Does George Washington deserve the title Father of our nation Research Paper

Does George Washington deserve the title Father of our nation - Research Paper Example George Washington is known as the Father of the Nation for various reasons. Not only was he the first president of independent America but he was also the head of the Revolutionary Army. As the Commander in Chief of the Revolutionary Army it was mainly because of his steadfastness, leadership and his explicit refusal to give in did the Colonists win the war in their favor. He made a bold attack on the Hessian fort in Trenton which turned the tables in favor of the Colonists as compared to the British. When it was time to take charge of the Continental Congress, because it proved again and again that it was incapable of leading a young nation, Washington took charge and that too in the most explicit way. Washington was a powerful, charismatic personality; merely looking at him convinced many people to predict great heights for this man including the title of the Leader of the Nation. The organizers of the Constitutional Convention were of the opinion that only because of the charismat ic and strong personality of George Washington did they enjoy success in the Convention. Hence, it was fortunate for America when Washington, who was also known as the ‘indispensable man’ not only attended the Convention of Philadelphia in 1787 but was also chosen to become its president and he indeed, did serve this position. Washington holds an exemplary position in the leading political and mainly military circumstances of the American Revolution. He became involved early in 1767 when he stood up against the political standing of the parliament of Britain. When the Battle of Lexington and Concord broke out he assumed military position as the Commander in Chief of the Continental Army. He depicted his readiness to go to war when he appeared in military attire in front of the Second Continental Congress. The Continental Army was formed on the 14th of June and the very next day was Washington appointed as its General or Commander in Chief. The job he took on was vast, c orresponding local wants and needs, rivalry amongst his inferiors, spirits amid the grades and shots by Congress to administer the army's dealings too narrowly, wishes of state governors for support, and an infinite requirement of funds to clothe, feed, arm, equip and move the troops. As it became more and more tensed politically for the colonies to continue peacefully Washington chaired a meeting in June 1774 and Fairfax Resolves were adopted then. These resolves called for many actions the most important being the assembling of the Continental Congress. Washington attended the First Virginia Convention in August and as it became more politically tensed in 1774 he helped train the militias of the country in Virginia and convened enforcement to boycott all those goods by the British which were instituted by the Congress. Washington is known most for his long lasting effects as the President of the United States of America, his first two terms being the most prominent. The Constituti on gained popularity and one reason for that was the appointment of Washington as its Chief executive. Washington was a dedicated patriot and time and again he passed various opportunities to gain supreme authority. When he arrived in the Capitol, he waited for the convening of the Congress before assuming his duties the President of America. His popularity was as such that people wanted him to be treated as King however, he passed that

Blue Front Essay Example for Free

Blue Front Essay Martha Collins, the author of Blue Front lived in Cairo, Illinois. Blue Front is the fifth volume of poems that she has written. Blue Front relays the eye witnessing of his father when he was five years old and used to sell fruit in the front of Blue Front Restaurant in 1909. One day when he was working, he was attracted towards the crowd where a black man was being lynched. That Black man was accused of raping and strangling of a White woman by a mob of Whites. Later, when the Black man was still alive, he was dragged and shot and then buried. His body parts were cut as souvenirs. In the same event due to escalation a White man was also then hanged who was also accused of raping. This whole situation portrays the racing factors that were present in America at that. At one place she writes one verse in Blue Front (2006) as, â€Å"the victim hanged, though not on a tree, this was not the country, they used a steel arch with electric lights, and later a lamppost, this was a modern event, the trees were not involved† Throughout the poem Martha has made the reader to search for the main idea which she has tried to give in the poems. The poems are low in syntax settings and many grammatical mistakes, but still if the reader indulges himself he can get the theme quite easily. Martha has written the poems thinking her in the place of his father and has provided all the information keeping his father as an eye witness. She says that moment was terrifying as a young child. Starting to look at the racism is its peak was quite heavy for him to swallow. The verse free narration of the poem varies from page to page for its style and rhythm which sometime make abrupt changes in the mood of the poem. All the verses clearly state the hatred of the mob that was taking part in the lynching of the Black person. She tries to perceive the mentality of the mob, but she just thinks that those people didn’t want to know anything until the person they are lynching is a Black. She feels for the Blacks of that time when the racism was active in Southern parts of Illinois and in all other parts of the country. White people used to lynch the Blacks for small accusations. The lynching was made a custom at that time and Whites used to bring their children as well to teach them the ways of lynching and how they should treat Blacks. Martha also states in her poem that how she feels to be a part of this White nation who has a history of being racist and is still continuing to be so. Even her father after that incident was very careful in his dealings with the Blacks and stayed away from them all his life and went to settle at the places where the whole community is White. Martha feels sorry for herself on this treatment of human kind. She however, don’t lose hope and in the end she gives a message that the life can be made better if we all work collectively. She says that everyone has the right to live freely and no one should object this. She knows that America is still experiencing racism in various parts where the Blacks still don’t have the right to live free. It is our responsibility to make world better place for living. We should abolish this from the face of earth to make it a better place for living. Works Cited Collins, Martha. Blue Front: Poems. New York: Graywolf Press, 2006.

Political Authority in Sophocles Antigone :: Antigone essays

Antigone:   Political Authority Political power results from the fear of force. The individual acts out of a fear of consequences of disobedience and in accordance with the desdire for self-preservation. Political Authority results from a belief in the moral correctness of the organization in question. The individual acts of a sense of obligation and acknowledges the right of the ruler, morally, to rule and the moral correctness of the laws are accepted. The laws are obeyed for their own sake.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In Antigone, Sophocles suggests there is no basis for political authority: that Creon's citizens obey him out of fear of the consequences of disobedience. Ismene's obeys his edict is because she fears death. The soldier reports the attempted burial of Polyneices and brings the captured Antigone to Creon to "save his own sweet skin." The chorus believes no one would risk death out of political or moral or religious objectives. Antigone utterly rejects the authority of Creon: "these laws were not made in heaven," she says, and I do not have to obey the laws of human beings. She acts as she does because she does not respect authority and because she does not fear death. Haemon appeals to Creon on the basis of power - he suggests public opinion is against Creon and Creoin is at risk of losing his power as king. Only Creon and Tireseas ever acknowledge the issue of political authority. And with both, it is unclear whether authority can be the m otivation, because in both situations, authority issues are tied to issues of power and personal gain. As the chorus comments - can one sublimate ones personal desires to the public good? If not then power is the only way to maintain public order.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Socrates asks how can an organization, that by its very nature must act immorally (eg. Allow injustice) have moral authority? Since a political community must require its citizens to accept, unquestioningly, (at least at times) its basic assumptions and must demand obedience to its laws for the community to continue to survive and prosper, it must stifle individual humans in their pursuit of knowledge. Political Authority in Sophocles' Antigone :: Antigone essays Antigone:   Political Authority Political power results from the fear of force. The individual acts out of a fear of consequences of disobedience and in accordance with the desdire for self-preservation. Political Authority results from a belief in the moral correctness of the organization in question. The individual acts of a sense of obligation and acknowledges the right of the ruler, morally, to rule and the moral correctness of the laws are accepted. The laws are obeyed for their own sake.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In Antigone, Sophocles suggests there is no basis for political authority: that Creon's citizens obey him out of fear of the consequences of disobedience. Ismene's obeys his edict is because she fears death. The soldier reports the attempted burial of Polyneices and brings the captured Antigone to Creon to "save his own sweet skin." The chorus believes no one would risk death out of political or moral or religious objectives. Antigone utterly rejects the authority of Creon: "these laws were not made in heaven," she says, and I do not have to obey the laws of human beings. She acts as she does because she does not respect authority and because she does not fear death. Haemon appeals to Creon on the basis of power - he suggests public opinion is against Creon and Creoin is at risk of losing his power as king. Only Creon and Tireseas ever acknowledge the issue of political authority. And with both, it is unclear whether authority can be the m otivation, because in both situations, authority issues are tied to issues of power and personal gain. As the chorus comments - can one sublimate ones personal desires to the public good? If not then power is the only way to maintain public order.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Socrates asks how can an organization, that by its very nature must act immorally (eg. Allow injustice) have moral authority? Since a political community must require its citizens to accept, unquestioningly, (at least at times) its basic assumptions and must demand obedience to its laws for the community to continue to survive and prosper, it must stifle individual humans in their pursuit of knowledge.

Explain Biblical Ideas About the Goodness of God Essay

Throughout the bible the goodness of God is shown in many ways, the bible presents God as being morally perfect, and everything that he is or will ever be is also presented as morally perfect; The Bible presents God as benevolent, an all loving figure. It displays this in a number of ways throughout the Bible, the first and possible the most important way is in the first book of the Bible, Genesis. Genesis states that everything that God creates is â€Å"Very good†; When God created the world in the Genesis creation story he commanded various things. â€Å"And God said, Let there be light: and there was light, and God saw the light, that it was good: and God divided the light from the darkness â€Å". (Genesis 1:3-4). The authors of the bible when praising God do so because he provides reason for it. The creation of animals, plants and waters are all necessary for the sustainment of life, and religion, â€Å"Be fruitful and multiply; fill the earth and subdue it; have dominion over the fish of the sea, over the birds of the air, and over every living thing that moves on the earth and God said, â€Å"See, I have given you every herb that yields seed which is on the face of all the earth, and every tree whose fruit yields seed; to you it shall be for food. (Genesis 1:28-29). Some Christians believe that there is still goodness like God’s around us today in the form of stewardship. We look after our world to improve it so we can pass it on to the next generation. Another way in which the bible shows Gods goodness is; Christians believe that God’s goodness is shown in his son Jesus, and his sacrifice in the name of God. Jesus came to earth as God in human form, he done this to experience the lives of his people. God thought it was all well and good requesting people to follow rules but because he cares he wanted to experience the lives of his believers and the difficulties they incur so he sent Jesus. Jesus was the ideal of moral goodness for humanity; he displayed the right way in which people should treat each other and how to worship God, and this was recorded and passed onto future generations by it being retold in the bible, even today people can still read it and gain knowledge of Gods sacrifice. The form of good described in the bible is very different from Platos form of good; Platos form of good was perfect and it didn’t exist on Earth it existed in the realm, making it a concept and not personal to anyone, Platos form of good doesn’t take an interest in situations or in life, it just simply exists, where as the idea of ‘Gods good’ in the bible focuses almost entirely on moral behaviour. It is concerned that humanity should be making the right choices to life by and always aims to be good. Plato’s form of the good is perfect, but because it doesn’t physically exist what ever goodness is on earth is only of copy of the ideal thus making it imperfect when it is practiced. So whatever you think you are doing is good, it is not. However God believes that everyone can be morally good thus living their lives accordingly. As soon as God creates humans he gives them rules of follow, they are to take responsibility for the earth he has created and not take from the tree of knowledge. This shows that he cares not for worship being their main duty, but he takes an interest in their lives. Gods goodness is also shown through his love in the bible, God gives humans free will, to make their own moral decisions but he clearly sets out what is right and what is wrong. However he doesn’t force them into obeying those rules, he is loving and lets them choose for themselves, this is an act of love. He knows that because he has made man in his image (Genesis 1:27) they are like God and they know what is expected of them. Even thought they haven’t been socialised they still know what is morally right. Plato would agree with this statement because he believes we all have knowledge of ideal forms from birth. God commands things to be good because he is omniscient and knows all. So everything that he commands will be perfect, good and loving.

