Animal Farm Summary

George Orwells Animal Farm is an allegorical novel about a group of farm animals who take over their farm in 1940s England. Through the story of the animals revolution and its aftermath, Orwell assesses the failures of the communist revolution in Russia. Chapters 1-2 The novel opens at Manor Farm, where Mr. Jones, the cruel and incompetent farmer, is drunkenly going to sleep. As soon as the lights in the farmhouse go out, the animals gather. Old Major, an elderly boar whos lived on the farm for a long time, has called a meeting. At the meeting, Old Major describes a dream he had the previous night, in which the animals lived together without humans. He then launches into an impassioned speech. In the speech, he argues that humans are the enemies of all animals, and he urges the animals of the farm to organize and rebel against the humans. Old Major teaches the animals—who have varying degrees of intelligence—a song called Beasts of England in order to instill a sense of revolutionary fervor in them. Old Major passes away three days later. Three pigs named Napoleon, Snowball, and Squealer use this sad event to rally the animals. When the animals, who are starving, break into the store shed, Mr. Jones attempts to whip them. The animals revolt and drive Mr. Jones, his family, and his employees off the farm in terror. Napoleon and Snowball quickly organize the animals and remind them of Old Major’s teachings. They give the farm a new name—Animal Farm—and hold a meeting to vote on rules. Seven fundamental principles are adopted: Whatever goes upon two legs is an enemy.Whatever goes upon four legs, or has wings, is a friend.No animal shall wear clothes.No animal shall sleep in a bed.No animal shall drink alcohol.No animal shall kill any other animal.All animals are equal. Snowball and Napoleon order that these principles of Animalism be painted on the side of the barn in large white letters. The cart-horse, Boxer, is particularly excited and declares that his personal motto will be â€Å"I Will Work Harder.† Napoleon does not join the animals in the harvest, and when they return, the milk has disappeared. Chapters 3-4 Snowball undertakes a project to teach all the animals on the farm how to read and write. Napoleon takes charge of a litter of young puppies in order to teach them the principles of Animalism. He takes the puppies away; the other animals never see them. The animals work together and know the business of the farm very well. For a time, the farm is peaceful and happy. Every Sunday, Snowball and Napoleon gather the animals for a meeting in which they debate what to do next and vote. The pigs are the smartest of the animals, and so they assume leadership and create the agenda every week. Snowball has many ideas for improving the farm and the lives of the animals, but Napoleon is against almost all of his ideas. When the animals complain that they cannot remember so many of Animalism’s commandments, Snowball tells them that all they have to remember is â€Å"Four legs good, two legs bad.† Neighboring farmers are afraid that a similar overthrow could take place on their own farms. They band together with Mr. Jones to attack the farm with a gun. Snowball thinks quickly and organizes the animals into an ambush; they surprise the men and chase them off. The animals celebrate the â€Å"Battle of the Cowshed† and confiscate the gun. They decide to fire the gun once a year to commemorate the battle, and Snowball is hailed as a hero. Chapters 5-6 At the next Sunday meeting, Snowball suggests building a windmill, which will provide electricity as well as grind grain. He makes a passionate speech arguing that the windmill will make their lives easier. Napoleon gives a short speech opposing the matter, but he can tell he has lost the argument. Napoleon makes a sound, and suddenly the dogs he took away for education—now fully grown—burst into the barn, snarling and biting. They chase Snowball away. Napoleon tells the other animals that Snowball was their enemy and had been working with Mr. Jones. He announces that the meetings are no longer necessary, and that Napoleon, Squealer, and the other pigs will run the farm for the benefit of everyone. Napoleon decides to build the windmill after all. Work commences on the windmill—Boxer works especially hard at it, excited at the easier life they will have when it is done. The animals notice that Napoleon and the other pigs begin to act more like men: standing on their hind legs, drinking whiskey, and living inside. Whenever someone points out that this behavior violates the principles of Animalism, Squealer explains why they are wrong. Napoleons leadership becomes increasingly totalitarian. When a storm causes the windmill to collapse, Napoleon deflects blame by telling everyone that Snowball sabotaged it. He corrects the animals about their memory of the Battle of the Cowshed, insisting he was the hero they all remember, and that Snowball was in league with Mr. Jones. He accuses various animals of being in league with Snowball; his dogs attack and kill each one he accuses. Boxer accepts Napoleons rule, repeating â€Å"Napoleon is always right† as a mantra as he works harder and harder. Chapters 7-8 The windmill is rebuilt, but another farmer, Mr. Frederick, gets into a disagreement over a business deal with Napoleon and uses explosives to destroy the new windmill. Another battle ensues between the animals and the men. The men are once again driven away, but Boxer is severely injured. The animals discover Squealer with a can of white paint; they suspect the Animalism principles painted on the barn have been altered. Chapters 9-10 Boxer continues to work, driving himself to do even more despite his injuries. He grows weaker, and eventually collapses. Napoleon tells the animals he will send for a veterinary hospital to come get Boxer, but when the truck arrives, the animals read the words on the truck and realize Boxer is being sent to the ‛knacker’ to be made into glue. Napoleon has sold Boxer for whiskey money. Napoleon and Squealer deny this and claim that the truck had recently been purchased by the hospital and hadn’t been repainted. Later, Napoleon tells the animals that Boxer passed away under a doctor’s care. Time passes. The windmill is rebuilt again and generates a lot of income for the farm, but the lives of the animals get worse. No longer is there talk of heated stalls and electric lights for all. Instead, Napoleon tells the animals that the simpler their lives are, the happier they’ll be. Most of the animals who knew the farm before the revolution are gone. One by one, the principles of Animalism have been erased on the side of the barn, until only one remains: â€Å"All animals are equal, but some animals are more equal than others.† The simplified motto has been changed to â€Å"Four legs good, two legs better.† The pigs have become almost indistinguishable from the men: they live inside, wear clothes, and sleep in beds. Napoleon invites a neighboring farmer to dinner to discuss an alliance, and changes the name of the farm back to Manor Farm. Some of the animals peer into the farmhouse through the windows and cannot tell which are the pigs and which are the men.

Domestic Violence Is A Serious And Ever Growing Problem

Domestic Violence Domestic violence is a serious and ever growing problem that the United States is faced with. Many people have suffered from domestic violence, and many more are still suffering even though the abuse ended years ago. Domestic violence victims still continue to suffer from the experience to this day. The effects of domestic violence creates something that will stick with the victim for a lifetime. Because victims fear reporting their problems to the police, many accounts of domestic violence goes unreported (American Academy of Experts in Traumatic Stress, 2001). Ignorance to the problem of domestic violence will lead to many people becoming unsocial, suicidal, depressed, and many other problems. Domestic violence will end when people feel safe with their intimate partners and are comfortable with who they are. People need to be aware of what domestic violence is and what the effects of an abuser are so they can avoid ever getting into a relationship that will eventually lead to violence. If people focus on the problems domestic violence creates, then people will feel safer with their partners and domestic violence will start to decrease in homes. This paper is intended to inform others about what victims of domestic violence suffer from, what they feel, and why they feel it. The following information is in-depth research about the effects of domestic violence on victims. Victims of domestic violence suffer from many disorders or trauma issues, and thisShow MoreRelatedDomestic Violence is a Global Issue1347 Words   |  5 PagesDomestic Viol ence (DV) is a critical social issue that negatively impacts not only our own culture in America but as well as all other cultures around the world. 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Aims and Values in School. 2.5 Free Essays

Aims and Values of Schools: Aims: * To attempt to reach a certain goal that gives people a purpose or intension to achieve a desired outcome. * It gives people/organisastions something to follow and work towards to achieve the best outcome. * To attempt the accomplishment of a purpose; to try to gain; to endeavor and aim to do well. We will write a custom essay sample on Aims and Values in School. 