Diabetes Research Paper Example | Topics and Well Written Essays - 1500 words - 2

Diabetes - Research Paper Example The research paper shows the prevalence of the disease. It gives information on the age group; race, ethnicity, body size and sex that have high chances of are getting diabetes mellitus. The paper also highlights on some minor causes of diabetes mellitus, and the severe complications resulted from the disease if it is not diagnosed at an early stage. Diabetes mellitus known as diabetes is the number of chronically metabolic diseases that are identified by rise in glucose levels in the blood; scientifically know as hyperglycemia (Chandalia at al., 2012). It may occur due to the pancreas producing inadequate amount of insulin, defect in insulin action, or both. It is considered to be the seventh cause of death in United States. The food we consume is catalyzed to glucose which is utilized by the body to provide energy. Hormone insulin, which is synthesized by the beta cells of the pancreas, regulates sugar levels in the blood. According to LeRoith et al. (2004), this is achieved by assisting the glucose in circulating blood to enter the body cells (p.225). Once the glucose has entered the body cells it is used to synthesize energy that is used in all body functions. Long term hyperglycemia result to ailments of the coronary artery, increases the risk of cardiovascular diseases such as strokes, heart attack, angina and heart failur e and causes diseases associated with peripheral arteries (macro vascular) and also micro vascular complications in patients. In some cases, it also results in lower limb amputation. The data received for statistics of the number of US residents that were diagnosed by diabetes and prediabetes in 2010 was derived by the Center for Disease Control and Prevention (CDC), National Patient Information Reporting System (NPIRS) and the United States renal data system of the national institute of health. The number of residential Americans aged 20 and above was 25.6 million which is

Maslow and Taylor Essay Example for Free

Maslow and Taylor Essay The maslow pyramid of needs symbolise a theory needs and motivations of the 40s by Abraham maslow this pyramid is divided to 5 levels, according to him the human being tries to satisfy one need in one level before they start thinking about the next one :the person start with the level at the bottom which is the bare necessities like food and the shelter when all physiological needs are stisfied the person steps up to the next level which is security (health, work, belongings) then they jump to the social needs where people need to be a part of a society a group a family where they can communicate and work as a team then the 4th need which is the esteem of thenselfs and people, people need to see that they are respected then the last one which is the self actualisation which measured by how people see themselfs and their success in challenges in their work On the other hand Taylor sees the work motivation differently and talks about it with a theory of scientific management : which is mostly based on motivation by pay because according to him workers dont enjoy their work thats why they need to be controled. for that managers should separate production into small tasks and workers should get the training for the task they are meant to do as they can work efficiently on their task , theses workers are paid according to the number0 of items they have produced on a period of time which motivate them to increase their productivity . in other words Taylor sees workers as machines and makes them over-exploited. The main difference between how maslow and taylor see the workers motivation is that the second thinks that money is the only motivation which we can see in everydays life that it is false, maslow separed motivation to 5 levels when the worker satisfies one level of needs he moves up to an other level and become more demanding this is why workers under taylorism went on strikes , because there is many factors apart from income that affects the workers motivation like the working conditions the recognisation of their work , the greatings of the manager

Richard Wrights - Black Boy :: essays research papers fc

Richard Wright's - Black Boy A Teacher's Guide for Secondary and Post Secondary Educators Introduction Richard Wright: An Overview Questions and Activities Before Viewing Questions and Activities After Viewing History: Questions and Activities Education: Questions and Activities Literature: Questions and Activities Psychology: Questions and Activities Sociology Political Science/Cultural Studies: Questions and Activities Bibliographies INTRODUCTION Although RICHARD WRIGHT: BLACK BOY focuses mainly on the life and history of an internationally acclaimed American author, the visual and audio components of the documentary richly contextualize the literature that Wright produced. In that sense, the documentary synthesizes a great amount of historical, social and cultural information about the twentieth century. It can be used to prompt extensive discussions, to stimulate students to undertake special research projects, to write papers or combine the arts and/or cultural knowledge into a learning experience. Since the documentary is ninety minutes in length, planning and scheduling viewing time for students is essential so that the documentary can be viewed in either one or two class periods. Teachers are encouraged to view and discuss the documentary together and decide whether it is more efficient to use it in teaching one discipline or if students might profit more from discussions that are not discipline bound. The Teacher's Guide is designed for those teachers who want to use RICHARD WRIGHT: BLACK BOY to enhance the experiences of their