performing analysis.

performing analysis. performing analysis.  For your course project, you will be operating a cookie company, making costing decisions, and performing an analysis. In Module 06, you will make a presentation of your analysis. This Week, you will prepare a mission statement; set strategic, tactical, and operating objectives; decide on a company name; set cookie specifications, and decide on a cookie recipe. Additionally, you will calculate a standard cost per cookie and decide on an accounting system. 1. Consider the company’s mission. a. Will you focus on quality, volume, or satisfying a niche? b. Will you sell using a traditional brick & mortar storefront or through eCommerce? Who is your target market? c. What are your expansion plans? d. What will be your main products? Where will you operate? 2. Write a mission statement for your company that reflects the decisions you made in the previous step. 3. Based on your company’s mission, describe the long-range goals, strategies, and objectives that your company will pursue. 4. Decide upon a company name. 5. Determine cookie specifications: size, color, key ingredients, appearance, quantity and packaging. 6. Develop a recipe that fits with your mission, goals, and specifications. 7. Create a job cost card for your cookie recipe and calculate cost per cookie. Assume overhead is allocated at a rate of $2 for every $1 of labor cost. 8. List some of the costs you will include in overhead



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The occurrence of breast cancer in men compared to women differs, developing 8-10 years later in men (Fentiman et al., 2006; 2009). The association of MBC with older age may mean that reported mortality due to breast cancer, as distinct from other age-related comorbidities, may be underestimated. Furthermore, Spiers and Shaaban (2010) note that, although in western countries breast cancer rates appear to be declining, the statistics quoted refer only to female breast cancer. These authors compared the incidence of 350 current MBC diagnoses annually in the UK, with figures reported in the late 1970’s and the start of the decade. They found an increasing rate of MBC incidence in the UK comparable to that observed in the United States by Stang and Thomssen (2008). The above discussion raises the question of why male breast cancer incidence appears to be increasing in the UK?
For non BRCA 1 or 2 carriers, age is a significant risk factor for the development of MBC (Cutuli et al., 2010; Fentiman 2009). Therefore, as the proportion of people in the UK classed as old or very old continues to rise (Office of National Statistics (ONS), 2015) it could be argued that a comparable rise in the incidence of MBC can be expected. Brinton et al. (2015) investigated additional risk factors and concluded that, out of 101 MBC sufferers and 217 controls, MBC risk was increased by levels of endogenous oestradiol, although no association was found with circulating androgens. Interestingly, the risk of MBC conferred by high circulating endogenous oestradiol was consistent with that associated with postmenopausal female breast cancer, reported by Kaaks et al. (2014), Dallal et al. (2014), Falk et al. (2013) and others. Brinton et al. (2015) controlled for variables that may confer risk of MBC such as cigarette smoking but did not control for known risk factors that include BRCA 1/ 2 status, previous history of gynecomastia and diagnosis of Klinefelter syndrome.
These are significant omissions that undermine the reliability of Brinton et al.’s (2015) findings. Sufferers of Klinefelter syndrome, for example, have a high ratio of circulating oestrogens compared to androgens (Weiss et al., 2005). Given that, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2016), the incidence of this condition affects 1 in 500 males, (which is higher than the incidence of MBC) it is reasonable to argue that the risk factor that contributed to MBC in Brinton at al.’s (2015) study could be attributed to this condition, and not high circulating oestradiol levels with no influence from androgens, as suggested.
Fentiman (2009) summarises research that has associated working with hydrocarbons or in hot environments with MBC. Other studies have examined if the trend towards increased Body Mass Index (BMI) observed in populations of western countries such as the US and UK may be linked to the incidence of MBC. Brinton et al., (2008), for example, found that a BMI of more than 30 conferred a risk of MBC, but this study was based upon a small sample size and thus provided limited statistical power to substantiate the authors’ findings. A case-controlled study of 156 men diagnosed with MBC conducted by Ewertz et al., 2001 found no significant associations with parity and age at first childbirth, which is unsurprising given the gender of their sample population. These authors associated the risk of MBC with obesity and diabetes which is not supported by consensual research demonstrating that this link is unsubstantiated (Giovannucci, et al., 2010). Furthermore, Ewertz et al. found no consistent pattern in the association between cigarette smoking and MBC, which is challenged by later studies of female breast cancer. These include Dossus et al. (2013), Xue et al. (2011), Luo et al. (2011) and McCarty et al. (2009).

