How to write an empathy essay
Tim Keller Has An Excellent Paper On This Topic, “Leadership & Church Size Dynamics
Thursday, August 27, 2020
Compare Wal-Mart Essay
1.Compare Wal-Mart. com with Amazon.com. What highlights do the destinations share practically speaking? Which are extraordinary to Wal-Mart? To Amazon.com? Walmart.com and amazon.com have a great deal of similitudes. A portion of the normal highlights between the two incorporate setting up a client account, the two of them have the shopping basket include, both these sites have the pursuit bar at the highest point of the page, the two of them permit you to figure out items dependent on value, ubiquity, significance, client audit, the two of them show you a rundown of things saw that coordinated what you looked for, the two of them have a blessing library, buys made on the Wal-Mart can either be delivered to your home or to a closest store either by Wal-bazaar or by an outsider seller from the commercial center. Amazon also has tie ups with various sellers everywhere throughout the world that you can purchase from. The two sites graphically show client audits for every thing. The two sites permit you to follow your request. The two locales have the arrangements of the day. Amazonââ¬â¢s is called todayââ¬â¢s arrangement and Wal-Martââ¬â¢s is called estimation of the day. The main thing I discovered one of a kind about Wal-Martââ¬â¢s site is that it has a catch on the highest point of the page called ââ¬Ëweekly adââ¬â¢ that shows little coupons that clients can reclaim. Amazon doesn't have this element. Another contrast between the two sites is their arrival strategy. Wal-Mart has a multi day merchandise exchange though Amazon has a multi day merchandise exchange. 2.Will Wal-Mart become the prevailing e-posterior on the planet, supplanting Amazon.com, or will Amazon.com overwhelm Wal-Mart on the web? What components would con-tribute to Wal-Martââ¬â¢s accomplishment in the online commercial center? What elements would bring down its capacity to overwhelm online deals the manner in which it has had the option to rule physical retail deals in numerous business sectors? At present, Amazon.com offers an a lot bigger and progressively fluctuated stock just as an assortment of highlights and advantages that Walmart.com can't coordinate. While Walmartââ¬â¢s retail locations have a colossal client base, huge numbers of whom will go to Walmart.com for accommodation, Walmart.comââ¬â¢s stock is for the most part made uniquely out of items that are accessible in Walmart stores. In the mean time, Amazon has a huge range of items in for all intents and purposes each class conceivable, from everywhere throughout the world. What's more, Amazon has many utilized things that are accessible at lower costs, just as uncommon, vintage, and antique things that are not part of Walmartââ¬â¢s stock. Amazon additionally offers an online ââ¬Å"marketplace,â⬠where customers can interface with venders anyplace on the planet, look at productsâ and costs, and now and then even haggle with merchants. Quite a bit of Walmartââ¬â¢s strength in the physical retail showcase is because of its plan of action of purchasing in such enormous mass amounts that it can offer lower costs to clients, just as being a one-quit shopping goal; in any case, since Amazon clients can correlation shop between Amazon venders, and on the grounds that Amazon can offer an a lot bigger assortment of items, both of Walmartââ¬â¢s points of interest are refuted. Consequently, it is far-fetched that Walmart.com will ever have the option to supplant Amazon. 3.Check the shopping helps offered at Wal-Mart. com. contrast them and those at Amazon. com. Walmart.com has an accessible database just as classifications that permit clients to peruse through their accessible items. Query items can be arranged by significance, value, client rating, top of the line, and so on. Clients can make profiles that store their delivery and charging data for comfort, just as past request data. Requests can be followed on the web. Clients who look for things at Walmart.com are additionally offered proposals for different items that may likewise intrigue them. Gift vouchers can be buy on the web, and gift voucher adjusts can be checked. Walmart.com additionally offers wedding and infant vault administrations, just as a ââ¬Å"Wish Listâ⬠that can be seen by others. A ââ¬Å"Value of the Dayâ⬠is offered to grandstand things that are marked down at even lower costs. Free delivery is frequently accessible on select buys. These shopping helps are practi cally identical to those on Amazon.com. Walmart.com offers one shopping help that Amazon doesn't have; numerous things can be delivered to the customerââ¬â¢s closest Walmart store for nothing, which can prompt noteworthy investment funds. 4.What online administrations can be bought on Walmart.com? Walmart.com offers the accompanying administrations on the web: â⬠¢Ã¢â¬ Straight Talk No-Contract Phones,â⬠where clients can buy a prepaid telephone, have it conveyed to their location, and actuated on the web or via telephone; â⬠¢Same-Day Photo Pickup,â⬠which permits clients to transfer advanced photographs to Walmart.com, which would then be able to be moved onto photograph prints, mugs, cards, schedules, and so forth., or even onto banners or fake canvases. A large portion of these items would then be able to be gotten up customerââ¬â¢s neighborhood store that equivalent day; â⬠¢Ã¢â¬ Contact Lenses at Walmart,â⬠which permits clients to enterâ their remedy contact focal point data and request an assortment of brand-name contact focal points at deal costs; â⬠¢Ã¢â¬ Enroll in a Medicare Part D Plan,â⬠an assistance which enables qualified candidates to apply for Medicare, just as get limits at Walmartââ¬â¢s drug store; â⬠¢Ã¢â¬ Walmart MoneyCenter,â⬠which gives an assortment of monetar y administrations web based, including Mastercards, prepaid platinum cards, cash moves, charge arrangement administrations, and Bluebird, a ââ¬Å"debit and checking alternativeâ⬠supported by American Express that offers a significant number of indistinguishable administrations from conventional banks. What's more, the Walmart Pharmacy offers numerous administrations web based, including medicine tops off and conveyance. Walmart likewise has a Wellness Center that offers wellbeing tips and apparatuses on the web.