students as they explore many and various school subjects. The guide is not designed to be exhaustive. It provides ideas for student activities and assignments, bibliographies of Wright's work, and a selected listing of background sources. Some older materials are included to suggest the state of scholarship and thinking about issues within Wright's lifetime or as reminders of what works might have influenced his thinking. In making assignments, it is suggested that the teacher add current articles and books that are deemed appropriate. The pre-viewing questions and activities are designed to help students gain background knowledge. The post-viewing student assignments focus on ways Wright's works mentioned in the documentary can be used to promote broader inquiries among the disciplines. Because the documentary contains scenes that portray Negro lynchings and an African woman's bare breasts, it is recommended that teachers and administrators below the college level review the program before showing it to students. Questions and activities are provided in the following disciplines: History, Education, Psychology, Literature, Sociology, and Political Science/Cultural Studies. The bibliography completes the guide.

The Rising Cost of Health Care Essay -- essays research papers

Rising medical costs are a worldwide problem, but nowhere are they higher than in the U.S. Although Americans with good health insurance coverage may get the best medical treatment in the world, the health of the average American, as measured by life expectancy and infant mortality, is below the average of other major industrial countries. Inefficiency, fraud and the expense of malpractice suits are often blamed for high U.S. costs, but the major reason is overinvestment in technology and personnel. There are three issues when it comes to the health care cost rising. The first is the rising cost in prescription drugs. The second area of rising cost is the increased technologies when it comes to the medical industry. The third problem is the aging population. Prescription drugs are the area of the fastest growing health care expense, and it is projected to grow at 20 to 30 percent each year over the next several years. There are many newer, more expensive drugs on the market, and the use of these prescriptions is exploding. In addition, with so much television advertising, many consumers ask their doctors for expensive, brand name drugs when there may actually be a generic drug that works just as well. Over the past decade, scientists have made significant advancements in the treatment of certain diseases. Unfortunately, just like any new product, the cost of developing these new technologies and treatments is extremely high. Plus, unlike other technology, heath technolo...

Comparative Public Administration Essay

The Arab Spring has created opportunities for countries across North Africa and the Middle East to redesign their constitutions. There are ongoing debates on whether these countries will adopt the Anglo-American model or look at other paradigms. Political leaders and scholars have turned to a number of academic fields such cultural studies, sociology, economics, and political science in attempt to answers some of these questions. However, no other field of study will provide more insight into the development of these new government structures than comparative public administration (CPA). Simply put, it is the study of comparing two or more public administrations by using multiple disciplines. This definition, however, does not sufficiently describe the complexity of this field or its contributions to other academic areas, government employees, and country leaders. Perhaps the area in which CPA provides the most aid is in its cross-national analysis. Through this research, countries are able to learn from one another. CPA is not limited to cross-national comparison though as it evaluates different administrative processes and systems within countries. To fully appreciate CPA, however, it is necessary to understand how politics factors into it, its progression over the years, and its analysis towards delineating future challenges to public administration. Politics in CPA The study of comparative public administration challenges the notion that public administration and politics are separate entities. Specifically, it has recognized that bureaucrats, pressure groups, and elected officials are all political actors in the policymaking process. In Germany, for example, politics influence policy formation because the law requires public agencies to consult with interest groups before making legislation and regulations. In other countries like the United States, public administrators and pressure groups engage in clientela politics which are mutually dependent relationships. Agencies rely on interest groups not only to shape policies but also for their survival. The interest groups lobby politicians and gain public support in order to help the agencies compete for government resources. At the same time, pressure groups benefit by gaining access to the decision-making process where they are able to represent their interests (Peters, 2010, p. 182). Nations w ith a single dominant party, in contrast, use politics to develop parantela relationships. The Chinese Communist party, for example, works with the bureaucrats on behalf of the interest groups, thereby ensuring policies decisions do not steer away from the party’s ideology. CPA also researches politics between public administration and other formal institutions, and it investigates the political strategies each side uses to assert their power and control over policies and budgets. The bureaucrats, for example, have technical knowledge and information which they use to their advantage. In