Influence of Pain on Quality of Life for Cancer Patients

Influence of Pain on Quality of Life for Cancer Patients Abstract Purpose: Pain is a common complaint of cancer patients which is found to significantly affect the quality of life of Head and Neck cancer patients. For patients suffering from cancer, control of symptoms and pain play a significant role in improving the overall quality of life of head and neck cancer patients. A literature search revealed that studies on the intensity of pain and quality of life before receiving anticancer therapy are lacking. Thus, this study was an attempt to assess the influence of intensity of pain on quality of life of cancer patients before receiving anticancer treatments Methods: A total of 100 histopathologically confirmed cases of head and neck cancer were interviewed. Intensity of pain was evaluated using the Brief Pain Inventory and the quality of life of patients was evaluated using EORTC QLQ-C30 module.. Results: The results showed that majority of patients suffering from oral cancer belonged to 5th and 6th decade of life. Kruskal Wallis test showed statistically significant in the quality of life and tumour stages. Chi square test also gave significant association between the quality of life and pain. Conclusions:. Assessment of Quality of life in cancer patients will direct the attention of clinician to the most important symptom; pain. Thus appropriate interventions can be instituted at right time along with palliative care to improve the Quality of Life of cancer patients. Keywords: Pain, Quality of Life, Cancer, Palliative care Introduction: Head and neck cancer encompasses a group of tumours involving the lip, oral cavity, nasal cavity, larynx, pharynx and paranasal sinuses. By incidence, it is the sixth leading cancer worldwide and eighth by fatality. Every year 0.5 million new cases are reported. It usually develops in 6th-7th decade of life and five year survival rate in a patient suffering from HNSCC is 40-50%. Approximately 40% of these tumours occur in the oral cavity, 15% occur in the pharynx, and 25% occur in the larynx; in 90% of the cases, the most common histologic type is squamous cell carcinoma. (1) Pain is the most burdensome symptom and is one of the most common complaints in a patients suffering from Head and Neck cancer. A systematic review evaluating the prevalence of pain in cancer patients over past 40 years reported high figures in the range of 52-77%. (2) The review also stated that as the stage of cancer advanced the prevalence of pain also increased. They reported a prevalence of 62%–86% in patients with advanced cancer. (2) These figures are in contrast to rapidly increasing research work in the field of pain relief. Pain is one of the most significant symptoms of cancer patients that affects multiple domains of life ranging from its impact on physical functioning to emotional functioning. It is a usual symptom of cancer patients, accounting for 30% to 40% of their chief complaints, and is of multifactorial aetiology. Approximately 58% of cancer patients suffer from unbearable pain, and this prevalence increases to 85% in patients with cancer in advanced stages. (3. A metanalysis which was carried out in the year of 52 studies for evaluating the prevalence of pain in cancer patients, reported that head and neck cancer patients had the highest prevalence of pain exceeding gastrointestinal gynaecological, breast and lung tumours. (2) In Head and Neck cancer patients, pain distresses the oral functions and is chief complaint in approximately 58% of the patients awaiting treatment and in 30% of the treated patients (4,5). The term â€Å"Quality of Life† has been used in literature in various ways both as a concept and an instrument of measurement. Very rarely has it been defined clearly. It may be considered as a subjective term which conveys the perception of a patient about his life which may either be positive or negative. It includes an assessment of general health, satisfaction, fulfilment, ability to cope, happiness, being in control and degree of independence. (6) Not only does pain affect the life of quality of patients before seeking antineoplastic treatment, also it has devastating effect in patients undergoing treatment. Thus there has been a growing interest in the inclusion of measures for improving life quality of patients before, during and after undergoing quality of life treatments. Literature search revealed that studies on the intensity of pain and quality of life before receiving anticancer therapy are lacking. Thus, this study was undertaken to assess the severity of pain and its impact on the quality of life (QoL) in untreated patients with head and neck carcinoma using questionnaire. Also the association of pain severity with clinical stage of the tumour and lymph node involvement was assessed. Materials and Methods: The study was carried out in the patients reporting to the outpatient department of K.L.E.V.K.I.D.S and Belgaum Cancer Institute. Ethical clearance was obtained from the institution. A total of 100 confirmed head and neck cancer patients were interviewed. Untreated histopathologically confirmed head and neck cancer patients were included in the study while patients who were receiving, or had completed their course of treatment for cancer, with recurring malignant disease and with compromised physical and mental state which prevented them from answering questions were excluded from the study. Patients were divided into four groups depending on their stage of tumour as follows:- Group I = Stage I=23 patients Group II = Stage II=25 patients Group III = Stage III=25 patients Group IV = stage IV=27 patients Pain was evaluated using â€Å"Brief Pain Inventory (BPI)† (7) which was validated in the North Indian Population.(8) The BPI is a 11 point scale which is presented horizontally from numbers ranging from 0-10. The Questions were translated in the local language of the patient. Patients were asked to rate their pain in the last 24 hours at its Worst, Least and on Average. Patients were also asked to encircle the number indicating the amount of pain they were having at present. The pain was then categorized into four groups: No pain (0), Mild pain (1-4), Moderate pain (5-6) and Severe pain (7-8) The Quality of Life of patients was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30) version 3.0 (9) which was validated in Indian Population (10).EORCTC QLQ-C30 is a 30 item questionnaire which consists of five functional scale, three symptom scale, six single items and Global Quality of life question.(8) The functional scale comprises a set of questions to evaluate the functioning of a cancer patient which includes Physical, Role, Cognitive, Social and Emotional Functioning. Symptom Scale includes three items to evaluate the fatigue, pain and nausea in patients. A number of single items such as Dyspnoea, Insomnia, Insomnia, Constipation, appetite loss, Diarrhoea and Financial difficulties were also included. The Symptom scale evaluated Fatigue, Pain and Nausea. Patients were asked to answer each question on a 4 point scale ranging from 1-4; corresponding to pain as Not at all (1), A little bit (2), Quite a Bit (3, Very Much (4). Patients were asked to rate the last two items (Global Quality of Life ) on a horizontal scale ranging from 1-7. All the scores thus obtained were linearly transformed to be expressed on a scale from 0-100. All the data was tabulated and non-parametric tests were applied. The data was subjected to Descriptive statistics, Mann-Whitney and Kruskal – Wallis test. Results: 100 histopathologically confirmed cases were enrolled in the study. The results showed that head and neck cancer was common in patients in 5th and 6th decade of life (35% and 32% respectively) with a mean age of 54.8 years (age range-24-86 years). Strong predominance of male population (79%) was seen. Out of a total 100 patients, 67% patients had the site of primary tumour in Oral cavity followed by Oropharynx (22 %), Larynx (6%)and Hypopharynx (5%). Lymph node involvement was present in 66% patients. The Mean scores for all the items on the scale was obtained using the EORTC QLQ-C30 Scoring Manual. Patients in the early stages of tumour scored significantly higher on function scale indicating higher functionality and ease in their daily activities. On contrary patients with advanced cancer scored higher on symptom scale indicating hampered quality of life and greater difficulty in doing their day to day work. Kruskal wallis test showed significant difference in the quality of life and the tumour stages, which was statistically significant .