Saturday, August 22, 2020
Life in the Antebellum U.S Essay Example | Topics and Well Written Essays - 2500 words
Life in the Antebellum U.S - Essay Example The Native Americans were the underlying tenants of land in America. They chased and accumulated to continue their dietary necessities. President Thomas Jefferson saw the foundation of an approach which permitted Native Americans to hold their hereditary terrains east of the Mississippi. The main condition joined to this was simply the local populace was to acclimatize with the remainder of the populace. They were to enhance their chasing and assembling rehearses with agribusiness. As time slipped by, it got outlandish for the administration hold their strategy. The fast populace increment among the workers and Whites in America made it unlikely for the legislature to hold this arrangement. They, in this way, turn in the uprooting of Native Americans from their hereditary land. The president Andrew Jackson marked 'the Indian Removal Actââ¬â¢ on May 26, 1830 (Keegan 72). The procured land was to be utilized to set up estates. These would guarantee huge scope creation of harvests th at would be utilized for food and different enterprises. It would likewise furnish the foreigners with a spot to settle in; where they could start assembling their lives. Time resulted, and the Whites infringed on Native Americanââ¬â¢s land dwarfing the local populace. They expected complete responsibility for land and built up their own establishments and frameworks. The Natives marked bargains that promised them equivalent land West of Mississippi in return for their unique bundles of land. Clans that didn't co-work confronted compelling expulsion from their territories by government authorities who manhandled their capacity. For instance, the Cherokee individuals experienced strong expulsion from their territory. This was in the wake of marking the ââ¬ËTreaty of New Echotaââ¬â¢ by a little piece of the whole clan. The inborn pioneers passed up a great opportunity of the whole bargain marking process. This prompted the passing of assessed 4,000 clan individuals in 1835. T he walk came to be known as the ââ¬ËTrail of Tearsââ¬â¢ (Keegan 27). The administration legitimized their activities by asserting that the nativesââ¬â¢ nearness disturbs the concordance in the locale. They likewise guaranteed that the land would profit the American populace. In any case, this was not so much evident. Huge numbers of the administration authorities were avaricious and basically wanted sole responsibility for land. This drove them to act in obtuse manners that prompted the passing of numerous Natives. These authorities likewise didn't respect the details of the bargains wherein they pressured the locals to sign. The Antebellum time frame saw expanded assembling of items in America. Most makers were, along these lines, needing modest work to satisfy their assembling needs. This must be given by outsider laborers. There were two classes of outsider laborers in the prior to the war time frame. The primary part is the laborers who relocated to America left their h omes to look for a way to continue their work without compulsion. The others experienced powerful removal from their nations without their endorsement. The zeitgeist of that time upheld the sweeping utilization of slave work. The flourishing slave showcase benefitted from the offer of slaves gained from vanquished states in the African mainland (Keegan 33). An assortment of components cooperated to add to boundless imperialism; and thus to subjection all around the globe. The predominant states were consistently in steady contradiction as they all raced to get pioneer domains abroad. The Berlin gathering 1885-1886 thought of rules of
Friday, August 21, 2020
Starting an Extracurricular Club in High School TKG
Starting an Extracurricular Club in High School Extracurricular activities are an important aspect of the college application process. But not in the way that many students think they are. Deciding which extracurriculars to pursue is an exercise in branding yourself, and it starts freshman year. Letâs compare two different activity lists and then discuss: Student #1:Environmental science club (freshman year)Debate team (freshman year)French club (freshman, sophomore, and junior year)Student newspaper (junior year)Math club (junior and senior year) Community service club (sophomore, junior and senior year)Student #2: Environmental science club (freshman year)Started recycling program at NYC apartment building (sophomore year)President of environmental science club (appointed junior year)Sustainability research with a professor at NYU (senior year)Coursera online courses on climate change initiatives (all years)When a college admissions team looks at your application, they should be able to easily discern what youâre interested in. Their takeaway should be that you took recognizable steps to educate yourself about your area of interest. They should see progress. Student #2 has achieved this goal. Student #1 has not. Joining multiple clubs and not progressing or diving deeper into any of them is 1) a waste of time and 2) not impressive to competitive colleges. Now that weâve shown you an activity list that demonstrates progression and dedication, letâs get back to the question. What do you do if youâre not interested in the extracurricular activities that your school has to offer? What if youâre interested in feminist literature, but your school isnât? We often hear from students that the clubs at their school are lackluster, uninteresting, and not worth joining. Maybe