Cervical Example For Free - Free Essay Example

Sample details Pages: 9 Words: 2555 Downloads: 6 Date added: 2017/06/26 Category Biology Essay Type Review Tags: Cancer Essay Did you like this example? NHS Cervical Screening Programme: Liquid Based Cytology vs. Conventional Cytology Introduction Cervical screening, such as the regular programme provided by the NHS, is a very successful way of detecting the early signs of cervical cancer (Kitchener, Castle, Cox, 2006). The NHS programme screens around 3.5 million (Moss et al., 2003) to 4 million (Karnon et al., 2004) women annually and it is estimated that this prevents between 1100 and 3900 cases of cervical cancer a year (Moss et al., 2003). Don’t waste time! Our writers will create an original "Cervical Example For Free" essay for you Create order In recent years a new way of screening the cervical samples has been developed. This is referred to as liquid based cytology rather than conventional cytology. However, there has been considerable debate over the costs and benefits of the new technology, as will be examined below. Background Information Cervical cancer is linked to human papillomaviruses (HPV), a family of common sexually transmitted viruses (Eifel, Berek, Markman, 2011). It is believed to be fairly common for women to be exposed to HPV viral cells but usually these are readily cleared by their immune response (Bosch Iftner, 2005). However, in some instances women can develop an HPV infection following exposure to viral cells. The infection can seem largely asymptomatic but actually causes the abnormal multiplication of cells in the cervix, leading to warts, lesions or benign tumours and, if the infection persists, it can cause cervical cancer (Bosch Iftner, 2005; Eifel et al., 2011). In fact, HPV is believed to be the main, perhaps even the sole, cause of cervical cancer. The NHS cervical screening programme is available to women aged between 25 and 64 years of age and involves taking a regular swab or smear of cells from inside their cervix (Moss et al., 2003). These are then sent to a pathology labo ratory where they are screened by a cytologist for any abnormalities associated with HPV. In the absence of any abnormalities women between the ages of 25 and 50 years are advised to return for testing every three years, and those aged between 50 and 64, every five years (Health and Social Care Information Centre, 2013). The 2013 national statistics for the UK screening programme indicated that 78.3% of eligible women were up to date with their smear screening (Health and Social Care Information Centre, 2013). Cervical Cytology The focus of this essay is on the process that takes place in the pathology laboratory, where the cervical samples are sent for cytological screening. A cervical cell sample that has no abnormal cells is categorised cytologically as being negative (negative for the presence of HPV or risk of cervical cancer). Alternatively, samples may be identified as containing borderline abnormal changes, or having dyskaryosis (Health and Social Care Information Centre, 2013). In some literature the terms dysplasia or CIN (cervical intraepithelial neoplasia) seem to be used in place of dyskaryosis (Eifel et al., 2011), but NHS literature seems to make most consistent reference to dyskaryosis. The extent of dyskaryosis is then classified across a range from mild to severe. Depending upon the severity, the woman may be referred for colposcopy or recalled for a repeat cervical smear test 6-12 months later. In the 2013 national statistics, 6.5% of cervical samples were identified as being abno rmal, although only 1.2% were classified as being high risk (Health and Social Care Information Centre, 2013). Recently a new cytological screening technique has been developed, called liquid based cytology (LBC). The aim of this new method was initially to try to reduce false-negative and false-positive results (Karnon et al., 2004; Siebers et al., 2009), as well as the number of samples that are ‘inadequate’ or ‘unsatisfactory’ for effective screening (Arbyn et al., 2008; Siebers et al., 2009). In the conventional cytology method, a woman’s cervical sample is transferred directly from the collection spatula onto a microscopic slide (Arbyn et al., 2008; Moss et al., 2003). This transfer process seems to sometimes lead samples to be ‘inadequate’ for screening because the transferred cells are too difficult to clearly discern. This manual process does also, very occasionally, result in false results, even when conducted by experi enced cytologists. The liquid based cytology (LBC) method involves a slightly different approach to the preparation of the slides. The cell sample is placed into a vial containing a preservative fluid (Arbyn et al., 2008; Moss et al., 2003). This creates a liquid suspension of the sample, which can then be poured onto the slide in a very thin, uniform layer. However, debate remains over whether this method really offers a substantial improvement over conventional cytology. The main points of contention surround accuracy and cost effectiveness, with other arguments