(p value On applying Mann Whitney test significant differences in the quality of life of patients with lymph node involvement and without lymph node involvement. (p value Chi square test also gave significant association between the quality of life and pain. (p value Discussion: This study was carried out to assess the influence of pain severity on quality of life of head and neck cancer patients before receiving any antineoplastic treatment. With approximately one million of new cancer cases being added every year in India and 80% of them presenting in advanced stages ( stage III and stage IV)(11)the need for pain relief and palliative therapy is imperative. Cancer pain still being one of the most dreaded and burdensome aspects of cancer patients draws attention to the management of pain in head and neck cancer patients. Inspite of introduction of WHO’s step ladder pattern for the management of pain control in cancer patients (12) it has been reported that less than 3% patients in India have an adequate access to pain relief. (13) . The present study also showed signification association between the cancer pain and stage of tumour. Patients with advanced stage of tumour experienced more difficulty in talking, swallowing etc. and poorer quality of life thus indicating a greater need for the institution of pain relief measures. The findings were consistent with the study done by Oliveira KG et al (14) who concluded that patients in advanced stages showed higher impairment in their functional status. Similar findings were noted by Connely et al (4) who reported that patients with squamous cell carcinoma experienced significantly incr eased function-related intensity of pain rather than spontaneous. The reasons for under treatment and inadequate pain relief could be attributed to poor resources, inaccessibility to morphine, misconception about the drugs for pain relief e.g. addiction, opiophobia of patients and communication problems. (15) Also the nature of Cancer pain is not fixed. It has multiple complex aetiologies and is recurring in nature. One of the very important reasons for the inadequate pain relief in cancer patients is that currently no such medication exists for chronic cancer pain that will provide more than 30% relief to the cancer patients.(16) This makes the institution of palliative and support care even more essential. The World Health Organization has defined Palliative care as â€Å"An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.† (17) WHO emphasizes on meeting the psychological, social and mental needs of the patients so as to improve their quality of life. However, it has been reported that approximately 85% of patients who are admitted to palliative care centres have inadequate relief of pain. (18). Despite the fact that HNC has the highest pain prevalence of all the cancers and is one of the initial symptoms that motivate the patients to seek medical opinion, health care professionals concentrate solely on the surgical aspects, radiotherapy and chemotherapy. The management of chief complain of the patient i.e. pain is neglected which leads to poor quality of life. Therefore an evaluation of cancer patients before initiating any antineoplastic treatment is critical to because most of the studies concentrate on the assessment of pain during or after treatment. Conclusion: The average time from the admission of patients to palliative care unit and their death is usually less than a month thus indicating that palliative care is usually initiated only in the terminally ill patients, An assessment of quality of life of cancer patients before treatment will draw the attention of the clinician to the most symptomatic and feared aspect of cancer i.e. pain. Thus appropriate measures for pain relief along with supportive and palliative care can be instituted right from the beginning of the treatment which will greatly enhance the quality of life of cancer patients. References: Parkin DM, Bray F, Ferlay J, Pisani P:Global cancer statistics, 2002. CA Cancer J Clin2005,55:74-108. Van den Beuken-van Everdingen MH1, de Rijke JM, Kessels AG, Schouten HC, van Kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007 Sep;18(9):1437-49. Cuffari L, de Tesseroli SJT, Nemr K, Rapaport A:Pain complaint as the first symptom of oral cancer: a descriptive study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2006,102:56-61. Connelly ST, Schmidt BL: Evaluation of pain in patients with oral squamous cell carcinoma. J Pain 2004, 5:505-510 Epstein JB, Emerton S, Kolbinson DA, Le ND, Phillips N, Stevenson-Moore P, Osoba D: Quality of life and oral function following radiotherapy for head and neck cancer. Head Neck 1999, 21:1-11. Bjordal K1, Kaasa S. Psychometric validation of the EORTC Core Quality of Life Questionnaire, 30-item version and a diagnosis-specific module for head and neck cancer patients. Acta Oncol. 1992;31(3):311-21. Cleeland CS, Ryan K: Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 1994, 23:129-138. Saxena A , Mendoza T,. Cleeland C. The assessment of cancer pain in north India: the validation of the Hindi Brief Pain InventoryBPI-H. J Pain Symptom Manage. 1999 Jan;17(1):27-41 Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JCJM, Kaasa S, Klee MC, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw KCA, Sullivan M, Takeda F.The European Organisation for Research and Treatment of Cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. Journal of the National Cancer Institute 1993; 85: 365-376. Chaukar DA, Das AK, Deshpande MS, Pai PS, Pathak KA, Chaturvedi P, Kakade AC, Hawaldar RW, DCruz AK. Quality of life of head and neck cancer patient: validation of the European organization for research and treatment of cancer QLQ-C30 and European organization for research and treatment of cancer QLQ-HN 35 in Indian patients. Indian J Cancer. 2005 Oct-Dec; 42(4):178-84. Seamark D, Ajithakumari K, Burn G, Saraswalthi Devi P, Koshy R, Seamark C. Palliative care in India. J R Soc Med. 2000;93:292–5. Vardy J, Agar M. Nonopioid drugs in the treatment of cancer pain. J Clin Oncol. 2014 Jun 1;32(16):1677-90. Khosla D, Patel F, and Sharma S. Palliative Care in India: Current Progress and Future Needs. Indian J Palliat Care. 2012 Sep-Dec; 18(3): 149–154. Oliveira KG, von Zeidler SV, Podestà ¡ JR, Sena A, Souza ED, Lenzi J, Bissoli NS, Gouvea SA. Influence of pain severity on the quality of life in patients with head and neck cancer before antineoplastic therapy. BMC Cancer. 2014 Jan 24;14:39. Thapa D, Rastogi V, Ahuja V. Cancer pain management-current status. J Anaesthesiol Clin Pharmacol. 2011 Apr-Jun; 27(2): 162–168. Bloodworth D. Opioids in the treatment of chronic pain: Legal framework and therapeutic indications and limitations. Phys Med Rehabil Clin N Am. 2006;17:355–79. Geneva: World Health Organization; [Last accessed on 2012 Mar 02]. â€Å"WHO Definition Of Palliative Care â€Å"Available from: http://www.who.int/cancer/palliative/definition/en . Lin YL, Lin IC, Liou JC: Symptom patterns of patients with head and neck cancer in a palliative care unit. J Palliat Med 2011, 14:556-559.

