The SPPiRE trial is a cluster randomized controlled trial that aims to assess the effectiveness of a web guided medication review in reducing potentially inappropriate prescribing and polypharmacy in older patients taking many medications in Irish primary care. General practices are randomized to either the intervention of a web guided medication review plus training or usual GP care. The primary outcomes are the number of repeat medications and proportion of patients with at least one potentially inappropriate prescription. Secondary outcomes include quality of life, treatment burden, attitudes to deprescribing and healthcare utilization.
breast cancer
cancer
epidemiology
community medicine
awareness of breast cancer
سرطان الثدي
وبائيات سرطان الثدي
epidemiology of breast cancer
prevention of breast cancer
risk factors of breast cancer
epidemiology of breast cancer in iraq
sign and symptoms of breast cancer
location of breast cancer
Myths And Facts About Breast Cancer.
Breast cancer is the most common cancer in the world, with around 2.26 million new cases diagnosed each year. With around 0.7 million fatalities per year worldwide, it is one of the major causes of death among female cancer patients. It is quite common in those aged 25 to 70, with peak prevalence in women aged 50 to 69.
Breast cancer occurs when a pre-cancerous tumour progresses to a malignant tumour in a multi-stage process that is triggered by abnormal and uncontrolled growth of normal cells. These abnormalities are brought on by physical carcinogens (ultraviolet and ionising radiation), chemical carcinogens (alcohol, aflatoxin, tobacco smoke), and biological carcinogens (viral infections, bacteria, or parasites). Breast cancer risk is also increased by genetic factors. 5 to 10% of breast cancer instances are caused by genetic abnormalities passed down through a family’s generations.
science has an evolving nature. what happened today may not be tomorrow, what is not today may happen tomorrow.
No one is complete so reading and thinking may open the door to the hidden ground.
breast cancer
cancer
epidemiology
community medicine
awareness of breast cancer
سرطان الثدي
وبائيات سرطان الثدي
epidemiology of breast cancer
prevention of breast cancer
risk factors of breast cancer
epidemiology of breast cancer in iraq
sign and symptoms of breast cancer
location of breast cancer
Myths And Facts About Breast Cancer.
Breast cancer is the most common cancer in the world, with around 2.26 million new cases diagnosed each year. With around 0.7 million fatalities per year worldwide, it is one of the major causes of death among female cancer patients. It is quite common in those aged 25 to 70, with peak prevalence in women aged 50 to 69.
Breast cancer occurs when a pre-cancerous tumour progresses to a malignant tumour in a multi-stage process that is triggered by abnormal and uncontrolled growth of normal cells. These abnormalities are brought on by physical carcinogens (ultraviolet and ionising radiation), chemical carcinogens (alcohol, aflatoxin, tobacco smoke), and biological carcinogens (viral infections, bacteria, or parasites). Breast cancer risk is also increased by genetic factors. 5 to 10% of breast cancer instances are caused by genetic abnormalities passed down through a family’s generations.
science has an evolving nature. what happened today may not be tomorrow, what is not today may happen tomorrow.
No one is complete so reading and thinking may open the door to the hidden ground.
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference!
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters.
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation a...semualkaira
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundationsemualkaira
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters..
Business and Government Relations Please respond to the following.docxCruzIbarra161
"Business and Government Relations" Please respond to the following:
Discuss the main reasons why a business should or should not be involved in political discussions or take a political stand. Use terms found in Chapter 9 to demonstrate your understanding of the material. You can submit your initial discussion post and responses in either written or video format (2-3 minutes or less).
.
Business Continuity Planning Explain how components of the busine.docxCruzIbarra161
Business Continuity Planning: Explain how components of the business infrastructure are included in a business continuity plan. Discuss the processes of planning, analysis, design, implementation, testing and maintenance in developing this plan. This assignment must be at least 2 full pages. Apply the 4-C's of writing:
Correct, complete, clear, and concise.
.
More Related Content
Similar to Criteria I – Introduction (4 points)1. Describe the common com
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference!
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters.
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation a...semualkaira
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters...
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundationsemualkaira
As an Obstetrics & Gynaecology, member of National Breast Cancer Foundation and a woman I find it very important to raise awareness about the importance of early detection of Breast Cancer. Make a difference! Spread the word about mammograms and encourage communities, organisations, your friends and family memebrs to get involved! Your help matters..
Business and Government Relations Please respond to the following.docxCruzIbarra161
"Business and Government Relations" Please respond to the following:
Discuss the main reasons why a business should or should not be involved in political discussions or take a political stand. Use terms found in Chapter 9 to demonstrate your understanding of the material. You can submit your initial discussion post and responses in either written or video format (2-3 minutes or less).
.
Business Continuity Planning Explain how components of the busine.docxCruzIbarra161
Business Continuity Planning: Explain how components of the business infrastructure are included in a business continuity plan. Discuss the processes of planning, analysis, design, implementation, testing and maintenance in developing this plan. This assignment must be at least 2 full pages. Apply the 4-C's of writing:
Correct, complete, clear, and concise.
