Critical Analysis of Diamond Shipwreck and Tang Shipwreck as the Essay

Basic Analysis of Diamond Shipwreck and Tang Shipwreck as the Milestones in the World Trade Relationship - Essay Example In spite of the fact that the material confirmations acquired from these two wrecks are not adequate enough to delineate the entire exchange relationship among the nations of the world, they are very ground-breaking as verifications to help the historians’ claims about the world exchange relationship, which had been significantly impacted by the contemporary force legislative issues of that time. The wrecks, being situated at thousands miles of separation and happening at a time frame hundred years, essentially fill in as achievements in the high points and low points of intensity relations just as exchange relations among the nations. Wreck portrayed by Roff Smith happened on an obscure date in the 1533 and is situated at â€Å"the sea shore sands of the Sperrgebiet† (Smith 3) on Namibia’s south coast, while Worrall’s wreck is situated under the blue water of â€Å"the Gelasa Strait, a channel molded section between the little Indonesian islands of Bangk a and Belitung† (Worrall 2). Contingent upon a date recorded on one of the Changsha bowls, Worrall expected that the wreck may happen on a mysterious date in the A.D. 826. The Overall Picture of Asia-Europe Trade Relationships among the Countries The material confirmations found at the wreck site in the Java Sea reasonably end up being solid help for the historians’ claims about the Chinese business relationship with the Arab nations, particularly with the financial powerhouse in Baghdad. Worrall claims that ‘The Silk Road and the Maritime Silk Route, which had connected China to the world, slipped by into neglect [after 878 AD]’ as a result of â€Å"[the Confucian] doubt of dealers and the remote influences† (Worrall 3). In all actuality â€Å"[the Confucian] doubt of dealers and the remote influences† was the unrivaled reason for the pass of the Silk Route and the Maritime Silk Route. Or maybe it was one of various causes â€such as, the O ttoman blockade and correspondence, Mongol savageness, rot of security, and so forth on along the Silk Route-that were remapping the political force connections among the nations. These reshaped power-relations among the nations were then impacting the Arab-China, Arab-Europe and, hence, China-Europe exchange relationship. Thusly, China turned internal and the European pilgrims were genuinely looking for a backup way to go to Fareast. The European investigation of the Atlantic and the New World was roused by various money related, strict and mechanical reasons. Following by the modern upheaval in Europe, the Age of Exploration was basically a period of developing exchange and business. In later 50% of the fifteenth century, the developing conflict among Europe and the Ottoman Empire started to limit the extent of exchanging silk and flavor including incense, therapeutic herbs, medications and opium, and so forth through the silk course and the zest exchange courses. As a reaction to this contracting extent of exchanging along the eastbound land and ocean course, the Portuguese and the Spanish were propelled to pick another two other options: first they were scanning for an elective course to east and Southeast Asian Markets; second, they were attempting to discover markets of modest slave-works, other significant products like gold, silver, ivory, and so on in the African district. Thusly, in 1418 the Portuguese started investigation along the African bank of the Atlantic. In any case, being outfitted by the Ottoman bar on the Silk course and on other eastbound ocean courses Vasco Da Gama, supported by the Spanish ruler, ventured to every part of the African Seacoast of the Atlantic a

Aunt Denise free essay sample

Consideration in Colorado Signal! Blare! Blare! It’s 4:30 A.M. what's more, Aunt Denise is up and preparing to start her day. She has breakfast with her better half (my Uncle Dan) and they head off to cooperate at 5:45. During the day, Aunt Denise encourages an uncommon needs class at the neighborhood primary school alongside two serious understanding gatherings (one toward the beginning of the day and one toward the evening). She drives back to the farm, likewise in Pueblo, around 4 P.M. Once at home, she and Uncle Dan share the errands of taking care of the ponies, gathering chicken eggs from the coop and planting (this is consistently Aunt Denise’s work). After a long day’s work and completing their tasks, Aunt Denise causes supper and together they to plunk down to a tranquil dinner. In spite of the fact that she appears to be a normal individual, Aunt Denise is really a caring individual. Along these lines, I picked her to be my legend. Auntie Denise’s youth is fairly similar to her life is currently. In her childhood, she was encircled by individuals who she cherished and who adored her consequently. Auntie Denise lived in a warm and caring condition held together by her great guardians and kin. Consistently her mom would peruse to her and different kids before bed and ensure they were glad. Auntie Denise adored and regarded both her folks for what their identity was and never hoodwinked them. Like her youth, Aunt Denise’s juvenile years were great and she came out of them sound. Since every last bit of her companions had similar qualities and convictions, they shaped a network that repulsed the idea of medications, liquor and smoking. One reason why they never were into any of that was on the grounds that their lives were revolved around chapel and furthermore in light of the fact that Jesus was with them. â€Å"†¦I never needed to escape or get things done to agitate my folks. I regarded and cherished them.