The Theme of The Cider House Rules Essay -- Homer Wells, moral obligat

During my senior year of high school, I often had dreams about leaving my parents house. Fantasizing about freedom and, the ability to come and go as I wished took the place of time designated for class work. I was tired of being told what to do, and I grew weary of the monotony of taking out the garbage and cleaning my room. Being told to come in the house by 10 pm while my friends stayed until 12 pm seemed unfair to me. The media bombarded my mind with the idea that being a football captain in senior year was supposed to be filled with keg parties, and orgies with cheerleaders. Schoolwork and housework weren't a a part of my 12th grade master plan. My thinking continued in this manner until I happened across a movie named "The Cider House Rules." It made me sit back and look at how ungrateful I was. I have both of my parents still alive and still together in the same house. I named about 15 friends who would praise God if they had what I had. Similar to my situation the main character in the Cider House Rules, Homer, was also desperate for a change of venue. Tired of the his mundane duties as a caretaker in the same orphanage that raised him, a way out became the only thing on his newly one tracked mind. The Cider House Rules is the tale of homer's struggle to find himself and to escape the grasp of the orphanage that was his prison. The story of Homer Wells, a child without parents who is raised and mentored by his orphanage's doctor, a man named Larch. Their bond was somewhat of an extraordinary one. Larch taught Homer everything about medicine and what he could about right and wrong. All Homer wanted was one thing Larch couldn't give him, freedom. Given the chance to leave the orphanage, and the only family he's ever k... ... him coming in the distance and was so filled with joy that he ran as fast as he could to meet his son. I learned from the mistakes of others, even if they are fictitious characters. Leaving home is inevitable, choosing the right time may be the most important thing. We all want to gain our independence and feel like a Man (or Woman). As young people its almost instinctive for us to want to get away from the evil clutches of "Mom and Dad." The old clichà © is ringing in my head like the emergency broadcast system, "You never miss the water until the well runs dry." Which really makes me think about being grateful for what we have, even though it seems to add up to chopped liver when compared to the joys of the world. Just like Homer and the Prodigal son, after "sowing our oats" we come to greater appreciate where home actually is, and we'll be glad to get there.

Running Head: Reframing Non-informational Matters

Reframing Non-informational MattersOther than her immediate advisors or the cabinet members the governor should seek advice from a criminology expert, local administrators, prosecutors and law enforcement officers. Her task force should contain the following appointees; the head manager who will oversee all the activities of the task force is running smoothly and report to her. A Criminology specialist who will advise on crime reduction, prevention and stop. Government prosecutors, local administrators who will mobilize people and talk them out of crime during meeting and the law enforcement officers and the operational staff in general.The language and metaphor she should use in her presentation to the individuals she would ask to serve on the task force should vary with the level of service and education but the message at the end of the day should be one. The top individuals in the task force should be spoken to in the horizontal communication. They should look and see the governo r as their leader. They should work very hard to ensure that the plan becomes efficient and effective. The governor should however speak to the lower appointee in a polite manner and ask for their cooperation and support to curb crime in the community. This is because the lower force men are the ones that interact more often than not with the layman. One of the metaphors she would use is prevention is better than cure. Her request can be worded differently to each potential member but should bring out the same meaning to each of them so that during their next meeting they can all be signing the same song .with the same goals and objectives that is success.The governor should announce her plan to the public in a simple and clear manner. She should be convincing and should also support her plan so as to win the public into believing it will work. Asking of questions to the public and requesting them to cooperate and help enhance the plan to succesed.She should fluently elaborate to th e public the merits of the plan if it pulls through.Her briefing to the media should be short and exact to the point. She should give the media a general over view of the plan and during the rest of the briefing process she should be busy asking the media rhetoric questions as well as using metaphor to defend herself and the plan again from their accusions.Examples she would use; Don’t you think that this plan if successful it kill two birds with one stone. Do you need a crime free Utopia or not? Do you think this plan will work out? Some of the tough questions she will get include; why didn’t you pick another way of getting fund? Who advised you on that strategy madam governor? How much expenditure shall your appointed team use during planning  Ã‚   and implement action of the plan. How will other nations react to your opinion of reducing criminal sentences and wouldn’t the criminal level increase due to this factor.One of the barriers of communication accord ing to   (Stan S.,David .K., John .K, 2003 p85)   is denial of information. For example the message may conflict with our personal beliefs or values. This factor may affect the law enforcement officer who beliefs that the criminal must be punished but the idea of preventing crime is new it might be ignored by some causing the plan not to work as supported to. Another barrier is lack of motivation or interest in communicating and interest in the message. The manager for example is supposed to be given a feedback of the progress of the plan from the lower workers. These messages are in a memo form. If the memos become very many the manager may lose the interest to read them that way communication barrier is created.Non-credibility of the source. The police force in is known to be very corrupt in their day to day work. If the police bring information to other members of the force e.g. the criminology expert may not believe the message due to their lack of credibility. This barrier is created. Use of complex channels of communication is another barrier to effective communication among the workforce. Important information does not reach the lowly workers because the transmission process is slow.These barriers can be overcome through the following techniques. In the case of lack of motivation. The manager would choice another form of communication like the fax machine which would give audio messages. This would motivate and interest him to know what the people are saying. In the case of non-credibility of the source the appointed law enforcement officers should strive and shun corruption and the group should also put down law to stop the vices. The lack of communication skill should be avoided by the individuals lacking the skills going through an academic training, formal education should also be given as well as streetwise language taught. A less complex communication channel should be created to allow for all members access information quickly.The plan should first be written down on a piece of paper. It should then be drawn in a diagram to show how co-operation of and the personnel in implementing it. The plan should then be produced into hard copies and given to the operational staff.Get one of the eloquent speakers with good communication skills.The elaborate the operational personnel showing them the job and how you wish the job to be done. Speak clearly on the part to be played by each operational staff. Elaborate on the means through which feedback is to be given to the manager as each person works to achieve the goals and objectives of the plan.The general barriers to communication that will exist among task force members and level of policy makers, administrators, middle managers, down to the operational staff are: communication skill as they are of different educational level, complex communication channel leading to poor transmission of information. Poor organizational climate is another barrier that generally affects the memb er of levels bringing about gossip.References;Kreps,G.Organizational Communication.2nd ed. New York: Longman, 1990.Farace, R.,Monge,P.and Russell, H.Communicating and Organizing.New York;Random House, 1977.

