Why Is HRT Prescribed For Menopausal Women - Free Essay Example

Sample details Pages: 4 Words: 1300 Downloads: 6 Date added: 2017/06/26 Category Statistics Essay Did you like this example? This dissertation to answer the research question (Why HRT is prescribed for menopausal women despite the risk of breast cancer?) was carried out as mentioned in the methodology section using the literature review methodology. The selected studies were appraised with the critical appraisal tools by the Public health resource Unit. The methodology of literature review had well assisted to review all the studies in the perspective of the other and divulge meaningful evidence and information which in a single study capacity would have been otherwise unnoticed. Don’t waste time! Our writers will create an original "Why Is HRT Prescribed For Menopausal Women" essay for you Create order The Critical appraisal tools have assisted to review all the studies comprehensively to ensure there validity, reliability and applicability so that the result could be generalized to all the menopausal women population. The studies which have been reviewed were conducted in various settings with participants from all types of study population hence the results are a wholesome reunion of the existing predisposing factors with the associated risk of HRT in the incidence of breast cancer. ANSWER TO THE RESEARCH QUESTION Every doctor has the relief of the patient of utmost importance while prescribing a treatment and every treatment is meant to bring relief. And treatment has dose schedules, administration guidelines and perhaps side-effects which are generally explained by the doctor. But unlike other medicines there is a lot of unrest around the use of HRT though the associated risk when evaluated with other factors is not high. Keeping the results and conclusions derived from these studies in the present and elements for further research in front, it is seen that HRT does have benefits. These associated benefits with use of HRT according to this study are: 1) Use of HRT decreases the risk of death overall (Sellers et.al,1997) (Sener et.al, 2009) and is associated with recurrence, metastasis-free survival and better overall and disease-free survival than HRT nonusers in the univariate analysis irrespective of the start of menopause (Sener et.al , 2009) (Bonneir et.al, 1998) 2) HRT does not increase the risk of breast cancer when administered to women for whom other risk factors have been excluded (Tzingounis et.al, 1996). 2) There is an inverse relationship between HRT and mortality due to coronary heart disease, stroke and cancers other than breast (Sellers et.al, 1997) 4) Use of HRT gives fewer locally advanced cancers and smaller and better-differentiated cancers compared to non-users (Bonneir et.al, 1998). 5) HRT is a favourable prognostic factor for breast cancer. (Bonneir et.al, 1998) 6) Use of HRT counteracts the increased incidence of breast cancer with the lower incidence of other tumors. (Olsson et.al, 2001) 7) Long term HRT use has a favorable effect against colorectal and endometrial cancer. (Writing Group for the Womens Health Initiative Investigators, 2002) (Corrao et.al, 2008). 8) Use of trans-dermal HRT compared to the oral use of HRT is associated with lesser risk of breast cancer (Million women study collaborators, 2003) (Corrao et.al, 2008) which is presumed by the WHI, 2002. However these benefits depend on many other inter-connected factors of duration of use, age of the menopausal woman, past personal history of HRT used, family history related to breast cancer, dose of the HRT administered and type of HRT regime prescribed. These same factors affect the element of risk as well in the following way. 1) Risk of breast cancer may be increased with HRT use for duration of 5 years or less in women with family history of breast cancer (Sellers et.al,1997) (Olsson et.al, 2001). 2) Increased risk of breast cancer after prolonged use of HRT (Olsson et.al, 2001) (Sellers et.al, 1997) (Corrao et.al, 2008) (Sellers et.al, 1997) (Olsson et.al, 2001). This risk increased with increasing duration of use and decreased with time and reached at baseline with 5 years time. (Ewertz et.al, 2005) (Million women study collaborators, 2003) 3) Higher risk in current users than in past users which was greater for combined therapy than for other oral types of HRT (Million women study collaborators, 2003). 4) Women who used combined estrogen and progestin HRT regime are at increased risk of breast cancer (Stahlberg et.al, 2004) (Million women study collaborators, 2003) and Oral HRT use for long term had a higher risk of breast cancer than trans-dermal use of HRT (Corrao et.al, 2008). 5) Increased risk of breast cancer with current use of HRT in women of 50 years of age and above which increased with increased use. No increased risk in women between the ages of 40-49 (Ewertz et.al, 2005) (Million women study collaborators, 2003). 