How Katherine Mansfield’s Writing Changed Through

Katherine Mansfield was predominantly a short story writer born in New Zealand in 1888. Although she has often been quoted demonstrating a negative view on New Zealand, she â€Å"thanks God she was born in New Zealand†. Her father was a successful business man and her mother was a younger woman. It is widely acknowledged that her parents played a major role on her views of men and woman in society and the gender imbalance.She began writing from a very early age writing for her Wellington high school newsletter. One of her first novels and one which strongly represents her views on the gender imbalance in society was Frau Brechenmacher Attends a Wedding. This story represents the Frau very much as the subservient housewife to her more dominant and intimidating husband. The first instance of this is when Frau threatens her daughter with the wrath of her father, to which the daughter immediately responds to the request.This story was strongly based on what Mansfield had seen in h er time living in Germany in the earlier stages of her career and the story is an undisguised satire of the German character, in particular the German housewife who Mansfield saw as unkind and somewhat shallow due to their displeasure of their role in society. The story of Frau Brechenmacher continues on and the Frau and her husband attend a wedding. Katherine Mansfield describes the bride as having the ‘appearance of an iced cake all ready to be cut and served in neat little pieces to the bridegroom beside her’.This is a very blatant and obvious piece of writing that outlines the woman’s role in a marriage. This shows that the bride is a mere object to the groom and her role in the marriage is to please her husband. Also, the story goes in to detail about the daughter being shown the role of a woman by her mother which is encouraging the cycle of woman’s servitude and therefore Mansfield puts a negative light on the subject, shown by the quote, â€Å"gir ls have a lot to learn† which carries a negative connotation.However, the Frau is aware of her situation and does not particularly enjoy it as â€Å"everybody laughed at his speech, except the Frau† and â€Å"She wanted to go home and never come out again†. Katherine Mansfield was opposed to the idea of the traditional role of woman in society and the gender imbalance that was so obvious to her as favourable to the man. Also, she saw and represented men as predatory. This is shown at the very end of Frau Brechenmacher Attends a Wedding when it is stated that she lay on her bed â€Å"who expected to get hurt as Herr Brechenmacher lurched in†. This is ot the first instance in the story where the Frau and even her daughter are shown to be intimidated by the dominant figure of the relationship in Herr Brechenmacher. This is why Katherine Mansfield intentionally chose to refer to him as ‘the father’ throughout the story as it is like a title. Title s are given to people who are important figures and by giving him this title and Herr Brechenmacher being referred to as the father by his wife and daughter show that they have a certain respect for him but also gives the sense of distance between the husband and his family.The idea of distance between the Frau and her husband is most prolifically represented when he ‘†lurches in† which implies the idea of forced sex on his behalf. This shows that even though they are husband and wife, they are extremely distanced and can potentially not even have consenting sex. This enhances Mansfield’s view of the woman as an object or accessory to the husband as purely for the pleasure of her partner. Frau Brechenmacher is also portrayed to be much more comfortable when she is in the house alone without her husband.Although she is often doing her duties for her husband, she is more relaxed in that environment without the oppressive Herr Brechenmacher. There is a sense of uneasiness when Herr Brechenmacher returns home as she sends her daughter into the bedroom and begins to rush to get everything ready and perfect for her husband. This gives the impression that the house is a sanctuary for all subservient women and that was how Katherine Mansfield viewed it and writes on the matter with such satirical influence.The short story, Frau Brechenmacher Attends a Wedding, is a story that does not carry many subliminal or hidden messages when dealing with the criticism of the women’s role in society. It is unlike some of her later works that hide the ideas that are intended to be portrayed. It is a very matter of fact piece of writing that was strongly scrutinized for the views and opinions that it was showcasing, which is potentially why Katherine Mansfield decided to write her later works that had similar themes with more discretion and subtlety.Another short story by Katherine Mansfield which deals with the same issues that are brought to light i n Frua Brechenmacher Attends a Wedding is ‘The Woman at the Store’ written two years after Frau Brechenmacher in 1912. Similarly with Frau Brechenmacher, ‘The Woman at the Store’ deals with the issues of gender imbalance and the oppressive male figure in relationships in a very unsubtle and obvious way. However, unlike Frua Brechenmacher, Mansfield deals with these issues in a much more violent and twisted manner in ‘The Woman at the Store’ which ends in a melodramatic twist.This is similar to other short stories written in the same era of Mansfield including ‘Ole Underwood’ and ‘Millie’. ‘The Woman at the Store’ is a story of two men and a girl travelling by horseback through a desolate environment in the North Island of New Zealand. They come across a house in which lives a woman and her daughter and one of the travelling men knows her from previous journeys. However, the woman is not what she used to be or how she is previously described to be â€Å"certainly her eyes were blue, and what hair she had was yellow, but ugly†.This comes to a surprise by all the travellers as they had been promised wondrous things by a character named Hin â€Å"Don’t forget theres a woman too, Jo, with blue eyes and yellow hair, who’ll promise you something else before she shakes hands with you†. It is revealed to us as the reader that the woman was once a beautiful woman and a barmaid but that had all changed once she became wed and bore children. This is also another common theme that is seen throughout Mansfield’s writings, particularly the ones that have a strong feminist base and represent men as oppressive and somewhat ruining their female counterparts.The idea of child-birth being the bane of a woman’s existence is shown in some of Mansfield’s works where she writes about the role of woman as objects for giving birth to children for the male in th e relationships sake. This is shown in ‘The Woman at the Store’ when the woman is abusive to her only child, yelling her and speaking down to her. Also, later in the story when all the characters are drinking whiskey around a table, the woman becomes upset and starts to talk about her life when she says â€Å"It’s six years since I was married, and four miscarriages†.This quote has a negative tone to it and gives the impression that the woman is not happy about her situation that her husband has left her in. The woman is also extremely bitter towards her husband for the life that he has given to her which is the way that Mansfield represents her ideas of the female in relationships being unpleased by marriage and the new role they have had to take on as the generic housewife. The bitterness of the woman towards her husband is best shown by the quote â€Å"Over and over I tells ‘im – you’ve broken my spirit and ruined my looks, and wot for†.The idea of men as predatory which is so often used in Mansfield’s works is also briefly alluded to in ‘The Woman at the Store’, however, in this story it is much less obvious. Jo, the oldest of the three travellers is pleased to learn that the woman at the store has been left alone by her husband and uses this as a window of opportunity to potentially sleep with the woman. This is made known to the reader when Jo cleans himself up before returning to the house to spend the evening drinking with the woman and the three travellers.Also, it is noted that â€Å"they were kissing feet under the table†. Jo and the woman end up sleeping together that night and although it may not seem to be predatory on Jo’s behalf, it can be interpreted this way. The reasoning for this is because Jo showed more interest in the woman once learning that her husband goes away and often and how much she dislikes this. Also, Jo often encourages the woman to continu e drinking whiskey which could be interpreted as him coaxing her in.The message that Katherine Mansfield is trying to convey in ‘The Woman at the Store’ is the criticism of women’s dependence on men during the time that the story was being written and it also criticises women for perpetuating the cycle of womanhood that they are subjected to. The fate of the woman’s husband is later revealed by her strange child who is known to draw everything she says instead of vocally delivering her messages. The child is also referred to by one of the travellers as having a â€Å"diseased mind†. This along with the repetition of the references to her drawings subconsciously prepares the reader for what is to come.The daughter, in spite of her mother, draws a picture of woman shooting a man and digging a hole to bury him in. Katherine Mansfield chose this ending to the story because it carries a shock-factor. Throughout the story, negative references had been mad e about the father of the child by the woman and how she despised him for what he had done to her. By ending the story like this, Mansfield has demonstrated that murder is the only answer to oppression and subjection imposed by the male role in society. However, this is only a satirical view by Mansfield.She uses such little sophistication in this story and ends it with such a melodramatic ending so that the idea woman do not have to put up with such degrading behaviour from their husbands becomes so clear and obvious. Another reference to the lack of sophistication in ‘The Woman at the Store’, one of Mansfield’s earlier short stories, is the juxtaposition of the weather and the tone or mood of the story. For example, when the weather is sunny, the mood of the story is light-hearted and as the weather turns more unpleasant, the mood of the story becomes more sinister.Between her short stories from the collection ‘A German Pension’ which included Frau Brechenmacher and ‘The Woman at the Store’ and her short story ‘The Garden Party’, many things had changed in the life of Katherine Mansfield. She had continued to write solidly through this time period but she had since moved from Germany and moved to London where she would meet her future husband, John Middleton Murray. They had spent some time in Paris and she also spent a few months in Paris, behind enemy lines, once war had broken out.Her brother had died in the war which was a huge blow to Katherine, and during this time her health had also declined and she was diagnosed with tuberculosis. All these events in Mansfield’s life had altered the way in which she wrote, with her stories having more focus on characters and inter-character relations. It brought about a whole new sophistication to Mansfield’s works; however her views on men had still not changed, even after having a somewhat contented marriage and other relations with men.This is shown in a letter to John Middleton Murray in 1919 – â€Å"Someone came to me and said Forget, forget that you’ve been wed. Who’s your man to leave you be Ill and cold in a far country? Who’s the husband – who’s the stone Could leave a child like you alone† This letter or poem if you will, shows that Mansfield has turned in to the women who is dependent on her male counterpart which she had prolifically wrote against in her earlier stories. However, she later acknowledged this and wrote about it in resentment.Also, during the time between her ‘German Pension’ collection and her later stories, including ‘The Garden Party’ she had developed her characters, often reflecting her own life and life experiences in them. This is what is seen to be her sophistication in her later works. Mansfield’s later works such as the ‘Garden Party’ have been known to focus less on the plotline of the story and more on specific events in the story, and more importantly, the relationships between her characters. It is through these relationships that her motives for writing he stories come through. For example, the way Laura in ‘The Garden Party’ tries to imitate her mother’s actions ‘â€Å"Good morning,† she said copying her mother’s voice. ’ This is a perfect example of Mansfield’s view on woman allowing the cycle of domestication to continue and when looked at in greater depth shows how the older woman influence their daughters to do so. Again, this is just one of Katherine Mansfield’s views on the role of woman in society that is shown throughout her short stories, but this time it is alluded to in a more subtle way. The Garden Party’ was written in 1922, more than 10 years after ‘The Woman at the Store’ and ‘Frau Brechenmacher’ but her views had not changed in this time. However, some of t he ways in which she presents her views in ‘The Garden Party’ are much more sophisticated than previous stories. For example, workmen are preparing to set up a marquee for the garden party and suggest that it should go in front of some karaka trees. Laura contemplates whether this should be done and comments on the beauty of the trees and how solitary they were.But in the end she decides that ‘they must’ be covered by the marquee. This could be seen as a metaphor for the beauty of woman being covered and hidden by men, being the marquee. And the fact that Laura uses the words ‘they must’ shows how she has been brought up to think that woman should be squandered by men. Laura from ‘The Garden Party’ is also often left admiring the workmen in the story and commenting on how wonderful they were. At first glance, any reader may take it at face value.But with prior knowledge of Mansfield’s other stories and her views, you would b e able to pick up on the underlying satire that is rampant throughout the story. Satire is one of the ways in which Mansfield expresses her views and opinions on different matters, quite often concerning gender imbalance. The idea of the woman being the domestic person around the house and the father being the oppressive figure just like in ‘Frau Brechenmacher Attends a Wedding’ is also evident in ‘The Garden Party. In the lead up to the party, Mrs Sheridan orders her children to do all different tasks while she does her own, and the children respond immediately as they look up to their mother. But however in one instance where she is in a rush she threatens them, â€Å"Do you hear me, children, or shall I have to tell your father when he comes home to-night? † â€Å"The Garden Party’ is very closely related to Katherine Mansfield herself, with the story being set in a grand house in New Zealand. When she was younger she lived in lavish houses with her parents and siblings just like in the story.Also, the main character Laura, can possibly be seen as Mansfield herself or having aspects and qualities like her. This is why this story is often regarded as her best short story as it incorporates many themes and because she is writing somewhat from her own life experiences, she is able to portray these themes and ideas extremely well. For example, Laura is the one character who shows respect for their neighbours who had just had a death in the family and she is shown as a character with a set of morals, just like Mansfield herself.The ways in which Mansfield relates herself directly to her situations and characters in her later works such as The Garden Party’ are what are seen as to be her sophistication and maturing in her writing style. She moved away from very obvious and simplistic ways of getting her ideas across to her audience, to a more subtle and underlying way of getting the ideas through to her readers. And becaus e of her maturing in her writing and her skill in her craft, she has become to be known as New Zealand’s, and one of the worlds, best short story writers of her time.