What are the main features of child directed speech and how does it help language acquisition?

The language traits that characterise child-directed speech tend to facilitate the acquisition of language. Children start their lives without language and are faced with the challenge of emerging into a world in which they cannot effectively communicate. From the time a child is born, however, they will begin to associate what happens around them with meaning. As time passes, they will begin to associate unknown verbal forms to known meanings. Parents show a unique type of speaking that is referred to as child-directed speech, motherese, or, more commonly, baby talk for example â€Å"moo-cow†.This speech has many unique characteristics that distinguish it from adult-directed speech. One feature of child language acquisition is that children master language by making mistakes until they fully acquire the skills. This ‘trial and error’ approach shows that learning is taking place, however, phonological development seems also to depend on physical ability to produce sounds. Some phonological errors used by children are deletion in words such as â€Å"do(g)† and â€Å"cu(p)†. Although some add on extra vowels, for example â€Å"doggie†.A lot of young children change one consonant or vowel for another, known as an assimilation such as â€Å"gog† instead of â€Å"dog†. These errors show that as a child learns a word is substitutes the sound of a letter for a different one. In phonology there are a variety of features used by parents for language acquisition such as higher pitch in the parents voice, a greater range of frequencies in the tone, a slower speed of speech, clearer enunciation, emphasis on one or two words in a sentence, and special pronunciations of individual words.This is more common from the mothers as it comes naturally to them and is done in order to allow infants time to process the information being conveyed to them. Rhythm is also emphasized when talking to a child and is used closely with th e emphasis of various syllables. One children can produce sounds effectively they can use these skills to form real words that others can recognize. Proto-words have meaning for the child and the parents so a child needs to acquire the vocabulary that will help them be understood by a wider audience. Also achild needs to learn the meanings of words in order to link objects and ideas. The rate of lexical development in children at 12 months is that they know 50 words which increase to 2,000 at 36 months which shows that language is aquired in the early stages. Parents also tend to use some lexical features in speech such as â€Å"mama† and â€Å"dada† to encourage the child to start speaking, as these words are usually the first two the child says in their early months. As the child starts to progress, the parent uses diminutives like â€Å"doggy†, â€Å"kitty†, â€Å"potty† for the child to understand easily.Children can link a word and the referen t easily as they can usually see it, or see a visual representation in a book. The social and interactive nature of many words also indicate the importance of interacting with others, suggesting that pragmatic awareness is vital to language development. The reduplicative such as â€Å"quack quack† and diminutives like â€Å"mummy† show the bridge between phonological and lexical development. Child directed speech features a unique syntax. Parents usually use short utterances rather than full sentence structures in order to convey meaning to their child.They are often repeated so children have practice in a particular concept. Child directed speech helps infants to detect syntactic boundaries and makes linguistic patterns easier to recognize. Children begin to understand word order through child directed speech which slowly expands into a deeper understanding of sentence structure. However, communicating with children can be difficult if you can’t maintain their attention, so you need to talk about a topic that interests them.For example if you are washing them you could talk about all the different body parts whilst washing them, if they splash talk about the splash. Ask a lot of questions and let them reply as this speeds the acquisition of verbal auxiliaries by the child. Parents should use lots of names for things and many words for actions as they play an important role in later language development. Conversations with children are mostly about the present, here-and-now, rather than topics pertaining to another time, past or future.Regarding grammar, in the first three or four years there is not much point in correcting them as it will just confuse them and may do harm to their confidence and self-esteem. It is best to let the child correct themselves spontaneously when they are ready. However you could drop hints to help them out in correcting what they are saying. In order to relate to a child during â€Å"baby talk†, a parent may deliberately fabricate some words, and may pepper the speech of non verbal utterances. The parents might refer only to objects and events in the immediate surrounding area, and will often repeat the child’s utterances back to them.Children employ a wide variety of phonological simplifications, usually assimilation or reduplication, in learning speech, where the child seizes on a stressed syllable, and repeats it to form a word. Within the context of normal conversation with their children caregivers use a variety of techniques to encourage the continuance of that conversation. Repetition is one of the most frequently used methods of prolonging conversation, as well as one of the particular traits of child-directed speech.Frequently heard words for objects will be better remembered and better articulated than other words once the child begins to develop a productive vocabulary of real words. The more times a child hears a sentence clearly modeled, the more that child†™s language learning is facilitated. The expand and recast technique serves as an alternative to repetition, and, is a method parents often use as it gives children new ideas and helps with the formation of grammar, as well as prolonging the conversation by recasting the prior topic into a new form.Turn-taking is another technique used in child-directed speech. Used early in the child’s development, turn-taking provides infants with the opportunity of learning the structure of conversations. The parents use cues such as exaggerated pauses to help infants learn to take their turns. Routines of turn-taking also serve other functions in linguistic development. Babies gain experience in vocalizing, and participate in situations in which that vocalizing becomes more language-like.