Norway, civil servants collect and analyze vast amounts of data to develop complex plans and budgets which politicians do not have skills or the time to understand. The overwhelmed political leaders have little choice but to accept the administration’s plans. Another useful device that civil servants use in Japan and France are advisory bodies. Although these advisory boards are attached to the ministries, the members are usually civil servants or interest group associates co nnected to the government agencies. Thus, the bureaucrats determine many of the final outcomes of policies (Peters, 2010, p. 219). Nevertheless, political institutions have their own devices to counter the bureaucrats. Political leaders create their own specialized institutions and counterstaffs to gain independent sources of information. The president of United States has the Office of Management and Budget (OMB) to monitor public expenditures while the Congressional Budget Office oversees the national budget on the legislative side (Peters, 2010, p. 220-221). Executive leaders also hire their own experts such as the Executive Office of the United States and the Office of the Chancellor in Germany. Since civil servants’ positions are permanent, elected officials exert their policy goals through political appointees as in the United States, Belgium, and France. In Germany, however, the minister may directly replace the senior civil servants with their own personnel (Peters, 2010, p. 226). Changes in CPA Traditionally, the field of comparative public administration focused on â€Å"public administration† aspects such as the bureaucratic structures and systems. In recent years, academics have shifted to the theme of â€Å"public management† where CPA identifies best practices to enhance the performance of bureaucracy. The theory of â€Å"New Public Management† (NPM) emphasizes generic management and market-based principles. It favors loosening bureaucratic rules to allow more creativity and flexibility, thereby â€Å"letting the managers manage† (Peters, 2010, p. 329). Moreover, NPM encourages competition by privatizing government services. An alternative approach to NPM is the participatory concept of governing. The participatory model streamlines the hierarchy found in traditional administrative system by empowering the lower echelons of civil servants (Peters, 2010, p. 334). Government workers become more productive through involvement in policy decisions (Peters, 2010). Other managerial reforms have included performances measures on the managers themselves and on the organization as a whole. This new tactic focuses on â€Å"making managers manage† (Peters, 2010, p. 335). Since employment is typically permanent in most agencies, leaders recognize that this status have made some civil servants comfortable and unmotivated in their jobs. CPA evaluates different methods to measure employee performances and explores different strategies to encourage them to work, including a variety of rewards and punishments (Peters, 2010, p. 336). Organizational performance reviews are challenging since there are many factors outside the agencies control that impact its successes. CPA aids in this process by identifying the indicators of poor performances in organizations, while also taking into consideration the external influences (Peters, 2010, p.341). Notable Challenges to Public Administration The study of CPA emphasizes a comparative approach to identify new challenges that public administration will face in the 21st century. One such challenge will be the issue of accountability. As mentioned above, many countries have transferred public services to the private sector. However in their attempts to increase efficiency, they have lost accountability. Transparency and ethical standards are no longer guaranteed. In order to solve this dilemma, a restoration of some form of government control is necessary. The challenge will be to find new models that balance efficiency and accountability (Peters, 2010). Yet, the biggest challenge will be finding long-term economic solutions in the face of demographic changes. In many societies, the over-65 population is increasing more than twice as fast as the overall population (Peters, 2010, p.8). Unless policy changes are made, this demographic shift will create unsustainable public expenses leading to budgetary deficits which could compromise pension programs and health care systems. By comparing public policies, governments can analyze policy options and understand the implications of their choices. Some countries have already changed their pension plans by increasing the age of eligibility for retirement; however, they may soon have to make difficult decisions regarding austerity measures such as benefit cuts. Conclusion It is important to understand that CPA does more than recognizing similarities and differences. CPA provides descriptive analysis and theories that help advance government institutions, improve government performance, and expand policy options. Before CPA can achieve its purpose, politics must be recognized as an influential factor in the research. In every aspect, politics is involved in the governmental decision making processes, especially policymaking. CPA research explores alternative strategies to improve public management and helps anticipate future challenges. As new regimes are formed, the field of CPA will be a valuable source of information to aid leaders in the process of nation-building. In return, existing CPA theories will likely be changed and new theories emerge through the research of the new governments in the Middle East and other parts of the world. Reference Peters, B. G. (2010). The Politics of Bureaucracy: An Introduction to Comparative Public Administration (6th ed.). New York, NY: Routledge.