2.5 or any similar topic only for you Order Now Values: In order to achieve goals and aims, one strives and endeavours to attain certain actions, however such actions will not be undertaken at the expense of core values. Values offer principles and standards of behaviour that people and organisations follow. Values have a major influence on a person’s behaviour and attitude and serve as guidelines in all situations. * They are ideals and beliefs shared by members of a culture about what is good or bad, desirable or undesirable. * Values offer a moral code to follow. How schools demonstrate and uphold their aims and values: Aims in schools are set out to follow guidelines and attain what the schools desire to achieve. The schools strive to exceed their personal objectives. The aims and objectives of the schools are set by the Head Teacher, working closely together with, parents, staff, the community and sometimes the children of the schools. Although schools mostly share the same aims and objectives, they may differ slightly as schools set out there own goals. It is important for schools to communicate with others their aims and objectives as much as possible, as this gives parents and others the opportunity to gain an impression of the schools in question. This can be done through school prospectuses, school website, and open evenings/days. The schools can also demonstrate their aims by developing links with local communities where they work to develop the aims to improve pupil’s education and environment. Looking at one school in particular, we can see how they communicate and set their aims, and whether they do this successfully. Aims 1: To maximise every child’s potential both educationally and socially: The schools aim is to teach in a way that interests and motivates pupils and to ensure that all pupils achieve outstanding academic results relative to their ability. The school regally tests the children’s level of abilities and offers extra tuition when needed. This offers extra support on a ‘one to one’ tuition bases. The school also offers the following to maximize every child’s potential: * In year 6 all children will have in their own individual tutor. The tutor meets the child on a regular weekly basis and discusses pastoral concerns as well as academic progress. Parents are welcome, therefore, to liaise with the tutor, who will have a good knowledge and understanding of their child’s progress. At the end of each term, parents are sent full reports, including subject comments, as well as social involvement in the school. * Parents are also sent ‘marked reading slips,’ during the term, which indicate attainment and effort grades, together with comments from the tutor. * Tests are done internally through the school during various times through the school year. This allows for the teachers to moni tor the pupil’s academic abilities. The school states that one of the features of the school ethos is that no two days are the same. They offer a wide range of sports and lessons to improve the child’s overall experience. They keep the children busy and offer a fun environment for learning. Sporting success is certainly a major part of life at the school in question, but they also realize that sport is about giving an opportunity for the majority of the school to work in a team, and to give them a sense of pride in their own performance. Games sessions at the school take place for all pupils every day of the week, except Thursdays, including matches on Wednesdays and Saturdays. They believe in ‘putting out’ as many teams as possible on match afternoons to include boys of all abilities. The school offers the following sports: cricket, athletics, squash, swimming, cross-country, hockey, polo, shooting, rugby, table tennis, and chess, tennis, football, athletics, golf, polo and croquet. Aim 2: To ensure that every child is treated equally regardless of race, gender, social background and special needs: Promoting equal opportunities is fundamental to the aims and ethos of the school. They welcome applications from candidates of all cultures and backgrounds. The school believes that this enriches the community and is vital in preparing the pupils for today’s world. They concentrate strongly on educating the individual, providing a comfortable and welcoming atmosphere where each individual feels valued. The school is committed to equal treatment for all, regardless of an individual’s race, ethnicity, religion, sexual orientation, disability, learning difficulty, body image or social background. We believe that the educational experience can only be enriched if children are exposed to as wide a range of cultural experiences as possible whilst they are developing. Scholarships and bursaries may be offered in order to make it possible for as many as possible who meet the school’s admission criteria to attend the school. The Headmaster, senior management team and staff play an active role in monitoring the schools policies on equal opportunities. Within their classes, assemblies, and sports they promote the following: * Interact with all children, and encourage them to work as a team. * Tolerance of each other and respect for each other’s position within the school community. * Positive images and role models to avoid prejudice and raise awareness of related issues. Foster an open-minded approach and encourage pupils to recognise the contributions made by different cultures. Bias should be recognised. * Understand why and how we will deal with offensive language and behavior. * Understand why we will deal with any incidents promptly and in a sensitive manner. * The school also offers extra English for children who are struggling wi th the language. A successful equal opportunities policy requires strong and positive support from parent and guardians, and full acceptance of the school’s ethos of tolerance and respect. Aim 3: To work in partnership with parent to encourage positive attitudes towards learning: A child’s home life has such a powerful effect on children’s learning especially in early years. It is important for parents to get involved and pay a keen interest in the progress of their child in school. The child not only receives skills, knowledge and intellectual stimulation but they also absorb a positive attitude towards learning and encouragement outside of school. At home parents can provide more one-to-one attention. At the school being discussed, they offer the following to encourage families to take an interest in their child’s progression: * Formal meetings for parents to discuss their child’s progress with individual subject teachers are held twice a year. The school also offers parents the chance to attend informal meetings any time of the year to discuss their concerns with their child progress. * Follow a homework policy: as the school along with the Department for Education believes that, ‘Well organised homework can play a vital role in raising standards of achievement. * The school believes that homework provides the following to the child’s success: It raises children’s achievement. It consolidates and extends the work they have done in school. It helps to inform parents about their child’s schoolwork and allows parents the opportunity to support their work. It is a valuable life skill and develops good work habits for secondary school and futur e employment. Aim 4: To ensure a safe and secure school community: Child Protection is always a top priority at the school in question. They recognise that it is its objective and duty to safeguard from harm, and actively promote the welfare of each individual child. * Their focus is of positive welfare outcomes for the schools children and upon reducing any risks to the children while they are at school. * Their primary aim is to ensure that they create an atmosphere in the school where all children feel secure and valued. All welfare provision is directed towards this goal, whether the provision is a matter of people, premises, policies or practices. Their policies and practices follow the National Minimum Boarding Standards and are informed by the Berkshire Local Safeguarding Children Boards Child Protection Procedures. * The school states that there is no place for abuse of any kind in their community and they will do all in their power to prevent any incidents of physical, emotional or sexual abuse at the school. The school itself recognises that all staff have a full and active part to play in protecting the pu pils from harm, and that the child’s welfare is of paramount concern. Staff at the school are reminded that the following things must be avoided at all times: * Corporal punishment, having favorites, humiliation and punishment outside of the schools disciplinary system. * Inviting individual boys into a staff room. Staff must respect privacy and private space, particularly in lavatories, changing rooms and showers. They are reminded to supervise and not watch. The school clearly states that all staff receive the relevant training in child protection and interagency working which must be updated every two years. All staff are issued with credit card sized key points for child protection. All staff who are appointed to a position in the school are subject to recruitment checks in line with DCSF Standard 4 and governors to DCSF Standard 4B, as well as in line with National Minimum Boarding Standard 14. * Risk assessments are done throughout the school to ensure that all environments are safe. * The school itself is a gated school and has CCTV cameras whic h provides the school with valuable information. The school’s child protection policy and procedures will be reviewed once a year by the Governing Body, including a review of the efficiency with which the related duties have been discharged. How to cite Aims and Values in School. 2.5, Papers

European Studies Essay Example For Students

European Studies Essay SUBJECT : EUROPEAN STUDIES A TITLE : Discuss the relative merits/demerits of an agricultural policy oriented to price reform rather than one based upon structural reorganisation GRADE : First Honour AUTHORs COMMENTS : I think its pretty okay. Email if anyine has any comments @ emailprotected TUTORS COMMENTS: Excellent essay! Indepth, critical analysis. Watch length!! The common market shall extend to agriculture and trade in agricultural products. Agricultural products means the products of the soil, of stock-farming and of fisheries and products of first-stage processing directly related to these products.The operation and development of the common market for agricultural products must be accompanied by the establishment of a common agricultural policy among the Member States (1) From the beginning of the European Union, EU policy has given emphasis to the agricultural sector. To this end, a Common Agricultural Policy (CAP) was established in 1963. (2) Provisions for this policy wer e made in the Treaty of Rome. The aims of this policy were to increase agricultural productivity, to ensure a fair standard of living for the agricultural community, to stabilise markets and to ensure reasonable prices for the consumer. (3) This is unusual in the context of the Treaty of Rome which provided for free trade and movement of resources. Agriculture was ill-adapted for this approach. Protection was given, not only by customs duties, but also by a variety of agricultural policies. This essay will discuss the merits and demerits of a the pre-1992 CAP with its emphasis on price reform, in comparison with the post-1992 CAP which was oriented to structural reform. It cannot be denied that there were merits of the pre-1992 price reform policy. There was a bountiful food supply with an increased variety and quantity of food. Farmers yields increased, particularly the large farmers. Producers were protected from the external market due to community preference and, therefore, dome stic agriculture could develop. There were also spin offs in food production. Although some of the policies created good returns for farmers, the demerits of said policies far outweighed any advantages they had. The core-periphery divide was widened, quantity became more