relating to patient anxiety and opportunities for HPV testing. Exploring the Issues Accuracy Evidence is mixed over whether LBC offers a substantial improvement in accuracy compared to conventional cytology. Early studies, such as that by Monsonego et al. (2001), were very favourable towards LBC. Further, in an extension of the LBC technique described earlier, it became possible for a computerised system to read the LBC slides to identify potential areas of concern prior to examination by a cytologist (Davey et al., 2007). Across a large Australian sample of over 55,000 women, Davey et al. (2007) found that this method of LBC was significantly better at detecting additional high grade histology cases than conventional cytology. However, more recent studies seem to undermine these reputed improvements of LBC over conventional cytology. For instance, in 2009, Siebers et al, drawing upon a sample of close to 90,000 women in the Netherlands, concluded that LBC â€Å"is neither more sensitive nor more specific in detecting CIN or cancer† (p.1764). This same point i s reiterated almost exactly by Arbyn et al. (2008) at the end of their thorough review of the most reputable, gold standard comparison studies. Whilst this creates a somewhat inconclusive picture, it is evident that LBC has not offered as marked an improvement in accuracy as might have been hoped. However, it is important to point out that none of the studies suggest that LBC is less accurate than conventional cytology. In fact, all of the studies mentioned above agree that LBC probably is more sensitive at picking up mild abnormalities and changes. It is just that this too is framed from a negative angle in the more recent studies because of concerns that unnecessarily following up these cases, when they are likely to be cleared by the patient naturally, would waste resources that would be better focused on high risk patients (Arbyn et al., 2008). There is, however, one clear point that emerges in favour of LBC in relation to accuracy. All studies seem to conclude that L BC does reduce the number of inadequate or unsatisfactory samples (Arbyn et al., 2008; Davey et al., 2007; Doyle et al., 2006; Moss et al., 2003; Siebers et al., 2009; Williams, 2006). For example, when LBC was initially trialled at three sites in the UK in 2002, Moss et al. (2003) collated data showing that LBC reduced inadequate slide preparations from 9% of samples down to 1-2%. In Scotland the difference was even greater, falling from 13% to 1.9%, and consequently referrals to colposcopy for women with repeated unsatisfactory results dropped from 25% to just 0.5% (Williams, 2006). These improvements substantially raise the efficiency of the whole screening programme. Therefore, it seems likely to have been these sorts of results that influenced the NHS that it would be cost effective to adopt LBC across the UK (Arbyn et al., 2008; Moss et al., 2003; Williams, 2006). Cost Effectiveness Turning to cost effectiveness, there are a number of aspects to take into consideration. As mentioned above, LBC may lead to a potential increase in costs if there is an increase in following up low risk abnormalities. Whilst this is framed negatively by Arbyn et al. (2008) it might be better, both for the patient and economically, to fully confirm that there is no cancer risk earlier on, rather than allowing any potential cancer to develop. Further, the significant reduction in inadequate samples may outweigh this through much larger potential savings. Reducing the number of women who are recalled due to an inadequate sample saves valuable nursing time, reduces administration costs and reduces the costs associated with repeating the whole procedure. With these primary care benefits in mind, Moss et al. (2003) estimated that LBC could generate savings of between one to ten million pounds annually. More recent studies have focused on the laboratory to consider whether LBC im proves productivity during this part of the process. Doyle et al. (2006) studied several laboratories during the change over from conventional cytology to LBC and found that on average each scientist was able to process more samples per day. The data collated by Williams (2006) similarly demonstrated that overall workload in the laboratories decreased and backlogs were cleared. Presumably, if LBC is combined with the computerised imaging technology that automates a large part of the process, there may be further efficiency as cytologist time and effort can be focused on the samples identified to contain abnormalities. Of course, all of this economising does not take into account the initial investment costs involved, or the on-going cost of the LBC specific materials. It is notable that both techniques mentioned in the NHS pilot study, ThinPrep and SurePath, are registered trademarks. Perhaps this is why more recent studies tend to argue that one of the disadvantages of LBC is that it is more expensive, both in terms of initial outlay and on-going operating costs (Arbyn et al., 2008; Eifel et al., 2011). Therefore, Arbyn et al. (2008) suggest that â€Å"economic advantage