they meet only once a week and/or get nothing done. If thatâs the case, youâre not off the hook. Here are a few courses of action that you can take:Start your own club. No robotics team at your school? Make one. Youâll have to convince your school that there is a need for a club, and there will be additional barriers to cross if your club will cost money. But create a proposal, try to keep costs down, and have a meeting. Build on an existing club. Letâs say youâre in the Mandarin club, but youâre also interested in the political climate of China. Approach the president of the club and ask if you can be in a charge of a meeting. Look for tangible improvements that you can make and pitch your ideas to those in charge. Take online courses. Coursera and Edx have thousands of ~free~ online courses. These classes are especially great because you can build on existing knowledge while stumbling upon potential new areas of interest. And most importantly, use the knowledge! Donât just click through the slides. Use what youâve learned to help you apply to internships, jobs, and summer programs. Read books. Itâs time to get on board with the fact that colleges are starting to ask what you read during y our free time. Geniuses read! Reading is so important. And we are not talking about the high school textbooks. If youâre interested in history, become an expert on a time period or region. Find your niche. This blog post is exclusively about things that you can do during and/or after school, and we have another blog post coming about summer options. If you take anything away from this post, it should be that you still have options even if your school doesnât currently have the best extracurricular activities to offer. Your goal is to become an expert in your field of interest, and while sometimes that requires thinking outside of the box, itâs still entirely possible. Need help figuring out how to find opportunities that stand out? Contact us here.
Monday, May 25, 2020
Diagnostic Paper on Joan Crawford - 2376 Words
Diagnostic Paper on Joan Crawford Abnormal Psychology Dr. Lewis Ethical Disclaimer In writing this, I am attempting to demonstrate an awareness of ethical practice. In preparation of writing this paper, I have researched information on the famous person indicated in an effort to make an attempt at providing a possible diagnosis of a psychological condition for which two theoretical orientations will be evaluated and used to support what is only an opinion. I am in no way qualified to give a diagnosis for the people mentioned within this document as it is a document written to demonstrate an understanding of educational material as it relates to the field of psychology. Any information mentioned with regard to the mental conditionâ⬠¦show more contentâ⬠¦In consideration of some of Crawfordââ¬â¢s early childhood occurrences, it may be possible to speculate on the etiology and possible diagnosis for conditions that Mrs. Crawford might have been suffering throughout her life. Joan Crawford was born at the turn of the century as Lucille Fay LeSueur in San Antonio, Texas to a single mother as Joanââ¬â¢s father left the family shortly before her birth (ââ¬Å"American Legends,â⬠2013). Though there are claims that her actual birthdate was before 1908, the date printed at the place of her interment reads as 1908-1977. For Hollywood starlets, lying about age might elongate audience and industry interest especially in regard to women, therefore it is easy to understand why the relentlessly ambitious and accomplished actress might have felt compelled to be untruthful over the years. Crawford had to climb her way to the top never having a moment to assess all the obstacles with which she would face throughout her life though, according to her, she would never have accepted professional assessment during her life as she explains to talk show host David Frost, ââ¬Å"I have never had to go to a psychologist or psychiatrist because I feel if you have an ounce of good sense and one good friend, youââ¬â¢ll never have to go to a psychiatristâ⬠(The David Frost Show, 1970). With attention to the enormous influence of the Roaring Twenties, Joan Crawford certainly embodied the newfound independence, freedom, andShow MoreRelatedManagement Course: MbaâËâ10 General Management215330 Words à |à 862 PagesEdition JonesâËâGeorge Driving Shareholder Value MorinâËâJarrell Leadership, Fifth Edition HughesâËâGinnettâËâCurphy The Art of M A: Merger/Acquisitions/Buyout Guide, Third Edition ReedâËâLajoux and others . . . This book was printed on recycled paper. Management http://www.mhhe.com/primis/online/ Copyright à ©2005 by The McGrawâËâHill Companies, Inc. All rights reserved. Printed in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publicationRead MoreStephen P. Robbins Timothy A. Judge (2011) Organizational Behaviour 15th Edition New Jersey: Prentice Hall393164 Words à |à 1573 PagesYorkââ¬âBuffalo Savannah Clay, Central Piedmont Community College David Connelly, Western Illinois State University Jeffrey Conte, San Diego State University Jane Crabtree, Benedictine University Suzanne Crampton, Grand Valley State University Douglas Crawford, Wilson College Michael Cruz, San Jose State University Robert Cyr, Northwestern University Evelyn Dadzie, Clark Atlanta University Joseph Daly, Appalachian State University Denise Daniels, Seattle Pacific University Marie Dasborough, Oklahoma State
Thursday, May 14, 2020
A Report On Organizational Environment Essay - 1537 Words