important than quality and consumers had to pay higher prices. Agricultural practices caused damage to the environment and international trading relations were strained. Until 1993 the EU rarely supported farmers by paying them direct subsidies from the taxpayers. (4) Instead the 30 billion ECU (and often more) was spent in the buying up of surplus commodities at minimum official prices and was also used to pay subsidies to traders to sell surpluses on the lower-priced world markets. (5) During the 1960s the price system was devised. The first problem with price policies is that of fluctuating and differing exchange rates. Green Money was the first solution to be developed to counter the problem of differing exchang e rates. This, however, could be manipulated by politicians to achieve different price levels in the member states than those indicated by the common price level. The lowering of the green currency towards a depreciating average rate, raised farms price levels in the national currency. (6) This meant that while regular citizens suffered from the devaluation of the currency, farmers were protected from this trend. Also although the higher prices were an advantage for the farmer, they were a nuisance for consumers. Monetary Compensatory Amounts (MCAs) were used in the 1970s when devaluations by France and revaluations by Germany made Green Money redundant. MCAs operated as levies on the French exports and subsidies on French imports. The reverse was applied to Germany. (7) MCAs, while allowing Community trade to continue even though common pricing was never established, had more disadvantages than advantages. They allowed the real level of prices to vary from country to country. This led to the distortion of production as farmers in the countries which have strong currencies, were paid more than farmers in countries with a weak currency. MCAs are also expensive to operate. MCAs were replaced in 1979 by the European Currency Unit (ECU) as part of the European Monetary system (EMS) which had been introduced in 1978. (8) An agricultural ECU which was 14% more valuable than the ECU was introduced. Until 1993 and 1995, when adjustments were made to this, vast amounts of officials were needed every day to administer the agri-monetary system and the monetary amounts had to be changed weekly. (9) The original agricultural price policy in CAP had three main components. The first of these was the target price, which was the basis for establishing all other prices. It is meant to provide a satisfactory return for the farmer. Threshold prices are the minimum entry prices for imports (higher than EU prices for domestic products) and they also safeguard against the undercutti ng of target prices. An intervention price is used if the market prices fall. If surplus production occurs, the commodities are bought by intervention agencies. This maintains a minimum market price level. Variable import levies were used to bring imports up to the threshold price and export refunds were used to remove the difference between the common market price and world price. (10) Variable levies are one of the most effective protective trade policies used. They protect domestic price guarantees from being defeated by trade flows. They can sometimes generate revenues and funds for the central authority controlling the levies. They also can introduce price stability for internal markets. They have a number of disadvantages, however. The levy shrinks imports and losses to the consumer and efficiency are usually caused. Producer returns can fluctuate more wildly. They can also strain international relations as the variable levy transfers domestic demand instability onto the world market. An administrative mechanism must also be implemented to bridge the gap between the higher price guarantee and the lower international price, and this can be expensive to operate as it depends on fluctuating prices, inflation and supply/demand. (11) The first problem posed by this three-tiered agricultural policy system, is the decision as to which system of pricing should be used. A compromise must be achieved between the highest prices and the lowest prices. If the highest prices are used production would be pushed to unacceptable levels. When this policy was first introduced, it was effective in the atmosphere of the time and production levels rose. By 1968 however the first of the fundamental problems with this policy became apparent. If product prices are prevented from falling while supplies continue to increase in a competitive market place, costs will inevitably increase to meet prices and cut off the people and capital who want to become part of the industry. Price supports, therefore, increase the costs of production. The irony of this is that in order to deal with the effects of increased production costs, price supports must increase also. Although in a competitive unsupported market this process would mean lower prices for farmers and consumers, it would also mean hardship for the marginal farmer. Attempts to stop this by implementing market support policies are bound to fail however, because the forces of competition are pushed in a different direction they are not removed. The demand for, and the price of, land and equipment will increase as farmers profits increase. The end result is that farm costs and output prices increase in tandem. This marginalises the small farmer even more. Another effect of this market support policy is that production increases as industry becomes more productive. This leads to large amounts of surpluses and therefore more subsidies are needed for these to be sold on the market. It also becomes more difficult to sell these products on a market flooded with already large amounts of these commodities The costs of the policy feed on themselves in order to increase. Any attempt to lower prices and cut costs, puts us back where we started. This is the fundamental fault with price policies in the CAP. The need for continually updating machinery and equipment for increased productivity means that much of the money intended for farmers often flows into ancillary industries and into the owners of assets who are employed in agriculture. These policies also encourage increased competition between farmers, and the large farmer usually benefits at the expense of the small farmer. Therefore these policies exacerbate the inequalities in the farming sector. The rigidity of the uniform market price does not take the differences between various areas of the farming community into account. As well as this, if there was a difference in support for Less Favoured Areas (LFAs), then the question of who should pay would be an issue of some contention. Co-responsibility levies are also an integral part of CAPs price policies. The CAP had started its life with unlimited guarantees of support, regardless of the quantities produced. This led to a massive agricultural budget. Support price decreases were introduced and this narrowed the gap between the EC price and the world market prices. This helped to reduce the EC budget and the intervention storage costs of the agricultural budget. This route was not successful for milk, however, and co-responsibility levies were introduced in 1977. (12) These were, for the most part, a success because the smaller farmer was then protected from these the full damage created by price cuts. There were also gains to the budget. The advantageous effects of the levy were muted, however, by the tendency of the Council Of Ministers to raise support prices to offset the impact of levies. In 1982 the budget costs of CAP had jumped by 11% and the price policy was once again in crisis. Intervention stocks began to climb. Generous price rewards in 1981 and 1982 meant that production levels were high and world markets became saturated. (13) Quotas were introduced in 1984 to try and force production more in line with demand. The super-levy was introduced alongside these quotas. Quotas and super-levies mean that at a wholesale level, responsibility for the super-levy is determined by the over-quota production at dairy level. This means generally that those farms who stayed within the quota would be subsidising those who over-produce. Quotas, in general, restrict imports in a given period below the amount which normally would occur. The disadvantages of quotas outweigh their advantages however. They stint the domestic market of supplies. Internal prices rise and buyers curtail their purchases. Domestic producers expand their output, however, and a glut occurs on world markets which have depressed prices for affected commodities. Quotas, although i nsulating the domestic market from world price changes, can also amplify domestic price swings. Despite quota introduction, surpluses remained high and the cost of maintaining the dairy policy actually increased. The quota levels agreed in 1984 were far too large and were set from 1983 production figures which were already 17% above domestic consumption. Also, as these quotas were only introduced for the dairy sector, production and surpluses in other areas continued to grow unchecked. Penalties for over-production were never really implemented and were easily avoided by raising prices and adjusting MCA rates. (14) An arable Set Aside policy was introduced in 1988. Producers can receive payment per hectare on each hectare taken out of production. Every producer must make more than a minimum area reduction of 20% to qualify. (15) This was run on a voluntary basis and farmers received compensation for the land they didnt use. Small farmers were exempted from Set Aside. The programme r esulted in only a 9% reduction of EU arable area. Production also increased and intensified as farmers concentrated their resources on their remaining land. Due to the land being left fallow, the following years production rates were high as the land was therefore more fertile. More money than ever since the price cuts was now being spent on export subsidies. Relations between the EU and its global neighbours were strained by CAP. The dictates of the CAP have led to a series of trade problems. The use of border fluctuations on world markets has placed the Community in a difficult situation. The CAP protects internal producers from external competition to some extent. Also export subsidies ensure that the world market becomes flooded with cheap commodities which undermine other global commodities. Depressed world prices occur, interspersed by periods of high rises in prices. Variable levies were used to bring import prices to a level higher than that of EU products. The Uruguay Round of world General Agreement on Trade and Tariffs (GATT) negotiations concluded by agreeing a 40% average reduction of tariffs. Domestic EU support must be reduced by 20% over six years based