might be peculiar to the United Kingdom where inadequacy rates for the conventional Pap were excessively high† (p.175). Patient Anxiety Beyond economics, another important point to consider is patient anxiety. A benefit of reducing inadequate samples is the reduction in anxiety for the patient. Although the nurse may try to reassure the woman that an inadequate sample does not indicate any abnormality, it may be difficult for the patient not to fear a risk of cancer. On the otherhand, if minor abnormalities picked up via LBC are followed up, as Arbyn et al. (2008) suggest, this might create unnecessary stress and anxiety for these patients and their families. This seems to suggest that between the two technologies patient anxiety may balance out being alleviated for some patients or created for others. However, perhaps the balance swings in favour of LBC here, as it would seem preferable to monitor cases of mild abnormality just in case these progress, rather than to create unnecessary anxiety due simply to technical inferiority. HPV Testing The other key advantage of LBC is the potential it offers to conduct additional laboratory tests. Preparing an LBC slide from the cervical sample uses only a small amount of the solution in the vial. Therefore, the remainder can be subjected to further tests. In particular, it is now possible for laboratories to test for the presence of HPV using HPV DNA testing (Kitchener et al., 2011). Any cases showing cell abnormalities during LBC can undergo HPV testing on the same sample. This might clarify any false-negative cases or mild abnormalities without the woman even knowing. It would also reduce the costs of referring false-negative patients for colposcopy or for an unnecessary recall screening. Whilst controversy has largely focused on conventional cytology and LBC, the NHS actually introduced LBC in combination with HPV testing (Moss et al., 2003). Recent studies have demonstrated that HPV testing may be more powerful than cytology, and suggest it may come to replace cytol ogy as the primary screening technique (Katki et al., 2011; Kitchener et al., 2011). Katki et al. 2011 advocate that one negative result via HPV testing offers â€Å"strong reassurance against cervical cancer for five years in women from age 30† (p.1470). This could significantly reduce primary care costs as currently women aged 30-50 are tested every 3 years under the NHS screening programme. Kitchener et al. (2011) have gone further than this, suggesting that HPV testing might even allow the interval between cervical screens to be extended to every six years. Conclusion There has been significant debate around the shift from conventional to liquid based cytology when screening for cervical cancer. This has been particularly heightened given the evidence that LBC does not appear to reduce false-positive or false-negative results in the way that had been hoped. However, in the UK at least, LBC significantly reduces the number of ‘inadequate’ samples, reducing primary care costs and patient anxiety in these cases. Although it is a little unclear whether LBC is more cost effective when all costs are taken into consideration, it seems that by investing in the technique the NHS is now well placed to quickly and easily adopt new scientific developments, such as wide-scale HPV testing. Given LBC, HPV DNA testing and the HPV vaccination, cervical cancer prevention seems to be a rapidly advancing area of science where new developments progress fairly quickly from research into routine health practice. Therefore, it seems wise that the NHS chose to invest in LBC and HPV testing when it did so that it can keep apace, and continue to offer cutting edge cancer screening to women. References Arbyn, M., Bergeron, C., Klinkhamer, P., Martin-Hirsch, P., Siebers, A. G., Bulten, J. (2008). Liquid compared with conventional cervical cytology: A systematic review and meta-analysis. Obstetrics Gynecology, 111(1), 167-177. Bosch, X. F., Iftner, T. (2005). The aetiology of cervical cancer. Sheffield: NHS Cancer Screening Programmes. Davey, E., dAssuncao, J., Irwig, L., Macaskill, P., Chan, S. F., Richards, A., Farnsworth, A. (2007). Accuracy of reading liquid based cytology slides using the ThinPrep Imager compared with conventional cytology: prospective study (Vol. 335). Doyle, B., OFarrell, C., Mahoney, E., Turner, L., Magee, D., Gibbons, D. (2006). Liquid-based cytology improves productivity in cervical cytology screening. Cytopathology, 17(2), 60-64. Eifel, P. J., Berek, J. S., Markman, M. A. (2011). Cancer of cervix, vagina, and vulva. In V. T. DeVita, T. S. Lawrence, S. A. Rosenberg (Eds.), DeVita, Hellman and Rosenbergs Cancer: Principles Practice of Oncology (9th ed.). Phildelphia: Lippincott, Williams Wilkins. Health and Social Care Information Centre. (2013). Cervical screening programme, England 2012-13. Leeds: UK Statistics Authority. Retrieved from https://www.hscic.gov.uk Karnon, J., Peters, J., Platt, J., Chilcott, J., McGoogan, E., Brewer, N. (2004). Liquid-based cytology in cervical screening: An updated rapid and systematic review and economic