† This fair demonstrates in light of the fact that she had such incredible guardians; Aunt Denise was never sent to the brink to plan something inept for drive them mad. She additionally revealed to me that, when gone up against with peer pressure, â€Å"†¦stop and think what the final product may be. Is it worth doing or being somebody you truly don’t need to be?† This is extraordinary guidance for any young person confronting com panions who need them to accomplish something they don’t need to do. I have a solid inclination that she followed her own recommendation. Just by conversing with her, you can recognize that Aunt Denise was similarly as caring and solid disapproved as she was in her childhood. Following quite a while of experiencing childhood in a caring family with astounding guardians, Aunt Denise bloomed into a hopeful youthful grown-up. She wedded Uncle Dan and had two kids, Christine and Rebecca. She self-taught them and dealt with them as her mom accomplished for her. The family stood together when moving around, living in a trailer, for Uncle Dan’s work and support each other when they lost their most youthful little girl, Rebecca, at the age of twenty-one. She had been with her companions on a train track when a train came. Every last bit of her companions had moved off the beaten path in time yet she just wasn’t sufficiently speedy and the train executed her. Auntie Denise still laments for the misfortune that they encountered ten years prior. It changed her viewpoint on life. She let me know, â€Å"I value every second I go through with loved ones, for I can't be sure whether it might be the last.† Even with that inauspicious occasion in her life, Aunt Denise is the most cheerful and young individual I know. At whatever point my family and I visit them in Colorado, her grinning face is the main figure we see. Auntie Dan and Denise, the name they were given to by my sibling when he was two, persistently welcome us into their home with hearts that are warm and full to the edge of stories that, undoubtedly, would begin with, â€Å"When you were little†¦Ã¢â‚¬  Aunt Denise disclosed to me this one, â€Å"When you were around eighteen months, y’all stayed with us at the lodging we were remaining at, up on Chapel Hill. We were totally assembled around talking and afterward you got genuine calm. For reasons unknown, you had left us and gone into the visitor room’s storeroom. You had gotten out my green food shading from my cake enlivening unit and spread it all over your face and the bottoms of your feet. At the point when gotten some information about what you had been doing, you didn’t state anyth ing other than we discovered minimal green impressions all over our cream shaded rug! In spite of the fact that the floor covering was useless, I didn’t get distraught at you.† Now, I don’t recollect what occurred, yet by its sound, I had a talent of falling into difficulty by having little â€Å"adventures†. This story just demonstrates how sympathetic Aunt Denise is, despite the fact that I destroyed the floor covering. She likewise educated me concerning when my mom contracted pneumonia and wasn’t ready to deal with my sibling and me. Auntie Denise remained for an entire week to watch us and to ensure my mother developed better. At whatever point my family visits them out in Colorado, Aunt Dan and Denise take us fossil chasing in the dry waterway beds all over their 50 sections of land of land. We will likewise help Aunt Denise in her nursery and gather eggs from the chicken coop. Auntie Denise works the primary school as an uncommon needs instru ctor. Despite the fact that of late she has been assisting with the customary second grade class in view of a deficiency of instructors, Aunt Denise’s genuine class is an exceptional needs gathering, typically based on the evaluations K-5. She shows them everything from to . The genuine motivation behind why Aunt Denise is my saint is on the grounds that she it the most cherishing and caring individual I have ever met. She never flops in putting others needs her own and could never at any point stop to consider not helping somebody out of luck. In the event that I at any point had an inquiry or an issue, or anybody besides, she would seize the opportunity to share her recommendation or contemplations regarding the matter. As I would like to think, I think Uncle Dan says all that needs to be said. â€Å"She is a balanced individual with good motives with regards to her companions. She would be my meaning of care and worry for others.† And that she is.