Morality in Politics Essay

People are forced to face moral challenges in making day-to-day decisions. When it comes to benefitting individual and societal good, the great question of politics is raised: what is the right thing to do? In Sophocles’ Antigone, there is a dilemma whether to abide by the laws of the gods above the laws of the state. Antigone makes a decision that not only affects her future but the future of the state under her uncle’s rule. Antigone gains a high moral sense in that she followed the laws of the gods and therefore did the morally right choice going against state laws, either case can be deemed as morally correct. In this essay it will be argued that citizens should be free to disobey state laws when conscience dictates. Sophocles’ play enacts the moral conflict of power between the laws of the gods and the laws of state. He presents the reader with a dilemma involving religious rituals passed down in the family and a new law passed by a ruler of the state. Antigone and her uncle, Creon, have a different set of values. Creon, the ruler of Thebes, values the constant order of the state and the public good. Antigone values family and religion, and views these commitments as superior to the laws imposed by her uncle. She claims, there is an â€Å"unchangeable unwritten code of Heaven,† (Sophocles, Antigone, 17) and she decides to act against the laws of her uncle to fulfill the laws of the gods, by giving her brother a proper burial ritual against Creon’s will. Antigone considers her uncle’s laws as sacrilege. Creon thought that his decision would bring stability to his state, as he claimed that â€Å"by corruption few men thrive and many come to mischief,† (Sophocles, Antigone, 12). Creon places the ‘polis’ above family and religious values and disregards the values that Antigone holds sacred. Sophocles positions Antigone as being the heroine of the play and allows her to justify her decisions, with the taking of her own life Antigone made a statement and accentuates the power she held and that Creon lacked. In the end, Creon is left with feelings of regret and no family, thus punished by the gods for not abiding by their laws. Antigone believed that her rights were not given to her by Creon but rather given to her by the gods. She was only doing what she thought was morally right. Antigone is a religious being and clearly values the gods higher than the state; she is willing to face the consequences. Antigone was willing to â€Å"meet with nothing more grievous, at the worst, than death, with honour,† (Sophocles, Antigone, 4) she courageously fulfilled her duties as a religious being. Many people would applaud Antigone’s bravery, for any private interest should be allowed to challenge the public good. In doing so, I believe that those private interests could eventually turn into a public interest. In the play, a prophet visits Creon to warn him of the consequences that have been brought about from his unjust laws. If it had not have been for Antigone publicly objecting to Creon’s law, it would probably not have been such a big issue that brought the concern of others. Antigone allowed for others to question Creon’s law and debate if it is morally right to go against the laws of the gods. Publicly refusing to follow a law brings attention to an issue that otherwise would have been ignored. One great example in our society is during the Civil Rights era; Martin Luther King Jr. ’s actions brought great attention to the issue of racial segregation. He believed that it was right to openly break a law that was not supposed to be a law at all. His actions although non-violent broke many laws that were made to impede success among the African American population in the U. S. He believed that by publicly and consciously breaking the law exposes brutality and promotes participation. In doing so, the people against the law were perceived as being brave and those watching were forced to question what was just. When issues become public and catch the