anylsis. Health Technology Assessment, 8(20). Katki, H. A., Kinney, W. K., Fetterman, B., Lorey, T., Poitras, N. E., Cheung, L., . . . Castle, P. E. (2011). Cervical cancer risk for women undergoing concurrent testing for human papillomavirus and cervical cytology: a population-based study in routine clinical practice. The Lancet Oncology, 12(7), 663-672. Kitchener, H. C., Castle, P. E., Cox, J. T. (2006). Chapter 7: Achievements and limitations of cervical cytology screening. Vaccine, 24, Supplement 3(0), S63-S70. Kitchener, H. C., Gilham, C., Sargent, A., Bailey, A., Albrow, R., Roberts, C., . . . Peto, J. (2011). A comparison of HPV DNA testing and liquid based cytology over three rounds of primary cervical screening: Extended follow up in the ARTISTIC trial. European Journal of Cancer, 47(6), 864-871. Monsonego, J., Autillo-Touati, A., Bergeron, C., Dachez, R., Liaras, J., Saurel, J., . . . Mottot, C. (2001). Liquid-based cytology for primary cervical cancer screening: a multi-centre study. British Journal of Cancer, 84(3), 360-366. Moss, S. M., Gray, A., Legood, R., Henstock, E. (2003). Evaluation of HPV/LBC cervical screening pilot studies. UK: First report to the Department of Health evaluation of LBC (December 2002). Siebers, A. G., Klinkhamer, P. J. J. M., Grefte, J. M. M., Massuger, L. F. A. G., Vedder, J. E. M., Beijers-Broos, A., . . . Arbyn, M. (2009). Comparison of liquid-based cytology with conventional cytology for detection of cervican cancer precursors. The Journal of the American Medical Associatio n, 302(16), 1757-1764. Williams, A. R. W. (2006). Liquid-based cytology and conventional smears compared over two 12-month periods. Cytopathology, 17(2), 82-85.

The European Union A Controversial Issue - 2459 Words

Since 1973 when the British first joined the European Union their membership has been a controversial issue. When conservatives in the United Kingdom won the general election in 2015, their election manifesto promised to hold a referendum on whether or not the United Kingdom should stay or leave the European Union. The referendum also referred to as â€Å"Brexit† is scheduled to take place by the end of 2017. The United Kingdom initially joined the union to be part of the common market for the purpose of trade and to develop international relationships. The main argument for those who are pro Brexit is that being part of the European Union is too costly for the United Kingdom, that the EU has grown to large, has interfered to far into†¦show more content†¦The EU has its own currency called the euro which 19 of the 28 European states use. It is run by members of the European parliament, these members set rules that cover a wide range of areas such as rules on transpor t and business. Once a state becomes a member of the European Union they have a right to withdraw from the Union under the Treaty on the European Union. Article 50 in the Treaty on European Union states, â€Å"Any Member State may decide to withdraw from the Union in accordance with its own constitutional requirements. If the United Kingdom votes to leave the Union, they would be the first state to ever withdraw their membership. The United Kingdom initially joined the European Union in 1973 for economic reasons hoping to promote trade and form relationships with other states in the Union. In 1975 the UK held its first national referendum on withdrawal from the European Economic Community. According to the poll,† 67 % of Britons voted to stay in the EEC and 32 % voted to leave the union† (GYE). Because of this result the UK stayed in the EU in 1975. Over the past 40 years the European Union has been through a lot of change, many more countries have joined the organizati on and the EU has extended its control over more aspects of daily lives. These changes have sparked a lot of controversy coming from both the UK public and

Hypermarket Impact on Small Retailer Free Essays

ABSTRACT Kedai runcit or sundry shops have been a standard feature of our housing estate landscape ever since there were housing estates. These mom-and-pop operations have been selling to their surrounding residents everyday essentials such as groceries, fresh produce, poultry, toiletries, etc. Their reasonable price and close distance have made them popular among residents of the housing estates in which they are located. We will write a custom essay sample on Hypermarket Impact on Small Retailer or any similar topic only for you Order Now Lately, though, their popularity has been on the decline due to competition from wholesale markets or hypermarkets which can offer the same items cheaper and conveniently under one roof. Local and foreign-bred hypermarkets such as Giants, Tesco and Carrefour have been invading our towns, big and small, leaving the traditional sundry shops fighting for their business. Many of these small-scale individually-owned shops have since closed their operations permanently or moved them a little further outskirt of town, away from the hypermarket catchment. Just how serious is the impact of these hypermarkets on the operation of the sundry shops has so far not been fully