on total Aggregate Measure of Support (AMS). All import restrictions must be converted to tariffs and reduced by 36% over six years. The volume of subsidised exports must be reduced by 21% over six years. Budgetary expenditure on export subsidies must simultaneously be reduced by 36% over six years. (16) The absolute failure of the agricultural price policy of CAP forced the EU to implement fundamental reform. CAP was producing large amounts of surpluses and was failing to support the majority of EU landholders. Support was being concentrated on 20% of the farmers who were responsible for 80% of the output. Intensive farming practices were damaging the environment. Since farmers received a subsidy per tonne produced, they intensified their farming practices to increase their output and income. N ot only was this leading to surpluses and a massive EU budget, but also to the destruction of the environment. More fertilisers and pesticides were being used. There was an increase in the density of the livestock on the land. Enlargement of farms meant that the natural habitat was being destroyed and marshlands were being drained. Therefore in 1992 there was radical change from a price oriented policy to a structural policy. There was also a move from price support to direct income support. It was generally recognised that a number of structural changes were required. These included the diversion of land to other uses, the conservation and protection of the environment, the integration of structural change with regional economic development and the implementation of direct income aids. (17) This impetus for change began, however, in 1988 when the Council of Ministers approved a regulation 2052/88 which was to reform the operation of the Structural Funds as part of the European Agri cultural Guarantee and Guidance Fund (EAGGF). (18) This regulation marked an important shift in structural policy from the individual farmer, to the region and rural community. The regulation set out five objectives. Objective 1 status areas are those which lag seriously behind and need major development and structural adjustment. These have a Gross Domestic Product (GDP) of less than 75% of the Community average. It was hoped to improve living and working conditions, to protect the environment and to improve processing and marketing of goods. (19) Objective 5b included areas that had a high share of agricultural employment and a low income level. (20) Objective 5a was a regrouping of measures which already existed in CAP i.e. funding for farm improvements, training and social assistance for farmers. (21) A number of reform and integration programmes were introduced. Partnership was seen as the way forward and evaluation of policy success became more important. The effectiveness of these schemes is questionable however. In 1992 the MacSharry reforms were introduced. This had three main aims i.e. early retirement for farmers and farm workers, the promotion of the use of land for forestry and to promote environmentally friendly agricultural methods. Farmers are permitted to retire at 55. They must then transfer their land to another farmer and will receive a pension from the EU. 50% of the cost of the pension is paid by the EU and 50% by the national government. (Although in Objective 1 areas the EU pays 75%.) (22) When land is not needed for agriculture or is of poor quality, an afforestation programme is implemented. Maintenance fees are paid. There is a maximum eligibility of 600 hectares and therefore the policy favours small enterprises. Again, the EU pays 50% of the cost or 75% in Objective 1 areas. (23) The environment is now also seen as an important problem to be tackled. There have been attempts to reduce pollution e.g. the Nitrates Objective which tri es to reduce the amount of nitrate pollution in EU waters. Extensification is encouraged to avoid the damage intensification and concentration have on the land. Long-term set-aside of 20 years has been proposed. Grants for the education and training of farmers in environmentally compatible farming have been implemented e.g. the Rural Environmental Protection Scheme (REPS) in Ireland. Organic farming is being promoted and a reduction in the amount of fertilisers and pesticides used is being encouraged. There has also been a general move towards trying to ensure that small farmers are not pushed off the land by larger farmers and discriminating agricultural policies. Diversification in rural economies is being encouraged. Integrated rural development programmes have also been implemented. Rural infrastructure has been improved. Attempts were made to improve research and development at a rural level. The EUs Structural Funds are clearly established as the key tenet of European level po licy initiatives. The Fund consists of four separate funds the European Regional Development Fund (ERDF), the European Social Fund (ESF), the European Agricultural Guarantee and Guidance Fund (EAGGF) (although only Guidance is relevant to Structural Funds) and the Financial Instrument for Fisheries Guidance (FIFG). (24) The Structural Funds are aimed at reducing regional and social disparities in the EU. Between 1989 and 194 the funds were allocated 10,000 million ECU per annum. (25) The EAGGF supports the modernisation of holdings, the processing and marketing of products and agricultural development measures and the promotion of local produce. The FIFG is responsible for the fishing fleet, aquaculture and coastal waters, fishing port facilities and the marketing of fishery and aquaculture. The ERDF is responsible for investment in infrastructure, transport, tourism, communications, environmental improvements and productive capacity. It also promotes research and development and p rovides advice and assistance for Small and Medium Enterprise (SMEs). Finally the ESF is concerned with vocational training and counselling, giving aid to self-employed people to start up a business and education schemes in some priority areas. (26) The ERDFs responsibility lies with Objective 1,2 5b and 6 areas. It promotes the development of the Objective 1 regions who are lagging behind, helps to counteract industrial decline and helps reorganise those regions which have a low population density or whose population is leaving the rural area and migrating to urban centres. Its main objectives are to foster co-operation between the local actors of different regions with a view to the exchange of experiences through transferring knowledge and expertise and by working together. It hopes also to improve the capabilities and working methods of local and regional areas in disadvantaged regions, both economically and socially, so that the regions can meet the challenges of modern society . (27) The ESFs aim is to raise the general standard of living by rendering the employment of workers easier and increasing their geographical and occupational mobility. (28) It targets in particular the long-term unemployed, those in danger of losing their job, young people, women, handicapped people and the socially excluded. It is governed by Objectives 3 and 4 of the Structural Funds. The ESF also supports the development of SMEs, tourism and diversification in Objective 1, 2 and 5b areas. (29) The ESF improved employment opportunities by implementing vocational guidance and vocational training courses. It also helps in job creation and wage subsidy projects. Finally, it encourages and supports technological development and research. For the period 1994-1999 the ESF will receive 33.5% of Structural funding. (30) The Guidance section of the EAGGF is involved in all agricultural structural development in the EU. It invests in and aids the modernisation of farms. It supports extens ification, set aside and environmentally friendly farming practices. It also gives aid to young farmers and offers early retirement. Aid for mountainous regions, poor ecological areas and LFAs is given. It encourages the increased use of agricultural products and agricultural materials for industry. The Guidance section essentially covers grants, mostly contributing to the multi-annual operational programmesope rating under the Structural Fund Objectives 1, 2, 5a, 5b and6. It is responsible for the protection of environmentally sensitive areas (for example intensive valley and marsh grasslands, moorland and hill and mountain areas), encouraging the reduction or abandonment of fertilises and pesticides, and maintaining or improving the upkeep of countryside features such as hedges and walls. (31) Like the EAGGF, the FIFG provides sectoral assistance which covers the whole of the European Union, corresponding to Objective 5a. Actions under the FIFG promote structural measures in the f isheries sector. It grants money to modernise fleets and to develop fish farming. It offers protection to some marine areas. It gives aid to help improve facilities at fishing ports. It helps in the promotion of products and in the processing and marketing of fishery products. (32) A number of rural initiatives have been taken to improve the structure of agriculture and therefore solve the problems which had been plaguing European agriculture for decades. A bottom-up approach has been taken i.e. local and regional initiatives are supported in preference to nationalinitiatives. According to the Cork Declaration issued 9th November 1996:-a rural development policy must be multi-disciplinary in concept, and multi-sectoral in application, with a clear territorial dimensionit must be based on an integrated approach, encompassing within the same legal and policy framework : agricultural adjustment and development, economic diversification notably small and medium scale industries and rur al services the management of natural resources, the enhancement of environmental functions, and the promotion of culture, tourism and recreation. (33) A bottom-up approach is used with each interested party submitting a proposal to the EU concerning the improvements that they would like to make. There are Single Programming Documents (SPDs) for each eligible area. These identify certain strengths and weaknesses in an area. All proposals submitted must be based on a particular Priority and Measure. If possible it should also complement other priorities and measures contained in the SPD. (34) The EU will make its decision based on the proposal and its relation to the SPDs for the area. An example of such a rural development initiative is the LEADER programme. This was an EU initiative which was to assist communities develop their own areas. It was a multi-sectoral and integrated project. Its aim was to find new and innovative solutions which would help the development of rural areas and increase rural integration. LEADER 1 covered 61% of EU land area and 30% of its population. (35) These