Cemetery Research for Family History and Genealogy

Cemetery Research for Family History and Genealogy The practice of marking the final resting place of a loved one goes back thousands of years. The ancient pyramids are conceivably the greatest example, standing today as a reminder of the ancient Egyptian glorification of life after death. Roman catacombs, a subterranean burial place for early Christians, contained niches where the fully clothed bodies were placed and which were then sealed with a slab inscribed with the name of the deceased, date of death and a religious symbol. Many of the elaborate grave markers erected in the 19th and early 20th centuries were styled after the memorials of the ancient Greek, Roman and Egyptian civilizations. Following the first World War, grave markers started to become smaller and less elaborate - plain crosses and simple, upright stone slabs decorated with carvings, symbols and epitaphs. Cemeteries are living lessons in history. People who buried their dead said much about themselves and the ones who had died. While not considered a primary information source, gravestones are an excellent source of dates, birthplaces, maiden names, spouses names and parents names. They can also provide evidence of military service, membership in a fraternal organization and religious affiliations. Why Visit Cemeteries? Why should you visit the cemetery if you already have a birth and death date for your ancestor? Because you never know what you may find. Nearby gravestones can lead you to other family members. Little grave markers can tell the story of children who died in infancy for whom no other records exist. Flowers left on a grave may lead you to living descendants. Other than a few records and documents and, perhaps, some family jewelry or heirlooms, your ancestors tombstone is the only physical evidence of the life they lived. There is nothing in your genealogical research that will connect you to your ancestor more than to stand in the one place on earth which contains their mortal remains and to see important pieces of their life carved into stone. It is an amazing, awe-inspiring experience. Next How to Locate a Cemetery The first step in cemetery research is the obvious one- to learn where your ancestor is buried. Death records will often contain this information, as will obituaries. Published cemetery surveys may list your ancestors. Check with family members and other relatives as well. They will often know of family burial locations or may be able to track down a mention on a mass or prayer card or in the family Bible. Funeral Home Religious Records Funeral homes and morticians can be great allies in helping you to locate cemetery records. Funeral home records may still exist which can contain a wealth of information, including the burial location. Funeral directors will have knowledge of most cemeteries in their area, and may also be able to point you to family members. If a funeral home is no longer in business, then check with other area funeral homes as they may know where the old records are located. If you know your ancestors religious affiliation you may want to try contacting the church in the area where your ancestor lived. Churches often maintain attached cemeteries and also keep records for their members who are buried elsewhere. Turn to the Locals The local genealogical or family history society is a good source for information on local cemeteries. These groups are continually working to preserve valuable cemetery information and may have compiled cemetery indexes or be able to provide clues to little known burial locations, especially family cemeteries. Old local histories can also prove useful in identifying former names and locations for cemeteries which have been moved. Cemeteries Online The Internet is fast becoming a valuable source for cemetery records as well. Many cemetery sites such as FindAGrave and BillionGraves, have online cemetery records, photos, or transcriptions, or use your favorite search engine to search for a specific cemetery. Special geographic place name search engines can also help to locate a cemetery, though the information available on the Internet varies widely by country. The U.S. Geographic Names Information Server, for example, allows you to narrow down your search by selecting cemetery as the feature type. Map Your Way to the Cemetery If you have narrowed down the area, but arent sure which cemetery may contain your ancestor, then maps, especially historical maps, can be of great assistance. Use land, tax or census records to help you pinpoint your ancestors land on a map. You will often find them buried in a nearby cemetery, or even in a family cemetery on their own property. Topographic maps or locality maps may show cemeteries, roads, houses and farms. Even little details such as elevation features can be useful as cemeteries were often erected on high ground. Next What to Take When You Visit the Cemetery When heading out to the cemetery for some tombstone research, a little advance planning can really help to make your visit a success. Best Time to Visit the Cemetery The best time to visit a cemetery is in the spring or fall - especially if it is one which is neglected and overgrown. Brush and grass will not be as high in the spring, which will help you to discern holes, rocks, snakes and other obstacles before you trip over them. Sometimes the season can have an impact on whether you even find the cemetery at all. I have located several family cemeteries in the southeastern U.S. which are situated in the middle of cornfields. Needless to say, it is nearly impossible to find such cemeteries when the corn is taller than you are! What to Bring to the Cemetery The well-dressed cemetery researcher wears long pants, a long-sleeved shirt, sturdy shoes and gloves to help ward off critters such as snakes, gnats, ticks and mosquitoes. If the cemetery is in a wooded or rural location you may also want to bring along a hoe to help cut down brush and a friend or fellow researcher for safety. Even if it is broiling hot when you visit the cemetery, the long pants and sturdy, comfortable shoes are a good idea.   Clues Beyond the Tombstones Whether the cemetery is public or private, you should do a search for existing records. Most commonly known as sextons records (a sexton is a caretaker responsible for the cemetery), these records can include burial registers, plat maps and plot records. These records will vary greatly by country and time period and may not exist, but never assume! A sign outside of the cemetery may be able to point you to its caretaker. Turn to the local phone book to contact area funeral directors or churches. Check with the area library or historical/genealogical society for tips on possible record locations. You may be surprised by what you can find. One last thing - before you visit a private cemetery, be sure to get permission from the land owner!   Plan Ahead for a Successful Cemetery Visit Dress appropriatelyBring paper, several pencils, a camera and plenty of filmConsider bringing optional items such as a digital camera, video camera, tape recorder or handheld computer.Extra batteries for anything that may need them!If you plan to do any tombstone rubbings, then be sure to bring the appropriate suppliesWater, rags and a soft nylon bristle brush for cleaning stones, plus clippers for clearing away grass and brushIf you are looking for unmarked cemeteries, you may want to bring a map so that you can mark their locations as you locate them Next Stories in Stone The highlight of any trip to the cemetery is reading the stones. Once you have taken that irresistible quick peek for your ancestors headstone, however, you should stop and plan out your route around the cemetery. Methodical might be boring, but it greatly decreases your chances of missing something important when youre searching a cemetery for clues. If the cemetery is not too large, and you have enough time, it can be very helpful to make a complete transcription of the cemetery. Even if you only make note of the names and dates on each tombstone, along with their location in the cemetery, this can save you a trip back in the future as well as help other researchers. There is a lot of information and advice available on the proper methods for transcribing tombstones. While these can serve as great reference guides, there is really no need to worry about formality. The important thing is to make a note of everything that you see. Make Your Visit Count Write down names, dates and inscriptions exactly as they appear on the stone. It is very easy to make assumptions in the excitement of the moment, and it will be very beneficial to have an accurate record as you move forward (or backward as the case may be) with your research. Be sure to sketch any symbols that you are unfamiliar with so that you can look them up later. These symbols or emblems may be valuable clues to membership in an organization which may have records about your ancestor. Make a note of the physical relationship between tombstones as well. Family members will often be buried together in the same plot. Nearby graves may belong to parents. Small unmarked stones may indicate children that died in their infancy. Neighbors and relatives may also be buried in adjoining sections. As you make your way around, be sure not to miss the back of the stones as they can also contain important information. Another good way to record cemetery information is to use a cassette recorder or video camera as you move around the cemetery. You can read off names, dates and inscriptions easily and make note of important information, such as when you start a new row. It also provides you with a backup for any written transcriptions that you have made. Pictures are worth a thousand words and are much better for tombstones than chalk or shaving cream. Use hand-held clippers to clear brush away from the stone and then use a nylon (never wire) bristle brush and plain water to clean the stone from bottom to top, rinsing well as you go. A bright sunny day and a mirror to help reflect the sunlight on the stone can really help to bring out the carvings.More: Tips for Taking Great Tombstone Photos Most important for your cemetery visit is to enjoy yourself! Visiting cemeteries is one of the most rewarding parts of genealogy research, so stop and take the time to commune with your ancestors.

The Rise and Fall of Grigory Rasputin essays

The Rise and Fall of Grigory Rasputin essays No other figure in Russian history has ever received the amount of vilification and disapproval heaped upon Grigory Rasputin. The self-appointed monk, who received practically little education in the intricacies of the Russian orthodox faith, came from the rural areas of Russia and achieved great recognition as staretz or holy man in the high circles of St Petersburg society. From rags to social prominence the life of Grigory Rasputin holds many of the events leading to the eventual overthrow of the Russian imperial system, the dethronement of the house of Romanov and the assassination of the imperial family. Rasputin, which means debauched one was a name he earned due to all his sexual endeavours, originally he was called Grigory Yefimovich Norvykh, who was born on the 10th January 1872 in Pokrovskye, a small village in Siberia he was of solid peasant stock. Although he went to school he was semi-illiterate but since a young age was believed to possess psychic powers, this was evident when his father was arguing over the theft of a horse and Rasputin who had been sick in bed for days got up and correctly picked out the thief. As Rasputin grew up he was known for finding ways to get in trouble with the authorities for drunkenness, stealing and womanising among many other offences. Soon after, he was encouraged by a hermit named Makar to take up religion. In fact it was while on one of his escapades that Rasputin was first impacted with the mystical powers of the Orthodox religion and at Verkhoturye Monastery he became fascinated with a renegade sect within the orthodox faith, the skopsty. Followers of the skopsty firmly believed that the only way to reach God was through sinful actions. In reality what the skopsty endorsed was to sin to drive out sin considering that he was one of the biggest sinners in the province, he showed great potential. They gathered in crypts, indulging in flagellati...

Whats a Bad ACT Score

What's a Bad ACT Score SAT / ACT Prep Online Guides and Tips When it comes to your college applications, you probably aren’t too worried about your ACT scores- unless, that is, you think your scores will be too low. Don’t panic just yet! Like most things in life, ACT scores are all relative- there’s no such thing as a bad ACT score in a vacuum. In this post, I’ll talk about what it means to have a â€Å"bad† score in relation to the entire US, your general peer group, your prospective colleges, and (maybe most importantly) yourself. Before We Start, a Note on Percentiles Understanding percentile scores is an important part of understanding ACT scores. Before Italk about different types of bad scores, I'll briefly explain what percentile scores are and why you should care about them. A percentile score is different from a percent score, even though the two mathematical concepts are related. Essentially, a percent score would tell you what portion of the ACT exam you got correct; a percentile score, on the other hand, tells you how you did on the exam compared to everyone else who took it.For example,a percent score of 90% would mean you got 90% of the questions right, whereas a percentile score of 90 would mean you scored better than 90% of the students who took the exam. Percentiles are more meaningful than percents when we talk about ACT scores because what’s important is how you score when compared to other students. A percentage score in isolation doesn't tell you how well you performed on a test or how difficult it was. You can get a low percentage score on a test and still do very well in comparison to other students, earning a high percentile score- this is an example of the difference between percentages and percentiles. Low ACT Scores for the General US Population Let's just say we're starting big. We're starting with the biggest possible comparison group - understanding how you do in relation to all other people who take the ACT is the first step in understanding these unique exam scores. First, the basics: the ACT is scored out of a possible 36 points.A score of 36 is rare enough that when it happens, local newspapers sometimes write about it - just google the name of your town and "perfect ACT score." The national average composite score is 21 out of 36 points. The top 25% of scorers, or those who are at or above the 75th percentile, receive scores of 24 and up. The 75th percentile is a reasonable cutoff for what could be considered "excellent" scores. The bottom 25% of scorers, or those who are at or below the 25th percentile, receive scores of 16 and below.You may very well have your own ideas about what a reasonable â€Å"bad ACT† score cutoff should be. For the general population, scores of 16 and below (so, scores that are lower than those of 75% of the population) could reasonably be considered low. Here are some important percentile cutoffs and corresponding scores for quick reference: 10th percentile composite score →13-14 25th percentile composite score→16-17 50th percentile composite score→21 75th percentile composite score→24 90th percentile composite score→28 Low ACT Scores forYour Peer Group We're starting to get a bit more personal. Knowing what your peers and classmates tend to score on the ACT will give you a more sophisticated understanding of where, exactly, you stand. Comparing yourself to the rest of the country (with a wide range of backgrounds, educations, resources, opportunities, target schools, etc.) is less helpful than comparing yourself to people who are similar to you in important ways, like geography or education. Here's how to get information on what your peers score: Get your hands on your school report. This report will give you aggregated information on the score distribution for your particular high school. You may already know how to gain access to this. If you don't, try googling "[Your High School Name] ACT score report." This information will be particularly easy to find in states with mandatory testing. Check in with your guidance counselor. If you don't have access to a school report, your high school guidance counselor should have an idea of what low ACT scores will look like at your school. Ask your peers or classmates. As a last resort, you could ask around to see what other students are scoring. Just make sure to be respectful if your classmates don't want to discuss their scores. If you want to get an idea of a more competitive score range, check in with honors students at your school. Once you have this information, here's how to use it effectively: Consider how your peers' score distribution compares to national scores? Do students at your school tend to score higher or lower than you’d expect based on the national average? If your peers have scores that are higher/lower than the national average, you could adjust your idea of what a bad ACT score is accordingly. For example, if your school's average ACT scores are lower than those of the national average (21),a â€Å"bad† ACT score cutoff at 25th percentile might be unreasonably high. Conversely, if your school has very high ACT scores, your understanding of a bad ACT score should be higher than the national 25th percentile score (16). Low ACT Scores forYourTarget Colleges Ultimately, a low ACT score for a particular college is a score that won’t get you in. Schools don't tend to publish hard ACT score minimums, but they do offer information about the ACT scores of their students. We can use current students' scores to infer what scores colleges expect from applicants. If you know the 25th and 75th percentile scores for a particular school, you know what that school considers to be â€Å"low† and â€Å"excellent† ACT scores. If your scores (current or future) fall within that range, it’s likely a good target school for you. But what if you're at the edges of, our even outside of, that 25th-75th percentile range? If you're close to the bottom end of the range, it doesn't mean it's impossible for you to get into that school. Colleges may accept students with lower ACT scores for any number of reasons- they might consider students strong applicants if they have a high GPA or impressive community service experience. Colleges may also take into consideration if students' high schools underperform on standardized tests or if they're athletes or legacies. Regardless of the strength of the rest of your application, you could apply to a college with higher ACT scores as a reach school. In fact, most students who apply to colleges with extremely competitive ACT requirements consider them reach schools. If you're scoring close to or above the 75th percentile score for a particular school, chances are you'll have a strong application. If this is the case, you may consider this one of your safety schools. Make sure you're applying to schools with more competitive ACT scores as well- you don't want to miss out on a high-ranking school! Here's how you get information on what schools consider bad ACT scores (it's pretty easy!): Google â€Å"[school name] PrepScholar admissions requirements." Look on the page for the 25th and 75th percentile scores That’s it! You can even use the page’s built-in tool to estimate your chances of getting into that school Low ACT Scores for Yourself It's time for some good, old-fashioned self-reflection (although I don't think Barack is thinking about his ACT scores). All these other comparisons won’t do you much good if you don’t take unique personal factors into account when figuring out what counts as a bad ACT score.Achieving goal scores may come easier for some students than others.For someone who struggles with key concepts or with test-taking anxiety, going from the 40thto the60th percentile is no less an achievement than going from the 70thto the90th for someone who doesn’t struggle with these issues. Conversely, even a student with relatively high baseline scores has room for improvement and can bring her scores up even higher with adequate preparation. Pushing yourself on the ACT, even if your scores are already objectively good, can open up some amazing opportunities. So how do you figure out what a bad ACT score is for you personally? Get a baseline score. Study for about 10 hours for test familiarity and quick content gains, then take a full practice test. There will definitely be room for improvement after you take this baseline - consider this first real practice test a soft â€Å"bad ACT score† cutoff. Work to improve. Students usually reach a personal maximum score after 40-80 hours of studying. You can expect to improve 3-4 points from baseline, but it's definitely possible to improve your scores by a wider margin. Getting that much prep in will mean you are dedicating yourself to excellence by your own standards. How Do You Improve Low ACT Scores? Worried that you have low ACT scores when compared to your peers, your target schools, or your own score potential? Your plan of attack will depend on how much time you have to study. Get started by reading our guide onhow long you should study for the ACT.Don't have a lot of time? Read our last-minutetipsandstrategiesor our10-day study plan. Are you in it for the long haul?Read ourstudy schedulefor students who have one year or more to prepare. Next, work towards a concrete goal after making a list of target,reach, andsafetyschools. Get instructions on how to set a goal score in ourACT score guide. Are you dissatisfied with anything but perfection? Read our famous guide to getting a perfect ACT score. What's Next? At this point, you may be getting sick of reading about the ACTs. Maybe the SATs are more your style. If you're still deciding between the two tests, find out which one may be the better fit for you. You can also learn more about what counts as an "excellent" or "bad" SAT score. Want to improve your ACT score by 4 points?We have the industry's leading ACT prep program. Built by Harvard grads and ACT full scorers, the program learns your strengths and weaknesses through advanced statistics, then customizes your prep program to you so you get the most effective prep possible. Check out our 5-day free trial today:

Resolving Conflicts at Work Essay Example | Topics and Well Written Essays - 750 words

Resolving Conflicts at Work - Essay Example This paper is a review targeted at analyzing the following statement: â€Å"Taking off masks and revealing hidden emotions†.   Hiding emotions can very often lead to a build-up of anger, or also make an individual lie or avoid the truth.   Doing this distorts the behavior of an individual, and an individual may even begin to believe that this â€Å"mask† is, in fact, really who he or she is.   Hiding emotions can result in several unsatisfactory actions.   One of these actions is known as â€Å"blowing up,† what this, in fact, means, is that anger has been allowed to build up within the individual, and then something sets the individual off, and everything that has been hidden comes out at once.   When the anger comes out, it may often be lashing out at something that really did not seem to be a serious concern in the first place, which may confuse the individual that is actually the target of the anger.   Ã‚  Ã‚  Ã‚   Another concept brought up in th e chapter is â€Å"Behaviors that Trigger Anger.†Ã‚   For many, anger can be difficult to understand because many do not often understand what the true source of that anger was. Responding logically to anger can sometimes make anger even worse.   Therefore, in a working environment, it may be important to bring a team together if somebody has become angry, and try to figure out what is not working for everybody.   Meetings like this can often be helpful because they can establish ground rules.

Strategic Assignment Example | Topics and Well Written Essays - 3000 words

Strategic - Assignment Example Currently, the company is the second-largest corporate organization in the world in terms of revenue after Samsung and is one of the most valuable brands having gained consumer loyalty and trust through good business practice over the years. In order to ascertain the degree of globalization within a particular industry, there are four main drivers that need to be analyzed and these include: market drivers, competitive drivers, government drivers and cost drivers. Market drivers seek to demonstrate customer behaviors in relation to company products in the market domain. Consumers are the major players in the industry as they determine the demand for market commodities and influence the decisions of the manufactures. The global consumers’ needs tend to converge at the same point. Cost drivers attributes to the aspects of competition among industry leaders at a regional or national level. The different dynamics that come into play in the course of operation depending on the region of operation. The convergence of consumer needs is one of the most important elements in any business venture. The dynamics of these common tastes and preferences may vary by product from one region to another basing on cultural practices, disposable incomes, and the homogeneity of the target population in reference to a particular product. Apple Inc. as an international organization offers the same product but differentiates it to suit the specific needs and preference of the society under operation. There is need for the product to be modified in a very professional way to maintain its brand identity while at the same time blending with the cultures, tastes and preferences of their specific target market in their various markets across the globe. Apple mobile manufacturing company has been keen in redesigning and customizing their electronic devices to suit the specific needs of its current market.

2010 Earthquake in Haiti Research Paper Example | Topics and Well Written Essays - 750 words

2010 Earthquake in Haiti - Research Paper Example It could either be natural or man-made, which can be equally damaging to life and property. An earthquake is an example of a disaster that could be perilous to mankind. This paper aspires to tackle the concepts regarding an earthquake focusing primarily on the 2010 Earthquake that transpired in Haiti. Moreover, it deems to know its impact to the people. An earthquake is one of the most frightening of all natural disasters as emphasized by Connolly (2004). Hundreds of thousands of people can die in a single earthquake (Connolly, 2004). Both Connolly (2004) and Roza (2007) highlighted that a powerful earthquake can destroy buildings, cause landslides, open deep cracks in the earth’s surface and even change the course of mighty rivers. This damage can lead to serious problems according to Connolly (2004), such as fires, gas explosions, floods and power outrages. One of the most alarming things about earthquakes as Connolly (2004) had pointed out is that no one can say precisely when or where they will happen. Although it is a daunting task to identify when or where an earthquake may take place, people can know how earthquakes transpire and what causes them; this is explored in a branch of science known as seismology that studies everything about earthquakes. The earth consists of numerous layers. Human beings live on the outer layer known as the crust. Although the crust is several miles thick, it is very thin compared to the whole planet. It is illustrated by Connolly (2004) as the cracked shell of a hard-boiled egg made up of many pieces that fit together. These pieces are labeled as plates which float on the surface of a layer of magma. The gaps where the plates meet are known as faults. The plates are persistently moving against each other along the faults. Usually, human beings do not notice this gradual movement. However, plates can also get stuck as they attempt to move past each

Week 8 Intelligence Failures or Misperceptions Assignment - 1

Week 8 Intelligence Failures or Misperceptions - Assignment Example available information concerning the plots that led to the attacks, analyze it appropriately and disseminate it effectively in time in order to protect the public. This failure led to the launching of an unprecedented Joint Inquiry by the Congressional intelligence committees, in order to investigate the records of the Intelligence Community regarding the 9/11 attacks and make recommendations for further legislative action (Week 8 Professor’s Wrap Up Note). Another factor that supports the claim of intelligence failures is that, although the Intelligence Community provided sufficient warning of an imminent attack in mid-2001 against the United States by Osama Bin Laden, the Community never learned the plans for aircraft hijackings in advance, which occurred on September 11. In addition, inquiries arose on whether the Intelligence Community failed to provide precise information about the ability of Iraqi to develop and use weapons of mass destruction (WMD), or whether the Administration of Bush systematically misused intelligence to acquire support for launching Operation Iraqi Freedom in March 2003, as well as for continuing military operations in Iraq. As of today, the inquiry and research into both of the perceived major contemporary  intelligence failures continues. According to Paul Pillar argument, the intelligence community was aware prior to 9/11 of the threats and received many from al-Qaeda that they will attack America on American soil. Along with the high amount of threats received in the summer of 2001, Americans had several chances of taking out Bin Ladin. However, the president and the intelligence community failed to act aggressively on the threats. And in 1993 America was attacked with the bombing of the World Trade Center.   This is an evidence of failed community intelligence and a weakness or inexperience of leadership. Other similar examples include the decision to go to war with Iraq, which was pure weakness and failures in presidential

Impact of World War II on the United States Essay

Impact of World War II on the United States - Essay Example Prior to the war, the New Deal was not able to overcome the stagnant state of the US economy despite the concerted efforts of the Roosevelt government. The unemployment rate remained steadily above 14 percent despite having considerably fallen since the darkest years of the depression. A consideration of a more penetrative government fiscal intervention gave way to speculations about real economic recovery in which it was posited that the recovery would become elusive if given to the care of the private sector (Vatter 1985, p. 7). Such recovery required much more Keynesian doses for the New Deal to finally affect full employment (Vatter 1985, p.11). Political impacts include several pursuits that aimed to repair a damaged economy during the New Deal era and the war itself. A political, psychological, and economic shift was a product of the New Deal and World War II in the United States. These concerns troubled the American government during the war years and immediately afterward: big government, the economy, and communism at home and abroad. It was inferred that the bourgeoning bureaucracy that ensued in the United States during the WWII was one characterized by the mounting of commissions, agencies, and administrations, aiming to serve the legal and political necessities of the period. Examples of these are the Foreign Economic Administration, Maritime Commissions and the War Shipping Administration, Selective Service System, US Employment Service, War Manpower Commission, War Labor Board, and War Food Administration (Vatter 1985, p. 87). Each of these had their on designated purposes in which central is the organizing and carrying out of American war-time economic production and output. All of these bureaucratic organizations formed a government front aiming to push through all forms of opposition in the interest of allied victory. The War Production Board (WPB) was established in order to distribute strategic materials as well as suspend the production of consumer products. The WMC attempted to balance the appropriat e distribution of men and women in military, industry, and agriculture during the war (Maddox 1992, p. 193). There was no questioning that the United States placed itself in a hegemonic position as a world power after the war, which may be referred to as one of its political impacts. Likewise, America's preoccupation with the promotion of democracy is essentially an idealist stance that emerged from the moralism and exceptionalism of the America political tradition (Ikenberry 2000, p. 103). This tradition is manifested through actual foreign policy, often carried out at the expense of more sober American international interests (Ikenberry 2000, p. 103). It is for the pursuit of making foreign policy commitments more acceptable to American public that the American democratic stance becomes a minor distraction. The American promotion of democracy after World War II reflects a pragmatic and evolving understanding of creating a stable political order in the international arena, which was later called "an American liberal grand strategy"

Week 8 Intelligence Failures or Misperceptions Assignment - 1

Week 8 Intelligence Failures or Misperceptions - Assignment Example available information concerning the plots that led to the attacks, analyze it appropriately and disseminate it effectively in time in order to protect the public. This failure led to the launching of an unprecedented Joint Inquiry by the Congressional intelligence committees, in order to investigate the records of the Intelligence Community regarding the 9/11 attacks and make recommendations for further legislative action (Week 8 Professor’s Wrap Up Note). Another factor that supports the claim of intelligence failures is that, although the Intelligence Community provided sufficient warning of an imminent attack in mid-2001 against the United States by Osama Bin Laden, the Community never learned the plans for aircraft hijackings in advance, which occurred on September 11. In addition, inquiries arose on whether the Intelligence Community failed to provide precise information about the ability of Iraqi to develop and use weapons of mass destruction (WMD), or whether the Administration of Bush systematically misused intelligence to acquire support for launching Operation Iraqi Freedom in March 2003, as well as for continuing military operations in Iraq. As of today, the inquiry and research into both of the perceived major contemporary  intelligence failures continues. According to Paul Pillar argument, the intelligence community was aware prior to 9/11 of the threats and received many from al-Qaeda that they will attack America on American soil. Along with the high amount of threats received in the summer of 2001, Americans had several chances of taking out Bin Ladin. However, the president and the intelligence community failed to act aggressively on the threats. And in 1993 America was attacked with the bombing of the World Trade Center.   This is an evidence of failed community intelligence and a weakness or inexperience of leadership. Other similar examples include the decision to go to war with Iraq, which was pure weakness and failures in presidential

Grossman's Cardiac Catheterization, Angiography, and Intervention Essay

Grossman's Cardiac Catheterization, Angiography, and Intervention - Essay Example The researcher states that cardiac telemetry helps in diagnosing the yield of arrhythmia and manages therapeutic caused by the consumption of antiarrhythmic drugs. They expected for arrhythmias to occur during post angiogram at approximately two hours. The cardiologists examined the condition of softness particularly on the femoral vein and the neurovascular observations as well as the rate of bleeding on both legs of the patient in every hour of operation. It suggests that Popliteral Femoralie maybe had experienced numbness in his legs which could have resulted from the failure of blood supply through lunar or radial arteries. Since the cardiologists observed on femoral veins, therefore, they mostly focused on lunar artery which is located in the legs. During angioplasty, femoral angiography is more efficient than radial angiography and this case that is why the cardiologists opt to do it on the patients’ legs where the lunar artery is located. Cardiologists seem to have inse rted the catheter through the lunar artery which is mostly associated with a lot of bleeding. Lidocaine is usually injected into patient’s body in either through the arm or the upper leg close to the hip. It numbs the body but does not make the patient to sleep. The catheter is threaded up to the heart through an artery with no pain. An x-ray camera although not mentioned, in this case, can assist in projecting images of the arteries on the screen where cardiologists can intervene about the obstruction in the artery. A contrast is later injected for it to flow up to the heart. If an impasse is found, a guide-wire is usually passed crosswise the narrowed segment which supports in placing a tiny balloon in that region. An inserted balloon catheter is later inflated many times where it flattens lamination inside an artery where the artery may crack, and the blockage is gone.

