the time of Prostascint imaging as   highlighted in a study by Raj et al (2002) are as follows: Prior investigations have demonstrated that 111In-capromab pendetide immunoscintigraphy is safe, with mild adverse effects and minimal increase in the levels of antibodies directed against murine antibody levels (Raj et al, 2002). There is a theoretical risk for occurrence of allergic reactions, including anaphylaxis, in patients who receive murine antibodies. Although serious reactions of this type have not been observed in clinical trials after administration of Indium In-111 Prostascint, Raj et al (2002) have suggested that emergency medications for the treatment of anaphylactic reactions should be available during admin ­istration of this agent. confirmatory trials in the future Due to difficulties in image interpretation, Prostascint imaging is associated with high rate rates of false positive and false negative image interpretation results.   Thus patient management should not be solely based on ProstaScint scan results without appropriate phase three confirmatory trials in the future. Positive Prostascint scan results should be followed by further confirmatory tests (e.g. histopathological analysis). Also these images should be interpreted only by physicians who have had specific training in Indium In-111 Prostascint image interpretation. High False positive scan rates associated with Prostascint may be detrimental to patient care by resulting in inappropriate surgical intervention in patients who had been cured of their primary cancer and have no cancer recurrence. On the other hand, inappropriate denial of curative therapy may occur in case results are not confirmed. Positive Prostascint scanning can also result in inappropriately high stage on sur ­gical staging if only areas of uptake are sam ­pled. Surgical sampling should not be limited to the areas of positive uptake, unless histologic examination Of these areas has yielded positive results Bone scans are more sensitive than Prostascint scanning for the detection of metastases to bone. Thus Prostascint scanning should not replace bone scan for the evaluation of skeletal metastases. Prostascint imaging involves use of radiopharmaceuticals, which must be used only by physicians and other health care professionals who are qualified for handling and using radionuclides. Care should be taken to minimize radiation exposure to patients and medical per ­sonnel, consistent with proper hospital and patient management procedures. Due to delayed clearance of In- 111 Prostascint and post scan localization in the bowel, blood , kidneys, and bladder, most researchers suggest that bladder   should be catheterized and irrigated when obtaining SPECT images. A cathartic must also be administered the evening before imaging the patient, and a cleansing enema should be administered within an hour prior to each imaging session. Conclusion From the above discussion it becomes apparent that Prostascint imaging using indium In-111 capromab pendetide offers important additional information to physicians who treat and manage prostate carcinoma patients. In the patients with primary disease, prostascint imaging should be considered after a definitive diagnosis of cancer has been made, prior to surgery or radiation therapy, when there is high risk for pelvic lymph node metastasis. Prostascint imaging serves as   a reliable, noninvasive means of differentiating patients with organ-confined disease from those with metastatic spread to lymph nodes and complements other indicators of metastatic disease like PSA, Gleason score etc. A positive Prostascint scan serves as an indicator for undertaking confirmatory studies  Ã‚   (biopsy of involved sites) prior to initiation of a definitive surgical procedure. In the modern era, high quality fused images (with CT or MRI) obtained from using higher-resolution gamma cameras, have confirmed the value of radioimmunoscintigraphy. However well designed randomized controlled trials in future are required to prove the exact clinical role of Prostascint imaging in cases of prostate cancer. References Hinke, G.H., Burgers, J.K., Neal, C.E., Texer, J.H., Kahn, D., Williams, R.D., et al. (1998). Multicenter radioimmunoscintigraphic evaluation of patients with prostate carcinoma using indium-111 capromab pendetide. Cancer, 83(4), 739-747. Jemal, A., Tiwari, R.C., Murray, T., Ghafoor, A., Samuels, A., Ward, E. et al (2004).   Cancer Statistics, 2004. Cancer Journal for Clinicians, 54, 8-29. Keane, T.E.,   Rosner, I.L., Wingo, M.S.,    McLeod, D. J. (2006). The Emergence of Radioimmunoscintigraphy for Prostate Cancer. Reviews in Urology, 8 (Suppl 1), S20–S28. Neal, D.E., Kelly, J.D.(2004). The prostate and seminal vesicles. In Russell, R.C.G., Williams, N. S., Bulstrode (Eds.), C.J.K.Bailey and Love Short Practice of Surgery. 24th Edition. (pp. 1370-1387). London: Oxford University Press. Raj, G.V., Partin, A.W., Polasiik, T.J. (2002). Clinical utility of indium 111-capromab   pendetide immunoscintigraphy in the detection of early, recurrent prostate carcinoma after radical prostatectomy. Cancer, 94(4), 987-96. Wolfgang, Dahnert. 2003. Radiology review manual: Nuclear medicine. 5th Edition.   Philadelphia: Lippincott Williams and Willikins: (pp.1080). Wong, T.Z., Turkington, T.G., Polascik, T.J., Coleman, R.E. (2005). Prostascint   (Capromab Pendetide) Imaging Using Hybrid Gamma Camera–CT Technology. AJR, 184, 676-680.