were mainly rural areas with a high dependence on agriculture or problems with a decreasing population. Tourism and SMEs were targeted. Accommodation like BBs and self-catering hostels were established. This brought tourism and money into the region and boosted the local economy as well as providing employment. Small enterprises, particularly those which specialised in crafts, were given aid. For example metalwork, textiles, leather, timber and furniture. Grants were given also to modernise farms and to help farmers farm more environmentally. The profile of the recipients who accepted the aid were farmers with above average farm sizes, who were young and well-educated and had access to information and capital. (36) Almost 1,500 jobs were created. (37) Community involvement in rural areas improved immensely and a sense of local ownership was fostered. It also created an impetus towards voluntary activities and encouraged co-operation between existing statutory agencies and private agencies who had worked together under the LEADER programme. An example of one of these LEADER programmes was the West Cork LEADER. This was established in 1991 with the objective of developing the local rural economy. (38) A plan was drawn up through initiatives in key sectors like agriculture, tourism, food, crafts and fisheries. Partnership was a key element of the programme. An integrated approach was taken. To date, there have been 125 projects in this area. For example, there has been a development in Castletownbare in co-operative fishing along with the creation and addition of jobs in the processing of fish products. Diversification was promoted by the development of a herb farm in west Cork. A new heritage centre was created in Bandon and a weir project was also begun there to help generate electricity for a local residential area. (39) In the UK the EAGGF has given a t otal of around 145 million (excluding allocations in Objective 1 regions and under the Community Initiatives) under Objective 5a for the period 1994-99. (40) Most measures are aimed at improving competitiveness and employment, while there are also measures providing for environmental considerations and for balanced land use and employment in LFAs. The UK decided on using 63% of the funding to implement measures concerning processing and marketing. 32% has been dedicated to developing mountainous LFAs. 5% has been allocated to investments on holdings. 0.3% will be given as support for young farmers and producer groups will receive 0.1%. (41) A total of around 45 million (excluding allocations in Objective 1 regions) has been allocated to the UK by the FIFG for the period 1994-99. (42) The UKs Objective 5a SPD for fisheries concentrates on adjusting fishing effort, modernising and improving the safety of vessels, adjusting the processing industry, and developing ports. A measure for t aking vessels out of service is underway for 1993-98. 7% of the fleet has currently been taken out of service and it is estimated that by the end of 1998 around 12% will have been withdrawn. (43) Can we therefore say that the post-1992 structurally oriented agricultural policy is more successful than the pre-1992 price-oriented one? There are several criticisms which can be levied against them. Objective regions came to rely heavily on the funding, and in some cases like Ireland, the increased funds represented a substantial augmentation of gross national income. Significant funding-level problems can be seen in examining the Social Funds operation, however. While its allocation increased from 2% of 1977 expenditure, to an estimated 8% between 1994 and 1999, this is clearly insufficient to withstand the tide of unemployment in the Community. (44) The Social Funds allocation of resources is not high enough to allow the authorities to tackle the underlying causes of unemployment. The Social Fund has been targeted at training and education and limited job creation, but fails to address the rigidities and barriers in wage markets and labour mobility. The funds sheer lack of financial clout has meant that it has failed to redress the fact that there are currently 20 million people unemployed in the EU, with 10 million of these classed as long-term unemployed. An even more scathing criticism of the lack of funding provided is that, of the several targeted Objective 3 and 4 areas which target youth and long-term unemployment, by 1993, only two had seen employment growth substantially above the EU average. (45) A further criticism is the fact that although ten thousand million ECU were allocated to the funds yearly from 1989 to 1993, and monitoring agencies were established to ensure the effective implementation of the Funds, reforms have been severely limited by the actual funding level. By 1992, only 3% of the EUs Gross Domestic Product (GDP) was going into the Fund s. The benefits of the new funding system have, however been crucial to several regions. Increased industrial activity, improved infrastructure, better farm structures and training of unemployed labour have all boosted regional economies around Europe. One final drawback of the Structural Funds is the notion that the Funds are swimming against the tide of other EU policies, and thus doomed to failure. The Guarantee section of the CAP tends to concentrate farming activity in the areas of efficient, wealthy farms, clearly against the dispersion aspiration of the Structural Funds. Given the huge commitment of funds to the Guarantee section of the CAP, the Structural Funds have clearly an uphill task to dislodge the concentration tendencies. A cursory glance at the raw data proves that the Structural Funds have not combated the problems they were created to tackle to a significant level. Twenty million people are still unemployed in the EU, and in 1990, GDP per capita in Ireland, Greece and Portugal was still 50-60% of the EU average. (Although these figures have since risen e.g. Ireland stands at 104% of the EU average). (46) While it is true that many worthwhile and indeed vital projects have been developed by the Structural Funds, the overall impact on the EU has been mitigated by a combination of planning, implementation and lack of funding difficulties. The Structural Funds were designed to reduce the tendencies towards divergence in the EU, but these largely remain, and unless an improved financial and developmental base is established, the Structural Funds will continually fail to address their targets. It cannot be denied, however, that they have had favourable effects. In the short period in which they have been in operation, (Structural Funds did not become important until 1989 and the subsequent MacSharry reforms), the Funds have been responsible for improving rural co-operation and development. Farmers are slowly becoming more environmentally aware and using environmentally-friendly practices. There has been a turnaround in internal migration patterns with the long-standing rural exodus being replaced by what has been referred to as an urban exodus. There is increasing migration from urban centres to rural areas. This is partly due to improved conditions, services and infrastructure in rural areas. These developments and improvements have been facilitated by the Structural Funds. There has been a dramatic rise in the number in the number of commuters and an enlargement of commuting catchments. (47) There has been an increase in the number of people who choose to retire in the countryside. More importantly there has been an increased flow of working-class return-migrants. (48) That the increase in urban to rural migrations was accompanied by a parallel decline in the opposite flow, was mainly due to changing demographic factors. Traditionally the rural exodus was basically fed by small farmers and their families but now, with impr oving rural conditions for smaller farmers, this trend is slacking off. There has also been a rise in the average rural incomes. (49) In conclusion, this essay maintains that price policies have a wider range of destructive demerits than they have merits. It can be seen from EU agricultural policy that the way forward is seen to be through structural reorganisation. There has been a shift from a pure agricultural policy, however, to a rural policy whose two main characteristics are to help maintain a pleasant and attractive environment through adequate aids to farmers and the adoption of a bottom-up approach which will integrate rural communities. The new structurally oriented agricultural policy costs less money to operate than the former price-oriented policy and has so far been more successful. More time is required however in order to determine whether the policy is truly successful. FOOTNOTES REFERENCES (1) Various Inputs, Internet, (Telecom Eireann, 1998) Treaty of Rome (as a mended):Agriculture (2) Josling, T.E. Langworthy, Mark Pearson, Scott, Options for Farm Policy in the European Community (Trade Policy Research Centre, 1981) page 2 (3) Various Inputs, op cit. Treaty of Rome (as amended) : Agriculture (4)Gardner, Brian, European Agriculture : Policies, Production and Trade (Routledge, London, 1996) page 30 (5) Ibid., page 31 (6) Gardner, Brian, op cit., (1996) page 47 (7) Marsh, John S. Swanney, Pamela J., Agriculture and the European Community (George Allen Unwin Ltd., 1980) page 31 (8) Ibid. (9) Gardner, Brian, op cit. (1996) page 49 (10) Grant, Wyn, The Common Agricultural Policy (Macmillan Press Ltd., 1997)page 67 (11) Houck, James P., Elements of Agricultural Trade Policies (Macmillan Publishing Company, 1986) page 62 (12) Moyer, Josling, Agricultural Policy Reform (Harvester Wheatsheaf, 1990) page 60 (13) Ibid., page 62 (14) Gardner, Brian, op cit. (1996) page 54 (15) Burger, Kess De Groot, Martin Post, Jaap Zachariasse, Vinus, Agricult ural Economics and Policy : International Challenges for the Nineties(Elsevier Science Publishers B.V, 1991) page 64 (16) Various Inputs, op cit. (1998) GATT (17) Burger, Kess De Groot, Martin Post, Jaap Zachariasse, Vinus, op cit. (1991) page 105 (18) Ibid. (19) Various Inputs, op cit. (1998) Agriculture : Regional Policy and Cohesion (20) Ibid. (21) Ibid. (22) Ibid. (23) Ibid. (24) Ibid., Structural Funds (25) Ibid. (26) Ibid. (27) Ibid., ERDF : Aims (28) Ibid., ESF (29) Ibid. (30)Ibid. (31) Ibid., EAGGF : Aims (32) Ibid., FIFG : Objectives (33) Ibid., Cork Declaration (34) Ibid., Structural Funds (35) Ibid., LEADER Programme (36) Ibid. (37) Ibid. (38) Ibid., LEADER Programme : Case Study (39) Ibid. (40) Ibid., EAGGF : Case Study (41) Ibid. (42) Ibid. (43) Ibid. (44) Ibid., Structural Funds (45) Ibid. (46) Ibid. (47) Ibid., Cork Declaration (48) Ibid. BIBLIOGRAPHY Bowler, Ian, Government and Agriculture : A Spatial Perspective (Longman Group Ltd., 1979) Burger, Kess De Groot, Martin Post, Jaap Zachariasse, Vinus, Agricultural Economics and Policy : International Challenges for the Nineties(Elsevier Science Publishers B.V, 1991) Gardner, Brian, European Agriculture : Policies, Production and Trade (Routledge, London, 1996) Grant, Wyn, The Common Agricultural Policy (Macmillan Press Ltd., 1997) Houck, James P., Elements of Agricultural Trade Policies (Macmillan Publishing Company, 1986) Josling, T.E. Langworthy, Mark Pearson, Scott, Options for Farm Policy in the European Community (Trade Policy Research Centre, 1981) Marsh, John S. Swanney, Pamela J., Agriculture and the European Community (George Allen Unwin Ltd., 1980) Matthews, Alan, The Common Agricultural Policy and the Less Developed Countries (Gill Macmillan Ltd., 1985) Moyer, Josling, Agricultural Policy Reform (Harvester Wheatsheaf, 1990) Ockenden, Johnathan Franklin, Michel, European Agriculture : Making the CAP Fit the Future (Pinter Publishers, London, 1995) Various Inputs, European Re view of Agricultural Economics 1973 : Volume 1 1989 : Volume 16 1992 : Volume 19-1, Volume 19-3, Volume 19-4 1994 : Volume 21-2, Volume 21-3/4 (Mouton de Gruyter) Various Inputs, Internet (Telecom Eireann, 1998) The Effects Of War And Peace On Foreign Aid Essay