investigated in Malaysia although many studies have been carried out elsewhere. Thus, this paper presents a study that has been carried out by the authors to investigate how serious the impact is in Johor Bahru. A sample of three hypermarkets was chosen for this study. Using GIS, we spatially showed the annual changes in the density of sundry shop licenses issued by the local authority within the catchment of each hypermarket, three years before as well as three years after the inaugural date of the hypermarket. Also using GIS, we corroborated the decline in the number of sundry shops within the surrounding housing estates with the residing addresses of the surveyed customers of the hypermarkets. The results obtained confirmed that the operation of hypermarkets does contribute to the decline in the number of sundry shops and the degree of the decline decreases radially outward from the location of the hypermarkets. The findings from this study suggest that some rethinking needs to be done about the manner in which hypermarket licenses, or sundry shop licenses for that matter, are issued. Even our current policy of allowing a certain percentage of new housing development to be set aside for shoplots may also need to be reviewed. Keywords: Hypermarkets, sundry shops, GIS spatial analysis 1. INTRODUCTION Kedai runcit or a sundry shop is any shop that sells groceries and other daily items directly to its customers in small quantity (Osman, 1988). Normally, sundry shops are owned by individuals or shared by several individuals and offer limited number of items and quantity. In Malaysia one can find sundry shops in almost every housing estates and villages and they normally have a limited cathment area. A hypermarket, in contrast, is a big-scale retail store that offers a variety of goods and services all conveniently under one roof (Duncan, Hollander and Savitt, 1983). A hypermarket commands a wide catchment area and it is normally owned by big companies who have numerous branches of the hypermarkets in many places. Among the more-popular chains of hypermarket operating in Malaysia are the locally-owned Giant Hypermarkets, and foreign-owned Tesco Hypermarkets and Carrefour Hypermarkets. Like in any modern country, hypermarkets in Malaysia have been expanding their operation to meet the demand of current generation for quality, convenience, product variety and long operation hours (Malaysian Ninth Plan, 2006). However, there are ever growing concern on the negative impacts of hypermarkets on the business of nearby neighborhood sundry shops (Johor Structure Plan 2002-2020, 2005). This is supported by Bennison Davies (1980) and Seiders Tigert (2000) whose study concluded that a hypermarket did have a negative impact on the growth of small sundry shops in the area. In spite of the same concern in Malaysia, there have been no study to investigate the spatial extent of the impact. Thus, a study was set up by the authors to investigate the spatial extent of the impact and also to find out the factors that attract customers to hypermakets, leaving their neighborhood sundry shops struggling for business. 2. OBJECTIVES The objective of the study was to spatially investigate the impact of a hypermarket on the operation of the surrounding sundry shops. In order to achieve the objectives the following tasks needed to be carried out: 1) identifying the suitable samples of hypermarkets; 2) identifying the market catchment of the hypermarkets; 3) collection of data pertaining to the number of business licenses issued to sundry shop operators within the catchment areas three years before as well as three years after the operation of the hypermarkets; 4) identifying factors that influence the decisions by the customers to shop at these hypermarkets. The method used to conduct the study is discussed in details in the following section. 3. METHOD The first step of the study was to choose a number of hypermarkets as units of analysis. Among the criteria taken into consideration in choosing the hypermarkets were: 1) the year they were opened for business to ensure that the chosen hypermarkets have been operating for at least three years; 2) the distances between each other to avoid overlapping of the market catchments; and 3) the types of goods sold at the hypermarkets so that they match those sold at the neighborhood sundry shops. Of the total of about ten hypermarkets in the City of Johor Bahru, three hypermarkets met these criteria and were chosen for the study. The three hypermarkets were from a locallygrown hypermarket chain known as Giant Hypermarket that are located in Southern City (in Johor Bahru City Centre), in Plentong and in Skudai (10km outskirt of Johor Bahru) (Refer Figure 1. 