.
business and its environment Discuss the genesis, contributing fac.docxCruzIbarra161
business and its environment
Discuss the genesis, contributing factors, modus operandi, effectiveness in generating social pressure, the strategy followed by target companies along with allied aspects with two examples from Canadian mining, manufacturing, telecommunication or utility companies.
minimum of 2000 words and 10 good quality references.
The paper should be properly cited as per
APA format.
.
business and its environment Discuss the genesis, contributing facto.docxCruzIbarra161
business and its environment Discuss the genesis, contributing factors, modus operandi, effectiveness in generating social pressure, the strategy followed by target companies along with allied aspects with two examples from Canadian mining, manufacturing, telecommunication or utility companies. minimum of 2000 words and 10 good quality references. The paper should be properly cited as per APA format.
.
Business BUS 210 research outline1.Cover page 2.Table .docxCruzIbarra161
Business BUS 210 research outline
1.
Cover page
2.
Table of content
3.
Executive summary
4.
Introduction
5.
Business Hypothesis / or Statement/ or the Main Question for the whole research
6.
Literature review
7.
Designing the questionnaires
8.
Pretest/ pilot test
9.
Adjust the questioners
– if required
10.
Collect the data from the official sample
11.
Data Entry
12.
Analysis
13.
Tabulations: Frequencies
“and Cross-tabulation if required”
14.
Report
o
Include the purpose for the business research
o
Time
o
Sample size
o
Location
o
Target
o
Way to collect the data (by email, personal, interview, phone…)
o
Challenges you faced
o
Findings /results
15.
Conclusion
16.
Recommendation
17.
References
18.
Appendixes
o
Questionnaire
o
All tabulations
.
BUS 439 International Human Resource ManagementInstructor Steven .docxCruzIbarra161
BUS 439 International Human Resource Management
Instructor: Steven Foster
Why did Nestle’s decentralized structure, which had brought the company success in the past, no longer fit the new realities of increasing global competition? What were the objectives of the GLOBE initiative? How was it more than just an SAP change?
.
BUS 439 International Human Resource ManagementEmployee Value Pr.docxCruzIbarra161
BUS 439 International Human Resource Management
Employee Value Proposition
Define and discuss EVP – what factors may make it difficult to determine EVP on a global basis? What considerations should be made to clearly understand and make use of this information? Why is EVP important for organizations to understand? What can organizations do to build a differentiated EVP?
.
Bullzeye is a discount retailer offering a wide range of products,.docxCruzIbarra161
Bullzeye is a discount retailer offering a wide range of products, including: home goods, clothing, toys, and food. The company is a regional retailer with 10 brick-and-mortar stores as well as a popular online store. Due to the recent credit card data breaches of various prominent national retail companies (e.g., Target, Home Depot, Staples), the Bullzeye Board of Directors has taken particular interest in information security, especially as it pertains to the protection of credit cardholder data within the Bullzeye environment. The Board has asked executive management to evaluate and strengthen the enterprise’s information security infrastructure, where needed.
In order to respond to the Board regarding their preparedness for a cyber-security attack, the Chief Financial Officer (CFO) has engaged your IT consulting firm to identify the inherent risks and recommend control remediation strategies to prevent or to detect and appropriately respond to data breaches. Your firm has been requested to liaison with the Internal Audit Department during the engagement. Your first step is to gain an understanding of Bullzeye’s IT environment. The Chief Audit Executive (CAE) schedules a meeting with key Bullzeye leadership personnel, including the CFO, Chief Information Officer (CIO), and Chief Information Security Officer (CISO).
The following key information was obtained.
Background
IT Security Framework/Policy -
Bullzeye has an information security policy, which was developed by the CISO. The policy was developed in response to an internal audit conducted by an external firm hired by the CAE. The policy is not based on one specific IT control framework but considers elements contained within several frameworks. An information security committee has been recently formed to discuss new security risks and to develop mitigation strategies.
The meeting will be held monthly and include the CISO and other key IT Directors reporting to the CIO.
In addition, a training program was implemented last year in order to provide education on various information security topics (e.g., social engineering, malware, etc.). The program requires that all staff within the IT department complete an annual information security training webinar and corresponding quiz. The training program is complemented by a monthly e-mail sent to IT staff, which highlights relevant information security topics.
General IT Environment -
Most employees in the corporate office are assigned a standard desktop computer, although certain management personnel in the corporate and retail locations are issued a laptop if they can demonstrate their need to work remotely. The laptops are given a standard Microsoft Windows operating system image, which includes anti-malware/anti-virus software and patch update software among others. In addition, new laptops are now encrypted; however, desktops and existing laptops are not currently encrypted due to budget concerns. The user provisioning.