Garbage Pollution Essays

Garbage Pollution Essays Garbage Pollution Paper Garbage Pollution Paper These persons are my mother and my social studies teacher. Introduction This school based assessment IS based on garbage pollution. The area chosen for survey on garbage pollution is the community of august town. You will learn about the causes that contribute to garbage pollution and the effects of it. The persons views of garbage pollution will also be taken into consideration. Table of Contents Title pollution 6 The reason for investigation Method of investigation Procedure for data collection Questionnaire page Definition of garbage 5 Statement of problem Continuation of questionnaire 11 Graphs 12 Graph 2 13 Graph 3 14 Graph 4 15 Graph 5 Analysis of interpretation of data 17 Statement of findings 18 Recommendation 19 Bibliography 20 7 8 9 10 16 Definition of Garbage Pollution All refuse other than industrial waste and effluents. It consists largely of easily decomposable and putrefying organic (animal and vegetable) waste from preparation, handling, storage, and sale of serving of food. Statement of Problem Why is garbage pollution one of the major issues of my community? What are the effects of it and how it can be solved? Reason for Investigation The reason for this investigation is due to inconsistency of appearances of the garbage collectors assigned to the august town community. And when the garbage is not collected it causes garbage pollution which attracts rodents and insects which can be dangerous to the human health due to the diseases that they carry. Another reason is to research and know different means by which the community cleanliness and beauty can improve. : Method of Investigation The researcher has chosen the questionnaire as a use for the investigation in attaining data. It is a simple way of collecting data and does no requires too much time. Procedures for Data Collection The research was conducted on September 1, 2012, on garbage pollution in the community of august town. The researcher walked around the community and distributed 30 questionnaires, randomly to persons that were seen, including friends and family. The questionnaires were given to persons between the ages of 12 to 18 years old. Out of the total respondents 15 were females and 15 were males. Getting the information that was necessary for the questionnaire on the spot made it much easier and it also saved allot of time. But ensured that each respondent spend enough time completing it so it wasnt being done in much haste.

Fuzzy Logic Momentum Analysis System For Financial Brokerage Accounting Essay Example

Fuzzy Logic Momentum Analysis System For Financial Brokerage Accounting Essay Example Fuzzy Logic Momentum Analysis System For Financial Brokerage Accounting Essay Fuzzy Logic Momentum Analysis System For Financial Brokerage Accounting Essay Abstract- The modeling of fiscal systems continues to keep great involvement for non lone research workers but besides investors and policymakers. Many of the features of these systems, nevertheless, can non be adequately captured by traditional fiscal modeling attacks. Fiscal systems are complex, nonlinear, dynamically altering systems in which it is frequently hard to place mutualist variables and their values. Financial securities firm is concerned with put to deathing orders of purchasing and merchandising of certain sums of portions at the best possible monetary value. Many mathematical and algorithmic systems have been developed for this undertaking, nevertheless they can non look to get the better of a criterion volume based system. This paper proposes a new model for high frequence trading utilizing an intelligent fuzzy logic based impulse analysis system. The system was applied to securities firm of fiscal stocks, and tested against the criterion volume based securities firm system. The Fuzzy Logic Momentum Analysis System has proven to surpass the traditional and standard systems that are used in the industry. Keywords ; Finacial securities firm ; fuzzed logic ; high frequence trading. Introduction It is good known that a chief insufficiency of much economic theory is that it postulates exact functional relationships between variables. On the other manus in fiscal clip series analysis, information points seldom lie precisely on consecutive lines or smooth maps. [ 7 ] suggests that trying to suit these nonlinear phenomena will present an unacceptable degree of instability in theoretical accounts. : As a consequence of this intractableness, research workers and investors are turning to unreal intelligence techniques to better inform their theoretical accounts, making determination support systems that can assist a human user better understand complex fiscal systems such as stock markets. Artificial intelligence systems in portfolio choice have been shown to hold a public presentation border over the human portfolio director and recent research suggests that attacks that incorporate unreal intelligence techniques are besides likely to surpass classical fiscal theoretical accounts [ 4 ] . Artificial intelligence attacks have late been normally adopted in fiscal modeling. Traditionally, stock market calculating methodological analysiss have been based on either cardinal or proficient analysis. Cardinal analysis efforts to find the intrinsic value of stocks based on extended macroeconomic informations, whereas proficient analysis relies on analyzing market activity, peculiarly historic monetary values and volume. Whilst there is much back uping research for both schemes in fiscal theory we focus on systems utilizing proficient methodological analysis as the subjective and complex nature of cardinal analysis means it has, to day of the month, received small attending in unreal intelligence research. Fuzzy logic was foremost introduced by [ 6 ] . It is a signifier of multivalent logic which, whilst retaining the deductive construction of classical symbolic logic, includes the construct of grade of truth. Rather than being either true or false, as in binary logic, statements in fuzzed logic have a rank map which defines a fuzzy set ( as opposed to a chip set in conventional set theory ) . Fuzzy logic is hence an ideal attack to jobs that require a representation that can cover with estimates, uncertainness and deficient information and it has been applied to spheres every bit diverse as pattern acknowledgment [ 10 ] , railroad control systems [ 2 ] and computing machine game design [ 11 ] . The regulation base and illation engine of a fuzzed system is comparable to that of the cognition base of an expert system. The application of fuzzed set theory in economic science was foremost presented by [ 12 ] and has since received much attending [ 3 ] Time series theoretical accounts were foremost combined with fuzzed theory by [ 5 ] giving rise to fuzzy time-series, the cardinal model of all the investing systems. Research workers making stock trading systems have implemented many fluctuations of this theoretical account. Most late, [ 1 ] has proposed the usage of Adaptive Neuro Fuzzy Inference Systems ( ANFIS ) , which combine the prognostic belongingss of nervous webs, with the concluding mechanisms of fuzzed logic to make an machine-controlled trading and prediction system that has been used for high frequence trading of foreign exchange currencies markets ( FOREX ) . This paper is outlined as follows. In subdivision II we give a general overview about fuzzed logic illation systems. Section III introduces the fuzzed logic impulse analysis system ( FL-MAS ) . Section IV explains the methodological analysis of utilizing FL-MAS for securities firm. Section V provides a public presentation analysis of the system. Finally, reasoning comments are given in Section VI. Fuzzy illation Systems Many types of fuzzed illation systems have been proposed in literature, nevertheless, in the execution of an ANFIS for fiscal anticipations and appraisal, the most