Should Marijuana be legalized Essay Example | Topics and Well Written Essays - 1000 words

Should Marijuana be legitimized - Essay Example As of now, there are numerous pundits of the said law who advocate the authorization of cannabis. Truth be told, ten states (California, Colorado, Maine, Minnesota, Mississippi, Nebraska, New York, North Carolina, Ohio, and Oregon) have begun to decriminalize it by forcing fines rather for ownership rather the prison time as discipline. There are divisions who contend that the substance isn't destructive and, consequently, ought to be barred from the illicit opiates order, in actuality, condemning its ownership. This paper will explore whether this contention has merit and that it is sensible to decriminalize its ownership and use. There are two significant contentions behind the call to legitimize weed. The first is the thinking that it isn't destructive to wellbeing. Defenders regularly refer to clinical investigations and research that discover pot as a protected medication. For instance, there is the Drug Enforcement Administration own managerial adjudicator Francis Young, who proclaimed in his 1988 choice to suggest marijuana’s sanctioning that: â€Å"Marijuana, in its regular structure, is one of the most secure restoratively dynamic substance known to mankind† (Barton 64). In this regard, Gieringer, Rosenthal and Carter (2008) further underscored that in creature tests, the deadly portion of cannabis would be around 20,000 to multiple times than that of the ordinary portion and would require the admission of 40-80 pounds of maryjane (1). They alluded to the present measurements that, up until now, no casualty has ever been recorded out of cannabis overdose. The subsequent point regularly refered to by those for authorizing weed is that this issue has gotten much the same as the circumstance during the Prohibition period when the boycott of liquor has come about to wrongdoing and debasement. The thought is that by authorizing cannabis, a wellspring of assets would be denied on the criminal associations that presently benefit hugely from the underground exchange. Likewise, says Gomberg

3 Medical School Interview Tips from a Former Student Adcom Member

Right now, every week, there are a slew of fresh faces coming to interview for a coveted spot at our medical school. They come mostly from Tennessee; many have done undergraduate work all over the country, had previous careers, and are very impressive on paper, but they all share one thing in common: a feeling expressed on their faces that hints at sheer excitement and terror mixed evenly. Interviewing for medical school is one of the most exciting things someone can do; the hours have been poured into taking classes, studying for the MCAT, writing the lengthy application, shadowing in hospitals, researching in labs, and often times neglecting personal life to become one of the few to don the white coat as a student doctor. There are a few things that I feel should be said to students getting ready to interview for medical school. Just a year ago, I was in those nervous, excited shoes and suit, and Im incredibly thankful for the mentors that guided me in the following ways: 1. Practice. Hours are spent practicing for the MCAT, why not practice for the one thing that could make or break an acceptance into one of the extremely competitive seats of a med school? Each undergraduate school has a career development center that is well versed in preparing students for professional interviews, both academically and industry-oriented. I always recommend setting up a practice interview with a career counselor, and gaining invaluable feedback on some personal quirks that arent always apparent to ourselves. A fault of mine is that I have unfaltering eye contact with a big, forward personality to match, and this is sometimes mistaken as aggressive and commanding to people. This was pointed out to me in a practice interview I scheduled, and I was guided on how to lighten up my intensity to let the more communicative, and expressive parts of me come across more clearly. A good way to practice answering interview questions and getting solid feedback is to work through Dr. Jessica F reedmans, The Medical School Interview with friends and family. Its a quick read and I found it helpful to hear my parents perspective with tidbits they thought would be important in telling my story while answering interview questions. 