Hepatocellular carcinoma

A 50-year-old married man with a family of three children presented chronic hepatitis C that developed to cirrhosis. Hepatitis C was linked to â€Å"intravenous drug used in 1960’s and trauma treatment involving several transfusion in 1975† (Schiff 2004, p. 183). Cirrhosis became complex due to â€Å"bleeding esophageal varice, but endoscopic banding intervention was successful in 2001† (Schiff 2004, p. 183).Advertising We will write a custom case study sample on Hepatocellular carcinoma specifically for you for only $16.05 $11/page Learn More The patient later had ascites and hepatic encephalopathy complications. A computed tomography conducted in â€Å"November 2001 showed a 6Ãâ€"6.5x7cm mass lesion in segment 7 of the liver (fig. 3), which later increased in size to 11.2Ãâ€"9.2Ãâ€"5.8cm on a repeat CT scan two months later while serum alpha-fetoprotein (AFP) was above 16,000ng/mL† (Schiff 2004, p. 183). Introduction Hepa tocellular carcinoma (HCC) is the most â€Å"common main liver cancer and the fifth most widespread cancer worldwide with a poor prognosis and it is the third most prevalent cause of death from cancer† (Ghanaati et al 2012, p. 167; Hennedige, Tiffany and Venkatesh 2012, p. 530). Some studies have recorded that HCC is mainly common in Asia where there are rampant cases of hepatitis B and C infection. The main risk factor for HCC is chronic hepatitis B virus infection (Carr 2012), which could be severe in densely populated regions (Ghanaati et al. 2012). Poor diet and metabolic factors may also influence prevalence of HCC (Abby and Zhu 2009). The condition is common in men aged between 30 and 50 years of age (Yang and Roberts 2010). These authors also observe that HCC diagnosis mainly occur in advanced stages, which make it contribute to high incidence and cases of fatality. Moreover, this later diagnosis also reduces effective use of curative treatments. Early diagnosis and su rgical resection together with local ablation are effective in enhancing conditions of patients with HCC. Imaging has critical role in determining the diagnosis of HCC. HCC has many imaging approaches, which include â€Å"ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and angiography† (Hennedige and Venkatesh 2012 p. 530; Ghanaati et al 2012).Advertising Looking for case study on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More These approaches are effective in diagnosis of patients with chronic liver problems and a possible HCC case. Imaging helps in â€Å"screening, diagnosis, medication planning, patient management, and observation after treatment† (Hennedige and Venkatesh 2012 p. 530). In the case study, one can observed that HCC management is difficult because of the changing nature of the condition, factors that affect cirrhosis, and the rapeutic challenges (Ghanaati et al. 2012). Surgical interventions and liver transplant have been effective in managing HCC. However, not all conditions of HCC may require surgical resection. Thus, non-surgical interventions are common because of â€Å"multifocal diseases, proximity to the vital vascular or biliary structures and the insufficient functional hepatic reserve in cirrhosis† (Ghanaati et al. 2012 p.168). In the absence of surgery, radiology options, such as transarterial chemoembolization (TACE), radiofrequency ablation, and microwave ablation (Firouznia, Ghanaati, Jalali and Shakiba 2011) are common in managing HCC (Schiff 2004). Anatomy The liver is the major and most multifaceted organ in the abdominal area of the body. It has several microscopic and functional lobules, which aid in various functions of the liver. The liver originates from the ventral mesogastrium, but the upper section goes beyond the ventral area. Both falciform ligament and ligamentum teres connect the liver to the anterior section of the body while omentum joins the liver and the stomach as the coronary and triangular ligaments link the liver and the diaphragm. The liver supplies blood to the body. It gets blood from the artery and vein. Hepatocytes are in charge for complex metabolic processes within the liver. In addition, they also account for processes related to lipid synthesis, carbohydrate and cholesterol control, secretion of lipoproteins, formation of urea, enzymes, serum albumin, and other proteins.Advertising We will write a custom case study sample on Hepatocellular carcinoma specifically for you for only $16.05 $11/page Learn More Moreover, the liver is critical in clearing drug chemical substances and unidentified bodies in it. Kupffer cells aid in immune functions because they filter foreign particles in the liver. The liver also has biliary passages, which form bile and hepatic ducts. These ducts lead to the duodenum. Fig ure 1: A: Normal Anatomy of the liver, B: Histological view (Gurakar et al 2013) Pathology HCC is also like other forms of cancer, which progress through various stages of tumour (Kojiro 2006). According to Sakamoto Masanori (2007), histopathological and molecular biological studies have revealed that HCC associated with â€Å"chronic liver disease evolves from precancerous lesions called adenomatous hyperplasia (also called dysplastic nodules) and early HCC to a progressed form† (Masanori 2007 p. 138). During the early stages of the HCC condition, it looks like microinvasive carcinoma. Later the condition progresses to a progressed HCC. The early stage of HCC is critical for the development of all other subsequent stages (Sakamoto 2009). In the case study, cirrhosis was in advanced stage, which resulted into several complications (Marrero 2003). However, it is difficult to understand progress processes of HCC during early stages, but recent studies have shown that HCC progre sses from cirrhosis, dysplastic nodules to tumours (Marrero 2003).Advertising Looking for case study on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More Moreover, studies have failed to indicate any possible tumour suppressor genes during the early stages of HCC. Further studies in gene expression may clarify early stages of HCC. As cases of HCC rise, several combined tumours will be available and history of pathologic factors and patients’ history would be critical for understanding the condition. Hepatitis B and C Hepatitis B and C are fundamental conditions that contribute to HCC. There are several cases of HCC in China and Japan because of hepatitis B. In addition, other regions also experience cases of HCC from hepatitis B and C. While the prevalence of the condition is similar, many cases of HCC result from hepatitis C more than hepatitis B (Gomaa, Khan, Toledano, Waked, and Taylor-Robinson 2008). Pathogenesis of HCC availability due to hepatitis B could result from high number of cell increment from chronic liver conditions or due to processes associated with hepatitis B viruses (Gomaa et al 2008). Hepatitis B DNA geno me may interfere with the regulatory roles of the liver and increase the condition. On the other hand, details on how hepatitis C contributes to the progression of HCC remain unclear, but other studies allude that such patients could have suffered hepatitis B prior to hepatitis C (Gomaa et al 2008). Cirrhosis The case study shows that regardless of cirrhosis etiology, it is always a risk factor for growth and progression of HCC. Cirrhosis has higher chances of increasing the development of HCC than hepatitis in any population (Gomaa et al 2008). As hepatocellular progresses, it may cause changes in tumour suppressor genes. Mutation may cause hepatocarcinogeneses. Majority of patients with HCC also have cirrhosis conditions (Carr 2012). Figure 2: Liver biopsy showing presence of cirrhosis, (Schiff 2004) Other Factors There are also a number of etiological factors, which affect HCC. They include alcohol, use of anabolic steroid, aflatoxins, and hemochromatosis (Gomaa et al 2008). Die tary compositions with carcinogenic aflatoxins are usually widespread in some parts of sub-Saharan Africa and Southeast Asia (Gomaa et al 2008). Consequently, there is high prevalence of hepatitis B in these regions. However, details on how hepatitis B and carcinogenic aflatoxins contribute to HCC remain poorly studied and understood (Gomaa et al 2008). In cases of hepatitis C infection, alcohol has played a major role in enhancing the condition of HCC. Still, it is not clear whether alcohol acts independently, or it acts with hepatitis C to increase the condition of HCC (Gomaa et al 2008). Role of imaging modalities in the diagnosis Imaging modalities include â€Å"ultrasonography (US), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and angiography† (Ghanaati et al. 2012). These modalities are useful in diagnosis of severe cases of liver conditions or suspected HCC (Ghariba, Thomasson and Li 2004). Ultrasonography (US) Ultrason ography is the first and commonly accepted form of HCC diagnosis because it is safe, fast, and cost-effective (Lee, Yoon and Kim 2012). However, ultrasonography does not provide optimal image quality in patients with cirrhosis. In this case, other modalities like CT and MRI are effective. The new ultrasound elastrography relies on strain to identify mechanical elements of tissue stiffness during diagnosis. The method may not be possible to apply because of deep and protected location of the liver. In this case, acoustic radiation is necessary in order to improve impulse elastography with short and focused US beam for tissue displacement (Ghanaati et al. 2012). Elastography has the ability to diagnose stiff superficial tissues, but â€Å"acoustic radiation force elastography can estimate the stiffness of the superficial