Marx's concept of alienation and Christianity's concept of sin and Essay - 1

Marx's concept of alienation and Christianity's concept of sin and disordered will - Essay Example We should realize alienation as a means in which, individuality, freedom, and subjectivity develop. Christians should view it as a process of self realization and self development. They should not view it as a way of creating fragmentation and division among people (Harvey 18). The concept of sin and disordered will should not be linked to alienation, nevertheless should Christians take excuse for the hostile alien powers that operate as if they are uncontrollable powers of nature. The remedy for Christianity and the actual meaning still remain debated. It is viewed in other terms as to being interpersonal or personal. We are, therefore, required to have a conscious choice of actions with Christians advised to reject techniques that are incompatible with the Christian world. We should be ready to accept things that promote unified and coherent world. Alienation should not be taken as an excuse for any sinful activity (Fromm

Microbiota and Cancer Treatment

Microbiota and Cancer Treatment Chloe Duffy Abstract microflora in humans regulates numerous bodily processes and cellular functions metabolism, inflammation, immunity, and now has been found to play a role in cancer treatments efficacy, side effects, after effects. talk about the body of the paper. In conclusion, the gut and potentially oral, etc microbiota can be modulated to protect the body from effects of treatment, or even enhance the effectiveness of the treatment. Introduction The human body contains numerous microorganisms that inhabit many parts of the body such as the skin, oral mucosa, and gastrointestinal tracts, known as the human microbiota. These microorganisms aid in metabolism, local and systemic immune system responses, regulation of inflammation, nutrient absorption, and even prevention of infection and diseases. Some of the most common bacteria within the gut microbiome are Firmicutes, Bacteroidetes, Bifidobacteria, Proteobacteria, Verrumicrobia, Actinobacteria, Fusobacteria, and Cyanobacteria; other types of bacteria such as Actinomyces or Lactobacillus are also common in other areas of the body. All of these types of bacteria play a role in different processes that are beneficial to maintaining health. Although these microorganisms are commonly found in most individuals, each hosts microbiota is unique. Genetics, antibiotic use, diet, type of birth delivery, lifestyle, and incidence of disease can all contribute to the composition of gut mic robiota.12   Although this means that the gut microbiome is variable and certain conditions can result in dysbiosis, it is also beneficial to have the capabilities to modulate and control the gut microbiota in order to maintain healthy bodily functions and immune responses to infection. Recently, there have been studies establishing a relationship between microbiota and cancer treatment. Particularly the gut microbiota that influences metabolic functions and inflammation and adaptive immunity play a major role in the initiation, proliferation, and response to anticancer treatment.12 In the majority of studies, the microbiota have been shown to enhance the effectiveness of cancer treatments and prolong the anticancer immune response. One way this has been demonstrated is by the transfer of faecal microbiota from mice that respond well to cancer therapy into unresponsive germ-free mice, resulting in improved anticancer reactions to treatment. Research has also shown that predictions can be made based on the patients gut microbiome whether or not they will have an efficient reaction to the cancer treatment or if they will exhibit negative side effects from the method of therapy.8 In addition to using the microbiome to predict patient reactions to therapy, studies have shown that it is possible to modulate the gut microbiota in order to either prevent or treat adverse effects that usually coincide with different therapies.19 These new developments are crucial for the progression of cancer therapies, especially immunotherapies. Many patients still do not respond to anticancer treatments that others do and with this promising research new opportunities for personalized therapy become an option for these individuals. Immunotherapies and modifying the microbiota of patients can offer more tailored treatment plans that can provide more promising results. In addition, these new methods can enable a more aggressive treatment plan for certain types of cancer without the fear of negative side effects or lasting damage to healthy tissue. With modulation of the microbiota, these adverse effects can be prevented and treated, using the microorganisms to protect against injury. The composition of the human microbiota plays an integral role in regulating the efficacy of anticancer treatment and development of adverse effects. (Should I include that targeting the microbiota can improve the efficacy and reduce adverse ef fects? Human Microbiome and Cancer Treatments       There are many different categories of anticancer therapies, the three main types are chemotherapy, radiation therapy, and immunotherapy. However, there is interindividual variation in the gut microbiota that can determine whether the immune system is competent enough and if the patient will respond to therapy positively or negatively.19 The targeting of gut microbiota can improve the efficacy of all of these treatment plans. The figure below shows some of the processes that gut microbiota can regulate anticancer therapies. Figure 1 12 This figure is an overview of a selection of anticancer treatments that the gut microbiota can mediate or perhaps enhanceà ¢Ã¢â€š ¬Ã‚ ¦ add more descriptionà ¢Ã¢â€š ¬Ã‚ ¦ Chemotherapy Chemotherapy is the use of drugs, usually cytotoxic, to treat cancer. These cytotoxic drugs are typically classified according to their mechanism of action, alkylating agents, heavy metals, cytotoxic antibiotics, and spindle poisons.12 These drugs cause significant damage to any rapidly dividing cells including healthy tissues, and can therefore have varying effects on individual patients. Gastrointestinal toxicity is a common adverse effect from anticancer drugs and can be so severe that the treatment has to be postponed or the dose is limited; this reduces the efficacy of the therapy. Targeting and modifying gut microbiota can be used to protect the intestinal epithelium and prevent the toxicity of these compounds. One mechanism of microbiota that can be exploited is its role in drug metabolism and microbial enzymatic degradation. An example of this is with the drug Irinotecan. Irinotecan is a chemotherapy drug that commonly causes severe gastrointestinal distress by increasing caecal Clostridium cluster XI and Enterobacteriaceae and cannot be used long term for treatment. SN-38, the drugs active metabolite is converted to glucuronide which is typically cleaved by bacterial beta-glucuronidases, commonly found in the Firmicutes phylum, for a carbon source; however, this releases the active SN-38 back into the intestinal lumen leading to diarrhea.19 In this study, however, it was discovered that the bacterial enzyme has a specific loop not present in the human enzyme; this is beneficial in developing drugs to target the bacterial enzyme specifically in order to prevent the adverse effects to continue anticancer treatment. Ciprofloxacin and amoxapine were two drugs that exhibited inhibition of the bacterial enzyme, suppressing the severe diarrhea.19 The microbiota enzymatic functions can also have a role in modifying the toxic profile of chemotherapy drugs. This can cause difficulty in creating custom chemotherapy treatment plans