interest of the majority of the people in the ‘polis’, the government is forced to do something about it. Creon responded with a stern and much too harsh punishment that led to the death of his niece, son and wife but if Antigone would not have contested his law he could have eventually reached complete domination of political power. The general population supported Antigone but they were too afraid to say anything until they finally felt that something must be done. Creon was running a totalitarian government and was corrupting the state. He was unable to see how unjust his law was until others brought it to his attention and tried to convince him that his use of power was wrong. Antigone’s defying actions instilled courage in the people to also speak against their ruler. It might be objected that when someone disobeys state laws whenever their conscience dictates they are only helping themselves, the person breaking the law is not thinking about the common good but rather fulfilling their own good or promoting anarchy. Civil disobedience may seem reasonable when we consider Martin Luther King Jr. ’s situation but it may not always be driven with good intentions. By disobeying, regardless of good or bad intentions, they are hurting the stability of the state. Creon argues, â€Å"Obedience is due to the state’ officer in small and great, just and unjust commandments†¦ (Sophocles, Antigone, 26). † Creon did not bother to judge his laws as just or unjust, he simply did what he considered was good for the state. It is thought that if people continue to please themselves in breaking the laws of the state that they will eventually break every law and lose all respect for the state. Civil disobedience may not always serve the public good and only serve to undermine order. Breaking a law weakens the state and it’s order, it promotes anarchy and disrespects authority. It should not be encouraged or tolerated. It is a civic virtue to abide by the laws of the state it is what leads to its success and stability. By breaking the law Antigone was faced with death, she claimed that she was honoring the gods and that they would honor her in the end. But one must question if honor is worth the permanence of death. Many people feel so strongly about their opinions that they are wiling to die just as Antigone did in Sophocles’ play. One notable person in history is Socrates; he willingly faced all punishments administered to him. He claimed to have had a contract with his state of Athens that obliged him to accept punishments for taking advantage of the state in the first place. This shows that even though Socrates may have broken some law, he still held respect for the state. Not every person that breaks a law is completely recalcitrant. Like Socrates, those who fight for civil rights and follow what they believe to be morally correct are aware of their wrongdoings and make it a statement when they finally submit to the law. They are submitting to punishments even if they are deemed unjust only to prove to the state that their morals are important and can withstand any punishment. In facing moral challenges one is often forced to face it is always difficult to decipher what is right and what is wrong. Everyone has different values and obligations. Here, Antigone’s values outweighed Creon’s overwhelmingly unjust laws. One must always question what is more important and find a balance between the two. Civil disobedience is allowed when the conscience dictates in situations that lead to a greater good. Not all private interests are egocentric some may also reflect the interest of the general population. Antigone, although harshly punished just as Martin Luther King, Jr. and Socrates were as well, have all rose among the common people and proved to be great. They encompassed a passion and bravery for their beliefs that was able to attract attention to conflicts in the law. Without their brave actions the state would not have been open to change and reach a new level of stability.