Single-Sex School and Co-Ed School Essay Example for Free

Single-Sex School and Co-Ed School Essay The education systems nowadays are made up of organizations ranging from kindergartens, general education schools, single-sex schools and co-ed schools to universities. This structure is designed to formulate people’s knowledge one step at a time according to their levels. School is one of the most important stages of educational system in our lives where we are trained to absorb basic knowledge and prepare for our future. Often times, schools are divided into single-sex schools, where only boys or girls study, and co-ed schools, where boys and girls study together. This choice demands that parents choose between co-ed school and single-sex school and decide what would be better for their children. This essay will compare and contrast these two forms of educational approaches to determine that co-educational school is better than single-sex school and is the most practical form of schooling. Co-education schools have a diversity of students from different economic and gender backgrounds. It is an efficient way of schooling for poorer countries that do not have the capital to build single-sex schools. Therefore, the biggest advantage of co-ed school is that there will be no need to open separate schools exclusively for boys or girls, because both boys and girls can study in same schools and they can be taught by the same staff. From childhood we know that kids like to play with each other and it is not depend on gender that is why friendships develop in natural way. From sociological point of view same thing happens in co-ed school. Pupils meet each other and have to be together in the society and if they will be studying together from the very beginning, they can understand well each other. As girls and boys become teenagers they participate in many activities, develop new societies and clubs in school where they are taking part in pleasant and friendly environment. This friendly atmosphere continues in the classroom, which allows them to share and express their point of view easily. In co-ed school boys and girls will be trained to take place in the community and how to behave with not just people of the same gender by also the other gender. For instance, if they will start working for international company where both genders are working together it would be easier for them to communicate with others, because they will know how to behave themselves. This experience will break their insufficient perceptions of each gender and will provide great social and personal development of relationships in later life. Another important point of co-education is that this type of school is very successful in challenging of sexist attitudes. In order to prove this we should answer on question â€Å"what do we know about sexism and how the single-sex or co-educational gender grouping of schools affects the occurrence, form, and severity of sexism in the classroom? † Sexism is an analogue to racism means a fundamental and pervasive institutionalized bias on the basis of sex, with discrimination usually directed against women. The rationale for sexism is the biological difference between males and females that dictates differential social roles, status, and norms (Lee, Marks, Byrd, 1994, pp. 2). In the past it meant that female had weak role in the society and males were powerful gender, which is always on the top. And this was the main purpose of development of single-sex schools. But nowadays women achieved equality in the society. As men they can work, build, manage, lead, guide or in other words do all things that men can do in the society. Sexism almost eradicated from our society and it is important point, and that is why co-ed school is very successful in challenging of sexist attitudes. For instance, there are many subjects that provide many discussions and debates in class and it is very important and useful for boys and girls. Because they learn that equality does not require similarity, and they know that they have equal rights and freedom of speech. It means that collaboration between boys and girls in the classroom helps them to develop confidence; they feel comfortable to share their ideas and opinions in any situation in the presence of opposite sex. Co-education improves pupils’ confidence to interact with opposite gender. Moreover, co-education creates a sense of healthy competition between both genders, because they need to work hard and pay serious attention to their studies. Also, co-educated pupils have strong friendship and respect to each other. For example, boys are trying to behave themselves very polite in company of girls. Moreover, they are trying not use rough and abusive language in presence of girls. Similarly, the girls are trying to dress properly and talk in a good manner, because they need good relationship with the boys if they are studying together. On the other hand if boys and girls are studying in separate schools, boys misbehave with the girls, because they are always having a curiosity to know about them. But when they study together, their curiosity is satisfied more easily and they do not consider girls as strange creatures or taboo. Despite the fact that co-ed schools are more modern and are similar with the current environment of the workplace, where boys and girls study together, some conservative people criticize co-education system. According to them, this system is against their tradition, because from ancient times they fear that co-education will help develop immoral relationships between boys and girls. They believe that in this system both the boys and girls will be spoilt. This was represented as the main possible disadvantage of co-education schools. Moreover, there was an experiment where boys and girls were studying in separate classes. And more of co-educational schools showed interest in segregating lessons. Academics and teachers have found that both genders have better concentration on core subjects and they are less distracted by opposite sex. The main idea is that separating boys and girls is not a cure for disruptive classrooms, but under the right conditions it can help to raise academic standards in schools. Despite of the fact that girls have better achievements than boys, they can also benefit from single-sex classes because they sometimes allowed them to perform without worrying about their image in front of girls. On the other hand there can be some problems in separating classes, because there is a need to avoid an intimidating atmosphere for other boys, who can be generated among all-boys’ classes, and to be alert to the dangers of generating a homophobic environment. In addition, there is also a need to beware of girls becoming aggressive towards each other. So, there are some risks of single-sex classrooms and schools. On the other hand, single-sex education is an old education system where boys and girls study in separate classrooms or schools. Some educational researchers have identified single-sex education as a way of facilitating a special educational experience for all students. Single-sex education refers to the education of students in an environment that consists of a single gender, either all-male or all-female environments (NASSPE, 2008). Not so long ago single-sex classes in co-educational schools were considered to be an appropriate educative aspect of K–12 learning environments (Pollard, 1999). In late 60s and early 70s in United States girls and boys were separated from each other on a single-sex basis. For example, in many schools in country classes were separated by gender where girls attended economics classes while boys attended agriculture classes and it was required for all pupils or students. The main purpose of creating single-sex classes was physical education and sex education of boys and girls. In other words, boys and girls was separated because of assumptions about their physical abilities and characteristics, their social and personal functioning, or beliefs held by adults regarding appropriate interaction among or between the sexes (Pollard, 1999). Moreover, some single-sex classes were created in order to exclude girls from some activities that were based on gender stereotypes that were not appropriate for them. According to Smith and Wilhelm, in general boys achieve lower grades than girls while girls are demonstrating higher performance. In general, girls are in particular benefiting from a single-sex education, but the authors just suggesting this idea. From my point of view, girls just do not shy or worry how will they perform in presence of boys and vise versa. Interestingly, many researches show that they participate in class more than boys, develop much higher confidence, have higher grades, and are more likely to choose ‘male’ disciplines such as science, math, etc. Moreover, they are more successful in their careers. That is why the majority of single-sex schools nowadays are for girls. The gender equality development around the world seems to pose a mixed attitude toward the single-sex schools. On one hand, single-sex schools appear to be against this wave in that they treat the two genders differently and cultivate the sexist view in people’s minds from when they are young. In this respect, single-sex system seems to be something attached to the obsolete past in human history and does not fit the modern world in every way. But on the other hand, compared with single-sex system, the co-ed system is possibly contributing to sexist views, too. Some people argue that in a co-ed system, boys and girls are exposed much more to the differences in their own characteristics and because girls mature earlier than boys, boys might find the learning environment inappropriately challenging and even depressing during this stage. Another advantage of single-sex schools is that teachers know better about their students’ characteristics and thus can modify their teaching methods to meet the needs required by the differences in the two genders, whereas in co-ed schools, girls and boys are forced to learn and be appraised in exactly same ways which might not be proper. This should sound a legitimate argument to people who accept that there are differences between the two genders. Although the two systems have sharp differences, they also share similarities. When we compare single-sex school and co-ed school, we can identify some similarities. In spite of the fact that these two types of schools separate student by gender, they both have the same educational program. Both types of schools use same books, literature and syllabus. Also, the goals of both schools are the same. They prepare students for future life; give them appropriate knowledge that will help to survive and thrive in our world, but in single-sex school it difficult to be prepared for real life because they do not have natural training of behavior with opposite gender. Moreover, both schools do not give them just knowledge, but also pay attention to the physical activities. For example, pupils attend different competitions, like football, basketball, volleyball etc. In addition, students participate in public affairs, like movements against drugs, participation in aid for children’s home or helping to greybeards. There are many differences between single-sex school and co-ed school. For instance, differences in behavior of girls and boys have been observed and commented for generations, but history records that until social expectations of girls were very different of boys, especially regarding education (Zanders, 1993, p. 16). The learning style and interests of girls and boys have been consistently different, because girls acquire a learning method involving personal relationships and imitation, but boys are learning through defining goal, restructuring the field, and applying abstract principles. Alternatively, girls’ learning styles require more open-ended learning tasks, they are both more reflective and empathetic and engage with tasks that are related to real situations, whereas boys show a preference for memorizing rules and abstract facts and express their comprehension factually (Zanders, 1993, p. 17). Single-sex schools are relying on more ancient perspectives on education, which are oriented to separate boys and girls. Co-ed schools are more modern and represent the current environment of the workplace, where boys and girls study together. According to many articles and researches single-sex school students say that they are studying better than in co-ed and this is because they are in the class of their gender. For example, in Kazakhstan, students from Kazakh-Turkish lyceum won a lot of awards in exact sciences like mathematics, chemistry and physics and all foreign language and they gave the highest results in their knowledge. Co-ed education schools trains students for their future lives, how to communicate and behave in real world. This education breaks all the boarders between genders and helps them to build a good, strong relationships. Moreover, students in single-sex school may lose some social skills that students in a co-ed school may gain. It happens because students in single-sex school are limited from communication with opposite sex. Another important thing that influences education is relationships with opposite sex. In co-ed schools, students sometimes cannot realize their abilities in subjects like mathematics, chemistry and physics. In co-ed school, there exist teenagers’ sex and unwanted pregnancy at a very young age. This is because they always focus some or all their attention on opposite sex. However, in single-sex schools it is not a problem, because nothing of this sort exists. Finally, I want to conclude that both of schools have advantages and disadvantages. In co-ed school, it will be easy to gain your social skills, but student can lose some points in education. In single-sex school student can focus attention only on education, but will not properly prepared for social life. There is a trade off between academic knowledge acquisition and social functional ability development. The knowledge student gain does not depend on the type of school. The factors that influence their education are student character, environment and his or her abilities. Parents should decide themselves where their child will learn, but it should guarantee that the choice represents the children’s own feelings. They should like the type of school they are going to. But some parents sex for their children prefer to choose single-sex schools in order to minimize their contact with the opposite, but it is important to understand that choosing for child all-female or all-male school will not stop them from searching for the opposite sex. If parents minimize contact when child is in school, but they cannot stop children meeting others through tuitions, extra classes, the neighborhood, or through friends. If their child meets someone with whom she or he shares home assignment or some exercises, and if she or he makes the decision to get physical with such person, theres little a parent can do. But on the other hand, when parents choose for their child a co-educational school, their child will have contact with opposite sex from the beginning. As a result, child will not only feel more comfortable in the company of the opposite sex, but will also be able to handle advances better. When parents making the decision of sending their child to a single-sex or a co-educational school, their decision should not be based on whether they want to minimize or increase childs contact with the opposite sex. Instead, they must consider the reputation of the school, the activities it offers and the quality of education and educators. For example, some schools offer sending students abroad for further studies. So, parents may consider this point if they want their child to go abroad. Because there is other less traditional schools that focus more on activities and less on academics. If this is something that appeals to them, then give this fact more priority than the student mix. In fact, when deciding what school to choose for child, parent’s choice should fall on the co-educational school because it will give huge experience and will train their child for future life.