Dominant Theories Of Neorealism And Neoliberal Institutionalism Politics Essay

Dominant Theories Of Neorealism And Neoliberal Institutionalism Politics Essay 1. While neorealism and neoliberal institutionalism are now considered the dominant theories in international relations, neorealism can be viewed as the more dominant of the two because it more accurately portrays state behavior from a positivist standpoint. Unlike neoliberalism which can only adequately explain the economic relations of nations, neorealism is able to explain how states react to one another in terms of security affairs. Quite empirically, neorealism argues that states only act in its own interest vis a vis the material structural incentives of the international system (Griffiths, OCallaghan and Roach 282). How states behave is reflected upon how they are also positioned in a hierarchy within the international system. In the end, states will behave in a manner that allows them to improve, or at the very least, maintain their positions in the hierarchy. The more powerful states are likely to be more influential in deciding the fate of global affairs while the weaker st ates will have relatively less say on matters of international import. Therefore, among neorealists, how the international system is divided is dependent on how the capabilities of states are distributed. The international system is essentially a system of anarchy. States pursue maximum utility in order to achieve their interests. From the neorealists point of view, states need the same things but are not equally capable of meeting their needs. For instance, states in the North American continent are relatively well-positioned economically than states in Africa. A consequence of the disparate capabilities between the states from both regions is that their cooperation is limited since partnerships will end up either in dependence or exploitation. On another note, the more affluent states engage in cooperation and competition to maximize relative gains and power. This desire and the ability to maximize power on the part of states results in what is called balance of power. Neorealists believe that the unequal positions of states in the international system gives rise to a security dilemma where states struggle to balance power either by 1) building more powerful armies and increasing mi litary spending, and 2) forging regional alliances or diplomatic ties with other states to check more powerful nations. Neorealists are able to characterize the distribution of power in the international system based on capabilities of nations: unipolar (a singular power), bipolar (two great powers), and multipolar (more than two powers). The establishment of European Union, for instance, is an attempt to balance power and promote a multipolar world in a present unipolar system ruled by the United States of America. On the other hand, neoliberal institutionalism uses positivism to explain why states cooperate and why they do not cooperate with each other. Using game theory as its method of analysis, neoliberal institutionalists explain that behavior of states depends on their analysis of gains and losses. States are interested in cooperating only with states and institutions that can deliver mutual gains and profitable arrangements. Neoliberalism responds to the neorealist conception of the international system as anarchic. While it does not contest or deny this, neoliberalism purports that this is exaggeration. Neoliberals contend that states do not compete all the time and that cooperative behavior among states is possible if the international system is decentralized. Leaning on the classic liberal view of the state as a rational and self-interested actor, states, when allowed to compete fairly in a decentralized environment, are able to maximize their relative gains in power and resources. 2. Neoliberalism and neorealism are considered modern interpretations of the classic positivist theories on international relations. While different in some conceptions of state behavior, both theories are complementary and mutually enforcing. They more alike than different; both theories are rooted in the explanation of international relations using the state as primary unit of analysis. They cannot be considered alternative theories to international relations, merely, a modern version of the traditional positivist view of IR. In some ways, neorealism and neoliberalism contradict but they are essentially mutually reinforcing interpretations of international relations. Both recognize anarchy in IR but at different extents. The neorealist believes that the global system is anarchic by nature and that the main preoccupation of states is how to ensure their survival. Thus, whatever alliances and cooperation is forged among nations is hinged upon the need to survive. Other states, like North Korea, rely on their own processes of survival, even violating international law to ensure that it is not crushed by the more powerful states. Its concept of balance of power requires it to develop its own nuclear problem to deter threat. If states do not recognize anarchy, they will be weakened. From a neorealist perspective, international cooperation is illusory, if not outright impossible to achieve. Neoliberal institutionalism recognizes that there is anarchy but there are creative ways to go about it, such as the building of regimes or institutions to mitigate anarchy. Neoliberals value the existence of international institutions such as the World Trade Organization, the United Nations, and other international regimes that ensure mutually beneficial relations among nations. The WTO for instance, sets norms and rules for global trade. The UN acts as an arbiter of international conflict. 