2. Read up! Im baffled sometimes when I give a tour to interviewees, and some have very basic questions that are easily accessibly on our website. The ones I know have invested time into reading about our school already understand the mission of the school, and want to know more in-depth things like what the student life is like, what things there are to do in the area, how accessible and helpful faculty are, and they essentially are interviewing me to see if my little corner of the world is somewhere they can see themselves fitting well in. Its absolutely ok, and I encourage interviewees to treat the interview day like a two-way interview. When I was in the hot seat, I asked so many questions about why my interviewers chose that school, why they like the area, and the pros and cons of that school. Youre the one that has to spend the next four years with your hands at the grindstone, so you should absolutely be invested in choosing a school that YOU see yourself at, not just one that offers you a seat. This is YOUR education, and I am a firm believer that you should take control and command of it, starting with the school you want! 3. Dont try and impress anyone. What I mean by this is that everyone already knows about everything youve ever done, because those things should have been well articulated in your application and secondaries. When we invite students for an interview, weve already thoroughly screened them, scrutinized their credentials, and know they are qualified to succeed in the rigorous medical education. The interview isnt to test academic prowess, but its so we can meet the person weve been reading about, are excited about, and see if we like each other. Come to your medical school interview prepared to show everyone the person youve written about in your application! We already know about your awards and what everyone else to say about you in your recommendation letters, and now we just want to spend some time and see if were a fit for you, and you for us. Be yourself. Be yourself. BE YOURSELF! Interview day is a lot of pressure, but its the most enjoyable and exciting part of this whole process, in my opinion. Having just gone through the rigors of applying and getting accepted to medical school, all I can say is that you should be extremely proud of the obstacles youve overcome to reach this momentous achievement. There are no magic tricks or secrets to interviewing and getting accepted to medical school; however, being an honest person with the integrity that I hope you wrote about in your application, and showing that person to us as a medical school and student body is a fast-track to an instant acceptance. The people we end up accepting are the people that I want to spend the next four years with, through the good and the bad, and they with us. The person Im willing to go out of the way for and write an email to the admissions committee is the person that would do the same for me, and is also someone Id want to have a beer with next year. So, on your interview, show them that person. Good luck! Not So Secret Secrets to Nailing the Medical School Interview is excerpted from the Accepted guide,  The Ultimate Guide to Medical School Interview Success.  To download the complete guide,  click here.   hbspt.cta.load(58291, 'f983525f-d810-452f-a0d3-c41270570189', {}); This is a repost of an article by  Joshua Wienczkowski.  For more articles by  Joshua, check out our  popular series  Journeys with Joshua. Related Resources: †¢ Prepare for Your Interview with an Admissions Expert †¢Ã‚  Sample Questions to Ask Your Interviewer †¢Ã‚  What I Learned as a Student Member of a Medical School Admissions Committee 3 Medical School Interview Tips from a Former Student Adcom Member Right now, every week, there are a slew of fresh faces coming to interview for a coveted spot at our medical school. They come mostly from Tennessee; many have done undergraduate work all over the country, had previous careers, and are very impressive on paper, but they all share one thing in common: a feeling expressed on their faces that hints at sheer excitement and terror mixed evenly. Interviewing for medical school is one of the most exciting things someone can do; the hours have been poured into taking classes, studying for the MCAT, writing the lengthy application, shadowing in hospitals, researching in labs, and often times neglecting personal life to become one of the few to don the white coat as a student doctor. There are a few things that I feel should be said to students getting ready to interview for medical school. Just a year ago, I was in those nervous, excited shoes and suit, and Im incredibly thankful for the mentors that guided me in the following ways: 1. Practice. Hours are spent practicing for the MCAT, why not practice for the one thing that could make or break an acceptance into one of the extremely competitive seats of a med school? Each undergraduate school has a career development center that is well versed in preparing students for professional interviews, both academically and industry-oriented. I always recommend setting up a practice interview with a career counselor, and gaining invaluable feedback on some personal quirks that arent always apparent to ourselves. A fault of mine is that I have unfaltering eye contact with a big, forward personality to match, and this is sometimes mistaken as aggressive and commanding to people. This was pointed out to me in a practice interview I scheduled, and I was guided on how to lighten up my intensity to let the more communicative, and expressive parts of me come across more clearly. A good way to practice answering interview questions and getting solid feedback is to work through Dr. Jessica F reedmans, The Medical School Interview with friends and family. Its a quick read and I found it helpful to hear my parents perspective with tidbits they thought would be important in telling my story while answering interview questions. 