International Finance.

International Finance. International Finance. 3 pages excluding cover and references Recommending a Short-Term Foreign Investment Suppose the treasurer of your company finds out you are enrolled in BUS450 International Finance. Knowing this, your treasurer seeks your advice. Your company has extra cash reserves of $100,000,000 and needs to invest it for 6 months. The treasurer has heard that investing in foreign currencies for the short term might have a higher yield when compared to a short-term United States investment. Research the following: ·  US 6 month interest rate · 6-month interest rate of a country of your choosing · spot exchange rate of your selected currency relative to the US Dollar · six-month forward exchange rate per the US Dollar. Prepare a proposal to your treasurer that outlines your research and recommendation. Provide calculations where necessary to support your recommendation. Summarize your findings in a three- to five- page paper, not including title and references pages. Be sure to properly cite your resources using APA style. The Week Three Assignment · Must be three to five double-spaced pages in length, and formatted according to APA style as outlined in the Ashford Writing Center. · Must include a title page with the following: · Title of paper · Student’s name · Course name and number · Instructor’s name · Date submitted · Should begin with an introductory paragraph that has a succinct thesis statement. · Must address the topic of the paper with critical thought. · You Must end with a conclusion that reaffirms your thesis. · The paper Must use at least three scholarly sources. · Must document all sources in APA style. · Must include a separate references page, formatted according to APA style



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The occurrence of breast cancer in men compared to women differs, developing 8-10 years later in men (Fentiman et al., 2006; 2009). The association of MBC with older age may mean that reported mortality due to breast cancer, as distinct from other age-related comorbidities, may be underestimated. Furthermore, Spiers and Shaaban (2010) note that, although in western countries breast cancer rates appear to be declining, the statistics quoted refer only to female breast cancer. These authors compared the incidence of 350 current MBC diagnoses annually in the UK, with figures reported in the late 1970’s and the start of the decade. They found an increasing rate of MBC incidence in the UK comparable to that observed in the United States by Stang and Thomssen (2008). The above discussion raises the question of why male breast cancer incidence appears to be increasing in the UK?
For non BRCA 1 or 2 carriers, age is a significant risk factor for the development of MBC (Cutuli et al., 2010; Fentiman 2009). Therefore, as the proportion of people in the UK classed as old or very old continues to rise (Office of National Statistics (ONS), 2015) it could be argued that a comparable rise in the incidence of MBC can be expected. Brinton et al. (2015) investigated additional risk factors and concluded that, out of 101 MBC sufferers and 217 controls, MBC risk was increased by levels of endogenous oestradiol, although no association was found with circulating androgens. Interestingly, the risk of MBC conferred by high circulating endogenous oestradiol was consistent with that associated with postmenopausal female breast cancer, reported by Kaaks et al. (2014), Dallal et al. (2014), Falk et al. (2013) and others. Brinton et al. (2015) controlled for variables that may confer risk of MBC such as cigarette smoking but did not control for known risk factors that include BRCA 1/ 2 status, previous history of gynecomastia and diagnosis of Klinefelter syndrome.
These are significant omissions that undermine the reliability of Brinton et al.’s (2015) findings. Sufferers of Klinefelter syndrome, for example, have a high ratio of circulating oestrogens compared to androgens (Weiss et al., 2005). Given that, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2016), the incidence of this condition affects 1 in 500 males, (which is higher than the incidence of MBC) it is reasonable to argue that the risk factor that contributed to MBC in Brinton at al.’s (2015) study could be attributed to this condition, and not high circulating oestradiol levels with no influence from androgens, as suggested.
Fentiman (2009) summarises research that has associated working with hydrocarbons or in hot environments with MBC. Other studies have examined if the trend towards increased Body Mass Index (BMI) observed in populations of western countries such as the US and UK may be linked to the incidence of MBC. Brinton et al., (2008), for example, found that a BMI of more than 30 conferred a risk of MBC, but this study was based upon a small sample size and thus provided limited statistical power to substantiate the authors’ findings. A case-controlled study of 156 men diagnosed with MBC conducted by Ewertz et al., 2001 found no significant associations with parity and age at first childbirth, which is unsurprising given the gender of their sample population. These authors associated the risk of MBC with obesity and diabetes which is not supported by consensual research demonstrating that this link is unsubstantiated (Giovannucci, et al., 2010). Furthermore, Ewertz et al. found no consistent pattern in the association between cigarette smoking and MBC, which is challenged by later studies of female breast cancer. These include Dossus et al. (2013), Xue et al. (2011), Luo et al. (2011) and McCarty et al. (2009).