a. Organizational Environment (1) Product Offerings: ââ¬Å"What are your main product offerings?â⬠, (Baldrige Performance Excellence Program, 2015). The agency provides law enforcement and security services in the protection of government employees and GSA owned and leased facilities. The main product offerings are: â⬠¢ Enforce Federal Laws, conduct criminal investigations, serve warrants through law enforcement authority granted by the Secretary of Homeland Security derived from Section 1315 of Title 40 (40 USC 1315) of the United States Code. â⬠¢ Provide law enforcement coverage for high security events to include major sports events such as the Super bowl and Final 4. â⬠¢ Provide special operations utilizing FPS K9 support. â⬠¢ Law enforcement response to crisis events and natural disasters. â⬠¢ Provide training to tenant agencies in crime prevention, active shooter and Occupant Emergency Plans (OEP). â⬠¢ Conduct Facility Security Assessments (FSA) for government tenants. â⬠¢ Provide armed contacted security services for federal facilities. (2) ââ¬Å"What is the relative importance of each to your success?â⬠, (Baldrige Performance Excellence Program, 2015). Each service that we provide is essential for securing federal assets from potential terrorist threats. (3) ââ¬Å"What mechanisms do you use to deliver your products?â⬠(Baldrige Performance Excellence Program, 2015). FPS services are provided through daily interaction with our stakeholders in the form of law enforcement patrols and response,Show MoreRelatedCompany Restructure Summary Essay example1714 Words à |à 7 Pagessummary The purpose of this report is to reorganize the company for growth, higher revenues, profitability and for greater competitiveness as well as give recommendation. This report has considered the organizational features to be re-modified and challenges to encounter This report summarizes the process that will follow and the proposed restructures. The proposed restructure reflects the need for new ââ¬Ëââ¬Ëorganicââ¬â¢Ã¢â¬â¢ organizational forms. Not only does a companyââ¬â¢s organizational structure help determineRead MoreTerm Paper of Coca Cola1494 Words à |à 6 PagesA Report On FORCES OF ORGANIZATION BEHAVIOR IN COCA-COLA COMPANY [pic] University Of Information Technology and Sciences University of information technology sciences Term paper On Coca-cola company ltd. Role of the Forces of organization behavior Read MoreLead And Manage Organizational Change1540 Words à |à 7 PagesLead and manage organizational change Assessment task 1 Requirements for change which are linked to the organisations strategic plan goals: ZieTel Logisticsââ¬â¢ strategic goals are: â⬠¢ To design and accommodate the current product lines to meet the required standards of food safety guidelines and procedures. â⬠¢ To implement and maintain a CRM system to ensure 100% of business data capturing and communication process. The corporate strategy is to ensure that the basis of changes in the organization isRead MoreAn Organization Of United Way1703 Words à |à 7 Pageslocally(ââ¬Å"United way worldwide,â⬠n.d.). Organizational theories all address several main questions about how a company works. They assume an organization has structure, goals, and members, but focus on the efficiency of the organization, how it achieves its goals, how its environment affects its operations and how it survives in the face of outside challenges. Theories can be usedto match the goals, business environment and the personnel of the company with the organizational structure best able to meet theRead MoreOrganizational Culture And The Social Environment Of The Workplace1590 Words à |à 7 PagesFoundation Organizational culture was discovered to be an important factor in the social environment of the workplace. The attitudes and beliefs of employees and management are what have shaped the culture of an organization. The culture of an organization has been particularly important in the healthcare setting because it has shaped the type of healthcare that the patients receive within the healthcare organization (Sovie, 1993). The construct organizational culture was developed after theRead MoreInternal Environment Of Apple Inc. Essay839 Words à |à 4 PagesThis section of the report will examine and analyse the internal environment of Apple Inc. which will cover the organisation structure. The internal environment of Apple Inc. would be examined through the use of SWOT analysis. SWOT analysis is used to analyse an organisation s strengths, weaknesses, opportunities and threats, in this case, the organisation is Apple Inc. however for the purposes of this section of the report, only the strengths and weaknesses will be examined and analysed. MeyerRead MoreOrganizational Structure Of A Successful Business924 Words à |à 4 Pages Discussion A well designed organizational business structure is considered to be the heartbeat of a successful business today. The organizational structure is the foundation for every compartment within a business. Everything from the number of employees, to the titles and positions for each employee, the policies and procedures of how the business with operate, and who will report to who. The organizational structure is to help with the uncertainties. Management should have a sense of how eachRead MoreOrganizational Structure, Culture, And Theory Of A Corporation Essay1042 Words à |à 5 Pagespurpose of this paper is to define and report, both, similarities and differences among three specific organizations. I will compare organizational structures, cultures, and theories between the specified healthcare organizations. I will then discuss challenges and opportunities for improvement. I will use these concepts to exemplify my