Use of HPV Vaccines for Cervical Cancer Prevention

Use of HPV Vaccines for Cervical Cancer Prevention HPV Vaccines: Will They Prevent Cervical cancer Introduction Human papilloma viruses (HPV) belong to the papillomaviridae family, they are double stranded DNA viruses. HPV is the most common sexually transmitted infection (STI) in the world (Urman et al. 2008). HPV is strongly associated with cervical cancer; more than 99% what are the other causes/factors please of cervical cancer cases are positive for HPV DNA and indeed, cervical cancer is the second most common malignancy in the world (Wang et al. 2007). In developed countries the incidence of cervical cancer has been reduced significantly by the introduction of a cervical screening programme. In developing countries where 83% of mortalities due to cervical cancer occur, there are no such programmes (Parkin et al. 2006). Can the introduction of a vaccine against HPV further reduce globally the incidence of cervical cancer? Many diseases caused by viruses are controlled in the developed world by ongoing successful vaccination programmes; Polio, Measles, Mumps and Rubella are a few examples. Smallpox caused by Variola virus was eradicated in 1979 through a successful worldwide vaccination programme. The factors that affect the Polio and MMR vaccine programmes success and those that affected the successful smallpox programme may also be contributory to the success of the HPV vaccination program. Vaccination of HPV is complex and multi factorial. This investigation studies a number of factors including: Vaccine efficacy Vaccine Cost/affordability/practicality of administration Production and Distribution Government backing and financial commitment Other support organisations such as the WHO, UNICEF, Gates Foundation, Social factors Media effects Public awareness Safety, and perceived fears Currently two prophylactic vaccines against HPV types 16 and 18, the most prevalent causes of HPV have been approved by the food and drug administration (FDA). Many developed countries have already introduced vaccination programmes using one of these vaccines. Can the vaccines and programme prevent cervical cancer? In order to effectively understand the implication of such a vaccination programme we must first fully examine the causative agent (HPV) and the consequential potential diseases including the biology, history and prevalence. Human Papillomavirus Approximately 200 types of HPV are identified of which around 40 infect the genital tract (McCance 2004). The majority of HPV types cause no symptoms, some types can cause warts and a minority may lead to cancer. Genital HPVs are transmitted via sexual contact, mainly intercourse, with an infected individual, and the risk of developing an HPV infection generally increases with the number of sexual partners, the sexual history of that partner or the introduction of a new sexual partner. Studies have shown that at least one type of HPV infection occurs soon after sexual debut, with around 30% of women infected with at least one high risk type within two years (Winer et al 2003; Winer et al 2008). HPVs are classified as either high risk or low risk, on the basis of association with cervical cancer. There are 15 types classified as high risk and three as probable high risk. High risk types include 16,18,31,33,35,39,,45,51,52,56,58,59,68,73,probable high risk types include 26,53,66 Low risk types include 6,11,40,42,43,54,61,70,72,81 and CP6108. More than 99% of cervical cancers are associated with HPV, of these 70% are associated with HPV type 16 and 18, with HPV 16 causing 50% and HPV 18 causing more than 15% in Europe (Smith et al..2007). HPV 16 is thus the single, most common high risk HPV. Interestingly HPV types 16 and 18 also cause 80% of anal cancer and 30% of vaginal and why the difference in % oper area research needed here.vulvar cancer and are associated with cancers of the, oropharynx and some rare cancers of the head and neck. (add reference form cervical cancer burden worldwide paper) The majority of HPV infections are asymptomatic, self limiting, and transient, with 70% of new HPV high risk type infections cleared within one year (with the median duration of an infection at 8 months) and 90% within two years (Ho et al 1998). The transient infection usually causes no clinical problems. A small proportion of high risk type infections persist due to host immune evasion, an evasion that results not only from restriction of HPVs to sites that are relatively inaccessible to host defences but also due to several mechanisms of preventing immune response what are these mechanisms please (a sk Dick if this is what he means . This persistence is the most important factor in the development of pre cancerous and cancerous lesions. The time span between infection by HPV and the development of pre cancerous lesions or cervical carcinoma varies from one to ten years (Moscicki et al 2006) and up to 20 years from other sources. HPV show little evidence of dramatic adaptability with phylogenic studies suggesting that the biology of HPVs has remained the same for over 200,000 years (Halpren et al 2000). While HPVs show historically the influence of point mutations, inserts, deletions and duplications, the predominant pattern of mutation within a given type is point mutation, with large scale rearrangements within the most conserved genes of HPVs such as L1 being rare (Myers et al 1996). Intra patient variation within HPV types is uncommon due to their low mutation rate. This low mutation rate is directly linked to the HPV replication strategy that requires host cell machinery, which has stringent proof reading mechanisms that avoid the incorporation of errors, conferring slow mutagenesis. All HPVs exhibit extreme specificity for infection of epithelial cells and do not infect or express their gene products in the underlying dermis. Although the mechanism of infection is not fully understood, the HPV epitheliotrophy resides for the most part in the interaction of specific transcription factors with the viral regulatory region known as the long control region (LCR). Infection with HPV can result in hyperproliferation of the host cell, and with certain high risk HPV types it may lead to transformation and immortalization. This is because high risk HPVs express two or more protein products (E6, E7 and E5) that transiently disrupt the cell cycle and stimulate cell division, knocking out at the same time the cellular mechanisms for growth inhibition. For a productive infection, HPVs require terminally differentiated cells. This HPV biology feature has impeded studies on the full reproduction life cycle because of the lack of highly efficient models of epithelial terminal di fferentiation in vitro. Most of the different stages in the HPV life cycle have been established using genetic engineering and molecular biology strategies. The dsDNA of HPV exists in a non enveloped icosahedral shaped virion 52-55 nm in diameter. The dsDNA genome is circularised and around 8000base pairs in length (Fig1). The genome encodes eight proteins, six early E1, E2, E4, E5, E6, E7, and two late structural proteins L1 and L2 and the previously mentioned noncoding LCR. Fig 1 HPV type 16 Genome structure, gene and functional domain location http://www.dnachip-link.com/Eng/library/HPV.aspusg 15/11/20009 Fig 1 shows the dsDNA genome of HPV type 16, and the location of the early and late genes along with the LCR that contains the origin of replication. An initial infection requires the access of infectious particles to the basal layer of the epithelium. Some HPVs require a break in the stratified epithelium to achieve this. Such breaks are not necessarily obvious and may occur under conditions where the skin is exposed to water or abraded, or subjected to an environment where micro traumas may occur such as possibly in aswiming pool or ect (must put an example)(in fig 2 shows as a cut). Following infection and uncoating it is thought that the virus maintains its genome as an episome in low copy numbers within basal cells of the epithelium. Although the pattern of gene expression in these cells is not well understood, it is generally thought that viral proteins E1 and E2 are expressed to maintain the viral DNA episome (Wilson et al.2002) and possibly to facilitate the segregation of genomes during cell division (You et all.2004). It is not known whether viral transformation proteins E6 and E7 are also expressed in the basal layer, but it does appear that initial infection is followed by a proliferative phase that results in the increase in the number of basal cells harbouring viral episomes. In normal uninfected epithelium, basal cells leave the cell cycle soon after migration into the superbasal cell layers where they undergo a process of terminal differentiation. During infection E6 and E7 are expressed in these cells stopping normal differentiation (Sherman et all.1997). E6 and E7 are believed to work together to achieve this and in lesions caused by high risk HPV types. During a natural infection the ability of E7 to stimulate S-phase progression is limited to a subset of differentiated cells with low levels of p21/p27, or which express high enough levels of E7 to overcome the block in S-phase entry. The viral E6 protein is thought to prevent apoptosis in response to unscheduled S-phase entry brought on by E7. The association of E6 with p53 and the inactivation of p53 mediated growth suppression and apoptosis is well documented, E6 may also associate with other pro-apoptotic proteins including bak (Thomas and Banks,1998) and bax (Li and Dou,2000). E6 is thus considered a predisposing factor in the development of HPV associated cancers, allowing the accumulation of chance errors in host DNA to go unchecked. Furthermore the E6 protein of high risk HPVs can stimulate cell proliferation independently of E7 via a c-terminal PDZ ligand binding domain. E6 PDZ is enough to mediate superbasal cell proliferation and may contribute to the formation of metastatic tumours by disrupting normal cell adhesion (Nguyen et al.2003) Amplification of the viral genome and the ability to package these genomes into infectious particles is essential for the production of infectious virions. For most HPV types this occurs in the mid or upper epithelial layers following an increase in activity of the late promoter. The late promoter gene is located within the E7 open reading frame, and the upregulation of the late promoter is thought to lead to increased expression of proteins involved in viral DNA replication, without directly affecting the expression of E6 or E7 necessary for S-phase entry. The amplification of the viral genome begins in a subset of cells in the proliferative compartment and requires the expression of all viral early gene products, these include E4 and E5 whose role in replication is not yet clearly understood. Binding of E2 to the HPV upstream regulator region is essential for viral DNA replication that is dependent on the differentiated state of epithelial cells. E2 recruits the E1 DNA helicase to the viral origin of replication. Throughout the virus life cycle, the relative levels of viral proteins are controlled by promoter usage and by differential splice site selection, with an increase in E1 and E2 allowing an increase in viral copy numbers in the upper epithelial layers. Current models suggest that a small increase in promoter activation during differentiation may lead to an increase in the level of E1 and E2 and a subsequent increase in genome copy number. The newly replicated genome could then serve as a further template for expression of E1 and E2, facilitating the amplification of viral genome and in turn further expression of E1 and E2 replication proteins. Viral DNA remains latent (not integrated) in basal cells of benign lesions. Replication occurs in the differentiating cells where capsid proteins and viral particles are found. Viral DNA is integrated in cancer cells, which contain no replicating virus. Once viral genome replication is completed, the expression of two virally encoded structural proteins, expressed in the upper layers of infected epithelia may occur. L1 the major capsid protein is expressed after L2 in a sub set of cells that express E4 (fig 2), this allows the assembly of infectious particles in the upper layers of the epithelium (Florin et al.,2002). A successful infection requires the virus to escape from the infected skin cell and survive extracellularly prior to re-infection. HPVs are non-lytic and are as such not released until the infected cells reach the epithelial surface. The intracellular retention of HPV antigen until the cell reaches the uppermost epithelial layers may contribute the compromised immune detection, especially as the virus has molecular mechanisms that limit the presentation of viral epitopes to the immune system in the lower epithelial layers (Ashrafi et al 2002). What are these mechanisms Figure 2 Papillomavirus type 16 Life Cycle and gene expression location within epithelium Taken from, The papillomavirus life cycle by John Doorbar published in the journal of clinical virology 32S (2005) S7-S15 Figure 2 diagrammatic representation of the skin with HPV type 16 gene expression incorporated, colour of arrows are representative of genes expressed within epithelial cells. The frequent detection of high risk HPV DNA in cervical lesions in the absence of any obvious disease, may be explained by the presence of the virus in a latent state, with only very few cells able to support the productive virus life cycle during epithelial cell differentiation. Following immune regression, HPV DNA is thought to remain in the basal epithelial cells waiting to be reactivated once levels of immune surveillance decline there are conflicting opinions (Zhang et al.1999). If regression is not achieved lesions may persist and in some instances progress to cancer. The number of lesion that progress to cancer is very low when compared to the prevalence of high risk HPV infection in the general public. The Progression of productive lesion to high grade lesions may result from the deregulation ( what happen to allow thes proteins to be deregulated intergrattion loss of E2 adn p53 association, be specific add biochemistry here please. in the expression of transforming proteins E6 and E7. The inability of a cell to support the whole virus life cycle is often associated with the development of cancerous lesions. The transformation zone (Fig 3) is particularly susceptible to cervical cancer; it appears that high risk types of HPV such as type 16 cannot complete their life cycle at this site Progression from CIN3 to cancer usually occurs in lesions that contain integrated copies of the viral genome in which E7 expression is elevated. Suggesting that retention of E6 and E7genes and the loss of E2 and E4 genes (that exert negative effect on cell growth) usually accompanies the development of invasive cancer. (reference) Remember for CIN refer to in that section or here but Cin must be corrulated with what causes the cancer and with whats happening with the virus that causes the change in CIN or the causes in CIN to occur. Cervical cancerisa considerable contributor to morbidity and mortality. Being the second most common cancer worldwide and the twelfth most common cancer in women in the UK. Cervical cancer in 2002 was the cause of 274,000 deaths worldwide (the most current data available)REF THIS FIGURE and continues to causes more than 1000 deaths in the UK each year. There are two main types of cervical cancer squamous cell cancer (the most common) and adenocarcinoma, although they are often mixed. They are named after the types of cell that become cancerous through neoplasia. Squamous cells are flat cells covering the cervix; adenomatous cells are found in the passageway from the cervix to the womb. Other rarer cancers of the cervix include small cell cancer. Deaths from cervical cancer in the UK have fallen over the last 20 years mainly because of the NHS cervical screening programme that reduced the mortality rates by 62% between 1987-2006. Screening may detect changes in the cells of the cervix at a pre-cancerous stage. Fig 3 TITTLE Showing location of transformation zone. Cell samples are examined for abnormalities, these abnormality are described in a standard format covering cytology and/or histology. What are these standard format CIN 1 CIN2 CIN3 LISL LGSIL HSIL HGSIL USE FIG 4 and explain whats happening with the proteins expressed and genome intergration where CIN number progression is concerned please. MUST DO From Lowy Schiller, J Clin Invest, 116:1167-73, 2006 Low grade squamous intraepithelial lesion (LSIL or LGSIL) indicates possiblecone biopsy, or laser ablation. High grade squamous intraepithelial lesion (HSIL or HGSIL) indicates moderate or severeCIN 2 or CIN3 (fig 3). While cervical screening has reduced the mortality significantly in the developed world cervical cancer is still a significant burden worldwide. Fig 4 Taken from, The popillomavirus life cycle by John Doorbar published in the journal of clinical virology 32S (2005) S7-S15 Fig. 5. CIN 1 resembles