6) The risk of breast cancer increased in women who were current HRT users and had used OC in the past. (Lund et.al, 2007) 7) HRT users developed breast cancer at a younger age than non HRT users (Sener et.al, 2009). According to the synopsis of the issues and factors derived it can be concluded that there are benefits associated with use of HRT which mutually depend on the risk factors. And this is the reason why HRT is prescribed for menopausal women despite the risk of breast cancer. And these will again depend on gynecologist judgment and patients level of knowledge and awareness (2006). RECOMMENDATIONS To bring the optimal benefit with minimally associated risk, HRT could be prescribed to menopausal women for lesser duration which the studies present as 5 years. This duration which could be disputable and the age of the women also has to be considered with the link of different effects of HRT in different age groups would again depend on the individual gynecologists judgment and the patients compliance for regular follow up and mammographic screening. An attempt has been made to clear the otherwise existing dilemma of prescribing HRT or not but this again depends on many other factors which are most importantly the patients follow up and the doctors perception of the associated prescribing strategies. However more research is needed as within the limitations of this dissertation though it is possible to conclude that there are benefits associated with the use of HRT despite the risk of breast cancer; it is not possible to chalk out an effective prescribing strategy. And to bring any considerable changes a prescribing strategy and better patient compliance for follow-up would be needed. LESSONS LEARNT These total results, conclusions and opinions from the studies have presented some principle elements which could guide through the dilemma of prescribing HRT to yet another menopausal woman. 1) It is evident that duration has a role to play in the increase of the foresaid risk of breast cancer and that there is no risk with the use of HRT in the past. 2) A lot would also depend on the gynecologist or the physicians prescribing principles. It would be needed by them to follow some guiding factors like evaluating high-risk and low-risk women, family history and previous history of Oral Contraceptives which would vary for each patient. 3) A regular follow-up and timely check up as mentioned would help to catch otherwise unnoticeable breast changes. 4) Another factor which needs to be pursued for future research and studies is the type of HRT regimes. In routine HRT is prescribed orally hence less is known about other methods of administration which could perhaps assist in reducing the risk. 5) It would also be helpful to find if there is a link with the BMI and use of HRT. Generally obesity is linked to many diseases and unhealthy conditions and this would help to categorize women into high or low risk group. This dissertation has tried to bring up some associating factors which could help to extract the optimal benefits with lesser risk. This systematic approach has helped conduct this dissertation so as to answer the research question. However research in healthcare is never ending and is expanding every day (Aveyard, 2010). New studies with various designs are being conducted around this topic as I write my dissertation which will bring in more new opinions and evidences which will form base for yet another dissertation or study tomorrow to help develop a successful prescribing strategy.

Should Businesses Be Held Accountable For Certain Standards

Businesses should be held accountable for certain standards in relation to their impact to society and/or give back to society. Without consumers purchasing their products, businesses would not be able to survive. Society and business are interdependent upon each other, and sometimes impact negatively and positively, but should have a duty to want to take a responsibility to â€Å"do the right thing†. Citizens are bound by judicial case law; businesses should be bound by certain moral obligations to society to encourage ethical behavior. With more strict laws and/or regulations, it would enforce businesses to uphold a higher standard to society instead of just receiving a profit from society; such as businesses like Wal-Mart that thrive on small communities and areas that have protected for environmental purposes maybe to fulfill a psychological or due to the fact Wal-Mart has the complex that eventually the organization is a prime example that money and time can buy everythin g whatever the cost and barriers may come in their way. Whether they are participating in unethical practices with their employees or with regards to the environment, either way the corporation and all businesses should be held to some form of ethical, legal, and/or regulatory standards towards society. Wal-Mart is one of the largest privately owned businesses in the world â€Å"totaling revenue of $421.8 billion and a net income of $16 billion in 2011† (Sethi). 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Appropriation in Art Essay Example For Students