learning process through prospective leadership plans, which could improve my healthcare organization. The organizational structure, culture, and theory of a corporationRead MoreThe Moral Code Of Ethics924 Words à |à 4 Pagespatients and the others we serve and they are: ââ¬Å"Work to ensure the existence of a process to evaluate the quality of care or service rendered; to avoid practicing or facilitating discrimination and institute safeguards to prevent discriminatory organizational practices; work to ensure the existence of a process that will advise patients or others served of the rights, opportunities, responsibilities and risks regarding available healthcare services; work to ensure that there is a process in place toRead MoreSTRATEGIC LEADER COMPETENCIES 1696 Words à |à 7 PagesArmy War College to produce a report which identified Strategic Leader Competencies for the post 9/11 Army. Dr. Leonard Wong and four U.S. Army War College students prepared a report under the direction of the Director of the Strategic Studies Institute. That report produced a list of six meta -competencies.3 Although the title of that report and the materials presented here have a similar name, that report dealt with soldiers operating in a strategic environment, where tactical and operational
Wednesday, May 6, 2020
The Topic Of Breast Cancer Treatments - 924 Words
I have chosen to research and argue the topic of breast cancer treatments. Breast cancer can be found in both women and men, and affects millions of lives a year. There are many treatment options for breast cancer such as radiation, lumpectomy, and mastectomy; however, many people are starting to choose not to undergo any treatment. A Mastectomy is when a person has their entire breast removed, and a lumpectomy is when only the tumor cell and some of the surrounding tissue is removed from the breast. If a person chooses to get a lumpectomy they have to have radiation for a least five weeks, and their risk of cancer coming back is higher. Chemotherapy and radiation are very hard on a personââ¬â¢s body and can cause more harm to the body than the actual cancer. I am interested in this topic because I want to go into the medical field. I am also interested in breast cancer treatments because it is a frequently diagnosed cancer, but there is a high survival rate. October is breast can cer awareness month; this campaign makes all people more aware of the general health risk this disease imposes. Breast cancer awareness month helps fund ongoing research and treatments to help fight for the cure. I want to learn more about breast cancer treatment options because there are thousands of lives affected by it a year. I want to know why there is more awareness brought to breast cancer than any other type of cancer. I want to learn what the best treatment options are; I want to learn ifShow MoreRelatedEssay about Breast Cancer Speech Outline991 Words à |à 4 PagesTopic: Breast Cancer Specific Purpose Statement: To inform my audience about breast cancer Pattern of Organization: Topical Order I. INTRODUCTION: A. Attention Grabber: Iââ¬â¢m sure many of you know of or have heard of Giuliana Rancic. Well if not, she is a news anchor for the tv channel E! and often co-hosts red carpet events such as the Golden Globes and the Academy Awards. Giuliana is a very busy and successful woman and on top of everything that she juggles, last October she was diagnosed withRead MoreThe Ethical Phenomenon Of Breast Cancer Screening And Treatments867 Words à |à 4 Pagesboth the BRCA1 and BRCA 2 gene mutations and choosing bilateral mastectomies for early-stage breast cancers (Weintraub, 2015). Oncologists saw a 50% increase for risk-reduction mastectomy surgery related to the ââ¬Å"Jolie Effectâ⬠. The impact of an actress, known for her beauty, to willing risk her body image to increase her lifespan survival has philanthropically advanced the issues surrounding breast cancer. Racial Cultural Williams, Templin, and Hines (2013) identified that some populations groupsRead MoreCell Signaling Essay1583 Words à |à 7 Pagesfactors of human disease. When it comes to the topic of human disease breast cancer and sickle cell anemia have been the most prevalent. The importance of these topics in reference to breast cancer and sickle cell anemia are the background information on these diseases, the general population affected, what gene/proteins are involved in these diseases, the symptoms of the diseases, the experimental research, and the key advances/ problems relaying to treatment for the diseases. Understanding the backgroundRead MoreBreast Cancer898 Words à |à 4 Pagesï » ¿Yamilet Dominguez Speech: Breast Cancer Intro Attention Getter: Did you know both men and women are able to get breast cancer? Thesis Statement: According to US Breast Cancer Statistics it states that in 2013 there were more than 2.8 million women with history of breast cancer. But thatââ¬â¢s not all, 2,240 invasive new cases were diagnosed in 2013 for breast cancer in men. Preview: When finding out about breast cancer, most people first like to know How did you know? Or What did you feel? InRead MoreThe Effects Of Herceptin On Cancer Models And Patients With Her2 + Breast Cancer1735 Words à |à 7 Pagesepidermal growth factor 2) receptors found on breast cells( Tan, 2010) . HER2 is a receptor protein that is a member of the epidermal growth factor receptor family and is over expressed in approximately 10-20% of breast cancers that have amplification of the HER2 gene (Jatoi, et al., 2010). Herceptin has been found to selectively apply anti-tumor effects in cancer models and patients with HER2+ breast cancer (Gajria Chandarlapaty, n.d.). Although all normal breast cells present HER2 receptors on theirRead MoreInformative Breast Cancer Speech Essay899 Words à |à 4 PagesInformative Speech: Breast Cancer Attention Getter: What do Sheryl Crow, Judy Blume, Suzanne Somers, Wanda Sykes and my Mother have in common? They are all breast cancer survivors. Topic Disclosure: Today I am going to talk to you about breast cancer information and awareness Preview: During my speech I will discuss: * Symptoms and Diagnosis * Treatment and Side effects * Ways to lower risk and Statistics Audience Link: There is a large amount of men and women who are diagnosedRead MoreCorina Tabron. 