productive infections caused by other HPV types and as such is the most benign form of cervical intraepithelial neoplasia , it is confined to the basal 1/3 of the epithelium, CIN 2 Moderate dysplasia confined to the basal 2/3 of the epithelium,CIN3 Sever dysplasia that spans more than 2/3 of the epithelium, and may involve the full thickness. INCIDENCE An estimated 493,000 new cases and 274,000 deaths in 2002 were caused by cervical cancer. The vast majority, some 83% of these cases, occur in developing countries, where cervical cancer amounts to 15% of female cancers with a risk before age 65 of 1.5%. In developed countries cervical cancer accounts for only 3.6%, with a risk of 0.8% before age 65. REF The highest incidence rates are observed in Sub-Saharan Africa, Melanesia, Latin America and the Caribbean, South-Central Asia, and South East Asia (fig 6) Fig 6 Worldwide Burden of HPV related Cervical Cancer Figures from 2002. Parkin MD et al 2006 The burden of HPV-related cervical cancers The vast majority of cervical cancers are squamous cell carcinoma adenocarcinomas being less common (fig 6). Generally the proportion of adenocarcinoma cases is higher in areas with low incidence of cervical cancer, accounting for up to 25% of cases in western countries (fig 6). This higher incidence of adenocarcinoma may be partially explained by cytological screening, which historically, had little effect in reducing the risk of adenocarcinoma of the cervix, because these cancers, and their precursors, occur within the cervical canal, and were not readily sampled by scraping of the epithelium of the ectocervix. Fig 5 Fig 5 showing the higher % of adenocarcinoma in counties that have screening programmes such as the UK and Denmark What is this showing? Make it clear.do you really need it. MORTALITY RATES Mortality rates are substantially lower than incidence rates. Worldwide 55% (could you double chek that this is the case please misses) of all those that develop the disease die, the figures vary significantly from the developed to the developing world. Low risk regions of the west such as Europe have a death rate of 37% while in developing countries where many cases present at relatively advanced stages, death rates are significantly higher increasing to 70%. Cervical screening programmes in the developed world identify pre-cancerous lesions at a stage where they can be easily treated accounting for the difference in mortality rates. TITTLE IF and figure number staying and refer to in text As cervical cancer affects a relatively high number of young women, it is a significant cause of years of life lost (YLL) in the developing world. Yang et al 2004 found that cervical cancer was responsible for the 2.7 million (age weighted) years of lives lost world wide in 2000, and that it is the single biggest cause of years of life lost from cancer in the developing world. In Latin America, Eastern Europe and the Caribbean, cervical cancer makes a greater contribution to YLL than disease such as Tuberculosis or AIDS. HPV is also associated with many other forms of cancer that could possibly be prevented with use of HPV vaccines; cancers of the penis, anus, vulva, vagina, oropharynx and some rare cancers of the head and neck are included. However cancer of the cervix is by far the most significant, in terms of incidence and mortality (table 1). Cancer of the vulva and vagina have a significantly lower incidence rate compared to cervical cancer, however since 80% of the incidence are caused by HPV types 16 or 18 women vaccinated against these types would also be protected against these forms of cancer. Incidence of squamous cell carcinoma of the anus are twice as common in females as males with HPV types 16 and 18 accounting for 83% of all cases. There is a particularly high incidence of anal cancer among homosexual males, shown by the high incidence rate in populations such as Sanfransisco, where gay incidence are higher than average (fig 7). Globally cancer of the penis is relatively rare accounting for 0.5% of cancers in men (table 1). HPV DNA is detectable in 40-50% of all penile cancers and serological studies have confirmed the role of HPV 16 and 18 (IARC 2005). Cancers of the mouth and oropharynx caused by HPV are very low at 0.06% of all cancers with 0.05% being caused by HPV types 16/18. Due to the small size of most studies and the absence of comparable measurements of prevalence of infection in normal subjects conducted for cancers of the vulva, vagina, penis and anus true prevalence is difficult to quantify. The figures shown in table 1, imply that we are dealing with a virus that discriminates primarily through disease aginst women, in particular young women. Gay men, however are also clearly an at risk group. Currently only young women are vaccinated aginst HPV types 16 and 18, however the JCVI (joint committee on vaccination and immunisation) have noted that the vaccines has not been conclusively trialled on men, and that there is insufficient evidence that the vaccine available would protect against anal, penile or head and neck cancer. However when more data becomes available they will consider vaccinating, high risk groups such as men who have sex with men. Add what this implies for prophylactic use of vaccine with other cancers cause by HPV And what you think about the ue of vaccine on highrisk men and its effectivity against other cancers caused by HPV types 16 and 18. Fig 7 TITTLE add Figure 6 showing that cancer of the anus are more prevalent in women than men with the major noted exception being San Francisco, where the increased incidence can be explained by a large number of homosexual men. Table 3 VACCINATION An effective vaccine should stimulate a suitable range of immune responses, mimic or improve on the protection gained from a wild type infection with little side effects. Critically the vaccine should be inexpensive, easily administered, transported and stored to further reduce cost and maximise convenience, this is especially relevant in the case of HPV vaccine as those that are not protected by the screening programmes of the developed world would benefit the most, ease of administration and storage is paramount in the developing world as stability and healthcare is more sporadic, and people are often more remote. There are many different kinds of vaccines available, and different vaccines have a variety qualities and limitations. Live attenuated vaccines contain a version of the pathogenic microbe that is avirulent, they often elicit an excellent cellular and antibody response with good longevity that can be lifelong with few doses. However there is always the possibility that the vaccine may revert to its virulent form, causing disease. For this reason a live attenuated vaccine is not appropriate for use against oncogenic HPV types. Recombinant vaccines can include one or more proteins that may illicit an immune response. A process has been developed to allow the removal of the genome from an attenuated or avirulent viral vector allowing the insertion of selected genetic material or proteins from another virus. The carrier viruses then ferry that viral DNA into host cells where the genes are expressed. Recombinant vaccines closely mimic a natural infection and therefore illicit a strong immune system. Inactivated vaccines are produced by killing the disease causing microbe by chemical (formaldehyde eg just double check), heat or radioactive means. These vaccines are more stable than live vaccines, and as there is no risk of reversion to virulence. They are also safer than live vaccines. Most inactivated vaccines stimulate a weaker immune response than live vaccines and several doses or boosters may be required to maintain immunity. DNA vaccines dispense with both the whole organism and its parts. They only include the essential part of the microbes genetic material. In particular, DNA vaccines use the genes that code for immunogens. Researchers have found that when the genes for a microbes antigens are introduced into the body, some cells will take up that DNA. The DNA then instructs those cells to make the antigen molecules. The cells secrete the antigens and display them on their surfaces. In other words, the bodys own cells become vaccine-making factories, creating the antigens necessary to stimulate the immune system. A DNA vaccine against a microbe would evoke a strong antibody response to the free antigen secreted by cells, and also stimulate a strong cellular response against the microbial antigens displayed on cell surfaces. The DNA vaccine is unable to cause disease Use of HPV Vaccines for Cervical Cancer Prevention Use of HPV Vaccines for Cervical Cancer Prevention HPV Vaccines: Will They Prevent Cervical cancer Introduction Human papilloma viruses (HPV) belong to the papillomaviridae family, they are double stranded DNA viruses. HPV is the most common sexually transmitted infection (STI) in the world (Urman et al. 2008). HPV is strongly associated with cervical cancer; more than 99% what are the other causes/factors please of cervical cancer cases are positive for HPV DNA and indeed, cervical cancer is the second most common malignancy in the world (Wang et al. 2007). In developed countries the incidence of cervical cancer has been reduced significantly by the introduction of a cervical screening programme. In developing countries where 83% of mortalities due to cervical cancer occur, there are no such programmes (Parkin et al. 2006). Can the introduction of a vaccine against HPV further reduce globally the incidence of cervical cancer? Many diseases caused by viruses are controlled in the developed world by ongoing successful vaccination programmes; Polio, Measles, Mumps and Rubella are a few examples. Smallpox caused by Variola virus was eradicated in 1979 through a successful worldwide vaccination programme. The factors that affect the Polio and MMR vaccine programmes success and those that affected the successful smallpox programme may also be contributory to the success of the HPV vaccination program. Vaccination of HPV is complex and multi factorial. This investigation studies a number of factors including: Vaccine efficacy Vaccine Cost/affordability/practicality of administration Production and Distribution Government backing and financial commitment Other support organisations such as the WHO, UNICEF, Gates Foundation, Social factors Media effects Public awareness Safety, and perceived fears Currently two prophylactic vaccines against HPV types 16 and 18, the most prevalent causes of HPV have been approved by the food and drug administration (FDA). Many developed countries have already introduced vaccination programmes using one of these vaccines. Can the vaccines and programme prevent cervical cancer? In order to effectively understand the implication of such a vaccination programme we must first fully examine the causative agent (HPV) and the consequential potential diseases including the biology, history and prevalence. Human Papillomavirus Approximately 200 types of HPV are identified of which around 40 infect the genital tract (McCance 2004). The majority of HPV types cause no symptoms, some types can cause warts and a minority may lead to cancer. Genital HPVs are transmitted via sexual contact, mainly intercourse, with an infected individual, and the risk of developing an HPV infection generally increases with the number of sexual partners, the sexual history of that partner or the introduction of a new sexual partner. Studies have shown that at least one type of HPV infection occurs soon after sexual debut, with around 30% of women infected with at least one high risk type within two years (Winer et al 2003; Winer et al 2008). HPVs are classified as either high risk or low risk, on the basis of association with cervical cancer. There are 15 types classified as high risk and three as probable high risk. High risk types include 16,18,31,33,35,39,,45,51,52,56,58,59,68,73,probable high risk types include 26,53,66 Low risk types include 6,11,40,42,43,54,61,70,72,81 and CP6108. More than 99% of cervical cancers are associated with HPV, of these 70% are associated with HPV type 16 and 18, with HPV 16 causing 50% and HPV 18 causing more than 15% in Europe (Smith et al..2007). HPV 16 is thus the single, most common high risk HPV. Interestingly HPV types 16 and 18 also cause 80% of anal cancer and 30% of vaginal and why the difference in % oper area research needed here.vulvar cancer and are associated with cancers of the, oropharynx and some rare cancers of the head and neck. (add reference form cervical cancer burden worldwide paper) The majority of HPV infections are asymptomatic, self limiting, and transient, with 70% of new HPV high risk type infections cleared within one year (with the median duration of an infection at 8 months) and 90% within two years (Ho et al 1998). The transient infection usually causes no clinical problems. A small proportion of high risk type infections persist due to host immune evasion, an evasion that results not only from restriction of HPVs to sites that are relatively inaccessible to host defences but also due to several mechanisms of preventing immune response what are these mechanisms please (a sk Dick if this is what he means . This persistence is the most important factor in the development of pre cancerous and cancerous lesions. The time span between infection by HPV and the development of pre cancerous lesions or cervical carcinoma varies from one to ten years (Moscicki et al 2006) and up to 20 years from other sources. HPV show little evidence of dramatic adaptability with phylogenic studies suggesting that the biology of HPVs has remained the same for over 200,000 years (Halpren et al 2000). While HPVs show historically the influence of point mutations, inserts, deletions and duplications, the predominant pattern of mutation within a given type is point mutation, with large scale rearrangements within the most conserved genes of HPVs such as L1 being rare (Myers et al 1996). Intra patient variation within HPV types is uncommon due to their low mutation rate. This low mutation rate is directly linked to the HPV replication strategy that requires host cell machinery, which has stringent proof reading mechanisms that avoid the incorporation of errors, conferring slow mutagenesis. All HPVs exhibit extreme specificity for infection of epithelial cells and do not infect or express their gene products in the underlying dermis. Although the mechanism of infection is not fully understood, the HPV epitheliotrophy resides for the most part in the interaction of specific transcription factors with the viral regulatory region known as the long control region (LCR). Infection with HPV can result in hyperproliferation of the host cell, and with certain high risk HPV types it may lead to transformation and immortalization. This is because high risk HPVs express two or more protein products (E6, E7 and E5) that transiently disrupt the cell cycle and stimulate cell division, knocking out at the same time the cellular mechanisms for growth inhibition. For a productive infection, HPVs require terminally differentiated cells. This HPV biology feature has impeded studies on the full reproduction life cycle because of the lack of highly efficient models of epithelial terminal di fferentiation in vitro. Most of the different stages in the HPV life cycle have been established using genetic engineering and molecular biology strategies. The dsDNA of HPV exists in a non enveloped icosahedral shaped virion 52-55 nm in diameter. The dsDNA genome is circularised and around 8000base pairs in length (Fig1). The genome encodes eight proteins, six early E1, E2, E4, E5, E6, E7, and two late structural proteins L1 and L2 and the previously mentioned noncoding LCR. Fig 1 HPV type 16 Genome structure, gene and functional domain location http://www.dnachip-link.com/Eng/library/HPV.aspusg 15/11/20009 Fig 1 shows the dsDNA genome of HPV type 16, and the location of the early and late genes along with the LCR that contains the origin of replication. An initial infection requires the access of infectious particles to the basal layer of the epithelium. Some HPVs require a break in the stratified epithelium to achieve this. Such breaks are not necessarily obvious and may occur under conditions where the skin is exposed to water or abraded, or subjected to an environment where micro traumas may occur such as possibly in aswiming pool or ect (must put an example)(in fig 2 shows as a cut). Following infection and uncoating it is thought that the virus maintains its genome as an episome in low copy numbers within basal cells of the epithelium. Although the pattern of gene expression in these cells is not well understood, it is generally thought that viral proteins E1 and E2 are expressed to maintain the viral DNA episome (Wilson et al.2002) and possibly to facilitate the segregation of genomes during cell division (You et all.2004). It is not known whether viral transformation proteins E6 and E7 are also expressed in the basal layer, but it does appear that initial infection is followed by a proliferative phase that results in the increase