organizational setting.

organizational setting.  organizational setting. The rough draft of your proposal is due now while the final draft due will be due in the upcoming weeks. See the attachments below for guidelines to ensure an A on this assignment. You will need to use your topic from the previous paper (Recycling in an Apartment Complex) The objective of the project is to participate in the development of a detailed proposal as used in any organizational setting. Access the quick summarized preview of Unit 5 final researched proposal checklist below so you can begin to address these items in your rough draft of the proposal due in this unit. This is in the attachments. Checklist: Contains no fewer than 1,500 words; no more than 3,000. Clearly identifies the audience and purpose. Shows research has been conducted and preliminary integration of research material is in place following APA formatted in-text citations. Adheres to assigned format — single spaced, double space between paragraphs, cover page, table of contents, and references. Include the following items in this order: Cover memo or letter saying you have completed your proposal and are now submitting it-brief Cover page Table of contents Executive Summary Body of the proposal that includes subheadings References page following APA Assignment 2: Using GraphicsYou read about design and using original graphics to convey many ideas using visual images (see Unit 4 Reading). In addition, use an original graphic (a table or a graphic depicting relationship or process — see the tutorial). You will be inserting this graphic into your proposal. For the purposes of this Assignment 2, also submit your graphic with an explanation. Also read How to write a non Plagiarized essay Checklist: Design your original graphic in a Word document. Further, these are not to be copied and pasted. Can be: chart, graph, or a table. Explain the graphic in a minimum of 200 words. 1) What you are trying to convey? 2) To whom you are trying to convey it? Use correct spelling and grammar. Acceptable references:Primary (original sources) written by experts in the field of study. Secondary sources supported by research in primary sources. Credible sources (experts in the area of study) Peer Reviewed journal articles are REQUIRED. Educational/university websites (edu) may be appropriate. Finally, .gov and .org are usually okay, but be careful. TURNITIN MUST BE UNDER 15% You will need a minimum of 5 references that are less than 5 years old.