Building on the work that you prepared for Milestones One through Th.docxCruzIbarra161
Building on the work that you prepared for Milestones One through Three, submit a document that builds upon the previously completed milestone summaries to provide an overall summary of the distribution company’s IT system as a whole. This should illustrate how each individual system component (network, database, web technology, computers, programming, and security systems) interrelates with the others and summarize the importance of IT technologies for the overall system.
.
Budget Legislation Once the budget has been prepared by the vari.docxCruzIbarra161
Budget Legislation
Once the budget has been prepared by the various agencies, it is often moved forward to the legislative body for authorization. The legislation process can result in unintended outcomes and restrictions. Search the internet and news reporting services for a story on an unintended outcome of interest to you and answer the following questions:
How did politics shape the outcome in unexpected ways?
Did “pork” spending or “apportionments and allotments” budget amendments affect the legislation?
Did a mid-year crisis or change in revenue expectations substantially impact the budget legislative action?
Respond to at least two of your classmates’ postings.
Performance Budgeting
Performance budgeting has been attempted at the local level in recent years. Address the issues of performance budgeting while answering the following questions: What attributes of performance budgeting make it particularly suitable to local government budgeting? Will the same attributes be as useful at the federal level? Respond to at least two of your classmates’ postings.
.
Browsing the podcasts on iTunes or YouTube, listen to a few of Gramm.docxCruzIbarra161
Browsing the podcasts on iTunes or YouTube, listen to a few of Grammar Girl's Quick and Dirty Tips series (grammar tips by Mignon Fogarty) or Money Girl's series (financial advice by Laura Adams).
Your Task: Pick a Money Girl or Grammar Girl podcast that interests you. Listen to it, or obtain a transcript on the website and study it for its structure. Is it direct or indirect? Informative or persuasive? How is it presented? What style does the speaker adopt? Was it effective? What changes would you suggest? Write an e-mail that discusses the podcast you analyzed.
.
Brown Primary Care Dental clinics Oral Health Initiative p.docxCruzIbarra161
Brown Primary Care Dental clinics Oral Health Initiative project
The project will consist of three elements:
•
Part 1: Economic Analysis of the Initiative of Choice [
Brown Primary Care Dental clinics Oral Health Initiative
5 pages) .
The economic analysis should include:
Principles of economics for evaluating and assessing the need for the public health initiative
A brief description of whether the initiative is a micro or macroeconomic program
A determination of whether the result of the initiative is a public or private good
A description of the initiative’s financing source
An explanation of how the initiative may affect supply and demand of public health services
•
Part 2: Financial Accounting Analysis (5 pages)
A 5-year proposed budget including major line items (see blank form for proposed budget on NIH grants pagelocated in the course syllabus or here:
Online Article:
U.S. Department of Health and Human Services (2009, June).
Public health service: PHS 398
. Detailed Budget for Initial Budget Period Form Page 4
http://grants.nih.gov/grants/funding/phs398/phs398.html
Grant Application PHS 398. U.S. Department of Health And Human Services Public Health Service.
-An analysis of budget line items, costs, sources of revenue, and deficits
-An analysis of the fiscal soundness and long-term viability of the public -health initiative
•
Part 3: Alternative Funding Sources (5pages)
Part 3: Alternative Funding Sources[ 5 pages
For this part of your Scholar-Practitioner Project you will evaluate funding sources for the public health initiative you selected in Week 2. Then, you will submit a mock grant proposal for an appropriate grant to supplement or allow expansion of your selected public health initiative.
The proposal should include:
•
The public health initiative’s purpose, background, goals, and objectives
•
A description of the funding sources you selected and explanation of why you selected it over others
•
Eligibility and selection criteria for the funding source
•
An explanation of the funds needed and how the funds may be used
•
The adjusted total 5-year budget you completed in week 9 (include all instructor recommendations)
(8 sources/references)
.
BUDDHISMWEEK 3Cosmogony - Origin of the UniverseNature of .docxCruzIbarra161
BUDDHISM
WEEK 3
Cosmogony - Origin of the Universe
Nature of God/Creator
View of Human Nature
View of Good & Evil
View of Salvation
View of After Life
Practices and Rituals
Celebrations & Festivals
Week 3 - Sources
.
Build a binary search tree that holds first names.Create a menu .docxCruzIbarra161
Build a binary search tree that holds first names.
Create a menu with the following options.
Add a name to the list (will add a new node)
Delete a name from the list (will delete a node)
NEXT PAGE
à
Search for a name (will return if the name is in the tree or not)
Output the number of leaves in your tree
Output the tree (Complete an inorder traversal.)
.
Briefly describe the development of the string quartet. How would yo.docxCruzIbarra161
Briefly describe the development of the string quartet. How would you relate this chamber ensemble to modern performing groups such as the jazz quartet? Or to a rock ensemble? What are some of the similarities and differences? Refer to the listening examples in the Special Focus to support your conclusions.