4/28/2017. Bio 351-02. Summary And Critique986 Words à |à 4 PagesCorina Tabron 4/28/2017 BIO 351-02 Summary and Critique of Cyclin D1 amplification is highly homogeneous in breast cancer The Cyclin D1 gene is a researchable protein researchers believe have ties to the development of breast cancer tumors. The body has many mechanisms in which it regulates many things; the temperature of the body, the menstrual cycle, production of certain cells. The Cyclin D1 protein assists in regulating the cell cycle. CCND1 specifically aids in regulating the G1 phase.Read MoreBreast Cancer Website Analysis881 Words à |à 4 Pagesvariances of information between two diverse websites regarding analogous topics to compare and assess their effectiveness for providing medical information on Breast Cancer to individuals. The websites that have been chosen for assessment are as follows: 1). http://www.webmd.com/breast-cancer/guide/understanding-breat-cancer-basics#1 2). http://www.cancer.gov/types/breast/hp/breast-treatment-pdq WebMD focuses on information that can be understood by individuals thatRead MoreInvasive Lobular Carcinoma Cancer And The Effect It Can Have Upon Your Life1145 Words à |à 5 Pagesday when I received the news that my grandma has been diagnosed with invasive lobular carcinoma breast cancer. My grandma and I are very close. Her diagnosis is what persuaded me to write my I- search paper on this specific breast cancer. One topic I am really focusing on when I write my paper is the genetic factors because its important to my family and I. Even though I began to research about the cancer when my grandma was diagnosed, there are still a lot of things I donââ¬â¢t know about and Iââ¬â¢m interestedRead MoreBreast Cancer : Cancer And Cancer1341 Words à |à 6 PagesWhat I chose to research on my cancer project was breast cancer, since breast cancer is one of the second deadliest cancers among women I felt like I should research into this topic more in-depth. Anyone, no matter male or female, we are born with some breast cells and tissue. Even though males do not develop milk-producing breasts, a man s breast cells and tissue can still develop cancer. Male breast cancer is very rare, yet more fatale because they are less likely to assume the lump is possibly
Tuesday, May 5, 2020
Positron Emission Tomography
Question: Discuss about the Positron Emission Tomography. Answer: Introduction: Positron emission tomography (PET/CT) is a nuclear medicine scan used in medical diagnosis. Nuclear medicine imaging utilizes small quantities of radioactivematerial in the diagnoses and determination of disease severity or treatment of various types of diseases including neurological, endocrine, gastrointestinal, heart, cancer disorders, among other body abnormalities. Because molecular activity can be pinpointed through nuclear medicine, the procedures involved allow for the potential of early disease detection and subsequent immediate response to the necessary interventions (Guiberteau, 2016). In most medical center, superimposition of images is done with CT or MRI to create special images. These images give information from two separate exams which are correlated and then interpreted into a single image that has information that is more precise and also diagnosis that is accurate. Additionally, PET/CT scans are able to do imaging exams simultaneously. The PET/CT scan does body functions measurements such as oxygen utilization, blood flow, glucose metabolism, which help doctors in the accurate evaluation of the functioning of tissues and organs (Wehrl, Judenhoffer, Wiehr, et al., 2009). CT imaging utilizes specialized x-ray equipment with contrast materials where necessary to give several images of the internal workings in the body.(See Appendix 1 for basic architecture and flow chart of PET/CT scanner). Radiologists interpret these images using a monitor. CT scans offer anatomic information in a precise manner. The PET scanner has low specificity but high sensitivity whi le the CT scanner has high specificity and low sensitivity hence a combination of the two offers the best image resolutions for specific diagnoses. The use of PET/CT scans in diagnosis of cancer is known to result in therapeutic decision changes in 30% to 40% of cancer cases (Hillner, 2009).The characterization and diagnosis by MRI and CT imaging is premised on different criteria such as tissue attenuation, texture, and size. MRI and CT offer information on tissue density, organ size, and also precise topographic and spatial localization. On the other hand, the basis of PET imaging is the radioactive agent bio-distribution over space and time which enables the visualization of pathophysiological and physiological processes of disease functionality characterization. Risks of a PET scan When the PET is used in combination with a CT scan, additional tracers are needed and this can prove to be harmful to persons with a