utilizing the modulation of microbiota because some of the bacteria can have multiple effects on different targets using the same enzyme. An example of this is the bacterium Mycoplasma hyorhinis, it contains a phosphorylase that can restrict the ability to inhibit cell growth and division by drugs containing pyrimidine nucleoside. Additionally, Mycoplasmas phosphorylase negates the efficacy of the drug gemcitabine. However, this same enzyme can improve the effectiveness of drugs containing the metabolite 5-fluoro-5-deoxyuridine.19 This proves the difficulty in modifying each patients gut microbiota to improve their chemotherapeutic efficacy. Although, it can be useful and can allow the treatment plans to continue without termination due to adverse e ffects, it will require much more research for each individual drugs reaction with gut microbiota enzymes. The gut microbiota can also indirectly affect the metabolism of chemo drugs through modifying gene expression and the physiology of the mucosal barrier in the intestines and liver. In one study, germ-free mice were compared with conventionally raised mice and mice given a probiotic. The germ-free mice exhibited altered gene expression to increase the rate of metabolism of many xenobiotics, whereas even after recolonization of the germ-free mice and administration of a probiotic, not all of the altered genes returned to normal gene expression.12 This raises the observation that not only does the differences in composition of microbiota and their enzyme function play a role in drug metabolism, the activity and lifestyle between individuals matters as well. Immunomodulation and affecting the tumor-microenvironment are two additional ways that the gut microbiota have been found to modulate chemotherapeutics. Cyclophosphamide is a drug that works through many different immunological pathways, stimulating the antitumor immune response.This drug alters the composition of the microbiota in the small intestine and induces the translocation of certain gram-positive bacteria into secondary lymphoid organs.16 Once the bacteria are translocated into the lymphoid organs, they can stimulate an immune response of T helper17 cells and memory TH1 cells. The translocation of the bacteria, typically Lactobacillus johnsonii, Lactobacillus murinus, and Enterococcus hirae, takes place because cyclophosphamide causes discontinuity of the intestinal barrier allowing these microorganisms to relocate to the secondary lymphoid organs. A gram-negative bacteria, Barnesiella intestinhominis is also involved in this chemotherapy drug; it   was shown to incre ase the systemic levels of cytotoxic CD8+ T cells and TH1 cell responses. This bacteria was also proven to activate IFNgamma-producing lymphocytes that are tumor-inflitrating.1 The role gut microbiota plays in the efficacy of cyclophosphamide treatment and immunomodulation was demonstrated by the use of germ-free mice and mice that were treated with antibiotics. The mice that were pre-conditioned with antibiotics proved to inhibit the anticancer effects of the chemotherapy drug and no reduction in the tumor size. Similarly, the germ-free mice had less pTH17 responses and their tumors were unchanged by cyclophosphamide. However, transfer of pTH17 cells restored the efficacy of the anticancer drug.1 These results show that the gut microbiota not only play a role enzymatically and through drug metabolism, but that the microbiome is used to activate the anticancer immune response. This is critical knowledge for the progression of immunomodulation with chemotherapeutics, and gives insight as to why not all patients may react the same to this type of treatment. However, modification of the gut microbiota can enhance the efficacy and response in the patients that typically do not show change in the tumor size. Gut microbiota can also affect the tumor microenvironment in correspondence (à ¯Ã†â€™Ã… ¸is that the right word?) with chemotherapeutics. Oxaliplatin and cistplatin treatments cause tumor cytotoxicity by forming intra-strand platinum-DNA adducts that lead to DNA double stranded breaks; reactive oxygen species is also involved in the damage of DNA. Although these methods are effective for creating an antitumor environment, it also causes severe damage to intestinal mucosal cells which can cause septicemia and systemic infection.12, 10 In germ-free mice the drug oxaliplatin did not induce as great of an inflammation response and consequently the antitumor efficacy was reduced, showing that inflammation is important in the drugs antitumor response. The induced DNA damage within the tumor cells was also reduced, however oxaliplatin was still able to enter into the tumor to form fewer of the platinum-DNA adducts.16 Another effect the microbiota have on these chemo drug antitumor mechanis ms was shown in germ-free mice, the production of ROS was inhibited without gut microbiota. This was previously thought to come from the cancerous cells, however the microbes prevented ROS production through tumor-infiltrating myeloid cells via NADPH oxidase 2.12 This is important to note because this shows that oxaliplatin will not be effective without gut microbiota or depleted myeloid cells. Oxaliplatin also works by inducing immunogenic cancer cell death, this can be achieved by exposing the cell surface- associated immunostimulatory signals, activating antigen-presenting cells which create and antitumor response.With a combination of activation of TLR4, DAMPs from the dying cells, and NLRP3 inflammasome, these can mediate the adaptive T cell-mediated response against the treated tumors.10 When mice are depleted of their microbiota, these cytotoxic and immunogenic effects are decreased, along with the efficacy of tumor reduction. These results demonstrate that gut microbiota can play a role in the cytotoxic effects of DNA damage and inflammation, but also can affect the adaptive immune response to cancer. Gut microbiota has an influential role in the efficacy, toxicity, and outcome of chemotherapeutics. Radiation Therapy Radiotherapy can consist of cancer patients receiving ionizing radiation therapy (RTX) that is typically for localized cancers, or total body irradiation (TBI) that is usually used in preparation for bone marrow transplants or adoptive T cell transfer immunotherapy. These can be effective treatment routes, however, there is a bystander effect on nearby cells that can cause inflammation, immune reactivity, and genome instability.12 These effects do not necessarily occur directly from the DNA damage caused by radiation, these typically are a result from disruption of gap junctions, and release of ROS, NO, cytokines, exosomes, and DAMP stress signals. There are just now beginning to be more studies done about how exactly microbiota can regulate the hosts response to ionizing radiation therapy. It is difficult to study because the effects from radiation can cause a myriad of reactions within the body; some of these effects can be immunostimulating while others can be immunosuppressive. When a patient receives radiotherapy, the antitumor signals are not just contained to the localized area of the tumor; there are antitumor responses that occur that are immune mediated and activate antigen-presenting dendritic cells and T cells. Therefore, because microbiota have been shown to mediate and affect the immunogenic responses in chemotherapy and immunotherapy, it is reasonable to believe microbiota play a role in the immune system responses due to radiation. One of the major limitations to radiotherapy is the safety concern for the patient while balancing the antitumor effectiveness of receiving ionizing radiation therapy. Different cance r types will have different radiation sensitivities as well as the local and