Listening examples:
String Quartet in E-Flat, No. 2
("Joke") by Haydn
String Quartet in C Minor
by Beethoven
String Quartet No. 2, Op. 17
by Bartók
.
Briefly describe a time when you were misled by everyday observation.docxCruzIbarra161
Briefly describe a time when you were misled by everyday observations (that is when you reached a conclusion on the basis of an everyday observation that you later decided was an incorrect conclusion). What type of error in casual inquiry (sources of secondhand knowledge) were you guilty of? Examples include over-generalization, stereotyping, illogical reasoning, etc
.
Broadening Your Perspective 8-1The financial statements of Toots.docxCruzIbarra161
Broadening Your Perspective 8-1
The financial statements of Tootsie Roll are presented below.
TOOTSIE ROLL INDUSTRIES, INC. AND SUBSIDIARIES
CONSOLIDATED STATEMENTS OF
Earnings, Comprehensive Earnings and Retained Earnings (in thousands except per share data)
For the year ended December 31,
2011
2010
2009
Net product sales
$528,369
$517,149
$495,592
Rental and royalty revenue
4,136
4,299
3,739
Total revenue
532,505
521,448
499,331
Product cost of goods sold
365,225
349,334
319,775
Rental and royalty cost
1,038
1,088
852
Total costs
366,263
350,422
320,627
Product gross margin
163,144
167,815
175,817
Rental and royalty gross margin
3,098
3,211
2,887
Total gross margin
166,242
171,026
178,704
Selling, marketing and administrative expenses
108,276
106,316
103,755
Impairment charges
—
—
14,000
Earnings from operations
57,966
64,710
60,949
Other income (expense), net
2,946
8,358
2,100
Earnings before income taxes
60,912
73,068
63,049
Provision for income taxes
16,974
20,005
9,892
Net earnings
$43,938
$53,063
$53,157
Net earnings
$43,938
$53,063
$53,157
Other comprehensive earnings (loss)
(8,740
)
1,183
2,845
Comprehensive earnings
$35,198
$54,246
$56,002
Retained earnings at beginning of year.
$135,866
$147,687
$144,949
Net earnings
43,938
53,063
53,157
Cash dividends
(18,360
)
(18,078
)
(17,790
)
Stock dividends
(47,175
)
(46,806
)
(32,629
)
Retained earnings at end of year
$114,269
$135,866
$147,687
Earnings per share
$0.76
$0.90
$0.89
Average Common and Class B Common shares outstanding
57,892
58,685
59,425
(The accompanying notes are an integral part of these statements.)
CONSOLIDATED STATEMENTS OF
Financial Position
TOOTSIE ROLL INDUSTRIES, INC. AND SUBSIDIARIES (in thousands except per share data)
Assets
December 31,
2011
2010
CURRENT ASSETS:
Cash and cash equivalents
$78,612
$115,976
Investments
10,895
7,996
Accounts receivable trade, less allowances of $1,731 and $1,531
41,895
37,394
Other receivables
3,391
9,961
Inventories:
Finished goods and work-in-process
42,676
35,416
Raw materials and supplies
29,084
21,236
Prepaid expenses
5,070
6,499
Deferred income taxes
578
689
Total current assets
212,201
235,167
PROPERTY, PLANT AND EQUIPMENT, at cost:
Land
21,939
21,696
Buildings
107,567
102,934
Machinery and equipment
322,993
307,178
Construction in progress
2,598
9,243
455,097
440,974
Less—Accumulated depreciation
242,935
225,482
Net property, plant and equipment
212,162
215,492
OTHER ASSETS:
Goodwill
73,237
73,237
Trademarks
175,024
175,024
Investments
96,161
64,461
Split dollar officer life insurance
74,209
.
Briefly discuss the differences in the old Minimum Foundation Prog.docxCruzIbarra161
Briefly discuss the differences in the old Minimum Foundation Program ( 1947 ) and the FEFP ( 1973 ).
What part of the basic FEFP formula ( State Aid = WFTE x BSA - (.96 AV } provides A. equity for students and B. equalization of funding for districts?
Review how student transportation dollars are calculated. What are the two major components?
What is the function of Workforce Development funds?
What are Categorical Program funds? How do they differ from general FEFP funding?
What are the four constructs on which the FEFP is based? ( Page 1--2
nd
paragraph )
Briefly define the following:
Full time equivalent
Program cost factor
Weighted FTE
Base student allocation
District cost differential
Sparsity supplement
Supplemental academic instruction
0.748 Mills Discretionary Compresion (audio is incorrect-changed from Local Discretionary Equalization).
ESE guaranteed allocation
Required local effort
Please answer all in as a mini- brief and follow directions as I tried to be as spicific as possible with the questions.
.
Briefly compare and contrast EHRs, EMRs, and PHRs. Include the typic.docxCruzIbarra161
Briefly compare and contrast EHRs, EMRs, and PHRs. Include the typical content and functionality of each.