0). These three hypermarkets served a number of residential areas, known in Malaysia as taman perumahan or housing estates, located between 0 – 20km surrounding them. The next step was the distribution of questionaire sets to 200 customers per hypermarket (100 during weekday and 100 during weekend) containing questions concerning their home addresses and the reasons for choosing to shop at the hypermarkets. Their home addresses were then inputted into the city plan in GIS format to dertermine the extent of each hypermarket’s cathment area. One way to measure the impact of a hypermarket on the neighborhood sundry shops is to actually count the number of sundry shops that are in business several years before and after the hypermarket is in operation. This is difficult to conduct since the monitoring would take as long as the number of years that we are interested in investigating. One way to expedite the process is to actually study the records of the number of annual business licenses issued to sundry shops and assume that each sundry shop that holds such license is actually operating a sundry shop. On this basis, the number of business licenses issued to sundry shops within three years before and after a hypermarket was in operation were obtained from the local authority (Johor Bahru Tengah Municipal Council). The locations of the business premises of these licenses were then plotted on the city map and then rasterised into a 50m grid format to give a density of sundry shop licenses per fifty square meters for each of the three years before and after the operation of the hypermarkets. The changes in the sundry shop density were then used to explain the impact of the hypermatkets on the business of the sundry shops. 2. Impact on Neighbourhood Sundry Shops If most of the customers that patronize these hypermarkets come from the surrounding housing estates as described previously, what is the impact on the sundry shops within those housing estates? The least impact would be slowing down of business for these neighborhood sundry shops while the worst impact would be closing down of business. While business slowdown can be investigated, this study only looked at the closing down of business by tracking the number of sundry shop licenses issued annualy by the local authority. Since the impact normally materializes a few years after the opening of a hypermarket, records of licenses three years before and after the opening of the hypermarket were inventoried. Changes in the number of sundry shops were investigated by studying the changes in the density of sundry shop licenses for every 50m2 area surrounding each hypermarket. This is done spatially in GIS by rasterising the 50m2 area into grids and varying the color of the grids according to the number of licenses within the grids for each particular year. Figures 5. 0 – 7. show the annual changes in the density of licenses within the grids for all the three hypermarkets studied. In general, the figures show the decreasing trend in the densities of sundry shops even before the opening of these hypermarkets except for the Plentong Giant Hypermarket. The decreasing number of sundry shops surrounding the Southern City Hypermarket (Figure 5. 0) could be attributed to competition among themselves and the o peration of another hypermarket chain at the very building occupied by the Giant Hypermarket before it took over the operation. Meanwhile the decreasing number of sundry shops surrounding the Skudai Hypermarket (Figure 7. 0) could be attributed to the opening of another Giant Hypermarket just 4km away the year before the Skudai Hypermarket opened, apart from competition among themselves. The number of sundry shops surrounding the Plentong Hypermarket (Figure 6. 0) on the other hand was on the increase prior to the opening of the hypermarket. Investigation revealed that this was due to the opening of several new housing estates in the area which normally, as the case is in Malaysia, come with a number of shoplots. How to cite Hypermarket Impact on Small Retailer, Essay examples

Leonardo Di Ser Piero Da Vinci Essay Summary Example For Students

Leonardo Di Ser Piero Da Vinci Essay Summary Leonardo was a man of many different talents; among those talents were polymath, painter, sculptor, architect, musician, scientist, inventor, engineer, writer, geologist, anatomist, cartographer, anatomist, and botanist. Leonardo was primarily known for his painting (Mona Lisa, the last supper, Vitamins Man), and his fascinating inventions (Helicopter, tank, flying Machine, Viola Organists) which I will be talking about in depth in my research paper. First study science, and then follow with practice based on science.. The painter who draws by practice and judgment of the eye without the use of reason is like the mirror the reproduces within itself all the objects which are set opposite to it without knowledge of the same. The youth ought first to learn perspective, then the proportions of everything, then he should learn from the hand off good master. Leonardo Dad Vinci The Renaissance marked the transition point from the middle ages to the modern world. Young Leonardo Did Seer Piper Dad Vince received his education of Painter, sculptor, and engineering in Florence in the early sass. In a time when coming with a new approach toward science was considered a direct insult or challenge to the church, Leonardo managed to project his new finding of science, Mathematics formulas, and logical reasoning without