Foundation Degree Paramedic Science Essay

Assignment – Critique of research article, â€Å"life after cancer; Living with the risk† Word count 2500 (excluding refs) Submission date – 6th July 2012 The purpose of this essay aims to provide a critical evaluation of a research article titled life after cancer; living with risk (Wilkins and Woodgate, Cancer Nursing 2011 vol 34, no 6, P487-494) it will be structured according to the recommendations of the critique guidelines of Parahoo, 1988. Parahoo states that the title should not be long and complicated and should reflect as much as possible what the research is about (Parahoo and Reid 1988, P69). The title in this case meets this criteria, it is concise but clear and suggestive of the content and context. It does not presume to validate or invalidate the research; again this is a recommendation of Parahoo 1988. The title is 2 parts, Life after cancer; this could be interpreted as life of a carer or relative after a cancer patient has died or indeed life for a cancer patient after successful treatment. The second part of the title (living with risk) goes someway to qualify the first and elicit that the subject matter discusses living with risk after cancer treatment. It does not however explain in the title what â€Å"the risk† refers to. This perceived risk could be research into a possibility that cancer survivors take more risks in everyday life than non-cancer survivors as they have faced their the harsh reality of their own morbidity and overcome this. It is not until reading the full text that it becomes apparent that the risk refers to the risk of being diagnosed with a secondary form of cancer. The researchers of the study have a strong affiliation to the field and both possess recognised formal qualifications, unusually both in the fields of nursing and medicine making both very credible. No conflicts have been disclosed again adding credibility to the study and findings as unbiased. The abstract of the does provide an overview of the intentions of the study, the sample used, an overview of the results, conclusions and the implications for practice. The abstract lists key area’s under the bullet points of, â€Å"background, objective, method, results and conclusions.† Making the study easy to follow and read in a logical and accepted format. The abstract is suitably brief but enticing with a word count of 225 words, this word count is an average size for an abstract but goes slightly over the 150-200 words recommended the book entitled, â€Å"the art of abstracting†, (Cremmins, Edward, The Art of Abstracting 2nd Edition, Info Resources Press, April 1996) The objective attempts to explain the rationale for the study and is neatly and subsinctly summarised in one sentence. The method of the study is of an interprative, qualitative nature examining in some depth the feelings perceptions and views of cancer survivors though a descriptive approach using face to face semi structured interviews. The interviews took place in the subjects own homes, this would suggest that the subject was comfortable and at ease leading to an open, frank and honest interview providing valuable and unbiased data. An interview guide was used during the interview to assist participants to articulate their thoughts; the study does not go into any further detail to clarify what was contained within the interview guide and how this may affect any results obtained from questions throughout the interview process. The results data was analysed by the constant comparative method of data analysis. This method of data analysis lends itself to complex and sensitive situations allowing the researcher to gain the trust of the subjects. (Method of Qualitative Analysis, Barney G. Glaser, Social Problems, Vol.12, No. 4, 1965, pp. 436-445) The conclusion summarises the key findings and recommendations contained within the study and is to the point leading onto the implications for practise which are summarised in context with the study. There is an acknowledgement within the implications that the findings are a foundation which is subjective that further research would be beneficial to build on findings of the subject with the objective of improving detection, treatment and views on secondary cancer. The literature review discusses numerous previous studies on the subject matter and references 11 others containing both qualitative and quantitative research giving a broad background into the study. The vast majority of previous studies appear to be of a quantitative nature which adds validity to the alternative qualitative approach chosen for this study. All of this indicates that the authors have researched the topic and acknowledge previous work contributed by other researchers in the study area. This strongly suggests a high awareness of the topic and gives due credit to other researchers, it is mentioned in the data collection methods section of the study that the literature review influenced the interview guide developed to assist with data collection which further acknowledges previous research. It does not appear within the context of the study that the literature review has bias or undue influence on the findings but rather to support their validity as the method of the st udy and findings of this study are presented from a different perspective. However to maintain a balanced perspective we should consider the reasons that to date only one previous study has been a qualitative study with almost 10 times that amount of previous quantitative studies in the area, the rationale for this is approach is discussed and addressed with good effect in the last paragraph of the literature review. An argument for using qualitative a method for this study is that