history of kidney diseases or persons with high levels of creatinine from medications they may be currently taking. When the eGFR45 it is an indication that there is no increased risk of damage to the kidney form the contrast material while an eGFR30, but does not surpass 45 indicates a slight risk of kidney damage. In such a situation, injecting additional fluid into the veins prior to and after injecting the contrast material will effectively prevent renal damage to the patient(Zagoria, 2015) Other minor risks include discomfort for persons who are afraid of needles or enclosed places (claustrophobic). There is also the possibility of developing an allergy due to the tracers. A person should alert the physician of any such allergies prior to having the test done. The Physician will require the patient to answer a number of questions to determine their eligibility (see Appendix 2 for the questionnaire) Benefits of PET/CT PET/CT scans offer tremendous advantages which can be summarized as: precise monitoring and treatment; accurate localization and staging; and early disease diagnosis. With the high quality images, patients have a better chance of getting precise diagnosis and avoid any additional and unnecessary procedures. A PET/CT scan allows for early cancer detection and reveals tumours which could be obscured by scarred tissue resulting from radiotherapy or surgery especially in the neck and head area (Fleming Johansen, 2008). Previously, difficulty was experienced in the interpretation of CT scan results done at different locations and at different times than a PET scan mainly because the body position of the patient changed with each scan. A PET/CT scan provides a complete image of the body occurrences both metabolically and anatomically simultaneously (RSNA, 2014) The ability of the scan to study the body functions allows for detection of any anatomical changes making it an effective diagnosis tool. The scan is able to distinguish between malignant and benign tumours which reduce the possibility of unnecessary surgeries. It is also effective in diagnosing the early stages of Alzheimer's disease, dementias, epilepsy, and other neurological disorders. PET/CT scans are infection free and pose no danger of secondary infection for patients (Glaudemans Signore, 2010). The Future of PET/CT Scans Molecular imaging using PET/CT scans is pivotal in cancer management as it assists in choosing the radiotherapy and cytostatic procedure that is most appropriate. It also contributes to the recurrence early detection. PET/CT shows promising signs of improving personalized medicine through better characterization of tumour extent, biological features, and response (Oyen, 2007). The use of intra-operative probes aid in minimal invasive surgery in tumour and sentinel nodes removal which could present morphological alteration that is unremarkable. Additionally, PET/CT offers treatment that is efficient through target radiotherapy of neuroendocrine tumours, thyroid disease, pain palliations for diffuse bone metastases patients, as well as non- There are new approaches being investigated which utilize alpha particles (Lucignani, 2008). In addition, PET/CT scans use in defining volumes of biological tumours and radiotherapy dose painting is promising plans for more efficient but less toxic tumour control (Weber et al., 2008; Anderson Ferdani, 2009) Positron emission tomography (PET) is now a vital imaging tool for cancer diagnosis and staging, as well as presenting prognostic evidences based on response. PET is important for the evaluation of unspecified solitary pulmonary nodules or masses, where PET has confirmed to be significantly more precise than computed tomography (CT) in the distinction between malignant and benign lesions. In the examinations for metastatic spread, PET is a vital in conventional imaging. However, currently, PET does not exchange conventional imaging. Benefits of PET/CT scan for cancer diagnosis Due to nuclear medicine image inherent characteristics as well as their low power resolution, it becomes challenging to define the exact disease' anatomical location which further complicates the interpretation of results. To avoid this challenge, a combination of the functional and molecular imaging offered by PET and the CT provided anatomical imaging is merged using combined scanners (Townsend, 2008) while development is underway for PET/MRI prototype (Wehrl et el., 2009).These hybrids allow for a diagnostic procedure to be carried out singularly through structure and function evaluation. The introduction of combined imaging allows for the possibility of diagnostic process re-examination, order of studies performance, and also therapeutic pathway construction. A radionuclide in a PET scanner tracks at a molecular level, a precise biological process. The radioactive tracer is able to distinguish between molecular/cellular activities that are normal from the abnormal. The positron emitters commonly used in this process include nitrogen-13, oxygen-15, carbon-11, and fluorine-18. These emitters while in their non-radioactive form are all active molecule biological constituents. Fluorine-18 is most suited for hydrogen. The emitters are thus suitable for labelling any molecule without making any changes to the respective metabolic pathway (Bockisch, Freudenberg, Schmidt, et al., 2009). Tumour Growth Process The simple way of describing the process of a tumour growth is that they divide and multiply before infiltrating neighbouring tissues and structures and finally spreading to distant locations through a process referred to as metastasis. Tumours