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The occurrence of breast cancer in men compared to women differs, developing 8-10 years later in men (Fentiman et al., 2006; 2009). The association of MBC with older age may mean that reported mortality due to breast cancer, as distinct from other age-related comorbidities, may be underestimated. Furthermore, Spiers and Shaaban (2010) note that, although in western countries breast cancer rates appear to be declining, the statistics quoted refer only to female breast cancer. These authors compared the incidence of 350 current MBC diagnoses annually in the UK, with figures reported in the late 1970’s and the start of the decade. They found an increasing rate of MBC incidence in the UK comparable to that observed in the United States by Stang and Thomssen (2008). The above discussion raises the question of why male breast cancer incidence appears to be increasing in the UK?
For non BRCA 1 or 2 carriers, age is a significant risk factor for the development of MBC (Cutuli et al., 2010; Fentiman 2009). Therefore, as the proportion of people in the UK classed as old or very old continues to rise (Office of National Statistics (ONS), 2015) it could be argued that a comparable rise in the incidence of MBC can be expected. Brinton et al. (2015) investigated additional risk factors and concluded that, out of 101 MBC sufferers and 217 controls, MBC risk was increased by levels of endogenous oestradiol, although no association was found with circulating androgens. Interestingly, the risk of MBC conferred by high circulating endogenous oestradiol was consistent with that associated with postmenopausal female breast cancer, reported by Kaaks et al. (2014), Dallal et al. (2014), Falk et al. (2013) and others. Brinton et al. (2015) controlled for variables that may confer risk of MBC such as cigarette smoking but did not control for known risk factors that include BRCA 1/ 2 status, previous history of gynecomastia and diagnosis of Klinefelter syndrome.
These are significant omissions that undermine the reliability of Brinton et al.’s (2015) findings. Sufferers of Klinefelter syndrome, for example, have a high ratio of circulating oestrogens compared to androgens (Weiss et al., 2005). Given that, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2016), the incidence of this condition affects 1 in 500 males, (which is higher than the incidence of MBC) it is reasonable to argue that the risk factor that contributed to MBC in Brinton at al.’s (2015) study could be attributed to this condition, and not high circulating oestradiol levels with no influence from androgens, as suggested.
Fentiman (2009) summarises research that has associated working with hydrocarbons or in hot environments with MBC. Other studies have examined if the trend towards increased Body Mass Index (BMI) observed in populations of western countries such as the US and UK may be linked to the incidence of MBC. Brinton et al., (2008), for example, found that a BMI of more than 30 conferred a risk of MBC, but this study was based upon a small sample size and thus provided limited statistical power to substantiate the authors’ findings. A case-controlled study of 156 men diagnosed with MBC conducted by Ewertz et al., 2001 found no significant associations with parity and age at first childbirth, which is unsurprising given the gender of their sample population. These authors associated the risk of MBC with obesity and diabetes which is not supported by consensual research demonstrating that this link is unsubstantiated (Giovannucci, et al., 2010). Furthermore, Ewertz et al. found no consistent pattern in the association between cigarette smoking and MBC, which is challenged by later studies of female breast cancer. These include Dossus et al. (2013), Xue et al. (2011), Luo et al. (2011) and McCarty et al. (2009).

pricing strategy

pricing strategy   pricing strategy. Suppose Navistar’s Canadian subsidiary sells 1,500 trucks monthly to the French affiliate at a transfer price of 527,000 per unit. Assume that the Canadian and French marginal tax rates on corporate income equal 45% and 50%, respectively. (16.1) a. Suppose the transfer price can be set at any level between $25,000 and $30,000. At what transfer price will corporate taxes paid be minimized? Explain. b. Suppose the French government imposes an ad valorem tariff of 15% on imported tractors. How would this tariff affect the optimal transfer pricing strategy? c. If the transfer price of 527,000 is set in euros and the euro revalues by 5%, what will happen to the firm’s overall tax bill? Consider the tax consequences both with and without the 15% tariff. d. Suppose the transfer price is increased from $27,000 to $30,000 and credit terms are extended from 90 days to 180 days. What are the fund-flow implications of these adjustments? 3. Suppose that DMR SA, located in Switzerland, sells $1 million worth of goods monthly to its affiliate DMR Gmbh, located in Germany. These sales are based on a unit transfer price of $100. Suppose the transfer price is raised to $130 at the same time that credit terms are lengthened from the current 30 days to 60 days. (16.3) a. What is the net impact on cash flow for the first 90 days? Assume that the new credit terms apply only to new sales already booked but uncollected. b. Assume that the tax rate is 25% in Switzerland and 50% in Germany and that revenues are taxed and costs deducted upon sale or purchase of goods, not upon collection. What is the impact on after-tax cash flows for the first 90 days?