suited theoretical account is the Sugeno theoretical account, which uses if-then-rules to bring forth an end product for each regulation which is the additive combination of the input variables plus a changeless term, and the concluding end product is the leaden norm of each regulation s end product. The regulation base in the Sugeno Model, has regulations of the signifier: If X is A1 and Y is B1 so f1 = p1* x + q1* y + r1 If X is A2 and Y is B2 so f2 = p2 * x + q2 * y + r2 ( 1 ) where X A ; Y are predefined rank maps, Ai and Bi are rank values, and pi, chi, and Rhode Island are the attendant parametric quantities that are updated in the forward base on balls in the acquisition algorithm. When we calculate the equation of First order Sugeno the grade of rank variable of X1 in rank map of Ai is multiplied by the grade of rank variable of X2 in rank map Bi and the merchandise is deemed a first Liner Regression Weight ( Wi ) . Finally the leaden mean F1 and F2 is deemed the concluding end product ( Z ) which is calculated as follows: A fuzzed illation systems shown in Fig. 1 is a regulation based fuzzy system that can be seen as an associatory memory and is made of five constituents ; regulation base which consists of the fuzzed if-then regulations, the informations base which defines rank maps of the fuzzed sets used in the fuzzy regulations, the determination devising unit which is the nucleus unit and is besides known as the illation engine, the fuzzification interface which transforms chip inputs into grades of fiting lingual values, and eventually the defuzzification interface which transforms fuzzed consequences into sharp end product [ 13 ] . Fuzzy Logic Momentum Analysis System Making a fuzzed illation system to observe impulse is a complex undertaking. The designation of assorted market conditions has been a subject topic to assorted theories [ 14 ] and suggestions. This paper proposes a fuzzed illation system which categorises the market conditions into 7 classs based on monetary value motion, and will utilize the current volume to find the engagement rates ( PR ) of the trading system each clip. Fuzzy Inference Momentum Analysis The first measure in planing the Fuzzy Logic Momentum Analysis System, FL-MAS, is specifying the market conditions that the fuzzy system has to place. In this paper we use the following 7 market conditions to cover all possible motions of the monetary value series: Beat uping Strong up Slightly up Average Slightly down Strong down Crashing These conditions are considered as lingual values for the fuzzy logic system, and will be used to find the current province of the monetary value formation and its impulse. As impulse is built up, the system looks at the old x sum of ticks and performs an illation process by adding all the motions of the current monetary value to the old monetary value to find whether the general tendency has been up or down after ten points. In other words, impulse is detected by the followers: where is the current monetary value, is the old monetary value, and is a fluctuating counter which goes up or down harmonizing to the motion of the monetary value. whenever monetary value goes up it adds 1, when the monetary value goes down it subtracts 1, therefore this can be used in placing market conditions for x sum of points, where if the market is traveling strongly upwards, it will be detected by holding more 1s than -1 or 0s. This can be explained in the undermentioned equation: ( 2 ) where is the period that we want to observe the impulse for. For illustration, if we want to observe the impulse of the last 100 ticks, we add all the up, down fluctuations and so feed the ensuing figure to the fuzzy system which would lie someplace in the rank maps shown in Fig. 2. Membership maps for the lingual variable of market conditions The same process is applied for ciphering the lingual variable volatility, where the lingual values are as follows: Very fast Fast Medium Decelerate Very slow The fuzzy logic system takes both market impulse and volatility in consideration ; it generates the regulations, and eventually takes a determination based upon the sum of market engagement. The Data Experiments in this paper have been carried out on high frequence tick-data of both Vodafone Group plc ( VOD ) and Nokia Corporation ( NOK ) . For both stocks, 2 months of high frequence tick-data between 2nd Jan 2009 and 27th Feb 2009 has been obtained, and split into 30 subdivisions each. This was done in order to avoid any car correlativity between the monetary values. In other words, the fuzzy logic system gets the first batch of informations, performs all the actions of bargains or sells on it, so the same is process repeated utilizing the criterion volume based system, eventually comparing the public presentation of both systems. Once the observation is obtained, the system skips about 10000 ticks and performs the same operations once more, for 30 times, each clip observing the public presentation of both systems. It has to be mentioned that 2 months of high frequence tick informations is a significantly big sum of informations, taking in consideration that for each loop the sy stem takes the analysis of the impulse of the past 100 ticks. Fig. 3 shows how the information is split after each simulation in order to avoid any possible similarities or autocorrelation in the monetary value. FL-MAS for securities firm tick informations discarded tick informations High frequence tick by tick informations Sim 1 Sim 2 Sim N The chief aim of the Fuzzy Logic Momentum Analysis System ( FL-MAS ) implemented in this paper is to surpass the industry criterion volume system, that has been used by securities firm houses to put to death big orders of purchasing or selling a certain stock. Many systems have used quantum modeling and analysis to find the assorted engagement rates ( PR ) , nevertheless they normally fail to surpass the criterion volume system in the long term [ 15 ] . This paper uses FL-MAS presented in subdivision 3, to find the PR in the market harmonizing to the current impulse. In other words, if we are on a bargain order, we would prefer to increase the PR ( figure of portions bought at that clip ) , when the monetary value is low, and diminish the engagement when the monetary value is high. Tick informations splitting mechanism Standard Volume System ( SVS ) A standard securities firm mechanism for put to deathing big orders is a simple volume based system, which parses the volume being traded, whenever a certain sum of portions ( a threshold ) have been traded, the system would purchase or sell ( depending on the order ) a certain per centum of that. In other words, if there is an order to merchandise 1 million portions of a certain stock. The threshold would be for e.g. 10,000 portions, and whenever 10,000 portions have been traded, if the PR is set to 25 % , the system would purchase or sell 25 % of the mean volume. ( 3 ) where N is the figure of operations required to make the mark order for illustration 1 million portions, % is a fixed PR, for illustration, 25 % whenever the threshold is exceeded. The above system has proved to be efficient and is being adopted by many securities firm houses around the universe. The purpose of this paper, is to turn out that FL-MAS outperforms this type of system on the long tally. FL-MAS The thought here is to utilize the fuzzy logic impulse analysis system described in subdivision 3, to place what market status we are presently shacking in. This will let us to change the PR ( % ) . This provides an advantage, since the system can merchandise sharply when the status is at an extreme. It would besides understate its trading when the status is at another extreme. In other words, if we are selling million portions, the system will do a trade whenever the threshold of volume has been exceeded. However if the current market status indicates that the monetary value is really high or beat uping so we know that