systemic toxicity and stress responses that have potential to cause significant injury or impair the antitumor immunity.12 Receiving ionizing radiation therapy is associated with damage to rapidly proliferating tissues such as epithelia, like the digestive tract mucosa, and bone marrow. These adverse effects can cause oral mucositis, diarrhea, and inflammation in the gut and can create gut microbial dysbiosis.12 A recent study investigated whether or not a faecal microbiota transplantation would protect against radiation-induced toxicity.They were able to come to the conclusion that faecal microbiota transplantation did in fact increase the survival rate of mice; in addition, the faecal microbiota transplant increased the peripheral white blood cell counts, maintained the intestinal epithelial integrity, and preserved the gut microbiota composition in mice that had been irradiated.7 Using the strategy of faecal microbiota transplantation could greatly improve the outlook for   radiotherapy patients, it can reduce injury to healthy tissues and improve patients prognosis after radiotherapy. The component that regulates irradiation-mediated intestinal toxicity is the TLR3 for double-stranded RNA. Knockout mice without Tlr3 are actually protected from TLR3-dependent cell death post radiotherapy, despite being sensitive to p53 dependent radiation-induced apoptosis. These knockout mice also survive longer and have less damaging effects on their intestines than wild-type mice. These results would suggest that blocking the TLR3 signaling could reduce the radiation-mediated gastrointestinal damage.12 In this study they also demonstrated that the DNA double stranded breaks, induced from radiation anticancer treatment, also activate a DNA receptor that is not present in melanoma 2 inflammasome; this would result in tissue damage and cell death. However, the bacterium Lactobacillus rhamnosus GG, a probiotic, has demonstrated  protection of the intestinal mucosa from radiation therapy-induced toxicity. This probiotic does this by using a TLR2/MyD88 signaling mechanism to reposit ion cyclooxygenase 2- expressing cells from the villi to the base of the intestinal crypts which induces reactive oxygen series, leading to activation of the NRF2 system; this system is cycloprotective.6 Therefore probiotics have some capabilities to prevent radiation-induced enteropathy. The probiotic composition that studies have found to be most beneficial are Lactobacillus acidophilus, B. bifidum, Lactobacillus casei, Bifidobacterium, Lactobacillus and Streptococcus spp.5 For clinical purposes, these probiotics can be used as a prophylactic strategy to limit the intestinal injury. All of these microorganisms have been proven to protect against gut toxicity from radiation anticancer treatments; this is greatly beneficial to the patients so they do not have to endure adverse effects, such as severe diarrhea, and can continue the treatments to increase their antitumor effectiveness. In contrast, some studies suggest that it is possible to predict whether or not a patient is going to have adverse effects to radiotherapy based off the presence of gut microbial dysbiosis or a well-balanced gut microbiome. They used pyrosequencing analysis of 16S rRNA gene to reveal the microbial diversity in the hosts gut microbiome. The individuals that had a significantly altered Firmicutes/Bacteroidetes ratio before the radiation cancer treatment, later developed diarrhea as an adverse effect from treatment. These results indicated that gut microbial dysbiosis before radiation antitumor therapy can be utilized to predict if the patient will develop adverse effects from treatment such as diarrhea.18 This knowledge could guide treatment plans to be tailored for the individual and could allow for preventative treatment options. Total body irradiation is usually used as a preparatory process for another type of anticancer treatment such as a bone marrow transplantation or adoptive T cell transfer immunotherapy. Contrary, to the logic of many of the studies in this review, germ-free mice were shown to survive longer than conventionally raised mice after total body irradiation, and actually required a higher dosage of radiation to induce intestinal disease and mortality.7 The germ free mice were reported to have less apoptotic cells of the intestinal mucosa and even less lymphocyte infiltration than the mice with regular gut microbiota.7 They hypothesized that this could be due to the germ-free mice having no gut microorganisms that could trigger mucosal inflammation or create damage from the radiation insult. One mechanism they were able to identify that contributed to the germ-free mice resistance to total body irradiation was the production of angiopoietin-like 4. This is a protein inhibitor of lipoprotein lipase that is normally suppressed by normal gut microbiota in the conventionally raised mice.12 This angiopoietin-like 4 protein, when knocked out of germ-free mice, causes the mice to be susceptible to the same intestinal damage as conventionally raised mice that block angiopoietin-like 4 protein. Interestingly, the transcription of angiopoietin-like 4 gene is regulated in response to certain gut bacteria; however, these same bacteria that induce angiopoietin-like 4 expression include Bifidobacterium, Lactobacillus, and Streptococcus spp. that also mediate the protection against the localized received ionizing radiation therapy.12 This can provide an explanation for although most studies have shown that mice treated with probiotics and have a healthy microbiome are resistant to radiotherapy toxicity, germ-free mice can provide some resistance as well. Although most of these studies focus on the gut microbiota, there are studies that reveal how the oral microbiota can effect prediction of enteropathy as well from radiotherapy for  nasopharyngeal carcinomas. Rather than diarrhea as an adverse effect from pelvic radiotherapy, oral and oropharyngeal mucositis are the most common side effects of radiation anticancer therapy for head and neck cancers.20 Similarly to using gut microbial dysbiosis to predict whether the patient would develop adverse effects from treatment, the same can be done with analyzing the oral microbial community and its correlation with radiation-induced mucositis. The results demonstrated that patients with a higher percentage of Actinobacillus exhibited severe mucositis later on after treatment.20 Their findings also showed, similarly, that they can predict future incidence of mucositis during radiotherapy based on the oral microbiota prior to treatment. This is significant because not only can this applicatio n be applied with gut microbiota, it can be applied with the oral microbial community and many others throughout the body corresponding to different types of cancer. Immunotherapy Immunotherapy approaches are currently a popular topic to study and these immunological therapies have shown great potential in long-lasting responses. The efficacy of this type of treatment, however, is limited more than radiation therapy or chemotherapy because of the vast difference in immune responses of individual patients and the susceptibility of different tumor types. However, with new information about the ability of gut microbiota to modulate the hosts response to immunotherapy, it is possible to further study the possibility of improving immunotherapy efficacy by targeting these microbiota. One of the first examples of gut microbiota maintaining the anticancer effect of immunotherapy, was the demonstration that the efficacy of adoptive transfer of tumor-specific cytotoxic T cells following total body irradiation was reduced in mice treated with antibiotics.12 After the total body irradiation causes the translocation of