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The occurrence of breast cancer in men compared to women differs, developing 8-10 years later in men (Fentiman et al., 2006; 2009). The association of MBC with older age may mean that reported mortality due to breast cancer, as distinct from other age-related comorbidities, may be underestimated. Furthermore, Spiers and Shaaban (2010) note that, although in western countries breast cancer rates appear to be declining, the statistics quoted refer only to female breast cancer. These authors compared the incidence of 350 current MBC diagnoses annually in the UK, with figures reported in the late 1970’s and the start of the decade. They found an increasing rate of MBC incidence in the UK comparable to that observed in the United States by Stang and Thomssen (2008). The above discussion raises the question of why male breast cancer incidence appears to be increasing in the UK?
For non BRCA 1 or 2 carriers, age is a significant risk factor for the development of MBC (Cutuli et al., 2010; Fentiman 2009). Therefore, as the proportion of people in the UK classed as old or very old continues to rise (Office of National Statistics (ONS), 2015) it could be argued that a comparable rise in the incidence of MBC can be expected. Brinton et al. (2015) investigated additional risk factors and concluded that, out of 101 MBC sufferers and 217 controls, MBC risk was increased by levels of endogenous oestradiol, although no association was found with circulating androgens. Interestingly, the risk of MBC conferred by high circulating endogenous oestradiol was consistent with that associated with postmenopausal female breast cancer, reported by Kaaks et al. (2014), Dallal et al. (2014), Falk et al. (2013) and others. Brinton et al. (2015) controlled for variables that may confer risk of MBC such as cigarette smoking but did not control for known risk factors that include BRCA 1/ 2 status, previous history of gynecomastia and diagnosis of Klinefelter syndrome.
These are significant omissions that undermine the reliability of Brinton et al.’s (2015) findings. Sufferers of Klinefelter syndrome, for example, have a high ratio of circulating oestrogens compared to androgens (Weiss et al., 2005). Given that, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2016), the incidence of this condition affects 1 in 500 males, (which is higher than the incidence of MBC) it is reasonable to argue that the risk factor that contributed to MBC in Brinton at al.’s (2015) study could be attributed to this condition, and not high circulating oestradiol levels with no influence from androgens, as suggested.
Fentiman (2009) summarises research that has associated working with hydrocarbons or in hot environments with MBC. Other studies have examined if the trend towards increased Body Mass Index (BMI) observed in populations of western countries such as the US and UK may be linked to the incidence of MBC. Brinton et al., (2008), for example, found that a BMI of more than 30 conferred a risk of MBC, but this study was based upon a small sample size and thus provided limited statistical power to substantiate the authors’ findings. A case-controlled study of 156 men diagnosed with MBC conducted by Ewertz et al., 2001 found no significant associations with parity and age at first childbirth, which is unsurprising given the gender of their sample population. These authors associated the risk of MBC with obesity and diabetes which is not supported by consensual research demonstrating that this link is unsubstantiated (Giovannucci, et al., 2010). Furthermore, Ewertz et al. found no consistent pattern in the association between cigarette smoking and MBC, which is challenged by later studies of female breast cancer. These include Dossus et al. (2013), Xue et al. (2011), Luo et al. (2011) and McCarty et al. (2009).

time audit.

time audit. time audit.  Each student will prepare a time audit. Choose either Module/Week 1 or Module/Week 2 of this course to complete your time audit. This will be difficult because it will require you to keep track of your time in 15-minute increments. All it takes is a little discipline. You need not to stop in the middle of something to record your time – simply wait until you finish the activity to record the event and time spent. By all means, do not wait until the end of the day to fill out your sheets. That would somewhat diminish the point of the assignment, as the whole point is to record activities and times as close to the time period as possible. Do not obsess with this assignment. Perfection is not required, only completion of this audit, recording the approximate time periods of daily activities, both typical and atypical. Again, only you and the professor will see your results (unless you wish to share with your classmates). To complete the audit, do the following: You will audit how you use time for 5 consecutive work days, in 15-minute increments. Think about your typical day, and begin listing the kinds of activities you do each day. You may use Microsoft Word, Excel, or any other means by which to keep track of these activities. While recording approximate time periods is allowed, try to record the times as close to the time period each occurred. Complete the sheets for morning, afternoon, and evening, and be sure to include any comments or observations. At the end of each day, complete a summary of all of the day’s activities. Do this each day, then submit all 5 days in 1 submission. MODULEWEEK1FORTIMEAUDIT.d