in the number of basal cells harbouring viral episomes. In normal uninfected epithelium, basal cells leave the cell cycle soon after migration into the superbasal cell layers where they undergo a process of terminal differentiation. During infection E6 and E7 are expressed in these cells stopping normal differentiation (Sherman et all.1997). E6 and E7 are believed to work together to achieve this and in lesions caused by high risk HPV types. During a natural infection the ability of E7 to stimulate S-phase progression is limited to a subset of differentiated cells with low levels of p21/p27, or which express high enough levels of E7 to overcome the block in S-phase entry. The viral E6 protein is thought to prevent apoptosis in response to unscheduled S-phase entry brought on by E7. The association of E6 with p53 and the inactivation of p53 mediated growth suppression and apoptosis is well documented, E6 may also associate with other pro-apoptotic proteins including bak (Thomas and Banks,1998) and bax (Li and Dou,2000). E6 is thus considered a predisposing factor in the development of HPV associated cancers, allowing the accumulation of chance errors in host DNA to go unchecked. Furthermore the E6 protein of high risk HPVs can stimulate cell proliferation independently of E7 via a c-terminal PDZ ligand binding domain. E6 PDZ is enough to mediate superbasal cell proliferation and may contribute to the formation of metastatic tumours by disrupting normal cell adhesion (Nguyen et al.2003) Amplification of the viral genome and the ability to package these genomes into infectious particles is essential for the production of infectious virions. For most HPV types this occurs in the mid or upper epithelial layers following an increase in activity of the late promoter. The late promoter gene is located within the E7 open reading frame, and the upregulation of the late promoter is thought to lead to increased expression of proteins involved in viral DNA replication, without directly affecting the expression of E6 or E7 necessary for S-phase entry. The amplification of the viral genome begins in a subset of cells in the proliferative compartment and requires the expression of all viral early gene products, these include E4 and E5 whose role in replication is not yet clearly understood. Binding of E2 to the HPV upstream regulator region is essential for viral DNA replication that is dependent on the differentiated state of epithelial cells. E2 recruits the E1 DNA helicase to the viral origin of replication. Throughout the virus life cycle, the relative levels of viral proteins are controlled by promoter usage and by differential splice site selection, with an increase in E1 and E2 allowing an increase in viral copy numbers in the upper epithelial layers. Current models suggest that a small increase in promoter activation during differentiation may lead to an increase in the level of E1 and E2 and a subsequent increase in genome copy number. The newly replicated genome could then serve as a further template for expression of E1 and E2, facilitating the amplification of viral genome and in turn further expression of E1 and E2 replication proteins. Viral DNA remains latent (not integrated) in basal cells of benign lesions. Replication occurs in the differentiating cells where capsid proteins and viral particles are found. Viral DNA is integrated in cancer cells, which contain no replicating virus. Once viral genome replication is completed, the expression of two virally encoded structural proteins, expressed in the upper layers of infected epithelia may occur. L1 the major capsid protein is expressed after L2 in a sub set of cells that express E4 (fig 2), this allows the assembly of infectious particles in the upper layers of the epithelium (Florin et al.,2002). A successful infection requires the virus to escape from the infected skin cell and survive extracellularly prior to re-infection. HPVs are non-lytic and are as such not released until the infected cells reach the epithelial surface. The intracellular retention of HPV antigen until the cell reaches the uppermost epithelial layers may contribute the compromised immune detection, especially as the virus has molecular mechanisms that limit the presentation of viral epitopes to the immune system in the lower epithelial layers (Ashrafi et al 2002). What are these mechanisms Figure 2 Papillomavirus type 16 Life Cycle and gene expression location within epithelium Taken from, The papillomavirus life cycle by John Doorbar published in the journal of clinical virology 32S (2005) S7-S15 Figure 2 diagrammatic representation of the skin with HPV type 16 gene expression incorporated, colour of arrows are representative of genes expressed within epithelial cells. The frequent detection of high risk HPV DNA in cervical lesions in the absence of any obvious disease, may be explained by the presence of the virus in a latent state, with only very few cells able to support the productive virus life cycle during epithelial cell differentiation. Following immune regression, HPV DNA is thought to remain in the basal epithelial cells waiting to be reactivated once levels of immune surveillance decline there are conflicting opinions (Zhang et al.1999). If regression is not achieved lesions may persist and in some instances progress to cancer. The number of lesion that progress to cancer is very low when compared to the prevalence of high risk HPV infection in the general public. The Progression of productive lesion to high grade lesions may result from the deregulation ( what happen to allow thes proteins to be deregulated intergrattion loss of E2 adn p53 association, be specific add biochemistry here please. in the expression of transforming proteins E6 and E7. The inability of a cell to support the whole virus life cycle is often associated with the development of cancerous lesions. The transformation zone (Fig 3) is particularly susceptible to cervical cancer; it appears that high risk types of HPV such as type 16 cannot complete their life cycle at this site Progression from CIN3 to cancer usually occurs in lesions that contain integrated copies of the viral genome in which E7 expression is elevated. Suggesting that retention of E6 and E7genes and the loss of E2 and E4 genes (that exert negative effect on cell growth) usually accompanies the development of invasive cancer. (reference) Remember for CIN refer to in that section or here but Cin must be corrulated with what causes the cancer and with whats happening with the virus that causes the change in CIN or the causes in CIN to occur. Cervical cancerisa considerable contributor to morbidity and mortality. Being the second most common cancer worldwide and the twelfth most common cancer in women in the UK. Cervical cancer in 2002 was the cause of 274,000 deaths worldwide (the most current data available)REF THIS FIGURE and continues to causes more than 1000 deaths in the UK each year. There are two main types of cervical cancer squamous cell cancer (the most common) and adenocarcinoma, although they are often mixed. They are named after the types of cell that become cancerous through neoplasia. Squamous cells are flat cells covering the cervix; adenomatous cells are found in the passageway from the cervix to the womb. Other rarer cancers of the cervix include small cell cancer. Deaths from cervical cancer in the UK have fallen over the last 20 years mainly because of the NHS cervical screening programme that reduced the mortality rates by 62% between 1987-2006. Screening may detect changes in the cells of the cervix at a pre-cancerous stage. Fig 3 TITTLE Showing location of transformation zone. Cell samples are examined for abnormalities, these abnormality are described in a standard format covering cytology and/or histology. What are these standard format CIN 1 CIN2 CIN3 LISL LGSIL HSIL HGSIL USE FIG 4 and explain whats happening with the proteins expressed and genome intergration where CIN number progression is concerned please. MUST DO From Lowy Schiller, J Clin Invest, 116:1167-73, 2006 Low grade squamous intraepithelial lesion (LSIL or LGSIL) indicates possiblecone biopsy, or laser ablation. High grade squamous intraepithelial lesion (HSIL or HGSIL) indicates moderate or severeCIN 2 or CIN3 (fig 3). While cervical screening has reduced the mortality significantly in the developed world cervical cancer is still a significant burden worldwide. Fig 4 Taken from, The popillomavirus life cycle by John Doorbar published in the journal of clinical virology 32S (2005) S7-S15 Fig. 5. CIN 1 resembles productive infections caused by other HPV types and as such is the most benign form of cervical intraepithelial neoplasia , it is confined to the basal 1/3 of the epithelium, CIN 2 Moderate dysplasia confined to the basal 2/3 of the epithelium,CIN3 Sever dysplasia that spans more than 2/3 of the epithelium, and may involve the full thickness. INCIDENCE An estimated 493,000 new cases and 274,000 deaths in 2002 were caused by cervical cancer. The vast majority, some 83% of these cases, occur in developing countries, where cervical cancer amounts to 15% of female cancers with a risk before age 65 of 1.5%. In developed countries cervical cancer accounts for only 3.6%, with a risk of 0.8% before age 65. REF The highest incidence rates are observed in Sub-Saharan Africa, Melanesia, Latin America and the Caribbean, South-Central Asia, and South East Asia (fig 6) Fig 6 Worldwide Burden of HPV related Cervical Cancer Figures from 2002. Parkin MD et al 2006 The burden of HPV-related cervical cancers The vast majority of cervical cancers are squamous cell carcinoma adenocarcinomas being less common (fig 6). Generally the proportion of adenocarcinoma cases is higher in areas with low incidence of cervical cancer, accounting for up to 25% of cases in western countries (fig 6). This higher incidence of adenocarcinoma may be partially explained by cytological screening, which historically, had little effect in reducing the risk of adenocarcinoma of the cervix, because these cancers, and their precursors, occur within the cervical canal, and were not readily sampled by scraping of the epithelium of the ectocervix. Fig 5 Fig 5 showing the higher % of adenocarcinoma in counties that have screening programmes such as the UK and Denmark What is this showing? Make it clear.do you really need it. MORTALITY RATES Mortality rates are substantially lower than incidence rates. Worldwide 55% (could you double chek that this is the case please misses) of all those that develop the disease die, the figures vary significantly from the developed to the developing world. Low risk regions of the west such as Europe have a death rate of 37% while in developing countries where many cases present at relatively advanced stages, death rates are significantly higher increasing to 70%. Cervical screening programmes in the developed world identify pre-cancerous lesions at a stage where they can be easily treated accounting for the difference in mortality rates. TITTLE IF and figure number staying and refer to in text As cervical cancer affects a relatively high number of young women, it is a significant cause of years of life lost (YLL) in the developing world. Yang et al 2004 found that cervical cancer was responsible for the 2.7 million (age weighted) years of lives lost world wide in 2000, and that it is the single biggest cause of years of life lost from cancer in the developing world. In Latin America, Eastern Europe and the Caribbean, cervical cancer makes a greater contribution to YLL than disease such as Tuberculosis or AIDS. HPV is also associated with many other forms of cancer that could possibly be prevented with use of HPV vaccines; cancers of the penis, anus, vulva, vagina, oropharynx and some rare cancers of the head and neck are included. However cancer of the cervix is by far the most significant, in terms of incidence and mortality (table 1). Cancer of the vulva and vagina have a significantly lower incidence rate compared to cervical cancer, however since 80% of the incidence are caused by HPV types 16 or 18 women vaccinated against these types would also be protected against these forms of cancer. Incidence of squamous cell carcinoma of the anus are twice as common in females as males with HPV types 16 and 18 accounting for 83% of all cases. There is a particularly high incidence of anal cancer among homosexual males, shown by the high incidence rate in populations such as Sanfransisco, where gay incidence are higher than average (fig 7). Globally cancer of the penis is relatively rare accounting for 0.5% of cancers in men (table 1). HPV DNA is detectable in 40-50% of all penile cancers and serological studies have confirmed the role of HPV 16 and 18 (IARC 2005). Cancers of the mouth and oropharynx caused by HPV are very low at 0.06% of all cancers with 0.05% being caused by HPV types 16/18. Due to the small size of most studies and the absence of comparable measurements of prevalence of infection in normal subjects conducted for cancers of the vulva, vagina, penis and anus true prevalence is difficult to quantify. The figures shown in table 1, imply that we are dealing with a virus that discriminates primarily through disease aginst women, in particular young women. Gay men, however are also clearly an at risk group. Currently only young women are vaccinated aginst HPV types 16 and 18, however the JCVI (joint committee on vaccination and immunisation) have noted that the vaccines has not been conclusively trialled on men, and that there is insufficient evidence that the vaccine available would protect against anal, penile or head and neck cancer. However when more data becomes available they will consider vaccinating, high risk groups such as men who have sex with men. Add what this implies for prophylactic use of vaccine with other cancers cause by HPV And what you think about the ue of vaccine on highrisk men and its effectivity against other cancers caused by HPV types 16 and 18. Fig 7 TITTLE add Figure 6 showing that cancer of the anus are more prevalent in women than men with the major noted exception being San Francisco, where the increased incidence can be explained by a large number of homosexual men. Table 3 VACCINATION An effective vaccine should stimulate a suitable range of immune responses, mimic or improve on the protection gained from a wild type infection with little side effects. Critically the vaccine should be inexpensive, easily administered, transported and stored to further reduce cost and maximise convenience, this is especially relevant in the case of HPV vaccine as those that are not protected by the screening programmes of the developed world would benefit the most, ease of administration and storage is paramount in the developing world as stability and healthcare is more sporadic, and people are often more remote. There are many different kinds of vaccines available, and different vaccines have a variety qualities and limitations. Live attenuated vaccines contain a version of the pathogenic microbe that is avirulent, they often elicit an excellent cellular and antibody response with good longevity that can be lifelong with few doses. However there is always the possibility that the vaccine may revert to its virulent form, causing disease. For this reason a live attenuated vaccine is not appropriate for use against oncogenic HPV types. Recombinant vaccines can include one or more proteins that may illicit an immune response. A process has been developed to allow the removal of the genome from an attenuated or avirulent viral vector allowing the insertion of selected genetic material or proteins from another virus. The carrier viruses then ferry that viral DNA into host cells where the genes are expressed. Recombinant vaccines closely mimic a natural infection and therefore illicit a strong immune system. Inactivated vaccines are produced by killing the disease causing microbe by chemical (formaldehyde eg just double check), heat or radioactive means. These vaccines are more stable than live vaccines, and as there is no risk of reversion to virulence. They are also safer than live vaccines. Most inactivated vaccines stimulate a weaker immune response than live vaccines and several doses or boosters may be required to maintain immunity. DNA vaccines dispense with both the whole organism and its parts. They only include the essential part of the microbes genetic material. In particular, DNA vaccines use the genes that code for immunogens. Researchers have found that when the genes for a microbes antigens are introduced into the body, some cells will take up that DNA. The DNA then instructs those cells to make the antigen molecules. The cells secrete the antigens and display them on their surfaces. In other words, the bodys own cells become vaccine-making factories, creating the antigens necessary to stimulate the immune system. A DNA vaccine against a microbe would evoke a strong antibody response to the free antigen secreted by cells, and also stimulate a strong cellular response against the microbial antigens displayed on cell surfaces. The DNA vaccine is unable to cause disease