2. Read up! Im baffled sometimes when I give a tour to interviewees, and some have very basic questions that are easily accessibly on our website. The ones I know have invested time into reading about our school already understand the mission of the school, and want to know more in-depth things like what the student life is like, what things there are to do in the area, how accessible and helpful faculty are, and they essentially are interviewing me to see if my little corner of the world is somewhere they can see themselves fitting well in. Its absolutely ok, and I encourage interviewees to treat the interview day like a two-way interview. When I was in the hot seat, I asked so many questions about why my interviewers chose that school, why they like the area, and the pros and cons of that school. Youre the one that has to spend the next four years with your hands at the grindstone, so you should absolutely be invested in choosing a school that YOU see yourself at, not just one that offers you a seat. This is YOUR education, and I am a firm believer that you should take control and command of it, starting with the school you want! 3. Dont try and impress anyone. What I mean by this is that everyone already knows about everything youve ever done, because those things should have been well articulated in your application and secondaries. When we invite students for an interview, weve already thoroughly screened them, scrutinized their credentials, and know they are qualified to succeed in the rigorous medical education. The interview isnt to test academic prowess, but its so we can meet the person weve been reading about, are excited about, and see if we like each other. Come to your medical school interview prepared to show everyone the person youve written about in your application! We already know about your awards and what everyone else to say about you in your recommendation letters, and now we just want to spend some time and see if were a fit for you, and you for us. Be yourself. Be yourself. BE YOURSELF! Interview day is a lot of pressure, but its the most enjoyable and exciting part of this whole process, in my opinion. Having just gone through the rigors of applying and getting accepted to medical school, all I can say is that you should be extremely proud of the obstacles youve overcome to reach this momentous achievement. There are no magic tricks or secrets to interviewing and getting accepted to medical school; however, being an honest person with the integrity that I hope you wrote about in your application, and showing that person to us as a medical school and student body is a fast-track to an instant acceptance. The people we end up accepting are the people that I want to spend the next four years with, through the good and the bad, and they with us. The person Im willing to go out of the way for and write an email to the admissions committee is the person that would do the same for me, and is also someone Id want to have a beer with next year. So, on your interview, show them that person. Good luck! Not So Secret Secrets to Nailing the Medical School Interview is excerpted from the Accepted guide,  The Ultimate Guide to Medical School Interview Success.  To download the complete guide,  click here.   hbspt.cta.load(58291, 'f983525f-d810-452f-a0d3-c41270570189', {}); This is a repost of an article by  Joshua Wienczkowski.  For more articles by  Joshua, check out our  popular series  Journeys with Joshua. Related Resources: †¢ Prepare for Your Interview with an Admissions Expert †¢Ã‚  Sample Questions to Ask Your Interviewer †¢Ã‚  What I Learned as a Student Member of a Medical School Admissions Committee

Patient Flow in Waiting Room - 1770 Words

Patient Flow in Waiting Room Haik Janoian MGT/554 Ââ€" Operations Management University of Phoenix Group PA04MBA10 April 5, 2006 Patient Flow in Waiting Room Healthcare clinics are under a great deal of pressure to reduce costs and improve quality of service. In recent years, healthcare organizations have concentrated on preventive medicine practices and have tried to reduce the length of time that patients stay in a hospital. Outpatient services have gradually become an essential component of healthcare. Organizations that cannot make their outpatient component cost-effective are finding themselves financially burdened in this ever-changing industry (Caldwell, 2005). Patient waiting times and waiting-room congestion in†¦show more content†¦As a result of this, when one patient takes longer to process, the Arrival Queue becomes a bottleneck. Patients begin to stack up behind one another while they wait for the other patients to be processed. This is point in the process that needs improvement. By fixing the time it takes to process each patient and removing or reordering certain steps, the cycle time could be reduced and the bottleneck eliminated. Work Process Improvement As stated earlier, the cost for health care is rising for both employers and