Focusing on one of these types of records, describe the key benefits for one of the stakeholders (e.g., patients, providers, or health care management) of being able to record and/or access patient data through this system.
Should all patient health information be recorded electronically? If so, explain why. If not, explain what the exceptions should be and why.
.
Brief Exercise 9-11Suppose Nike, Inc. reported the followin.docxCruzIbarra161
*Brief Exercise 9-11
Suppose
Nike, Inc.
reported the following plant assets and intangible assets for the year ended May 31, 2014 (in millions): other plant assets $954.9; land $226.7; patents and trademarks (at cost) $530.7; machinery and equipment $2,137.2; buildings $967; goodwill (at cost) $207.5; accumulated amortization $59.3; and accumulated depreciation $2,290.
Prepare a partial balance sheet for Nike for these items.
(List Property, Plant and Equipment in order of Land, Buildings and Equipment.)
NIKE, INC.
Partial Balance Sheet
As of May 31, 2014
(in millions)
[removed]
[removed]
$
[removed]
[removed]
$
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
:
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
$
[removed]
[removed]
:
[removed]
[removed]
[removed]
[removed]
*Exercise 9-7
Wang Co. has delivery equipment that cost $50,840 and has been depreciated $24,960.
Record entries for the disposal under the following assumptions.
(Credit account titles are automatically indented when amount is entered. Do not indent manually.)
(a)
It was scrapped as having no value.
(b)
It was sold for $37,200.
(c)
It was sold for $19,360.
No.
Account Titles and Explanation
Debit
Credit
(a)
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
(b)
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
(c)
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
*Exercise 9-8
Here are selected 2014 transactions of Cleland Corporation.
Jan. 1
Retired a piece of machinery that was purchased on January 1, 2004. The machine cost $62,160 and had a useful life of 10 years with no salvage value.
June 30
Sold a computer that was purchased on January 1, 2012. The computer cost $37,000 and had a useful life of 4 years with no salvage value. The computer was sold for $5,630 cash.
Dec. 31
Sold a delivery truck for $9,310 cash. The truck cost $23,600 when it was purchased on January 1, 2011, and was depreciated based on a 5-year useful life with a $3,290 salvage value.
Journalize all entries required on the above dates, including entries to update depreciation on assets disposed of, where applicable. Cleland Corporation uses straight-line depreciation.
(Record entries in the order displayed in the problem statement. Credit account titles are automatically indented when amount is entered. Do not indent manually.)
Date
Account Titles and Explanation
Debit
Credit
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
(To record depreciation expense for the first 6 months of 2014)
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[removed]
[remo.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
We all have good and bad thoughts from time to time and situation to situation. We are bombarded daily with spiraling thoughts(both negative and positive) creating all-consuming feel , making us difficult to manage with associated suffering. Good thoughts are like our Mob Signal (Positive thought) amidst noise(negative thought) in the atmosphere. Negative thoughts like noise outweigh positive thoughts. These thoughts often create unwanted confusion, trouble, stress and frustration in our mind as well as chaos in our physical world. Negative thoughts are also known as “distorted thinking”.
Instructions for Submissions thorugh G- Classroom.pptxJheel Barad
This presentation provides a briefing on how to upload submissions and documents in Google Classroom. It was prepared as part of an orientation for new Sainik School in-service teacher trainees. As a training officer, my goal is to ensure that you are comfortable and proficient with this essential tool for managing assignments and fostering student engagement.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
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Criteria I – Introduction (4 points)1. Describe the common com
1. Criteria I – Introduction (4 points)
1. Describe the common complaint/problem selected- breast
cancer
2. Discuss the pathophysiology of the common
complaint/problem.
3. Detail the necessary review of systems and what would be
seen on physical examination for this complaint/problem.
4. Provide rationale from the literature to support your work.
In the United State, breast cancer is the leading cause of
cancer death among female. Breast cancer ranks second (after
lung cancer) as a cause of cancer death in women. In 2016,
around 245, 229 new cases of female breast cases reported, and
41,487 women died of this disease (CDC, 2019). In 2018,
approximately 63,960 cases of in situ disease and 266,120 cases
of invasive disease were diagnosed.1 About 40,920 breast
cancer-related deaths occurred in 2018, which represents 6.7%
of all cancer-related deaths.2 Female breast cancer is most
common in middle-aged and older women; median age at
diagnosis is 62 years.2 In 2016, more than 3.5 mil- lion women
were breast cancer survivors.3 The lifetime risk of developing
breast cancer in the United States is 12.4% (1 in 8 women ).
(ACS, 2019)
Breast cancer mortality was 41% higher among black women
(29.2 deaths per 100,000 population) than white women (20.6
deaths per 100,000 population). Breast cancer death rates
decreased during 2010–2014 among both blacks and whites,
although differences in trends by race and age were found.