require energy for growth and metastasis and hence utilize glucose. Glucose provides the tumour cells with the necessary energy for activity. While the normal body cells also utilize glucose to carry out their respective functions, tumour cells utilize glucose at higher rates than the normal cells (Salskov et al., 2007). Labelling is done using fluorine-18 which like FDG is a glucose analogue. Fluorine-18 is used as a tracer as it decays quickly which minimizes exposure of the patient to radiation. Fluorine-18 is also preferred as a tracer because it naturally indicates the metabolic state of cells and more so in cancer cells and hence it is detected easily. For the detection of cancerous cells using PET/CT scan, Fluorine-18 is often used in t he form of the biologically active F18-FDG model which is a radioactive labelled glucose analogue which allows for metabolism of glucose in both abnormal and normal cells (Salskov et al., 2007) In this case study, the patient was a 39 year old female who had a documented history of colorectal cancer. She was first evaluated in April 2015. After the initial evaluation, the patient went through preoperative radiation therapy. This was followed by rectal cancer surgical resection which was done in late May 2015. Systematic chemotherapy course was adhered to after the surgical procedure. In September 2015, a follow up PET scan showed a previously identified uptake of FDG in the pelvic area which was consistent with the malignancy that had been treated. The respective lung lesion pathology results indicated adenocarcinoma that was metastatic and which was consistent with primary colorectal cancer. As mentioned earlier, a follow PET/CT scan that was done some months after the resection indicated that there was no recurrence f cancer or existence of any residual malignancy as shown in the images below. A follow up was scheduled for July of 2017 and is likely to show no evidence of malignancy. PET/CT after resection showing no evidence of malignancy The role of FDG-PET was critical in the patient's initial staging of colorectal cancer and also in the monitoring that followed. In addition, PET/CT also aided in the characterization of the SPN lesion as being suspicious for cancer. Physicians and professionals in the medical field have recognized and appreciated the role that PET/CT scans play in managing solitary metastatic lesions and more so in the determination of whether a patient is a candidate for a metastasectomy or lymph node, liver, or lung lesion ablation using radiotherapy. In the case where the metastasis is solitary, the outcomes have shown to be promising as seen in the case study discussed above. In this case, the nodule was characterized using PET/CT scan as being suspicious for cancer while it was still at a relatively small size and at an initial stage of metastasis. By using PET/CT scan, the SPN lesion was confirmed as being solitary and eligible for a procedural metastasectomy. However, it should be noted that nodules that are less than a centimetre in size cannot be characterized reliably by a PET/CT scan. References Anderson, C.J., Ferdani, R., (2009). Copper-64 radiopharmaceuticals for PET imaging of cancer: advances in preclinical and clinical research, Cancer Biother Radiopharm. 24: 379-93. Bockisch, A., Freudenberg, L.S., Schmidt, D., Kuwert, T., (2009). Hybrid imaging by SPECT/CT and PET/CT: proven outcomes in cancer imaging. Semin Nucl Med. 39: 276-89. Fleming AJ, Jr, Johansen ME. (2009). The clinicians expectations from the use of positron emission tomography/computed tomography scanning in untreated and treated head and neck cancer patients.Curr Opin Otolaryngol Head Neck Surg.16:12734. Glaudemans AWJM, Signore A.(2010). FDG-PET/CT in infections: the imaging method of choice?European Journal of Nuclear Medicine and Molecular Imaging.37(10):19861991 Guiberteau, M (2016) Positron Emission Tomography - Computed Tomography (PET/CT) https://www.radiologyinfo.org/en/info.cfm?pg=pet Lucignani, G.,(2008). Alpha-particle radioimmunotherapy with astatine-211 and bismuth-213,Eur J Nucl Med Mol Imaging 35; 9:1729-33. Macklis, R.M., (2007). Radioimmunotherapy as a therapeutic option for Non-Hodgkin's lymphoma, Semin Radiat Oncol. 17:176-83. MacManus MP, Seymour JF, Hicks RJ. (2007). Overview of early response assessment in lymphoma with FDG-PET.Cancer Imaging.7:108 Oyen, W.J., et al. (2007). Targeted therapy in nuclear medicine--current status and future prospects. Ann Oncol. 18:1782-92. RSNA (2014). FDG-PET/CT UPICT V 1.0 Imaging Protocol. https://www.rsna.org/uploadedFiles/RSNA/Content/Science_and_Education/QIBA/UPICT_FDG-PET_Protocol_ver08July2014.pdf Salskov, A., Tammisetti, V.S., Grierson, J., Vesselle, H., (2007). FLT: measuring tumor cell proliferation in vivo with positron emission tomography and 3'-deoxy-3'-[18F]fluorothymidine, Semin Nucl Med. 37;6:429-39. Townsend, D.W., (2008). Dual-modality imaging: combining anatomy and function, J Nucl Med.49:938-55. Weber, D.C., et al., R.,(2009). Recurrence pattern after [(18)F]Fluoroethyltyrosine-Positron Emission Tomography-guided radiotherapy for high-grade glioma: A prospective study, Radiother Oncol. 93;3:586-592. Wehrl, H.F., Judenhofer, M.S., Wiehr, S., Pichler, B.J., (2009). Pre-clinical PET/MR: technological advances and new perspectives in biomedical research, Eur J Nucl Med Mol Imaging 36:56-68. Zagoria, R. (2015). CT and MRI Contrast and Kidney Function. (Retrieved 19th April, 2017). https://radiology.ucsf.edu/blog/abdominal-imaging/ct-and-mri-contrast-and-kidney-function.
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