this is a good clip to sell a batch of portions, for illustration 40 % of the current volume. The same thing applies for when the impulse indicates that the monetary value is strong down which means that the system should sell less sums of volume at this low monetary value, for illustration 15 % . The contrary mechanism applies for purchasing portions. When the market is crashing, this is a good index that we should purchase a big ball of volume ( 40 % ) , and when the monetary value is at an mean point, this means that it would act like the SVS system i.e. purchasing 25 % of Volume. This is shown in Table 1. Engagement rates for buy side and the sell side of FL-MAS Market Condition Buying Praseodymium Selling Praseodymium Beat uping 10 % 40 % Strong up 15 % 35 % Slightly up 20 % 30 % Average 25 % 25 % Slightly down 30 % 20 % Strong down 35 % 15 % Crashing 40 % 10 % Performance Measures After implementing both SVS and FL-MAS, the standards at which both systems will be compared against each other will be the outperformance of FL-MAS on the SVS in footing points. TheA footing point is a unit of step used frequently to depict the per centum at which a alteration in the value or rate of a fiscal instrument has occurred. One footing point is a1/100th of a per centum orA 0.01 % . It is besides tantamount to 0.0001 in denary signifier. To cipher the betterment ( elf ) for the buy side in footing points we use the undermentioned expression: iˆ?iˆ?iˆÂ © For the Sell Side the betterment in footing points is: iˆ?iˆÂ µiˆÂ © Where is the entire cost of purchasing x sum of portions utilizing FL-MAS, and is the entire cost of purchasing the same figure of portions utilizing the traditional SVS. Consequences This subdivision displays the consequences of utilizing both FL-MAS and SVS to purchase 1million portions of VOD and NOK. For each symbol 30 simulations have been carried on the tick-data set described in subdivision 3. The information has been split as described in order to avoid any autocorrelations, both systems have been run and tested on the same information sets. Table 2 displays the cost at each simulation for purchasing 1million portions of NOK utilizing both systems. The mean monetary value of the whole set is besides displayed, and eventually the betterment of FL-MAS against SVS is displayed. This betterment rate can be either positive ; when FL-MAS has outperformed SVS or negative ; when FL-MAS was outperformed by SVS. Table 3 provides a full analysis of Table 2, by demoing clearly the mean outperformance rate of purchasing 1million portions of NOK utilizing FL-MAS, which turns out to be a positive of 2.98 footing points, which means that on mean utilizing FL-MAS we save about 3 footing points whenever we buy 1 million portion of NOK. Table 3 besides displays the consequences of implementing both systems to purchase 1 million portions of VOD. These consequences for VOD ( besides displayed on Fig.4 ) show a much higher mean of around 12.5 footing points. Experiments have been performed once more by reshuffling the information sets utilizing the informations slots that have non been used before, and the observations were really similar to these consequences. Hence another measuring mechanism was to detect the median of the consequences. The median is described as the figure dividing the higher half of a sample or distribution from the lower half. Both Medians for NOK, and VOD were positive, bespeakin g that on mean FL-MAS outperforms SVS for all the purchasing Simulations. Comparing the public presentation of FL-MAS against SVS for purchasing 1M portions of NOK Average Monetary value Cost of purchasing 1m NOK Shares utilizing FLMAS Cost of purchasing 1m NOK Shares utilizing SVS Improvement in footing points 11.55 11278964 11285761 6.02 12.19 11581642 11572708 -7.72 11.57 11904468 11910571 5.12 11.12 11610312 11581174 -25.16 11.45 11076799 11087759 9.88 11.36 11456338 11452293 -3.53 11.03 11390049 11404634 12.79 10.89 10947120 10956223 8.31 10.45 10923870 10950576 24.39 10.31 10373596 10377899 4.15 10.63 10354815 10367941 12.66 10.78 10655795 10644194 -10.90 10.70 10816236 10814437 -1.66 10.45 10723627 10737409 12.84 10.24 10281461 10286957 5.34 10.48 10214443 10205979 -8.29 9.67 10553155 10547707 -5.17 9.67 9581014 9602197 22.06 9.40 9754339 9740190 -14.53 9.22 9521736 9544895 24.26 9.10 9282640 9280416 -2.40 9.38 9135088 9149560 15.82 9.27 9434147 9457587 24.78 9.42 9262702 9272236 10.28 9.77 9439104 9430047 -9.60 9.87 9807817 9799844 -8.14 9.49 9880881 9885421 4.59 9.58 9585207 9580119 -5.31 9.48 9619778 9624263 4.66 9.40 9556780 9555829 -1.00 9.67 9350444 9359424 9.59 9.98 9724834 9707290 -18.07 9.94 9869580 9869177 -0.41 Analysis of consequences of purchasing 1m portions of NOK and VOD Mean ( elf ) Median ( elf ) Entire ( elf ) Buying NOK 2.98 4.63 101.18 Buying VOD 12.48 1.58 374.53 Besides the entire betterment of both is really high indicating that for both the 30 simulations, a 101.18 footing points was saved utilizing FL-MAS on NOK, and a 374.53 on VOD. Buying 1m portions of VOD Similarly, the sell side is displayed in Table 4, and analysed in Table 5. Similar to the bargain side, all simulations and experiments utilizing FL-MAS and SVS, have displayed that on mean FL-MAS has proved to be the better system, and therefore would increase the profitableness of a fiscal securities firm house that executes multiple big orders. Fig. 5 displays the merchandising of 1m portions of VOD. Comparing the public presentation of FL-MAS against SVS for selling 1M portions of VOD Average Monetary value Cost of selling 1m VOD Shares utilizing FLMAS Cost of selling 1m VOD Shares utilizing SVS Improvement in footing points 139.75 138379831 138304137 5.47 142.10 141880579 141466276 29.20 147.30 145752861 145974583 -15.21 145.70 147127925 147242618 -7.80 144.50 145284236 145840646 -38.30 148.30 141887321 141926909 -2.79 138.30 138593022 138540789 3.77 137.60 138159371 138119542 2.88 138.45 137192635 137152512 2.92 138.80 136243869 137297036 -77.30 138.70 138854269 138889050 -2.50 135.95 134818894 134622571 14.56 133.85 135551066 135198498 26.01 136.50 133744440 133824812 -6.01 135.55 136450408 136384280 4.85 139.50 136381824 136248448 9.78 138.30 138364382 138217262 10.63 136.85 136263730 136277519 -1.01 134.20 133894601 133855738 2.90 134.56 133894289 132534941 101.52 127.10 129477007 129129593 26.83 128.90 127159502 127174918 -1.21 130.85 129889373 129821846 5.20 135.50 130203793 130019981 14.12 136.85 135468629 135441956 1.97 136.45 136622702 136595289 2.01 138.05 136719313 136746751 -2.01 136.65 134943043 135082269 -10.32 132.15 133857223 134159108 -22.55 Analysis of consequences of Selling 1m portions of NOK and VOD Mean ( elf ) Median ( elf ) Entire ( elf ) Selling NOK 1.6812 2.9291 57.16 Selling VOD 2.73 2.46 81.83 Selling 1m portions of VOD Decision The job of order executing is a really complicated one. To be able to supply the best monetary value, an executing system has to dynamically alter the engagement rates at each case in order to provide for monetary value alterations, which are driven by impulse and volatility. This paper has introduced a system that makes usage of fuzzed logic, in order to ground out the current market status which is produced by the accretion of impulse. FL-MAS is a fuzzed logic impulse analysis system that outperforms the traditional systems used in industry which are frequently based on put to deathing orders based on the leaden norm of the current volume. Consequences of the enforced system have been displayed and compared against the traditional system. The system proves that on norm it increases profitableness on orders both on the bargain and sell sides. Further work and research has to be done to optimize the public presentation of the system. This could either include the usage of a familial algorithm to optimize the rank maps or the usage of Adaptive Neuro Fuzzy systems which would bring forth all the possible regulations for the system.