Overall, breast cancer death rates decreased faster among white
women (-1.9% per year) compared with black women (-1.5% per
2. year). Among women aged <50 years, breast cancer death rates
decreased at the same pace among black and white women,
whereas white women aged ≥50 years had significantly larger
decreases. The largest difference by race was observed among
women aged 60–69 years: breast cancer death rates decreased
2.0% per year among white women compared with 1.0% among
black women. Death rates from breast cancer have been
declining since about 1990, in part due to better screening and
early detection, increased awareness, and continually
improving treatment options, decline in prescriptive hormone
replacement therapy after menopause. (ACS, 2019).
Breast cancer is a disease in which cells in the breast grow out
of control. The majority of breast cancers (95%) are sporadic;
only a small proportion, particularly those diagnosed in young
women, are due to a highly penetrant autosomal-dominant trait.
Over the past 5 years there has been consider- able progress in
the identification and localization of the genes responsible for
hereditary breast cancer. Two in particular have grabbed the
headlines; these are BRCA1 and BRCA2. Subtypes of breast
cancer include those driven by specific hormones, such as
estrogen, progestogen or the protein HER2. Sixty percent of
breast cancers are estrogen positive. Twenty percent of breast
cancers are HER2-positive. Another 20 percent are triple-
negative breast cancers, a type of breast cancer that tests
negative for estrogen, progesterone and HER2. Triple-negative
breast cancer is among the more aggressive forms of the
disease.There are different kinds of breast cancer. The kind of
breast cancer depends on which cells in the breast turn into
cancer.Breast cancer can begin in different parts of the breast.
A breast is made up of three main parts: lobules, ducts, and
connective tissue. The lobules are the glands that produce milk.
The ducts are tubes that carry milk to the nipple. The
connective tissue (which consists of fibrous and fatty tissue)
surrounds and holds everything together. Most breast cancers
begin in the ducts or lobules.
Breast cancer can spread outside the breast through blood
3. vessels and lymph vessels. When breast cancer spreads to other
parts of the body, it is said to have metastasized. Most breast
cancer are adenocarcinomas.
The most common kinds of breast cancer are
· Invasive ductal carcinoma. The cancer cells grow outside the
ducts into other parts of the breast tissue. Invasive cancer cells
can also spread, or metastasize, to other parts of the body.
· Invasive lobular carcinoma. Cancer cells spread from the
lobules to the breast tissues that are close by. These invasive
cancer cells can also spread to other parts of the body.
There are several other less common kinds of breast cancer,
such as Paget’s disease , r medullary, mucinous, and
inflammatory breast cancer.
Early inflammatory breast cancer may include persistent itching
and the appearance of a rash or small irritation similar to an
insect bite. The breast typically becomes red, swollen, and
warm. The skin may appear pitted like an orange peel, and
nipple changes such as inversion, flattening, or dimpling may
occur.
Ductal carcinoma in situ (DCIS) is a breast disease that may
lead to breast cancer. The cancer cells are only in the lining of
the ducts and have not spread to other tissues in the breast.
The main factors that influence your breast cancer risk are
being a woman and getting older. Other risk factors include—
· Changes in breast cancer-related genes (BRCA1 or BRCA2).
· Having your first menstrual period before age 12.
· Never giving birth or being older when your first child is
born.
· Starting menopause after age 55.
· Taking hormones to replace missing estrogen and progesterone
in menopause for more than five years.
· Taking oral contraceptives (birth control pills).
· A personal history of breast cancer, dense breasts, or some
other
breast problems.
· A family history of breast cancer (parent, sibling, or child).
4. · Getting radiation therapy to the breast or chest.
· Being overweight, especially after menopause.
While BRCA1 and BRCA2 gene mutations may increase your
odds of developing breast cancer, your odds of having either
mutation are pretty small. An estimated 0.25% of the general
population carries a mutated BRCA gene, or about one out of
every 400 people.
If one of your parents has a BRCA mutation, you have a 50%
chance of inheriting the mutated gene.
Odds can also vary depending on a person’s ethnicity. For
example, people of Ashkenazi Jewish descent have a 2.5%
chance of inheriting a BRCA mutation, or about 10 times the
rate of the general population. It’s estimated that 55 – 65% of
women with the BRCA1 mutation will develop breast cancer
before age 70. Approximately 45% of women with a BRCA2
mutation will develop breast cancer by age 70.
Some things may increase your risk
The main factors that influence your breast cancer risk are
being a woman and getting older. Other risk factors include—
· Changes in breast cancer-related genes (BRCA1 or BRCA2).
· Having your first menstrual period before age 12.
· Never giving birth, or being older when your first child is
born.
· Starting menopause after age 55.
· Taking hormones to replace missing estrogen and progesterone
in menopause for more than five years.
· Taking oral contraceptives (birth control pills).
· A personal history of breast cancer, dense breasts, or some
other
breast problems.
· A family history of breast cancer (parent, sibling, or child).
· Getting radiation therapy to the breast or chest.
· Being overweight, especially after menopause.