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The occurrence of breast cancer in men compared to women differs, developing 8-10 years later in men (Fentiman et al., 2006; 2009). The association of MBC with older age may mean that reported mortality due to breast cancer, as distinct from other age-related comorbidities, may be underestimated. Furthermore, Spiers and Shaaban (2010) note that, although in western countries breast cancer rates appear to be declining, the statistics quoted refer only to female breast cancer. These authors compared the incidence of 350 current MBC diagnoses annually in the UK, with figures reported in the late 1970’s and the start of the decade. They found an increasing rate of MBC incidence in the UK comparable to that observed in the United States by Stang and Thomssen (2008). The above discussion raises the question of why male breast cancer incidence appears to be increasing in the UK?
For non BRCA 1 or 2 carriers, age is a significant risk factor for the development of MBC (Cutuli et al., 2010; Fentiman 2009). Therefore, as the proportion of people in the UK classed as old or very old continues to rise (Office of National Statistics (ONS), 2015) it could be argued that a comparable rise in the incidence of MBC can be expected. Brinton et al. (2015) investigated additional risk factors and concluded that, out of 101 MBC sufferers and 217 controls, MBC risk was increased by levels of endogenous oestradiol, although no association was found with circulating androgens. Interestingly, the risk of MBC conferred by high circulating endogenous oestradiol was consistent with that associated with postmenopausal female breast cancer, reported by Kaaks et al. (2014), Dallal et al. (2014), Falk et al. (2013) and others. Brinton et al. (2015) controlled for variables that may confer risk of MBC such as cigarette smoking but did not control for known risk factors that include BRCA 1/ 2 status, previous history of gynecomastia and diagnosis of Klinefelter syndrome.
These are significant omissions that undermine the reliability of Brinton et al.’s (2015) findings. Sufferers of Klinefelter syndrome, for example, have a high ratio of circulating oestrogens compared to androgens (Weiss et al., 2005). Given that, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2016), the incidence of this condition affects 1 in 500 males, (which is higher than the incidence of MBC) it is reasonable to argue that the risk factor that contributed to MBC in Brinton at al.’s (2015) study could be attributed to this condition, and not high circulating oestradiol levels with no influence from androgens, as suggested.
Fentiman (2009) summarises research that has associated working with hydrocarbons or in hot environments with MBC. Other studies have examined if the trend towards increased Body Mass Index (BMI) observed in populations of western countries such as the US and UK may be linked to the incidence of MBC. Brinton et al., (2008), for example, found that a BMI of more than 30 conferred a risk of MBC, but this study was based upon a small sample size and thus provided limited statistical power to substantiate the authors’ findings. A case-controlled study of 156 men diagnosed with MBC conducted by Ewertz et al., 2001 found no significant associations with parity and age at first childbirth, which is unsurprising given the gender of their sample population. These authors associated the risk of MBC with obesity and diabetes which is not supported by consensual research demonstrating that this link is unsubstantiated (Giovannucci, et al., 2010). Furthermore, Ewertz et al. found no consistent pattern in the association between cigarette smoking and MBC, which is challenged by later studies of female breast cancer. These include Dossus et al. (2013), Xue et al. (2011), Luo et al. (2011) and McCarty et al. (2009).

ethical dilemma

ethical dilemma ethical dilemma.  1. Format a. Use Microsoft Word, 12 point font, single spacing. b. Use the format demonstrated in the sample paper called “Excerpts from A papers ..” provided under Writing Resources in Blackboard for Assignments 2 through 4. This format incorporates the use of headers that distinguish the different areas of thought within the memo. Additionally, for Assignments 1 you may incorporate headers if necessary to more effectively convey your ideas. c. Where using headers in Assignments 2 through 4, you must include these: 1. Facts 2. Issue 3. Analysis (note- this is where you may want to use additional headers to further organize your thoughts) 4. Recommendation d. Suggested Paper Length – these are ranges, not absolutes 1. Assignment 1 should be between 500 and 600 words; 2. Assignments 2 and 3 should be between 750 and 1000 words; 3. Assignment 4 should be between 1400 and 2000 words. e. The purpose of the guide is to help you understand whether you have thought deeply enough about the topic. Your grade does not depend on the number of words written. However, your grade will be affected by whether or not you have fully analyzed the issue and fully supported your conclusion/decision. If you find that you are significantly over this range of words, you should edit your paper so that your ideas and words are conveyed in the most concise manner. This does not mean eliminating key arguments. It just means editing your wording so that it is more concisely written. f. Inside your document – DO NOT include any personal information inside your document (such as name, CougarNet ID, etc). We will not remove this information before submitting it for assessment. ethical dilemma 1. Task Think of an ethical dilemma/issue that you experienced recently – one in which you had to decide whether one choice or another was the more ethical. This can be a situation you experienced at work, at home, or elsewhere. First, briefly describe the situation and the decision you made. This should take up no more than approximately one-third of your paper. Second, FULLY discuss your rationale for the decision. The most important part of this paper is that you fully support your decision (i.e., provide a detailed explanation for your decision). This section of the paper should consist of about two-thirds of your paper. You should review the online lectures on writing and critical thinking (and the sample papers) before beginning the assignment.