microbiota into the secondary lymph nodes, the prolife ration of the transferred T cells in the tumor and their antitumor activity was enhanced. CpG- oligodeoxynucleotide intratumor therapy is an immunotherapy that uses the TLR9 agonist CpG- oligodeoxynucleotide to induce an antitumor effect. The antitumor effect is then increased when the immunosuppressive effect of IL-10 is prevented by using the IL-10 receptor antibodies. This method induces the secretion from myeloid cells of tumor necrosis factor and IL-12 that in turn cause hemorrhagic necrosis and can redirect tumor-infiltrating macrophages and dendritic cells from and anti-inflammatory to a pro-inflammatory state.12 There is an antigen-specific T cell antitumor that is elicited within this pro-inflammatory environment which results in the clearance of tumors in conventionally raised mice.12 This is not the case in germ-free mice or mice that have been treated with antibiotics. In these mice the tumors treated with CpG-ODNs and anti-IL-10R progress and the immunotherapy is inefficient. Finally, if the mice have a low amount of microbes, the myeloid cells do not produce pro-inflammatory cytokines and the TNF-dependent hemorrhagic necrosis and antitumor immunity are not induced.12 In these tumors, of microbiota-depleted mice, the amount of infiltrating inflammatory monocytes before treatment were unchanged but the number of Ly6C+ major histocompatibility complex class II+ were reduced. This suggests that the differentiation of infiltrating inflammatory monocytes into macrophages and dendritic cells is impaired. After CpG-oligodeoxynucleotide treatment, there are major differences in the gene expression of TNF and IL-12 in tumor-infiltrating myeloid cell  subsets between microbe-depleted and conventionally raised mice.12 There is another reduction in the response to this treatment from TLR4 -deficient mice, however, treatment with the TLR4 agonist LPS to the microbe-depleted mice reinstitutes the responsiveness of the myeloid cells.12 The results from this study demonstrate that the gut microbiota primes the myeloid cells for sensitivity to TLR9. Another study using CpG-oligodeoxynucleotides showed that the CpG-ODNs correlates with the frequency of different genera in the faecal microbiome of mice at the time of treatment.12 Allistipes and Ruminococcus are positively correlated with TNF production, however, Lactobacillus fermentum, Lactobacillus murinum, and Lactobacillus intestinalis are negatively correlated, meaning when one of the bacteria from the genera Lactobacillus were administered, there was an impairment of TNF production.12 This indicates that different types of bacterial species can have opposite effects; therefore, using antibiotics, prebiotics, or probiotics, can change the gut microbiota composition or frequency resulting in mediating the hosts response to immunotherapies. The use of immune checkpoint inhibitors is a final immunotherapy method that has been greatly studied and researched. In the majority of patients, the antitumor immune response is suppressed but can be reactivated by the release of certain signal factors. The immune checkpoint inhibitors, which are antibodies against the cytotoxic T lymphocyte-associated antigen 4 and programmed cell death protein 1 or its ligand PD1 ligand, exhibit strong antitumor activity in animal models and even long lasting clinical efficacy in cancer patients.12 Although this is a promising therapy, there is always the concern of variation of response between patients and between different types of cancers. These checkpoint inhibitors can also induce adverse effects such as colitis and inflammation of the pituitary gland in response to the cytotoxic T lymphocyte-associated antigen 4 antibodies, and thyroid dysfunction and pneumonitis after the blockade of the PDL1-PDL1 interaction.14, 15 Two recent studies investigated the influence gut microbiota has on this type of immunotherapy, specifically how anticytotoxic T lymphocyte antigen blockade requires Bacteroides spp. and how Bifidobacterium spp. enhances the effectiveness of antiprogrammed cell death ligand 1 therapy.14, 15 In the first study, in mice and patients the T cell responses specific for B. thetaiotaomicron or B. fragilis correlated with the effectiveness of CTLA-4 blockade. This was confirmed because the tumors in the germ-free mice did not respond to the CTLA blockade, but when the mice were treated with B. fragilis, this defect was overcome.15 The second study compared melanoma growth in mice with particular commensal microbiota and then observed the differences in antitumor immunity. They then sequenced the 16S ribosomal RNA which identified Bifidobacterium as associated with the antitumor effects. The administration of Bifidobacterium improved the tumor control as much as the programmed cell death prot ein 1 ligand 1- specific antibody treatment, and combination treatment almost ceased tumor growth.14 The results from these studies demonstrate that the mechanism of how anti-PDL1 treatment improves the antitumor immune response does not have to include microbiota inflammation and immune activation, like what is induced by anti-CTLA4. Anti-CTLA4 may alter the composition of the gut microbiota that favors its own antitumor activity. Yet, the effectiveness of the anti-PDL1 therapy is aided in hosts with a pre-existing antitumor immune response if Bifidobacterium spp. are within the gut microbiota.12 Microbiota and Lasting Effects from Treatment After the use of cancer treatments, many times there can be lasting effects even into adulthood from childhood cancer therapies. This study demonstrated that restoring the microbial diversity in patients suffering from immune dysregulation, as a result from childhood acute lymphoblastic leukemia, could reduce chronic inflammation and reduce development of late adverse effects.4 They observed that adult survivors of childhood ALL all had microbial dysbiosis or lack of microbial diversity. The composition of host microbiota is crucial to immune activation, for example T cell activation and increased levels of IL-6 and CRP. Therefore, they hypothesized that the microbial dysbiosis was related to the background chronic inflammation in adult survivors. Additional studies would have to be performed to determine causation, but this study creates the possibility that therapeutic interventions that restore microbial diversity to the ALL survivors could help to reduce the long-term negative ef fects. Further research would need to be done to determine the proper mechanism to restore healthy microbial diversity to humans.   Ã‚   Figure 2 1 References 1. Alexander JL, Wilson ID, Teare J, Marchesi JR, Nicholson JK, Kinross JM. Gut microbiota modulation of chemotherapy efficacy and toxicity. Nature Reviews Gastroenterology Hepatology. August 2017. doi:10.1038/nrgastro.2017.20. paper 10 2.Bultman SJ. Emerging roles of the microbiome in cancer. Carcinogenesis. 2013;35(2):249-255. doi:10.1093/carcin/bgt392. paper 17 3. Champer M, Wong AM, Champer J, et al. The role of the vaginal microbiome in gynecological cancer: a review. BJOG: An International Journal of Obstetrics Gynaecology. 2017. doi:10.1111/1471-0528.14631. paper 9 4. Chua LL, Rajasuriar R, Azanan MS, et al. Reduced microbial diversity in adult survivors of childhood acute lymphoblastic leukemia and microbial associations with increased immune activation. Microbiome. 2017;5(1). doi:10.1186/s40168-017-0250-1. paper 7 5. Ciorba MA, Riehl TE, Rao MS, et al. Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner. Gut. 2011;61(6):829-838. doi:10.1136/gutjnl-2011-300367. paper 24 6. Ciorba MA, Stenson WF. Probiotic Therapy in Radiation-Induced Intestinal Injury and Repair. Annals of the New York Academy of Sciences. 2009;1165(1):190-194. doi:10.1111/j.1749-6632.2009.04029.x. paper 23 7. Cui M, Xiao H, Zhou L, et al. Faecal microbiota transplantation protects against radiation induced toxicity. EMBOpress. 2017. doi: 10.15252/emmm.201606932. paper 2 8. Dubin K, Callahan MK, Ren B, et al. Intestinal microbiome analyses identify melanoma patients at risk for checkpoint-blockade-induced colitis. Nature Communications. 2016;7:10391. doi:10.1038/ncomms10391. paper 5 9. Galloway-Pena JR, Jenq RR, Shelburne SA. Can Consideration of the Microbiome Improve Antimicrobial Utilization and Treatment Outcomes in the Oncology Patient? Clinical Cancer Research. 2017. doi:10.1158/1078-0432.ccr-16-3173. paper 8 10. Iida N, Dzutsev A, S