Pathology
5. Most breast cancers are epithelial tumors that develop from
cells lining ducts or lobules; less common are nonepithelial
cancers of the supporting stroma (eg, angiosarcoma, primary
stromal sarcomas, phyllodes tumor).
Cancers are divided into carcinoma in situ and invasive cancer.
Carcinoma in situ is proliferation of cancer cells within ducts or
lobules and without invasion of stromal tissue. There are 2
types:
· Ductal carcinoma in situ (DCIS): About 85% of carcinoma in
situ are this type. DCIS is usually detected only by
mammography. It may involve a small or wide area of the
breast; if a wide area is involved, microscopic invasive foci may
develop over time.
· Lobular carcinoma in situ (LCIS): LCIS is often multifocal
and bilateral. There are 2 types: classic and pleomorphic.
Classic LCIS is not malignant but increases risk of developing
invasive carcinoma in either breast. This nonpalpable lesion is
usually detected via biopsy; it is rarely visualized with
mammography. Pleomorphic LCIS behaves more like DCIS; it
should be excised to negative margins.
Invasive carcinoma is primarily adenocarcinoma. About 80% is
the infiltrating ductal type; most of the remaining cases are
infiltrating lobular. Rare types include medullary, mucinous,
metaplastic, and tubular carcinomas. Mucinous carcinoma tends
to develop in older women and to be slow growing. Women with
these rare types of breast cancer have a much better prognosis
than women with other types of invasive breast cancer.
Inflammatory breast cancer is a fast-growing, often fatal cancer.
Cancer cells block the lymphatic vessels in breast skin; as a
result, the breast appears inflamed, and the skin appears
thickened, resembling orange peel (peau d’orange). Usually,
inflammatory breast cancer spreads to the lymph nodes in the
armpit. The lymph nodes feel like hard lumps. However, often
no mass is felt in the breast itself because this cancer is
dispersed throughout the breast.
6. Paget disease of the nipple (not to be confused with the
metabolic bone disease also called Paget disease) is a form of
ductal carcinoma in situ that extends into the skin over the
nipple and areola, manifesting with a skin lesion (eg, an
eczematous or a psoriaform lesion). Characteristic malignant
cells called Paget cells are present in the epidermis. Women
with Paget disease of the nipple often have underlying invasive
or in situ cancer.
Pathophysiology
Breast cancer invades locally and spreads through the regional
lymph nodes, bloodstream, or both. Metastatic breast cancer
may affect almost any organ in the body—most commonly,
lungs, liver, bone, brain, and skin.
Most skin metastases occur near the site of breast surgery; scalp
metastases are also common. Metastatic breast cancer frequently
appears years or decades after initial diagnosis and
treatment.Hormone receptors
Estrogen and progesterone receptors, present in some breast
cancers, are nuclear hormone receptors that promote DNA
replication and cell division when the appropriate hormones
bind to them. Thus, drugs that block these receptors may be
useful in treating tumors with the receptors. About two thirds of
postmenopausal patients with cancer have an estrogen-receptor
positive (ER+) tumor. Incidence of ER+ tumors is lower among
premenopausal patients.
Another cellular receptor is human epidermal growth factor
receptor 2 (HER2; also called HER2/neu or ErbB2); its presence
correlates with a poorer prognosis at any given stage of cancer.
In about 20% of patients with breast cancer, HER2 receptors are
overexpressed. Drugs that block these receptors are part of
standard treatment for these patients.
Some warning signs of breast cancer are—
· New lump in the breast or underarm (armpit).
· Thickening or swelling of part of the breast.
7. · Irritation or dimpling of breast skin.
· Redness or flaky skin in the nipple area or the breast.
· Pulling in of the nipple or pain in the nipple area.
· Nipple discharge other than breast milk, including blood.
· Any change in the size or the shape of the breast.
· Pain in the breast.
Symptoms of breast tumors vary from person to person. Very
often breast tumor discovered by patient as breast mass or
during routine physical examination or mammography. Some
common, early warning signs of breast cancer include:
· Skin changes, such as swelling, redness, or other visible
differences in one or both breasts
· An increase in size or change in shape of the breast(s)
· Changes in the appearance of one or both nipples
· Nipple discharge other than breast milk
· General pain in/on any part of the breast
· Lumps or nodes felt on or inside of the breast
Symptoms more specific to invasive breast cancer are:
· Irritated or itchy breasts
· Change in breast color
· Increase in breast size or shape (over a short period of time)
· Changes in touch (may feel hard, tender or warm)
· Peeling or flaking of the nipple skin
· A breast lump or thickening
· Redness or pitting of the breast skin (like the skin of an
orange)
Symptoms and Signs
Many breast cancers are discovered as a mass by the patient or
during routine physical examination or mammography. Less
commonly, the presenting symptom is breast pain or
enlargement or a nondescript thickening in the breast.