employees; therefore, both employers and employees are seeking for medical groups that provide systems of very well coordinated care. Coordinating care creates significant advantages for patient by delivering high-quality care efficiently, so that patients get the most for their health care dollars. When services are integrated and carefully designed across the stream of care, this thoughtfulness up front eliminates duplication of processes and inappropriate services. Patients, employers and medical groups benefit in terms of better health and streamlined costs associated with the care. Survey after survey suggest that the biggest frustrations for patients are: 1. Appointment access 2. Phone Access 3. Getting information about their test results 4. Understanding how to use medical group systems (referrals, eligibility, business department, etc.) With a structured Work Process Improvement process, ourShow MoreRelatedImprove Er Wait Times1004 Words   |  5 PagesWays to Improve Emergency Room Wait Times Veronica Padlo California College San Diego MAN324 May 2, 2010 Dru Macasieb Abstract It seems that emergency room wait times are ridiculous and there is no need for it. My mom has been in and out of the hospital since last April and the most annoying thing in the world is having to wait 3 hours to see a doctor. This paper is going to focus on ways to improve emergency room wait times. With all the advancements in technology you would think thatRead MoreApplication Of Rfid As Medical Application For A Hospital1542 Words   |  7 Pagesimprove patient health care has been the common goal pursued by the hospitals all over the world. 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The average number of students in process (those who are waiting and those who are being served) at each station is: Drop-o ® - 5 students Read MoreInadequate Staffing And Emergency Department Capacity1295 Words   |  6 Pagesemergency department capacity also results in patients leaving without being seen. A descriptive retrospective study conducted by Bambi et al showed that on Mondays when the patient volume was the highest the waiting time was also the longest in comparison to Saturday and Sundays which had lower patient volume and thus shorter waiting time. The increase in wait time was attributed to the â€Å"higher workload of ED staff and the rise in the number of patients in need of intensive care or who have acute

Negative Propaganda Essay - 1421 Words

Propaganda is a form of communication, a way to influence on the attitude of a community toward some position or cause. The propaganda in its origins was neutral; nevertheless, it had been used to manipulate. For this reason, the propaganda also can be defined as information that is deliberately expressed in order to harm or hurt a person. The deliberate spreading of such information lead to persuasion, persuading to do things that are not the regular scheme of a person which may result affected because habitually someone searches to benefit which is the person in charge of everything, the head master. â€Å"Propaganda is communication for the purpose of persuasion†. The perfect example of persuading the people in order to hurt others is the†¦show more content†¦Hence, Paul Joseph Goebbels became Adolf Hitlers propaganda minister in 1933, which gave him power over all German radio, press, cinema, and theater. Likewise, they created a disunion of the countries with which Germany faced, it was possible with this type of propaganda that the will and strength to fight to be destroyed. Joseph Goebbels with all the power of the media maintained Hitler’s in power and implemented all their policies to exterminate a millions of people in the Holocaust. â€Å"It was characteristic of the rise of the Nazi movement in Germany and of the Communist movements in Europe after 1930 that they recruited their members from this mass of apparently indifferent people whom all other parties had given up as too apathetic or too stupid for their attention. The result was that the majority of their membership consisted of people who never before had appeared on the political scene. 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Critical Appraisal Check Control Studies â€Myassignmenthelp.Com

Question: Discuss About The Critical Appraisal Check Control Studies? Answer: Introduction The current paper seeks to critically analyze the study by Hassan, Bondy, Wolff, Abbruzzese, Vauthey, Pisters, Evans, Khan, Chou, Lenzi, and Li (2007). By doing so, the validity and usefulness of the findings will be assessed. Since Hassan, et al (2007)s research was a case-control study, the tool provided by the CASP (Critical Appraisal Skills Programme) will be used (case control study) to guide the appraisal. The paper will also determine the extent to which there is a causal association between pancreatic cancer-which is the main outcome- and consumption of alcohol, smoking of cigarette, pancreatic cancer family history, diabetes mellitus, and history of pancreatitis. Overall, Hassan, et al (2007)s study is found to be of good quality since its methodological strengths surpass its weaknesses, and