quantitative studies can be criticised for attempting to reduce a highly complex situation into a simple cause and effect paradox. Therefore the rationale for using qualitative methods does seem highly relevant and would support the data collection method chosen and the survey design. As interviewing allows the researcher to gain unique insight into other perspectives about the phenomenon being researched (Glesne and Peskin 1992) the argument put across is a rather compelling one to support further research using the method chosen to give a balanced view with evidence from both q ualitative and quantitative data research rather than from just one perspective. The hypnosis attempts to establish the perceived risks of a secondary diagnosis of cancer following successful treatment and attempts to obtain the views of the participants in relation to screening for the well-established increased medical risk, the hypothesis sets out to demonstrate that views are conflicting and wide ranging; throughout the text this hypothesis becomes well established. The overall approach of the study as previously discussed was an interpretive, descriptive qualitative design although the purpose states that this is part of a larger mixed method study aimed at establishing themes and patterns through the views and opinions of participants that had been specifically selected for inclusion due to their previous diagnosis, treatment and subsequent survival of various forms of cancer. The sample group was a relatively small number using only 22 participants (16 women and 6 men, it could be argued that this was a female dominated sample group that may have implications on the results) however using the qualitative format the sample group was of an acceptable size, the focus of the qualitative data is on the quality of the data collected as each participant is a source of a large volume of data. (Boswell and Cannon, Introduction to nursing research, qualitative research meathods, chapter 8, page 196.) The sample group was specifically selected to fit the inclusion criteria (Cancer survivors who were 5 or more years out from the initial cancer diagnosis, at least 19 years old at the time of the interview, resident to the area of the interviews and could speak and understand English) The nature of the selection and inclusion was purposive in nature, this is perfectly acceptable as the objective is to explore and describe the phenomena and not generalise the findings as qualitative research by its nature is not specifically designed to be representative of the general population. (Holloway and Wheeler, 2010, p 138) The research method chosen was specifically designed to be an emic perspective to describe the thoughts and feelings of post cancer patients, this method is ideal to understand and describe complex and sensitive information. Purposive sampling has been used as the participants have all been selected due to specific criteria. The primary goal in purposive sampling is not to generate a sample that is representative but rather one that is selected to represent certain subject characteristics that are relevant to the investigation. (Stommel and Wills, Clinical research, concepts and principles for advanced practice nurses, p302-303) A clear description of the sampling rationale and recruitment process is evident, (Bluff 1997). To maximise variation participants were selected that had differing ages at the time of the initial diagnosis and different types of cancer. This demonstrates an excellent cross section of variables to maximise results. Participants were recruited exclusively from a central cancer registry and hospital based database, the study goes on to state that this register is â€Å"largely untapped† meaning that the participants would not have preconceived ideas or previous experience of prior studies of this kind. Non eligible potential participants were excluded from the study prior to recruitment to ensure validity of the study. The age range was 19 – 87 years, however with the upper age range it could be concluded that the perceived risk of secondary cancer and subsequent screening views may vary vastly from younger participants due to the age difference. Fifteen of the participants were employed (full or part time) and the remaining participants were either retired or disabled, it could be argued that unemployed and disadvantaged people were not represented in the sample group who may have had differing views from the sample group interviewed. This assumption could also be continued that as all participants were white, ethnic groups were under represented and again may have differing views due to racial, cultural or social backgrounds. An argument that only white participents were deliberately selected for the study is a moot point as cancer is not a racially or culturally specific disease as perhaps a study into something like sickle cell crisis would be. The age range was wide and the average age is listed as 40 years old at the time of diagnosis however we know that some participants were far from the average age at the time of diagnosis but this maximises variation in the study. The data was collection method for the study was done using a semi structured interview technique; the same researcher (Krista Wilkins, PhD, RN) completed all of the 23 face to face interviews. By using the same researcher we can assume continuity of the interview with the same structure being followed throughout. It is noted that 1 participant was interviewed twice because the first interview had ended early, the study does not elaborate as the reasons why the first interview ended early. By being interviewed twice an argument could be put that the data collected should not be included as the participant