gender Essay -- essays research papers

Introduction Women have come a long way in the area of the workforce in the past one hundred years. If you were to look back one hundred years ago, you would never see a woman working outside of the home. Society had the idea that a woman's place was in the home cooking, cleaning, reproducing and care giving. They had the idea that there was no place for her in the workforce because that was a place for only men. Yes, it is true that some people may still have this view today but a lot of things have changed over the years. Women are no longer only restricted to working in the home doing domestic chores. However, this did not come easily but rather after many years of fighting to get the same rights as men. Slowly women started to enter the workforce fulfilling roles such as secretaries and nurses. It was jobs like these that were viewed as woman's jobs and you would never see a woman doctor, fireman or police officer. Women were still being marginalized into a certain category of jobs. However, women continued their fight and today they fulfill such roles as doctors, fireman and police officers. In this essay, we will focus on the entry of women into the police force. We will not only look at what it took for women to get into the police force but also what types of roles they play in the police force today. In addition, we will look at what roles women hope to play in the police force in the future. By doing this we hope to show you how far women have come in the area of police work in the past one hundred years and how far they will still have to go. History of Women In The Police Force In the past, policing and women were never associated with each other. Policing was a male dominated profession which women were not welcomed to join. However, these biases and unfair beliefs that women were not welcomed in the police force began to change slowly. In the nineteen tens and twenties woman began to be employed by the police forces. Women's social groups began to lobby that women should be able to be employed by police forces. With all of the support groups that women were involved in, pressure began to mount for there to be a representation of women in male dominated police forces. The first women police officer in Canada was sworn in the Vancouver police force in 1912. "1912: Vancouver - Mrs. Lurancy Harris and Miss Miller were sworn in as 4th clas... ...rk. This includes such jobs as police chiefs, police sergeants and deputy police chiefs. However, they will only be able to prove themselves to the public and the police force if they are given the same chances as men to obtain these positions! Reference Page Cohn, Alvin W. 1978. The Future of Policing. Beverly Hills, CA: Sage publications Inc. Hernandez, E. 1982. Females in Law Enforcement. Femininity, Competence, Attraction, and Work Acceptance. Criminal Justice and Behavior, 9, 1:13-34 Kearney, Katherine G. White & Thomas. Men & Women at Work LeBeuf, Marcel-Eugene & McLean, Julia. 1997. Women in Policing in Canada: Beyond the Year 2000-Its Challenges. Ottawa, On: Canadian Police College. Lunneborg, Patricia W. 1989. Women Police Officers. Springfield, Illinois: Charles C Thomas Publishers. Martin, Susan Ehrlich, and Jurik, Nancy C. Doing Justice, Doing Gender. Sage Publications "RCMP Having Trouble Getting and Keeping Female Mounties". Canadian Business & Culture . pg.11. August, 1996. "Survey Suggests Majority of Female Mounties Have Been Sexually Harassed". Canadian Business & Culture. pg.26. September, 1996.

Marketing Report Bokomo Foods Essay

1.0. A report presenting market data in order to inform a cereal company Bokomo Ltd. To consider whether to expand more in the United Kingdom market. 2.0 Executive summary. This is a short report, containing marketing data on both the cereal market and a specific business, Bokomo UK. The data was obtained from secondary marketing research. Bokomo ´s website was one of the main reference guide. With the findings and analysis, it was recommended that Bokomo should expand their own brand products more in the UK. The PEST analysis of the UK grocery industry included in this report was used to highlight the external factors that can affect Bokomo’s operation and interpret how these factors will influence Bokomo. Furthermore, through the market analysis it was found that Kellogg’s and Weetabix mainly lead the cereal industry, followed by Nestle and Jordans. These companies have a wide range of brands targeted at different consumers, and they have customer loyalty, which can make it harder for newer companies to enter this sector. As mentioned before, in the cereal market there are a large variety of targeted consumers like children, women, and families. The main key trends in the market are convenient snacks and consciousness towards health. Apart from that, own branded labels are also gaining popularity as they offer consumers the same product at a cheaper price. SWOT analysis allowed us to devise the company’s internal analysis. Strengths included their well-known reputation and customers such as large food retailers (Tesco ´s), to which they sell manufacture and packaging services. Weaknesses consist of the negative aspects the company faces, including their not household name, and general negative publicity they face in this complex sector. Opportunities were devised from the social factors from the PEST analysis as changes in consumer tastes and trends are opportunities were this company can benefit from by meeting those needs. These were also  an important part of the report as it affected the final recommendations for the company. Threats included the financial recession and increasing levels of immigration. Bokomo Foods is a major cereal producer in the United Kingdom, established around 80 years ago. Despite not being a household name, is a UK leading cereal maker and the company has achieved diversity by producing a range of own-label products. Furthermore, they manufacture branded products for large companies, as well as branded packaging services like Bag in Box, Pot or Pouch. All of these services are for leading retailers such as Tesco ´s, Sainsbury ´s and Morrison’s, among many others. 3.0 Introduction + Aim. This is a report whose aim is to present market data in order to inform Bokomo plc. a cereal company, whether further expansion in the UK market is beneficial at this time. The report will identify and analyse the current business situation, using SWOT analysis, and review the macroeconomic perspective of the general UK grocery industry using PEST analysis. The SWOT analysis will help us examine the specific company factors, as it is essential to understand these in order to relate them back to the PEST and market trends. Both internal and external factors affect how Bokomo will operate now and in the future. 