it has internal and external validity. CASP Tool for Case Control Study The critical appraisal tool for evaluating case control studies is composed of three wide matters that should be put into consideration, validity of the findings, what the findings are, and whether the findings will help locally (CASP, 2017). The three issues are then broken down into a total of 11 questions, which will be used to guide evaluation of the chosen article. Validity of the Results The authors addressed a clearly focused issue since the objective of carrying out the research was evident with a clear outline of the population and risk factors being investigated. A case control was appropriate to answer the question since pancreatic cancer is a rare condition. As Song and Chung (2010) outlines, case controls are suited well when investigating rare outcomes. Also, case control studies allow for more than one risk factor to be evaluated for a just one outcome (Song and Chung, 2010). In Hassan, et al (2007)s study, multiple risk factors including, heavy intake alcohol intake, pancreatic cancer cigarette smoking, and pancreatitis family history, and diabetes mellitus were all examined for pancreatic cancer. The authors used hospital-based case-control. The cases were incident as they were selected from patients that had recently been diagnosed with pancreatic cancer. As CLIO (2004) outlines, using incident cases as opposed to prevalent increases confidence that exposures occurrence were before the outcome diseases onset. Additionally, using incident cases ensured no cases of over-representation of long duration. The number of cases selected was significantly large (808 participants) and were varying with age, ethnicity, sex, and social classes, ensuring that they were a representative of a defined population. The exclusion and inclusion criterion was clear ensuring consistency in the characteristics of cases. All the cases had been diagnosed with pancreatic ductal adenocarcinoma, resided in the U.S. and would communicate in English. Patients with other types of cancers were excluded together with those with past history of cancer. As such, the cases were selected in an acceptable way. When recruiting controls, the authors were keen to avoid bias. Controls were chosen from healthy friends as well as genetically unrelated members of the patients family with other cancer types other than pancreatic cancer. This would help minimize selection bias by excluding first degree and relatives that are not related by genetics but with pancreatic cancer as controls since the former may have genetic factors related to the outcome while thelatter may share the same lifestyle factors that may predispose them to the disease such as dietary habits. Therefore, by doing so the study would determine the true relationship between pancreatic cancer and some risk factors such as family history of the disease, cigarette smoking, and environmental factors without the link being altered. The controls were in many ways similar to the cases. The authors used matching where the cases and controls were frequently matched by factors such as age, ethnicity, and sex. As Rose and Laan (2009) suggests, matching helps to increase the efficiency of the study by allowing similar distributions across confounding variables between case and controls. Although some scholars such as Pearce (2016) argue that matching does not eliminate confounding but instead may introduce it by the matching factors, it is more feasible that matched sampling results to balancing controls and cases across the chosen matching variable levels, thus reducing variance and improving statistical efficiency (Rose and Laan, 2009). As such, Hassan, et al (2007) improved the efficiency of their study through matching. A studys validity is also determined by the rate of non-response. According to Groves (2006) high non-response can lead to non-response bias. In Hassan, et al (2007)s study, the non-response rate was 19.4% with the reasons for failure to participate varying. However, the authors justified that statistical analysis showed that there was no significant differences between missed and selected patients based on sex, race/ethnicity, age, residency state, and educational level. As such, the study was free from non-response bias. The quality of case control studies is contributed by the number of cases and controls selected. In the current study under appraisal, the authors recruited the same number of cases and controls. Selecting equal number increases the efficiency of a study as BMJ (n.d.) states. However, the cases comprised older individuals and had lower level of education compared to controls, an aspect that may have interfered with the study results. Ascertainment of exposure may also impact on the validity and reliability of a study. Just like most case-control studies, Hassan, et al (2017)s study established exposure from personal recall by means of self administered questionnaire and structured interviews. As BMJ (n.d.) states, the validity of information from personal recall depend significantly on the subject matter. Therefore, it