Paget disease of the nipple manifests as skin changes, including
erythema, crusting, scaling, and discharge; these changes
usually appear so benign that the patient ignores them, delaying
diagnosis for a year or more. About 50% of patients with Paget
disease of the nipple have a palpable mass at presentation.
8. A few patients with breast cancer present with signs of
metastatic disease (eg, pathologic fracture, pulmonary
dysfunction).
A common finding during physical examination is asymmetry or
a dominant mass—a mass distinctly different from the
surrounding breast tissue. Diffuse fibrotic changes in a quadrant
of the breast, usually the upper outer quadrant, are more
characteristic of benign disorders; a slightly firmer thickening
in one breast but not the other may be a sign of cancer.
More advanced breast cancers are characterized by one or more
of the following:
· Fixation of the mass to the chest wall or to overlying skin
· Satellite nodules or ulcers in the skin
· Exaggeration of the usual skin markings resulting from skin
edema caused by invasion of dermal lympha tic vessels (so-
called peau d’orange)
Matted or fixed axillary lymph nodes suggest tumor spread, as
does supraclavicular or infraclavicular lymphadenopathy.
Inflammatory breast cancer is characterized by peau d'orange,
erythema, and enlargement of the breast, often without a mass.
A nipple discharge is common. Inflammatory breast cancer has
a particularly aggressive
According to the American Cancer Society, when breast cancer
is detected early, and is in the localized stage, the 5-year
relative survival rate is 99%. Early detection includes doing
monthly breast self-exams and scheduling regular clinical breast
exams and mammograms.
References
American Cancer Society. Breast cancer facts & figures. 2019.
https://www.cancer.org/research/cancer-facts-statistics/breast-
cancer-facts-figures.html
9. Gorham, R. (2020). Caring for women on adjuvant therapy for
breast cancer: Role of the NP in the primary care
setting. Women’s Healthcare: A Clinical Journal for NPs, 8(1),
6–16.
Center for Disease Control and Prevention (2019).
https://www.cdc.gov/cancer/breast/pdf/BreastCancerFactSheet.p
df
Center for Disease Control and Prevention. (2016). Leading
cancer cases and deaths, female, 2016. Retrieved from
https://gis.cdc.gov/Cancer/USCS/DataViz.html
Kosir, M. A. (2019). Breast Cancer. Merck Manuals
Professional Edition. Retrieved
https://www.merckmanuals.com/professional/gynecology-and-
obstetrics/breast-disorders/breast-cancer#
Below is a brief summary of my research:
Supporting prescribing in older patient with multimorbidity in
primary care (SPPiRE) is a cluster randomised controlled trial
that was designed to assess the effectiveness of a web guided
medication review in reducing potentially inappropriate
prescribing and polypharmacy in patients aged ≥ 65 years who
10. are prescribed ≥ 15 medicines, in Irish primary care.
I suggest you review your EBM notes about randomised
controlled trial design. This is a cluster randomised controlled
trial, meaning groups or “clusters” are randomised together.
This is done to avoid contamination, as the intervention is being
delivered by GPs and it would be difficult for a GP to treat their
own patients differently. Each GP practice is randomised as one
I also suggest you look up the CONSORT reporting
requirements for randomised controlled trials.
Population:
Patients aged ≥ 65 years who are prescribed ≥ 15 medicines, in
Irish primary care
Intervention:
Web guided medication review and professional training videos
Control:
Usual GP care
Outcome measures:
Primary outcome measure:
Number of repeat medicines
Proportion of patients with at least 1 PIP
Secondary outcome measures:
Health related quality of life
Multimorbidity treatment burden questionnaire
Patients attitudes to deprescribing
GP reported health care utilisation
I suggest that your literature review should be on medication
review guidelines and the evidence for medication reviews.
Here is a recommended reading list for your literature review:
· https://www.ncbi.nlm.nih.gov/pubmed/28764753 (the trial’s
protocol)
·
11. https://www.icgp.ie/speck/properties/asset/asset.cfm?type=Libra
ryAsset&id=0329F12C%2D4355%2D4E18%2D8DC194DF812D
B2E7&property=asset&revision=tip&disposition=inline&app=ic
gp&filename=Med%5FReview%5FQRG%2Epdf (Irish College
of General Practitioners quick reference guide on medication
reviews, this document will give an overview on what
potentially inappropriate prescribing is, and why it is important
to address).
· https://www.ncbi.nlm.nih.gov/pubmed/17630041 (review
article on appropriate prescribing and polypharmacy in the
elderly)
· https://www.ncbi.nlm.nih.gov/pubmed/27321600 (Systematic
review on interventions to improve prescribing in the elderly)
· https://www.ncbi.nlm.nih.gov/pubmed/22500541 (review
article on “deprescribing”)
I also suggest you look at the following clinical guidelines in
addition to the ICGP medication review reference guide above:
SIGN Polypharmacy guidelines
NICE multimorbidity guidelines
NICE medication optimisation guidelines