4.0 The grocery market environment – PEST analysis 4.1 Political Political factors have a great influence on the analysis of external factors since they are determined by the degree of government intervention in the economy. The political situation in the UK is stable. Her Majesty’s Government, led by Prime Minister David Cameron of the Conservative Party, is mainly concerned about the financial crisis affecting economies all over the world and to strengthen the economic position of UK globally. Through employment legislations, the government encourages retailers to provide a mix of job opportunities from flexible, lower-paid and locally-based jobs to highly-skilled, higher-paid and centrally-located jobs (Balchin, 1994). Migration has a large impact on the grocery industry, as it provides new customers, as well as opportunities for supermarkets to cater to the different culinary cultures of immigrants. Migration also leads to a change in size of labour pool, which could have an effect on the availability of workers. Latest figures from the Office for National Statistics show some 503,000 people came to live in the UK in the year ending June 2013, compared with 517,000 people the previous year (ONS.gov, 2013). 4.2 Economic Economic factors are important to consider in regard to the UK grocery market, as they are highly influential to demand, costs, prices, and profit. One of the most influential factors on the economy is high unemployment level, which decreases the effective demand for many goods, adversely affecting the demand required to produce such goods. Unemployment in the UK is at 7.1% as of January 2014, according to BBC. Another highly relevant economic factor is the grocery market size and the market growth. IGD forecast that the UK grocery market value will be worth  £205.9bn in 2018, a 21.3% increase on 2013 (IGD.com, 2013). This is beneficial news to Bokomo, since any expansion would be possible in regard to the availability of area in the market to expand. Another market characteristic of importance is the amount of spending on groceries in regard to overall retail expenditure in the UK. The grocery market’s share accounts for 54.9p in every  £1 of UK retail spending (IGD.com, 2013). 4.3 Social According to Askew (2013) sales in the cereal industry have been under pressure in these past years, especially due to the changing social trends and habits of consumers. Even though sales in this market have been stable, growth has been slow. Traditional breakfast habits have changed and people consume fewer cereals because of a busier lifestyle. Also increasing number of consumers skip breakfast. An increase in female workers has also had an impact on this, which is why competition for convenient options is growing  more each time. An increasing number of people now look for easy and quick alternatives to sitting down and eating. However, they expect to receive the same nutrients and healthy benefits with these convenient options. A growing number of women now pay special attention to what they are eating, checking the labeling, nutritional information and ingredients of each product. Increasingly, women have a greater concern with their weight and healthy eating. Lately, the demand for children’s cereals has declined because of the sugar content it has. Cereal companies use marketing to their advantage and attract kids with unhealthy products. Their main source has been television adverts and most of the cereals for children have high sugar content with low nutritional value, a fact of which more parents are aware. Apart from consumer concerns about health, they are also becoming more aware of the environment. In this specific market, many cereal companies now control their water use, energy use, waste produced, etc. Most of them also pay close attention to the packaging of the product, like using recycled packaging. Another social factor that affects the grocery market in general is the diverse culture in UK. There are so many people with different cultures that do not choose cereals as their first choice for breakfast; instead they have their own eating habits. Therefore, it is important for the producers in the grocery market to understand the needs of the entire population and meet them. Furthermore, supermarket own-brand products have gained a lot of popularity because of the economic downturn. As consumers have limited spending power, they prefer spending on a cheaper product that allows them to get the same benefits. 4.4 Technological In the present technological age, everyone, from personal to professional  interaction, is highly reliant on technology. Therefore, technological advances are important for the development and maintenance of business culture. Advances in technology have allowed the grocery industry to grow. An excellent example is the demise of Blockbuster, who was reluctant to explore online options, and their consequent refusal to buy Netflix and to adapt to changing trends lead to their bankruptcy and final closure on January 14, 2014. Online grocery shopping holds 11% of the distribution channels of the UK grocery market and predictions suggest online sales in the US will grow by 15% in 2014 to  £189.3 billion, while in Europe, sales are expected to rise by 18% to  £131.2 billion. Online shopping has helped people spend their day more efficiently and reduced the effort of having to carry heavy grocery bags. Technological advances at the supermarket has contributed to more efficient customer service and stocking efforts. The adoption of Electronic Point of Sale (EPoS), Electronic Funds Transfer Systems (EFTPoS) and electronic scanners have greatly improved the efficiency of distribution and stocking activities, with needs being communicated almost in real time to the supplier (Finch, 2004). Devices such as the self-checkout machine and Radio Frequency Identification (RFID) have permitted the grocery industry to grow and accommodate customers in an effective way. 5.0 Description of product specific market 5.1 Main competitors The leading cereal brands and the biggest competitors of Bokomo cereals in the UK are Kellogg’s and Weetabix, reported Companies&Markets (2013). Kellogg’s arrived in the UK in 1922 and since then has maintained its position in the market, by focusing on innovation and expansion of their products. In 2012, it had 32% of value share, leading in the UK cereal market offering a wide range of products. Over the years, Kellogg’s has expanded to over 180 countries in the world and has around 39 brands of cereals. Weetabix, on the other hand, was launched in 1932; it has been a  long-standing brand and has fought its competitors to stay in this position in the UK. Weetabix has also introduced many different brands and has been innovating to adapt to consumer preferences over the years. Also Jordans, a breakfast cereal company based in Bedfordshire, founded in 1855. Although, the company produced its first cereal in 1981 called Original Crunchy, it was in the years between 2000 and 2005 when it faced rapid growth and became one of the largest cereal brands in the UK. Its great focus over the years has been on the packaging, to make it stand out in grocery stores and it is also known to be included in the â€Å"healthy, natural cereal segment† Moreover, Nestle formed in 1990. It was launched as a joint venture between General Mills and Nestle S.A. and named Cereal Partners Worldwide (CPW). They offer the traditional cereals, as well as a range of brands including the world-known Cheerios. 