Appropriation in Art Essay Throughout history, the issue of appropriation in art has become a heated debate on whether it is good or whether it is bad. Appropriation is fundamentally the act of taking something from somewhere else and placing it into a new context. In art, appropriation is seen as using (or taking) someone elses artwork, manipulating it and ultimately changing the whole meaning behind the work. It is seen as a significant issue as many people (including art critics, art historians and art enthusiasts) see appropriation as whilst, others see it as being inappropriate and immoral, and see the growth in appropriation as being a destroyer of art. It is of the opinion that art indeed feeds off itself and every artwork, art movement, and art period is influenced and shaped by those before it. Artists throughout history have been using each others works to portray different meanings, however, it is only know that its use is being questioned on whether it is original or just a carbon copy of another work. There are a number of artists that are considered Appropriation Artists. Some of these artists include Marcel Duchamp, Yasumasa Morimura, and Maria Kozic. Such artists as Edouard Manet, Pablo Picasso and Leonardo Da Vinci have inspired these artists to the extent that they have used the Great Artists' actual artworks in their own works. Appropriation seemed to have flourished in the 1980s and was a very popular technique to use in commercial and advertisement. For this reason the Pop Art Movement (that was most popular in the 1950s and 60s) can also be seen as an excellent instance of appropriation, with the help of such artists as Clause Oldenberg, Andy Warhol, and Roy Lichenstein, who appropriated everyday items and made them into works of art. These artists believe that their works are like a form of homage to another artist. It is their way of learning more about the artists on how he works, operates, and practices. The issue on whether appropriation is a good or bad thing is dependent on ones view of art. Those who are familiar with Da Vincis Mona Lisa may know Marcel Duchamps appropriated version of the great piece. He took an actual replica of the work and placed a bold, black mustache and beard on the famous ladys face. Many saw this act as a form of vandalism and were disgusted on the way Duchamp violated such a treasure. However, oblivious to them was Duchamps way of expressing his way of decreasing the high art status of the work and also suggesting Da Vincis sexual ambiguity. Subjectively, this work of Duchamps is an insult to one of the finest artists and artworks in history, and should be considered as a form of vandalism. His work is mocking Da Vinci and ridiculing the talents of the great man. Though there is no limit to art, the question When is it actually art, and when is it stealing and vandalising still arises. Despite this fact, some appropriation artworks are very clever and interesting. Pablo Picassos Weeping Woman was appropriated for an advertisement for Australian Air Express. Their ingenious way of including their logo, which is synonymous to them, into the painting, is very clever. It seems as if it is actually part of the painting and it matches the painting perfectly (unlike Duchamps). One of the most well known appropriator is Yasumasa Morimura. He has appropriated a number of artworks from a number of artists. His Daughter of Art History Theatre A, 1989 is an appropriation of Edouard Manets A Bar at the Folies-Bergere, 1881-2, and his Futago, 1988 is Manets Olympia, 1863). .u934438d0a1a48d46e438d1610334bc78 , .u934438d0a1a48d46e438d1610334bc78 .postImageUrl , .u934438d0a1a48d46e438d1610334bc78 .centered-text-area { min-height: 80px; position: relative; } .u934438d0a1a48d46e438d1610334bc78 , .u934438d0a1a48d46e438d1610334bc78:hover , .u934438d0a1a48d46e438d1610334bc78:visited , .u934438d0a1a48d46e438d1610334bc78:active { border:0!important; } .u934438d0a1a48d46e438d1610334bc78 .clearfix:after { content: ""; display: table; clear: both; } .u934438d0a1a48d46e438d1610334bc78 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u934438d0a1a48d46e438d1610334bc78:active , .u934438d0a1a48d46e438d1610334bc78:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u934438d0a1a48d46e438d1610334bc78 .centered-text-area { width: 100%; position: relative ; } .u934438d0a1a48d46e438d1610334bc78 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u934438d0a1a48d46e438d1610334bc78 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u934438d0a1a48d46e438d1610334bc78 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u934438d0a1a48d46e438d1610334bc78:hover .ctaButton { background-color: #34495E!important; } .u934438d0a1a48d46e438d1610334bc78 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u934438d0a1a48d46e438d1610334bc78 .u934438d0a1a48d46e438d1610334bc78-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u934438d0a1a48d46e438d1610334bc78:after { content: ""; display: block; clear: both; } READ: Disadvantages Of Converge Us Gaap And Irfs Accounting EssayHe doesnt seem to change much, however he loves to reproduce artworks in which he can replace the women