creating a new reform of cultural beliefs. Among his reaction we can find what is considered to be an early predecessor of todays helicopter. Between 1480 and 1493 Leonardo Dad Vinci designed what is known today as the Aerial Screw or also known as the Helical Air Screw. Leonardo Helical Air Screw measure approximately fifteen feet across and the material used to build it were reed, linen, and wire. The main power proportion came from four men that were standing in the middle of the craft rotating different pedals in order to rotate the screw like shaft (See figure L-1). Leonardo was a very methodical reader and writer. He often read books that interest him with pen on hand. He was so critical of himself that he used to describe his though in writing, and draw them most of the time in order to retrace his thinking. In the old time it was common for inventors to read others innovators ideas in order to create new ones or reproduce the same invention with improvements. One of those creations was the Leonardo Assault Vehicle. After researching Roberto Evaluators De re military, Leonardo Dad Vinci went ahead and created the Assault Vehicle with a technology that was unheard of at the time. Due to the lack of funds and the war at the Apennines Peninsula Leonardo had o restrain his master creation to Just a blueprint. The Assault Vehicle had an upside- down cone shape with four wheels at the bottom, and a crankshaft for propulsion. Been that Leonardo was so critical of his own invention, he decided to make improvement to his own invention at a later time. One of those improvements was the vehicle self-propulsion. Leonardo achieved this improvement by creating a spring-power system (As the Motor), and an innovated differential transmission system. (L-2 Picture of Assault Vehicle) Another area in which Leonardo Dad Vinci broke new ground was painting. But to his misfortune in life by 1514 most of his paintings were not completed due to lack of commissions and Italians wars. One of those paintings happened to be the Mona Lisa or La Cocooned a 16th century oil painting portray of Lisa did Antonio Maria Grenadine which in todays expert opinion it is one of the most impossible to comprehend painting in the history of art. Leonardo started to paint the Mona Lisa in 1503 under the commission of Francesco did Bartholomew did Zinnia del Giaconda and finished nil 519 shortly before he died. .u9a37f76abba6922fcd4f147e6cde90be , .u9a37f76abba6922fcd4f147e6cde90be .postImageUrl , .u9a37f76abba6922fcd4f147e6cde90be .centered-text-area { min-height: 80px; position: relative; } .u9a37f76abba6922fcd4f147e6cde90be , .u9a37f76abba6922fcd4f147e6cde90be:hover , .u9a37f76abba6922fcd4f147e6cde90be:visited , .u9a37f76abba6922fcd4f147e6cde90be:active { border:0!important; } .u9a37f76abba6922fcd4f147e6cde90be .clearfix:after { content: ""; display: table; clear: both; } .u9a37f76abba6922fcd4f147e6cde90be { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .u9a37f76abba6922fcd4f147e6cde90be:active , .u9a37f76abba6922fcd4f147e6cde90be:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .u9a37f76abba6922fcd4f147e6cde90be .centered-text-area { width: 100%; position: relative ; } .u9a37f76abba6922fcd4f147e6cde90be .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .u9a37f76abba6922fcd4f147e6cde90be .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .u9a37f76abba6922fcd4f147e6cde90be .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .u9a37f76abba6922fcd4f147e6cde90be:hover .ctaButton { background-color: #34495E!important; } .u9a37f76abba6922fcd4f147e6cde90be .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .u9a37f76abba6922fcd4f147e6cde90be .u9a37f76abba6922fcd4f147e6cde90be-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .u9a37f76abba6922fcd4f147e6cde90be:after { content: ""; display: block; clear: both; } READ: Renaissance Question mark EssayBy 1511 Leonardo had to migrate under the Melee family protection to Vapor where he sided and produced magnificent creation of arts for two years in order to repay the Melee family hospitality. While at Vapor Leonardo continued to develop his new projects and improving his paintings knowing that sooner or later he will have to find a more suitable patron in order to be able to finance his work. The solution to financial impasse came in February 1 513 in the hand of Giovanni De Medici, the younger descendent of Lorenz IL Magnificent. With the death of Pope Julius II in Rome and Giovanni ser piero asserted to papacy under the name of Pope Leo X . Giuliani De Medici rather of Pope Leo X and by them commander of the papal army, invited Leonardo to Rome for his knowledge of art and military technology. The invitation to Rome by Giuliani De Medici was the opportunity that Leonardo Dad Vinci was waiting for. Unlimited commissions, immeasurable social status, and a very power full patron. What else? By September 1513 Leonardo relocated himself back to Rome where he was accommodated in the Vatican luxury Belvedere villas together with all his painting including some half stages such us the Lead, the Mona Lisa, and the Saint Anne.