5.2 Targeted consumers Cereal companies target many different kinds of people, although the easiest group of people to target has been children. BMSG (2013) stated they do it through advertisements on television, and somehow try to grab their attention by creating colourful, animated images and providing gifts in the cereal box each time. Another group targeted in this sector are the women because of their increasing concern for health and weight loss. Along with the children, women also form a big part of the consumers of this market. Nowadays, there are so many brands that have launched low-fat cereals and cereal bars also. Some also provide some advice, tips and dietary plans, Nytimes article (2010). Generally, families in the UK are also targeted consumers because some families still sit and have their meals together and believe that breakfast is the most important meal of the day. Apart from that, families are more concerned with what they are eating, especially making sure that the smaller ones eat healthy (Marketingmagazine(2010) Unlike maybe some students at university who would not pay so much attention to their breakfast, particularly not on a daily basis. 5.3 Key trends in the cereal market Marketingmagazine (2008) stated A rising key trend in the cereal industry is the quick and convenient ‘good to go’ snacks, like cereal bars. Cereal bars have gained a lot of popularity among a wide range of audience in recent years because people not having time for breakfast. Due to this reason, there has been a significant decline in the sales of the cereal market. Companies have been mostly focusing on this convenient aspect of the market so that people don’t just skip breakfast entirely and their business doesn’t face a loss. As health also plays a crucial role in this market and recently people are more conscious about what they are putting in their body, convenient snacks are the best option as they cover both points. Nowadays, ‘good to go’ snacks are not just used for breakfast but also during the entire day as an alternative to other unhealthy snacks. As a result of the sudden popularity of these snacks, now there are a great variety of them in different formats. On the other hand, the popularity of own branded labels is growing in the grocery market. It saves consumers a significant amount of money and they offer a similar or better quality product. It has resulted in a much higher level of competition in the market. 5.4 SWOT Analysis Bokomo website (2014) 5.4.1 Strengths Bokomo is UK’s leading cereal maker; this is a major strength as they have established a firm position in the British cereal market. They operate in various markets inside the cereal industry, providing food manufacture, retailing and catering. Bokomo can provide tasty, fresh cereal products any business is looking for, at a very competitive and cost-effective price†. British company (although owned by South Africa’s Pioneer Foods) with substantial manufacturing plants in Wellingborough and Peterborough. This means Bokomo has the resources and specialist expertise to offer unique flexible manufacturing and packaging services. Companies needing a brand-new  breakfast cereal raced through New Product Development (NPD) or an innovative production line set up in record time can contact Bokomo. This makes them have an advantage as nowadays there are many organisations looking for branded cereal products. Bokomo is a world-class player, and in order to maintain that s tatus they need world-class facilities. They have two factories in the UK, specifically in Wellingborough and Peterborough. These factories offer them a cutting-edge manufacturing plant, in other words, the latest, high quality, reliable and sustainable facilities. This leads to the production of high quality products. Food standards are also controlled and supported by SAP business information software, which makes customers feel more confident and secure with the products and services Bokomo delivers. Bokomo ´s experts in the management team and the company ´s aim of constantly innovating and removing old production facilities has helped them produce large quantities of high quality products very efficiently and to the shortest imaginable lead-times. Their customers know Bokomo as a business that main objectives is to offer high quality products. This has been maintained by using high quality ingredients and top experts in recipe formulation. They are one of only 2 manufactures that produce wheat biscuits in the Northern hemisphere enabled them to have the largest control and knowledge of this production process. Even if Bokomo UK is based in the United Kingdom, they have also diversified. Geographic market diversification has enabled them to sell in many countries around Europe, Scandinavia and even as far as the United States of America or the United Arab Emirates 5.4.2 Weaknesses Bokomo stated â€Å"you’ve possibly never heard of us† – this means that individual customers do not know them as their own – branded products is very niche, and they are more specialized in producing in a business to business way. This is a very common weakness for companies that operate Behind the Brand. Constant changing of consumer’s tastes (opting for cereal bars, instant porridge or other breakfast solutions) can be considered a weakness, as its difficult and expensive to innovate and keep up to meet their needs. Difficulties to compete with well known brands cereals  products such as Corn Flakes, Crunchy Nut, Special K. Have to create a delicious product that attracts customers quickly and expensive to implement the R&D and marketing. On the other hand it can also be considered and opportunity. Negative publicity to which ready-to-eat cereals have been subjected due to their high sugar content 5.4.3 Opportunities Social trends are important opportunities for Bokomo. Customers aiming towards healthy living or any other lifestyle changes means there is an opportunity towards which research and operate in. They have achieved and been keeping up to date with this as they have many products related to this trend. Great health benefits, such as products enabling the final consumer to control cholesterol levels. Multi-grain flake is another trend and potential opportunity for Bokomo. Consumers are changing their tastes towards healthier goods, and leaving behind old-fashioned sugary confections. Consumers are also increasingly purchasing Branflakes as they are considered to be great for supporting a healthy digestive system. Another trend â€Å"busier schedules†, people are increasingly feeling they have no time to spend on having breakfast and snacks. Bokomo muesli is available to cater for the increasing demand for â€Å"breakfast on the go†. They offer them in bags and boxes, which facilitates the final customer to transport to their work place. This is an example of an opportunity for Bokomo because if they keep-up to date with trends, they will become more efficient and desirable for large retailers to purchase their products, and everyone will benefit form the sales. UK retailers are also focusing on added-value products: Add value by introducing natural minerals and vitamins into whole grain wheat and making the final product more healthy and nutritional. Own-label share of the business mix for large supermarket retailers. It is a main direction for Bokomo to go towards to as they can increase considerably their business operations, as the focus is now towards manufacturing own-label and branded products. Bokomo has realized the immense potential for expansion as the large retailers keep increasing the sale of this type of good. ‘One-stop’ shopping, or shopping in large supermarkets were customers can find any type of product in the same building has been  beneficial for Bokomo as these businesses are their main clients. If they increase their sales, Bokomo will also benefit from this, as they will sell them more and so increase revenue will mean increase levels of profitability. 