and deep tissues due to application of shear wave† (Choi 2010). This method works well together with other conventional ultrasonography because it enhances con spicuity and differentiates between benign and malignant lesions (Hosseini 2011). Computed tomography (CT) CT images are useful in diagnosis of central liver lesions. This may take place after sonography and normal sonograhphy for patients who may have high-levels of ÃŽ ±-fetoprotein (Sahani, Holalkere, Mueller and Zhu 2007). In the case study, CT imaging showed that the patient had a 6Ãâ€"6.5x7cm mass lesion in segment 7 of the liver (fig. 3), which later increased in size to 11.2Ãâ€"9.2Ãâ€"5.8cm on a repeat CT scan two months later while serum alpha-fetoprotein (AFP) was above 16,000ng/mL (Schiff 2004; Sahani, Holalkere, Mueller and Zhu 2007). CT scan serves different roles during diagnosis. It is applicable during â€Å"HCC staging and post-diagnosis after surgical resection, percutaneous ethanol injection, or radiofrequency ablation† (Ghanaati et al. 2012). CT scan improves contrast in HCC diagnosis. This happens after an injection of extracellular contrast-enhancing a gent, which aid in depicting and identification of HCC. CT perfusion performance involves the use of Multi Detector CT (MDCT) and injection of iodinated contrast materials in order to enhance temporary changes in tissue attenuation (Ghanaati et al. 2012). Figure 3: CT scan demonstrating mass in right hepatic lobe (Schiff 2004) Magnetic resonance imaging (MRI) MRI is suitable for patients who have not shown any diagnostic results in CT diagnosis or patients who may not show positive results with iodinated contrast agents. MRI is better than CT scan in cases of hyperintense malignant lesions. In addition, enhanced MRI yields better images than CT contrast-enhanced scans. Still, MRI shows minute lesions clearly than other modalities of HCC diagnosis. MRI produces better result and efficacy relative to CT scan for effective decision-making on managing patients’ conditions. There is also Magnetic resonance elastography (MRE), which does not attack the body tissues, but reviews me chanical qualities of the body tissue. MRE aids in identification of malignant and benign liver tumours (Choi 2010). MRI uses Diffusion-weighted image (DWI) technology as a non-invasive quantification to enhance the rate of detection of focal liver conditions (Ghanaati et al. 2012). The technique uses cellular necrosis to enhance membrane permeability to facilitate free diffusion of water molecules. Figure 4: MRI HCC (Ghanaati et al 2012) Positron emission tomography (PET) PET is a new modality of HCC diagnosis. However, it is a new technique in terms of functions in HCC diagnosis, particularly in tracing certain hepatocyte. This technique will eventually improve the HCC diagnosis among patients with severe conditions of HCC and liver problems. PET technique yields a three-dimensional image of the body (Bailey, Townsend, Valk and Maisey 2005). It uses gamma rays from tracer in order to construct the image. PET can also use CT scan to accomplish the imaging process. Treatment and pr ognosis Studies have indicated that HCC is not sensitive to radiotherapy or chemotherapy interventions. However, several interventions exist for managing HCC, which include cisplatin gel injection, percutaneous ethanol, cryosurgery, radiofrequency ablation (surgical and percutaneous), hepatic artery chemoembolization, and liver transplant among others (El-Seragemail, Marrero, Rudolph and Reddy 2008). However, the case study focuses on the RFA and chemoembolization for managing advanced conditions. Table 1: Barcelona Clinic Liver Cancer (BCLC) staging classification and treatment schedule Stage Status Treatment Stage 0 Very early HCC Resection Stage A Early HCC Radical therapies (resection, liver transplantation, or percutaneous treatments) Stage B Intermediate HCC Chemoembolization Stage C Advanced HCC New agents in a randomized controlled trial setting Stage D End-stage disease Symptomatic treatment CLT, cadaveric liver transplant LDLT, living donor liver transplant PE I, percutaneous ethanol injection RF, radiofrequency PS, performance status Adapted from (Sala, Forner, Varela and Bruix 2005) Radiofrequency Ablation (RFA) RFA is a relative new method of managing HCC. It relies on ‘heating’ to destroy tumour in the liver. It has a thin probe, which reaches the tumour with the aid of ultrasound (Bruix and Sherman 2005). However, this technology applies to small tumour within the liver. Moreover, it has low-levels of side effects to the HCC patient. RFA is also simple to use because it can work in â€Å"an open or laparoscopic technique, physicians can apply RFA by the use of percutaneous approach (a direct injection through the skin)† (Gurakar et al 2013). Physicians can also use RFA alongside other interventions like liver resection and cryotherapy (Ghanaati et al. 2012). Hepatic Artery Chemoembolization This is the most common intervention method for treating unresectable liver tumours (tumours beyond operation). Chemoembol ization treatment offers many benefits than other intravenous pump infusion interventions (Bruix, Sala and Llovet 2004). It takes the injected drugs to the tumour and controls blood flow without extending contact time for tumour and drug. It reduces oxygen supply to the tumour and improves high drug concentration on the tumour. Chemoembolization also has a long duration for drugs to stay in the liver, which may be more than a month after the treatment. It also enhances high chances of the patient survival after undergoing medication. Chemoembolization has high-levels of vascularity, which enhances neuroendocrine tumour treatments. In fact, Chemoembolization is the most favourable intervention for unresectable hepatocellular carcinoma, and neuroendocrine tumours of the liver (Bruix et al 2004). Figure 5: Liver tissue chemoembolization (Schiff 2004) Summary and conclusion HCC is a common primary liver cancer with poor prognosis and treatment, which have contributed to high numbers of mortality rate associated with it. The condition progresses through various stages as the patient in the case study indicates. Studies have linked HCC with hepatitis B and C, liver cirrhosis and other factors like alcohol, use of anabolic steroid, aflatoxins, and hemochromatosis. However, details on how these factors relate to enhance HCC remain scanty. Imaging techniques (specifically CT and MRI) have critical role in the diagnosis and evaluation of liver problems, tumours, and HCC interventions. Imaging helps patients whose conditions do not require surgery. The patient in the case study required chemoembolization because liver transplantation was not effective due to high chances of recurrence and the intermediate stage of the condition. Reference List Abby, Siegel and Andrew X. Zhu. â€Å"Metabolic Syndrome and hepatocellular carcinoma.† Cancer (ACS) 115, no. 24 (2009): 5651–5661. doi:10.1002/cncr.24687. Bailey, Dale, David W. Townsend, Peter E. Valk and Michael N . Maisey. Positron Emission Tomography: Basic Sciences. Secaucus, NJ: Springer-Verlag, 2005. Bruix, Jordi and Morris Sherman. â€Å"Management of hepatocellular carcinoma.† Hepatology 42, no. 5 (2005): 1208–1236. doi:10.1002/hep.20933. Bruix, Jordi, Margarita Sala and Josep Llovet. â€Å"Chemoembolization for hepatocellular carcinoma.† Gastroenterology 127, no. 5 (2004): S179–S188. doi.org/10.1053/j.gastro.2004.09.032. Carr, Brian. â€Å"Introduction: Hepatocellular Carcinoma.† Seminars in Oncology 39 no. 4, (2012): 367–368. Choi, Bi. â€Å"Advances of imaging for hepatocellular carcinoma.† Oncology 78, no. 1 (2010): 46–52. doi: 10.1159/000315230. El-Seragemail, Hashem, Jorge Marrero, Lenhard Rudolph and Rajender Reddy. â€Å"Diagnosis and Treatment of Hepatocellular Carcinoma.† Gastroenterology 134, no. 6 (2008): 1752-1763. doi:10.1053/j.gastro.2008.02.090. Firouznia, Kavous, Hossein Ghanaati, Amir Hossein Jalali, and M adjid Shakiba. â€Å"Advances of interventional radiology in treatment of hepatobiliary diseases in Iran.† Hepat Mon. 11, no. 7 (2011): 507–10. Ghanaati, Hossein, Seyed Moayed Alavian, Ali Jafarian, Nasser Ebrahimi Daryani, Mohsen Nassiri-Toosi, Amir Hossein Jalali, and Madjid Shakiba. â€Å"Imaging and Imaging-Guided Interventions in the Diagnosis and Management of Hepatocellular Carcinoma (HCC)-Review of Evidence.† Iran J Radiol 9, no. 4 (2012): 167–177. doi: 10.5812/iranjradiol.8242. Ghariba, Ahmed, David Thomasson and King Li. â€Å"Molecular imaging of hepatocellular carcinoma.† Gastroenterology 127, no. 5 (2004): S153–S158. doi.org/10.1053/j.gastro.2004.09.029. Gomaa, Asmaa Ibrahim, Shahid A Khan, Mireille B Toledano, Imam Waked, and Simon D Taylor-Robinson. â€Å"Hepatocellular carcinoma: Epidemiology, risk factors and pathogenesis.† World J Gastroenterol., 14, no. 27 (2008): 4300–4308. doi: 10.3748/wjg.14.4300. Hennedig e, Tiffany and Sudhakar Kundapur Venkatesh. â€Å"Review: Imaging of hepatocellular carcinoma: diagnosis, staging and treatment monitoring.† The Journal of the International Cancer Imaging Society 12, no. 3 (2012): 530-547. DOI: 10.1102/1470-7330.2012.0044. Hosseini, Saiedi. â€Å"Risk factors and incidence of hepatocellular carcinoma in southeast iran.† Hepat Mon. 11, no. 8 (2011): 666–7. doi: 10.5812/kowsar.1735143X.710. Kojiro, Masamichi. Pathology of Hepatocellular Carcinoma. Oxford: Wiley-Blackwell, 2006. Lee, Jeong, Jeong-Hee Yoon, and Kyung Kim. â€Å"Diagnosis of Hepatocellular Carcinoma: Newer Radiological Tools.† Seminars in Oncology 39, no. 4 (2012): 399–409. Marrero, Jorge. â€Å"Hepatocellular Carcinoma:† Current Opinion in Gastroenterology, 19, no. 3 (2003): 243-249. Sahani, Dushyant, Nagaraj-Setty Holalkere, Peter Mueller, and Andrew Zhu. â€Å"Advanced Hepatocellular Carcinoma: CT Perfusion of Liver and Tumor Tissue—I nitial Experience.† Radiology 243, (2007): 736-743. doi: 10.1148/radiol.2433052020. Sakamoto, Masanori. â€Å"Pathology of early hepatocellular carcinoma.† Hepatol Research 37, no. 2 (2007): S135-8. Sakamoto, Masanori. â€Å"Early HCC: diagnosis and molecular markers.† Journal of Gastroenterology 44, no. 19 (2009): 108-11. doi: 10.1007/s00535-008-2245-y. Sala, Margarita, Alejandro Forner, Maria Varela and Jordi Bruix. â€Å"Prognostic Prediction in Patients with Hepatocellular Carcinoma.† Seminars in Liver Disease 25, no. 2 (2005): 171-180. Schiff, Eugene R. â€Å"Case Study in the Management of Patients with Hepatocellular Carcinoma.† In Management of Patients with Viral Hepatitis, Paris, 2004, edited by Fabien Zoulim, 183-188. Paris: Beaujon Hospital, 2004. Yang, Ju and Lewis Roberts. â€Å"Epidemiology and management of hepatocellular carcinoma.† Infect Dis Clin North Am. 24, no. 4 (2010): 899-919. doi: 10.1016/j.idc.2010.07.004. This case study on Hepatocellular carcinoma was written and submitted by user Molecule Man to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