3. Marxism remains of the most relevant theories that provide alternative explanations to international relations. First of all, departing from the traditional realist and liberal view of the state as the fundamental unit of analysis, Marxism treats class as the unit of analysis. Marxism argues that the international system was established to protect the property interests of the upper classes and the most affluent states. Hence, the struggle in the international system is essentially a class struggle between rich and powerful nations and the exploited nations. Variants of Marxist theory of international relations include the world-systems theory, dependency theory, and neo-Marxism. Marxism divides the world not into political entities but economic classes. Using its analysis of the base and superstructure, Marxism contends that economics supersedes politics in the global order. International relations was developed by the capitalist class to ensure capital accumulation of wealthy corporations and affluent states. The world-systems theory developed by Wallersten argues that the world can be divided into economic classes: 1) First World represents the most affluent or the core, and 2) Third World represents the poorest and underdeveloped or the periphery. According to the world-systems theory, only the core countries are able to benefit from international relations because they own the means of production while the periphery countries are exploited. The dependency theory which grew popular in Latin America propose that the poor countries (classes) are transformed into mere source of cheap labor and raw materials, hence, keeping them utterly dependent on affluent nations. International institutions such as the WTO are said to perpetuate this inequality. To resist this unequal relations, Marxists argue for protectionism and economic control policies that will liberate them from the control of the global economic regime, including import substitution to replace export-based economic models. Work Cited Griffiths, Martin, OCallaghan, Terry, and Steven Roach. International relations: the key concepts. 2nd ed. New York: Routledge, 2002.

Jasmine Essay -- essays papers

Jasmine Bharati Mukherjee was born on July 27, 1940 in Calcutta, India. (Pradhan ) She was born into a wealthy family, which assisted her in her dream of becoming a writer. She lived in India, Europe, the United States, and Canada. Migrating to these countries that are so different from her place of birth enabled her to write very powerful novels on immigrant experiences. Mukherjee’s novels focus on exploring the migration and the feeling of alienation that is experienced by these immigrants. (Pradhan) Her works have explored such themes as isolation, sexism, discrimination, the mistreatment of Indian women, and exploring identities. In Bharati Mukherjee’s novel Jasmine, the character shows some similarities to the author, but there are many differences. Both were born in India, but Jasmine was not born into wealth. Jasmine does not have the same resources as Bharati, so it is harder for her to leave her home and to migrate to the United States. One of the similarities between Jasmine and the author is their drive to go after what they want and to not stop until they get it. Bharati’s drive is to become a writer, and Jasmine’s is to go to the United States. Another similarity is their struggle to find their identity when they migrate to the United States. This is one of the major themes in Jasmine. One important aspect about the novel Jasmine is that it is not written in chronological order. The novel is written as though the main character is remembering events out of sequence. The author employed this method of writing quite efficiently. It was not entirely confusing and it set a mood of anticipation of what is to come. The novel starts out when Jasmine is a young girl in India. She is consulting an astrol... ...arries his child. This is evidence that she is steering further away from her Indian values. Someone may say that Jasmine is about a victim struggling in America or that it is about an immigrant who has assimilated herself into becoming an American. I think it is a little bit of both. I think that the main theme of this novel is exploring identities. Jasmine’s struggle in America and her immigrant experience force her to explore within herself and to discover what she is capable of doing in life. Jasmine has many stages in her life. Even her name changes throughout the novel, becoming more American, which corresponded to the stages in her life. Jasmine went through a metamorphoses in this novel in which she had to suffer many terrible and some wonderful events in order to become the person that she is at the end of the novel when she leaves Bud to be with Taylor.