5.4.4 Threats The cereal industry offers products which are considered to be relatively expensive, which can be easily replaced with simpler breakfast choices such as bread. The financial recession has been a main factor for the decrease in expenditure, specially concerning families, as there are other much cheaper products to replace the cereals and cereal bars. High unemployment has made a substantial impact on the demand for such goods, adversely affecting the demand required to product those goods. Increasing levels of immigration specially in the UK, has meant that they do not have the same culinary cultures and so those breakfast products will not satisfy the needs and wants of everyone. 5.0 Recommendations With the above analysis it is better for the company to target smaller retailers where their own labeled products won’t be affected by competitive brands like Kellogg’s, and when they achieve this they should concentrate more on developing their own branded products around the UK. As mentioned above in the SWOT analysis, cereal products are considered to be expensive due to the added value implemented on them so it would be better to decrease these levels of adding value and start off with lower prices, in recession periods. 6.0 Limitations Bokomo website allowed us to obtain up-to-date and official information and statistics of the company. The information was limited because the company sold themselves and emphasized on its positive aspects because they have to promote their brand to the consumers. A part from this we also used other sources including, online articles about food industry, which helped us, get an un-biased view of the company and the cereal market as a whole. The  drawback of using other sources or secondary research was that the methods used were unknown so we examined the most official and valid sources. 7.0 References Askew, K. 2013. Breakfast cereal: Are cereal sales going soggy? [Online] Available at: http://www.just-food.com/analysis/are-cereal-sales-in-developed-markets-going-soggy_id123417.aspx Bainbridge, J. 2010. Sector insight: Breakfast cereals | Marketing Magazine. [Online] Available at: http://www.marketingmagazine.co.uk/article/990662/sector-insight-breakfast-cereals Bainbridge, J. 2008. Sector Insight: Cereal bars | Marketing Magazine. [Online] Available at: http://www.marketingmagazine.co.uk/article/817580/sector-insight-cereal-bars Balchin, A. (1994) Part-time Workers in the Multiple Retail Sector: Small Change from Employment Protection Legislation? Employee Relations, Vol. 16 Iss: 7, pp.43 – 57 BBC News. 2014. UK unemployment rate drops to 7.1%. [Online] Available at: http://www.bbc.co.uk/news/business-25841570 BERKELEY, C. 2013. Cereal companies leverage online marketing to target children with sugary products | Berkeley Media Studies Group. [Online] Available at: http://w ww.bmsg.org/newsroom/news-releases/cereal-companies-leverage-online-marketing-to-target-children-with-sugary-products Bodimeade, M. 2013. UK breakfast cereals market dominated by Kellogg’s and Weetabix. [Online] Available at: http://www.companiesandmarkets.com/News/Food-and-Drink/UK-breakfast-cereals-market-dominated-by-Kelloggs-and-Weetabix/NI6602 Bokomo.co.uk. n.d. About | Bokomo. [Online] Available at: http://bokomo.co.uk/about Business News Daily (November 22, 2013) PEST Analysis: Definition and Examples, Available at: http://www.businessnewsdaily.com/5512-pest-analysis-definition-examples-templates.html Euromonitor.com. 2013. Breakfast Cereals in the United Kingdom. [Online] Available at: http://www.euromonitor.com/breakfast-cereals-in-the-united-kingdom/report Igd.com. 2013. UK Grocery Retailing. [Online] Available at: http://www.igd.com/our-expertise/Retail/retail-outlook/3371/UK-Grocery-Retailing/ Internetretailing.net (March 18, 2014) UK retailers expected to make

I wonder if Princeton should be poorer Essay

â€Å"l wonder if Princeton should be poorer. † BY akp1993 If you’re a high school senior trying to seduce the admissions officer reading your application essay, this may not strike you as the ideal opening line. But Shanti Kumar, a senior at the Bronx High School of Science, went ahead anyway when the university prompted her to react in writing to the idea of â€Å"Princeton in the nation’s service and in the service of all nations. † Back in January, when I asked high school seniors to send in college application essays about money, class, working and the economy, I wasn’t sure what, if anything, ould come in over the transom. But 66 students submitted essays, and with the help of Harry Bauld, the author of â€Å"On Writing the College Application Essay,† we’ve selected four to publish in full online and in part in this column. That allowed us to be slightly more selective than Princeton itself was last year. What these four writers have in common is an appetite for risk. Not only did they talk openly about issues that are emotionally complex and often outright taboo, but they took brave and counterintuitive positions on class, national identity and the application process itself. For anyone looking to inspire their own children or grandchildren who are seeking to go to college in the fall of 2014, these four essays would be a good place to start. Perhaps the most daring essay of all came from Julian Cranberg, a 17-year-old from Brookline, Mass. One of the first rules of the college admissions process is that you don’t write about the college admissions process. But Mr. Cranberg thumbed his nose at that convention, taking on the tremendous cost of the piles of mail schools send to potential students, and the waste that results from the effort. He figured that he received at least $200 worth of pitches in the past year or so. â€Å"Why, in an era of record-high student loan debt and unemployment, are colleges not reallocating these ludicrous funds to aid their own students instead of extending their arms far and wide to students they have never met? † he asked in the essay. Antioch College seemed to think that was a perfectly reasonable question and accepted him, though he will attend Oberlin College instead, to which he did not submit the essay. â€Å"It’s a bold move to critique the very institution he was applying to,† said Mr. Bauld, who also teaches English at Horace Mann School in New York City. â€Å"But here’s somebody who knows he can make it work with intelligence and humor. † college that sent him a DHL â€Å"priority’ envelope, noting inside that he was a priority to the college. â€Å"The humor here is not in the Jokes,† Mr. Bauld added. â€Å"It originates in a critical habit of mind, and the kind of mind that is in this essay is going to play out extremely well in any class that he’s in. † Admissions professionals often warn people not to think that they can write their way into the freshman class. The essay is one document that, even in the best of circumstances, is written by an individual telling one story,† said Shawn Abbott, the assistant vice president for undergraduate admissions at New York University. â€Å"l don’t believe that any one writing sample should trump what they did over four years. † Still, he acknowledged that his staff had been taken with the story told by Lyle L’, a 19-year-old Brooklyn resident who applied this year. He wrote about his familys restaurant and his mother, an immigrant from China who once wanted to be a doctor and now works behind a cash register. When I visit my friends, I see the names of elite institutions adorning the living room walls,† wrote Mr. Li, a senior at Regis High School in Manhattan. â€Å"l am conscious that these framed diplomas are testaments to the hard work and accomplishments of my friends’ parents and siblings. Nevertheless, the sight of them was an irritating reminder of the disparity between our households. I was not the upper-middle-class kid on Park Avenue. Truth be told, I am Just some kid from Brooklyn. Instead of diplomas and accolades, my parents’ room emits a smell from the restaurant uniforms they wear seven days a week, all year round. â€Å"