in them with himself. Though his works are similar to Manets, they are also very different; his version of Olympia has much more detail, is brighter, and more modernized than the original. This then supports the idea that appropriation is indeed not a form of stealing and vandalism, but a form of expressing your understanding of certain things. The belief that art feeds off itself is a question that supports appropriation. Andy Warhol (Pop Artist) appropriated Campbells Soupcans a number of times to create a numb er of works. His most famous one being Campbells Soup, 1965. A few years later, Maria Kozic (Australian Artist) used Warhols work to create her own. She shattered the Campbells Soup imaged to create her own work which she called Masterpieces (Warhol), 1986. As seen, this is a great example of how one idea can reproduced throughout history and has a new meaning everytime it is created. In conclusion, as shown through numerous deliberations and discussions, it is seen that the topic of appropriation in the world of art is a very significant and important issue. It is a very significant issue as it has both positive and negative perspectives. It can be seen as another form or movement of art, like cubism or expressionism, or it can be seen as a form of stealing and vandalism. Due to this, appropriation in visual art is a very significant issue. Through the many artists who have used other artists famous works to emulate their view (like Duchamps debatable appropriation of Da Vincis Mona Lisa), to artworks being used to advertise products (like Picassos Weeping Woman in Australian Air Express Advertisements), the question of whether appropriation is art or whether it is vandalism is actually dependent on individuals themselves and from their understanding of art. It is of the opinion that there is a limit to when appropriation is art, to when it is wrong and immoral, but it depends on what is being appropriated, how it is being appropriated, what is the new meaning going to be. The amount of discussion and debates on the issue of appropriation therefore makes it a very significant issue in the world of Visual Arts.

Writing in My Diary Essay Example For Students

Writing in My Diary Essay Dear Beloved Diary, I recall the moment when my friend returned after years of trading fur in the West as a Mountain man. His stories of riches in the West convinced my parents to trek away from our lovely home in New York to reach a place unknown to me. I gathered my very few belongings and helped Ma pack some of the food for the long journey ahead of us on the Oregon Trail. This is now a part of my very distant past. We have been traveling for five weeks now and have struggled to overcome obstacles. For about a week we have had a food shortage and I am forced to eat in very small portions. Unfortunately, my father injured his arm and is now unable to hunt. Ma and I try to make due with just berries and plants we see along the way. We have had to cross rivers which has caused us to lose a grand majority of our supplies. Along the way, we have met many new people who all travel for different reasons. Some hope to find riches, others are in search of freedom. We met a family of Mormons who had been denied the right to practice their religious duties. I met their eldest daughter Emily, who like me is terrified of the journey ahead of us. We will write a custom essay on Writing in My Diary specifically for you for only $16.38 $13.9/page Order now Dearest Diary, We settled in Oregon Country, where we lived for only three months. My family and I disliked the overpopulation and decided to move all the way to Texas. My father said that the government promised to grant each family that settled in Texas a large piece of land. Of course a child of my age ponders of what life in Texas will be like. My father answered every question I threw at him. He told me that Texas wanted to gain independence from Mexico. To gain independence he explained to me that the people begun a revolution. He said about 5 years ago there were two important battles that helped them gain complete independence. One battle was in the Alamo, where a small number of rebels fought against a large Mexican army. Months later, they captured Santa Anna leading to their independence. Ma, father and I now live in an independent Texas. I hope that 1842 brings me many new adventures to conquer. I am very excited to be living in Texas where we have enough land to plant crops to trade with other families. Dear Lovely Diary, Im well aware I havent written in you for years. It is just, once grown, one puts away childish things. I come back to you, to tell you that I now have a little sister to care for that just recently turned 14 born in 1843. Charlotte is a handful, she dances, prances, and sings until mother calls for dinner time. Every night, my father calls us close to the fire to tell us stories and tales on what is happening outside of Texas. Tonight he tells us about Manifest Destiny. He tells us the great desire that America has to declare land near the Pacific Ocean.