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The occurrence of breast cancer in men compared to women differs, developing 8-10 years later in men (Fentiman et al., 2006; 2009). The association of MBC with older age may mean that reported mortality due to breast cancer, as distinct from other age-related comorbidities, may be underestimated. Furthermore, Spiers and Shaaban (2010) note that, although in western countries breast cancer rates appear to be declining, the statistics quoted refer only to female breast cancer. These authors compared the incidence of 350 current MBC diagnoses annually in the UK, with figures reported in the late 1970’s and the start of the decade. They found an increasing rate of MBC incidence in the UK comparable to that observed in the United States by Stang and Thomssen (2008). The above discussion raises the question of why male breast cancer incidence appears to be increasing in the UK?
For non BRCA 1 or 2 carriers, age is a significant risk factor for the development of MBC (Cutuli et al., 2010; Fentiman 2009). Therefore, as the proportion of people in the UK classed as old or very old continues to rise (Office of National Statistics (ONS), 2015) it could be argued that a comparable rise in the incidence of MBC can be expected. Brinton et al. (2015) investigated additional risk factors and concluded that, out of 101 MBC sufferers and 217 controls, MBC risk was increased by levels of endogenous oestradiol, although no association was found with circulating androgens. Interestingly, the risk of MBC conferred by high circulating endogenous oestradiol was consistent with that associated with postmenopausal female breast cancer, reported by Kaaks et al. (2014), Dallal et al. (2014), Falk et al. (2013) and others. Brinton et al. (2015) controlled for variables that may confer risk of MBC such as cigarette smoking but did not control for known risk factors that include BRCA 1/ 2 status, previous history of gynecomastia and diagnosis of Klinefelter syndrome.
These are significant omissions that undermine the reliability of Brinton et al.’s (2015) findings. Sufferers of Klinefelter syndrome, for example, have a high ratio of circulating oestrogens compared to androgens (Weiss et al., 2005). Given that, according to the Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2016), the incidence of this condition affects 1 in 500 males, (which is higher than the incidence of MBC) it is reasonable to argue that the risk factor that contributed to MBC in Brinton at al.’s (2015) study could be attributed to this condition, and not high circulating oestradiol levels with no influence from androgens, as suggested.
Fentiman (2009) summarises research that has associated working with hydrocarbons or in hot environments with MBC. Other studies have examined if the trend towards increased Body Mass Index (BMI) observed in populations of western countries such as the US and UK may be linked to the incidence of MBC. Brinton et al., (2008), for example, found that a BMI of more than 30 conferred a risk of MBC, but this study was based upon a small sample size and thus provided limited statistical power to substantiate the authors’ findings. A case-controlled study of 156 men diagnosed with MBC conducted by Ewertz et al., 2001 found no significant associations with parity and age at first childbirth, which is unsurprising given the gender of their sample population. These authors associated the risk of MBC with obesity and diabetes which is not supported by consensual research demonstrating that this link is unsubstantiated (Giovannucci, et al., 2010). Furthermore, Ewertz et al. found no consistent pattern in the association between cigarette smoking and MBC, which is challenged by later studies of female breast cancer. These include Dossus et al. (2013), Xue et al. (2011), Luo et al. (2011) and McCarty et al. (2009).