may have had time to think about, discuss and research the upcoming questions in the repeat interview which could potentially affect the validity of the findings, this presumably was not considered to be an issue as the participant and data were not excluded from the study or conclusions drawn. As mentioned previously in the literature review key themes that had been discovered in the literature review were included to develop an interview guide. This suggests that all of the interviews were conducted not only by the same researcher but also following the same structure (or semi structure) with the interview guide being used as an â€Å"aide memoir† to keep the interviews on track and relevant. A person centred open ended approach was used as research shows that people respond well to this type of questioning ensuring that the information elicited was detailed, personal and rich in information.(Geer JG, Public opinion quarterly, volume 52, issue 3, p356-357) The interviews took place in the participants own homes which would establish both comfort and confidence in a familiar and â€Å"safe† environment encouraging an open, honest and useful interview and eliminating the desire for social acquiescence however we must remind mindful of participant reactivity to the researcher in this technique. The interviews lasted generally no longer than an hour, the timeframe given is credible and suggestive that the participant was allowed sufficient time to relax and â€Å"open up† within the interview ensuring rich data collection but without the effect of feeling rushed or exhausted discussing a potentially stressful, personal and emotive topic. However no upper or lower time limit was set so that if the data being collected at the point of an hour was valuable the participant was not cut short and valuable data excluded. Field notes were taken immediately after the interviews and included observations about the setting and impressions including non-verbal communications. This could be criticised as being a subjective observation and no reference is made to indicate the qualifications of the interviewer to make meaningful conclusion from observations of this type. All interviews were digitally recorded (with the participants consent) the recordings and field notes were later transcribed verbatim which supports the validity and credibility of the study immensely. There was no evidence of a pilot study to add further validity to this study. In this study all proper ethical principles have been adhered to, ethical permission was granted by gaining informed consent from all participants and from local university and hospital ethical review committees. The process lead to a delay between the study being carried out and publication with the study taking place between July 2008 and July 2009 and publication in issue 34 of the publication, Cancer nursing in Nov – Dec 2011. (Wilkins and Woodgate, Life after cancer – living with the risk, Cancer nursing, issue 34, p487 – 494, Dec 2011) but this length of time is not uncommon. The importance of gaining ethical approval is so that no harm comes to participants and the research community as a whole is not affected by the negatives of publicity which bring the research community into disrepute and go against the very objective of research to improve evidence based practice (Blaber, A. 2008, Foundations for Paramedic Practice, a Theoretical Perspective). The data analysis in this case forms the main body of the study and gives numerous personal experiences and thoughts to form the findings, all quotes have been annomalised to maintain the dignity and privacy of the participants. The data is broken down in a logical format helping the reader to understand the conclusions reached by the researchers and go a long way to help understand how the findings were reached. The limitations of the study are readily acknowledged and openly state that the findings are not generalised to all cancer survivors, it goes on to state that the data was only collected at one time point, this could be addressed by further studies and perhaps a longitudinal study would be beneficial to broaden the picture. The study failed to reveal any risk perceptions due to different variables for example age, type of cancer etc. To its credit the limitations does acknowledge that ethnic variability may have revealed additional information. The discussion is an in depth appraisal of the study as a whole including the findings, the conclusion is brief and does not introduce any new information, rather it summarises the previous sections of the study and draws the reader to an informed conclusion. Reference List Blaber, A. (2008) Foundations for Paramedic Practice, a Theoretical Perspective. Open University Press, pg 49. Boswell, C and Cannon, S. (2011) Introduction to nursing research, qualitative research methods, Jones and Bartlett publishers, chapter 8, pg 196. Cremmins, E. (1996) The Art of Abstracting 2nd Edition, Info Resources Press, pg. 46 Geer JG, (2005) Public opinion quarterly, volume 52, issue 3, Lawrence Erlbaum associates publishers, p356-357 Glaser, B. (1965) Method of Qualitative Analysis, Social Problems, Vol.12, No. 4, pp. 436-445 Holloway, I. and Wheeler, S. (2010) Qualitative Research in Nursing and Healthcare. 3rd ed. West Sussex, UK: Wiley-Blackwell, pg. 6, pg.138. Parahoo, K. (1988) Research Skills, Number 5. Critical Reading of Research. Nursing Times, 84 (43),pg 69-72 Stommel, M and Wills, C. (2004) Clinical research, concepts and principles for advanced practice nurses, Lippincott Williams and Williams, p302-303 Wilkins, K and Woodgate, R. (Dec 2011) Cancer nursing, Life after cancer – living with the risk, Lippincott Williams and Williams, issue 34, p487 – 494.