may have been difficult for some participants to remember their past habits, reducing the reliability of the findings. For instance, one of the risk factors sought to be investigated by Hassan, et al (2007) was dietary habits. Recall bias may have resulted since it may be problematic for individuals to remember their past nutritional habits. Additionally, it is more likely that cases may remember past exposures than controls since they may have figured the potential causes of their conditions. As Carlson and Morrison (2009) states, bias may result if controls and cases recall differently past exper iences. Confounding factors may affect the findings of a study as they may distort the true association between variables. They may falsely demonstrate an evident or mask an association between a risk factor and an outcome when there is no existence of any relationship (Skelly, Dettroli, Brodt, 2012). Hassan, et al (2007) addressed various confounding such as exposure to tobacco, use of alcohol, and chronic illnesses. Other important confounding factors accounted for by the authors are genetic and lifestyle considerations where they excluded first degree relatives and spouses respectively. These factors may increase the risk of developing pancreatic cancer. Therefore, by the authors recruiting controls that were considered free from exposure to them they decreased the effect of confounding on the study. What the Results Are Hassan, et al (2007)s findings revealed that diabetes mellitus, heavy consumption of alcohol, history of pancreatitis, pancreatic cancer family history, and cigarette smoking were significant pancreatic cancer risk factors. The study also revealed synergistic interactions between family pancreatic cancer family history, cigarette smoking, and type 2 diabetes in women. The results were adjusted for confounding and the associations were most likely insignificantly affected by these factors. The precision of a research finding is an important determinant of the quality of the study. Precision can be indicated by sample size and studys efficiency (Carlson and Morrison, 2009). Overall, Hassan, et al (2007)s study provided precise results since they included balanced groups of non-exposed, exposed, without outcome, and with outcome. Additionally, the adjusted odds ratio had narrow confidence intervals, indicating high precision in estimating the associations. Whether the Results Will Help Locally Hassan, et al (2007) incorporated a significant number of participants in their study. Additionally, participants were composed of people from different geographic areas, ages, and ethnic groups, making it representative. Therefore, the results can be generalized to a more universal population. Therefore, the study has external validity Conclusion The study by Hassan, et al (2017) can be deemed of good quality based on the current appraisal. Although it was found to have some weaknesses such as recall bias, its precision and internal and external validity were not compromised. The authors addressed most of the issues that may lower the quality of the study such as confounding factors, selection of cases and controls, addressed a clearly focused question, and chose controls effectively. As such, the study can be applied to the general population and can be used to support evidence-based healthcare coupled with other evidences from other research studies. References BMJ. (n.d.). chapter 8: case-control and cross sectional studies. The BMJ. Retrieved from https://www.bmj.com/about-bmj/resources-readers/publications/epidemiology-uninitiated/8-case-control-and-cross-sectional Carlson, M.D.A., Morrison, R.S. (2009). Study design, precision, and validity in observational studies. Journal of Palliative Medicine. 12(1), 77-82. CLIO. (2004). Incident vs. Prevalent cases. CLIO Learning Modules. Retrieved from https://cliomods.stanford.edu/trailmaps/selection/case-control/incident-vs-prevalent-cases/index.html Critical Appraisal Skills Program, (CASP). (2017). Critical appraisal checklist, case control studies. Retrieved from https://www.casp-uk.net/#!casp-international/c1zsi Groves, R.M. (2006). Nonresponse rates and nonresponse bias in houseghold surveys. Public Opinion Quarterrly. 70(5), 646-675. Hassan, M.M., Bondy, M.L., Wolff, R.A., Abbruzzese, J.L., Vauthey, J., Pisters, P.W., Evans, B., Khan, R., Chou, T., Lenzi, R., Li, D. (2007). Risk factors for pancreatic cancer: case-control study. Am J Gastroenterol, 102(12), 2696-2707. Pearce, N. (2016). Analysis of matched case-control studies. BMJ. 352 Rose, S. Laan, M.J. (2009). Why match? Investigating matched case-control study designs with causal effect estimation. The International Journal of Biostatistics. 5(1) Skelly, C.A., Dettroli, J.R., Brodt, D.E. (2012). Assessing bias: the importance of considering confounding. Evidence-Based Spine-Care Journal. 3(1), 9-12. Song, J.W. Chung, K.C. (2010). Observational studies: cohort and case-control studies. Plast Reconstr Surg. 126(6), 2234-2242. Young, J.M. Solomon, J.M. (2009). How to criticaaly appraise an article. Nature Reviews Gastroenterology and Hepatology. 6 (2), 82-91.