All the Pretty Horses essays

All the Pretty Horses essays All the pretty horses is an excellent piece of writing by Comic McCarthy. The main theme of the novel is the desire for freedom. The term freedom is used almost sarcastically as the author explores the essence of the freedom man desires only to find that it is actually a paradoxical term. On the one hand, we want freedom, which would allow us to do anything as we like but on the other, the author discovers that there is no real freedom without laws. The freedom we dream of is free from the shackles of law but the freedom that man can truly cherish and enjoy prospers within the confines of law. The young protagonist of the novel, Grady, is a representative of average American youth. He is a man who dreams of boundless freedom and since he can no longer enjoy that kind of freedom on the ranch his family had in America, he decides to run away to Mexico. For a brief time in this country, it looks as if Grady has found everything that he had ever wanted. He starts working on a splendid ranch with a large number of pretty horses and also falls in love with the beautiful daughter of his employer, a girl called Alejandra. These dreams are however very short-lived and Grady soon realizes that accountability and responsibility that he so despised in the US were actually the ingredients real freedom is made of. Grady comes of age and discovers that lawlessness doesnt breed freedom; it curtails free will and generates evil. In Mexico, he is forced to do thing against his will- things that he would have never been asked to do in the US like leaving Alejandra and killing someone in prison in self-defense. He along with his friend is thrown into prison for no real reason and that infuriates him even further. In this coming of age story, Grady learns the meaning of true freedom. He also learns much to his chagrin that without laws and rules, life is a rudderless boat that allows no exercise of free will. It lacks a ...

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Language Attitudes And Ideologies English Language Essay

Language Attitudes And Ideologies English Language Essay In a contemporary society especially in a diverse country such as South Africa, language plays an important role in defining identity. As a result of the many diverse cultures, South Africans are exposed to a vast amount of different languages. These languages form part of identity and thus are accompanied by certain language ideologies and attitudes. Language ideology may be defined as shared beliefs about language forms and practices embedded in social conflicts over power (Volk and Angelova, 2007:177). Attitudes on the other hand are closely related to ideologies, and are described as learned reactions toward a person or situation (Steinberg, 2007). This essay aims to research the effects of a multilingual university (UWC) community on language use and ideology. It will also provide reasons for these effects and how attitudes relate to language ideology. To begin the study my research population consisted of a UWC male student, age twenty five and his first language is Setswana. In order to conduct the research I first posed a question to this student. The question was as follows; Given that you have been at UWC for at least two years, what effect is your membership of a multilingual university community having on your language use and ideology? The student answered that being at UWC has changed his ideology of different languages, because of the diverse language speakers and the formation of strong friendships he has been forced to become familiar with other languages. I then used this response as a framework to begin the research. As this is a qualitative research study I have made use of the survey-questionnaire method to gather my data. I have particularly applied the Linkert Scale style questionnaire that consists of statements and of which the participants answers are among the following; strongly agree/ agree/ unsure/disagree/ strongly disagree. The participant would then provide the reasons for their answers. The statements on the Linkert Scale questionnaire were as follows: I am happy with English as the main medium of instruction at UWC I would be more successful in my academic studies if my home/first language could be used in lectures and tutorials The other languages are sufficiently developed for use at tertiary level, and should not only be used for informal communication Its a good thing that we have a common language here at UWC to help us communicate across linguistic boundaries Im pleased that Ive picked up some words and expressions in other languages here at UWC The other part of the questionnaire asked for reasons for answers and provided writing space for the students response. In this case the student then provided reasons for his response to the above statements which made up the full data which I have made use of in this essay. The findings consisted of the responses to the above statements and the reasons for the response. The participants response to statement one was that he strongly agrees with English being a medium of instruction at UWC. His reason for his response was as follows Since different students come from different backgrounds/cultures and languages its only fair to have English as a lingua Franca common to all. Thus in this case I have found that the participant feels that English is a language spoken by all students at UWC. He also suggests that it is fair to have English as a medium of instruction, because all students at UWC share the common understanding of English whether it be a first, second or third language acquisition. This explains English as a lingua franca, the term lingua franca describes a language serving as a regular means of communication between different linguistic groups in a multilingual speech community Holmes (1997:86). The participant in this case is happy with the f act that English is used as a medium of instruction. The students response to statement two was that he disagrees that he would be more successful academically if his first language was a medium of instruction. The students reason for this is as follows No, I am more competent in English than my mother tongue when it comes to reading and writing as I last stopped using my first language for reading and writing in standard 3. It is clear, judging by the participants response, that he has lost proficiency in his first language in reading and writing due to being educated in English for so long. As a result of being educated in English for such a long time the student seems to feel more competent with English. This evidence gives rise to the notion that English may be the predominant language for educating a multilingual society due to its global recognition. The participants response to statement three was that he strongly disagrees with the assumption that, other languages are sufficiently developed for use at tertiary level and should not only be used for informal communication. The students reason for this is When it comes to Afrikaans and Xhosa I understand because these are the languages predominantly spoken in the Western Cape, but if its other languages it would not be fair to the other 11 official languages which are not used in tertiary education. The student in this instance feels as that English, Afrikaans and Xhosa are the only three languages developed at tertiary level as there is predominance in the amount of speakers of these languages. However, the participant disagrees that other languages should be used as a medium of instruction at tertiary level because it would be unfair to those who cannot understand the language. The student also feels that should one language, other than English/Afrikaans or Xhosa, be used as a m edium of instruction at tertiary level it would be unfair to the other eleven official languages that are not used in this way. The students answer to statement four was that he strongly agrees that its a good thing that we have a common language at UWC to communicate across linguistic boundaries. The students reason for this is as follows; If it wasnt for English as a lingua franca we would all be lost unless we share a 1st language, So it very good that we have a lingua franca as we connect/communicate well. In this case it is evident that the participant feels generally pleased that there is a language that can break through linguistic boundaries. The student in this case feels that English has the power to do so as a result of its wide range of speakers. It is also clear that the student agrees that English as a lingua franca helps us to communicate with other students from different linguistic backgrounds. The last statement the partaker responded that he agrees that he is pleased he has picked up some words and expressions in other languages. His reason for this is Yes I am this helps to communicate better with student who I do not share the same 1st language with, helps to build friendships and more, it brings people together. With regard to this response it seems that the student is pleased that he is able to pick up words form other languages that help to form relationships. To conclude the findings it is apparent that language attitudes form part of ideologies. Judging by the data I have gathered the participant provided insight of his attitude toward different languages especially English. It is obvious that English is a medium of instruction that the participant is pleased with as he would not have chosen UWC as an institution for higher education if this was not the case. The participant thus has a positive attitude towards English and the ideology (shared beliefs of language forms and practices) that English is a lingua franca common to all, increases this positive attitude. In this instance it brings to mind the assumption that we attain our attitudes from our ideologies. In essence it is apparent that our ideologies influence our attitudes toward various languages and it is these components that constitute as part of our identity. Language thus forms part of identity and in a modernised multilingual society the choice of identity is open to all. To elaborate one can side with the post-modern researchers who suggest that Post-modern accounts of identity have reacted against traditional and essentialist views by proposing an almost unlimited range of identity choices (Wallace, 2008:61). We as South Africans may be faced with the challenge of the battle between predominant and minor languages in a diverse country that consists of many different languages. Yet it is still astonishing to see that an institution such as UWC is able to bring people together even if it is through the use of English as a medium of instruction.