All About Pirates and Their Treasure

All About Pirates and Their Treasure We’ve all seen the movies where one-eyed, peg-leg pirates make off with great wooden chests full of gold, silver, and jewels. But this image isnt really accurate. Pirates only rarely got their hands on treasure like this, but they did still take plunder from their victims. Pirates and their Victims During the so-called Golden Age of piracy, which lasted roughly from 1700 to 1725, hundreds of pirate ships plagued the waters of the world. These pirates, while generally associated with the Caribbean, did not limit their activities to that region. They also struck off the coast of Africa and even made forays into the Pacific and Indian Oceans. They would attack and rob any non-Navy ship that crossed their paths: mostly merchant and slave vessels plying the Atlantic. The plunder the pirates took from these ships mainly were trade goods profitable at the time. Food and Drink Pirates often plundered food and drink from their victims: Alcoholic drinks, in particular, were rarely if ever allowed to continue on their way. Casks of rice and other foodstuffs were taken on board as needed, although the less cruel pirates would leave enough food for their victims to survive. Fishing ships were often robbed when merchants were scarce, and in addition to the fish, pirates would sometimes take tackle and nets. Ship Materials Pirates rarely had access to ports or shipyards where they could repair their vessels. Their ships were often put to hard use, meaning that they were in constant need of new sails, ropes, rigging tackle, anchors, and other things necessary for the day-to-day maintenance of a wooden sailing vessel. They stole candles, thimbles, frying pans, thread, soap, kettles, and other mundane items and would often also plunder wood, masts, or parts of the ship if they needed them. Of course, if their own ship were in really bad shape, the pirates would sometimes simply swap ships with their victims! Trade Goods Most of the loot gained by pirates was trade goods being shipped by merchants. Pirates never knew what they would find on the ships they robbed. Popular trade goods at the time included bolts of cloth, tanned animal skins, spices, sugar, dyes, cocoa, tobacco, cotton, wood, and more. Pirates had to be choosy about what to take, as some items were easier to sell than others. Many pirates had clandestine contacts with merchants willing to purchase such stolen goods for a fraction of their true worth and then resell them for a profit. Pirate-friendly towns such as Port Royal, Jamaica, or Nassau, Bahamas, had many unscrupulous merchants willing to make such deals. Slaves Buying and selling slaves was a very profitable business during the Golden Age of piracy, and slave ships often were raided by pirates. Pirates might keep the slaves to work on the ship or sell them themselves. Often, the pirates would loot the slave ships of food, weapons, rigging, or other valuables and let the merchants keep the slaves, who were not always easy to sell and had to be fed and cared for. Weapons, Tools, and Medicine Weapons were very valuable. They were the tools of the trade for pirates. A pirate ship without cannons and a crew without pistols and swords were ineffective, so it was the rare pirate victim that got away with his weapon stores unplundered. Cannons were moved to the pirate ship and the holds cleared of gunpowder, small arms, and bullets. Tools were as good as gold, whether they be carpenters tools, surgeons knives, or navigational gear (such as maps and astrolabes). Likewise, medicines were often looted: Pirates were often injured or ill, and medicines were hard to come by. When Blackbeard held Charleston, North Carolina, hostage in 1718, he demanded- and received- a chest of medicines in exchange for lifting his blockade. Gold, Silver, and Jewels Of course, just because most of their victims didnt have any gold doesnt mean that the pirates never got any at all. Most ships had a little gold, silver, jewels, or some coins aboard, and the crew and captains were often tortured to get them to reveal the location of any such stash. Sometimes, pirates got lucky: In 1694, Henry Avery and his crew sacked the Ganj-i-Sawai, the treasure ship of the Grand Moghul of India. They captured chests of gold, silver, jewels, and other precious cargo worth a fortune. Pirates with gold or silver tended to spend it quickly when in port. Buried Treasure? Thanks to the popularity of Treasure Island, the most famous novel about pirates, most people think that the bandits went around burying treasure on remote islands. In fact, pirates rarely buried treasure. Captain William Kidd buried his loot, but hes one of the few known to have done so. Considering that most of the pirate treasure to be had was delicate, such as food, sugar, wood, ropes, or cloth, its not surprising that idea is mostly a myth. Sources Cordingly, David. New York: Random House Trade Paperbacks, 1996 Defoe, Daniel. A General History of the Pyrates. Dover Maritime, 60742nd edition, Dover Publications, January 26, 1999. Konstam, Angus. The World Atlas of Pirates. Guilford: The Lyons Press, 2009 Konstam, Angus. The Pirate Ship 1660-1730. New York: Osprey, 2003