Can We Ever Leave The Past Behind?. To answer the question, we need to look at the origin of human behaviour, ideas, and feelings? – are they innate or learned? (from past experiences) – nature or nurture? Nature is inherited abilities and genes present at birth, and Nurture is behaviours acquired after birth from the influence of experience. Many modern theories suggest that experience, environment and genetics all play a role in influencing our present behaviour, but they don’t all agree on the degree of these influences. It has long been understood that certain physical characteristics are biologically determined by genetic inheritance e.g. colour of hair, eyes and skin, physical characteristics such as the shape of our nose etc, and even certain diseases are a function of the genes we inherit e.g. Parkinson’s. These facts drive research to discover if psychological characteristics such as behavioral tendencies, personality attributes and mental abilities are also wired in before we are born. Mcleod (2007) writes that on the extreme nature side of the debate there are the biological theorists who focuses on genetic, hormonal and neurochemical explanations for our behaviour and characteristics that are not observed at birth, but develop later in life as a product of maturation. And at the other end of, pro the nurture debate, are the behaviorists who believe all behaviour is learned from the environment through conditioning; it is how we are brought up that governs the psychologically significant aspects of development and behaviour we exhibit in our present. Examples of the nature position include Bowlby’s theory of attachment, which views the bond between mother and child as being an innate process that ensures survival, and also Freud’s theory of aggression as an innate drive (called Thanatos). These contrasts with the behaviorists, eg Skinner, who believed that language, is learnt from other people via behavior shaping techniques and Bandura’s social learning theory that states aggression is learnt from the environment through observation and imitation eg BoBo doll experiment (NCHP 2011). Other psychological theories suggest that there is a middle ground to these extremes that explain present day behaviours; a middle ground to include some biology and some acquired through experience. How much of each is open to debate especially in the light of advances in genetics. McLeod (2007) quotes the Human Genome Project as an example stimulating interest in tracing types of behavior to particular strands of DNA located on specific chromosomes, with scientists on the verge of discovering (or have already discovered) the gene for criminality, alcoholism or the “gay gene”. Freud maintained a balanced view between nature and nurture, all-be-it a shifting one. His concept of the dynamic unconscious was an important contribution to the psychology of human behaviour in that the human mind played an important role in determining how a person behaved – but the existence of external events could not be disregarded. Many approaches in the field of psychology suggest that behaviour is directed by an individual’s goal but the idea of the goal directed unconscious is an original Freudian concept. Underlying this theory is the belief that any individual’s behaviour is the direct result of the influences of all prior experience and that no individual aspect of human behaviour is accidental. Freud believed that early childhood experiences formed solid foundations on which the developing child would structure the rest of their life i.e. the adult personality was formed in childhood according to their experiences. If the experience was happy and balanced then the child would develop into a well balanced and adjusted adult. Psychotherapy utilises the psychodynamic approach which places importance on the childhood years and how conflicts were resolved. Jung disagreed with aspects of Freud’s theories, especially his psychosexual stages; he developed his own theories which became known as Analytical Psychology. He did agree with Freud that man is driven by libido, but felt it was more a ‘life force’ which was responsible for development. His concept of the unconscious was different to Freud’s Ego, Id and super-ego structure, and suggested that the psyche was composed of three components: the ego, the personal unconscious and the collective unconscious: the ego represents the conscious mind while the personal unconscious contains memories, including those that have been suppressed. The collective unconscious is a unique component in that Jung believed that this part of the psyche served as a form of psychological inheritance. It contains all of the knowledge and experiences we share as a species and is where his archetypes exist as innate models. The five archetypes Jung was most interested were the anima, animus, persona, shadow and self. (Snowden 2010) Jung argued that whereas the first part of a person’s life involves a coming to terms with the outer environment and its challenges – through work, friendships and relationships – the emphasis on the second part, from middle age onwards, is to come to terms with one’s own personality. Faced with declining opportunities, energies and possibly health, the individual must find new purpose and meaning in life through components. Snowden (2010) writes that although ultimately beneficial, this can be difficult, because it involves accepting parts of one’s personality which one may prefer to leave undiscovered e.g. The shadow. Jung believed that a whole race could relate back to its origins e.g. aborigines, Eskimos, Negros. He based this theory on research which showed uniformity of ideas and customs in a particular group. He answered his critics by suggesting that these themes showed as fantasies in psychotic people who, he said, would never have known that material, and also in his later dream analysis work. Criticism came, not just from supporters of Freud, but scientists who wanted empirical evidence. The criticism was centred upon four main areas: Jung’s methodology. The theory of archetypes Jung’s concept of religious experience The role of religion within individuation. Roheim (1945) felt that since all humans share broadly the same experiences, it is hardly surprising that they develop myths along similar lines. Research documented by Geza Roheim (1929-1953) showed that although he was primarily a theoretician, his theory was always based on rigorous observation and study e.g. Australian Aborigines. He was one of the first anthropologists to successfully apply Freudian theories to the analysis of cultures. Robinson (1969) writes: “Roheim’s “ontogenetic theory of culture” is considered a major contribution to this field”. (p129) Roheim believed that cultural differences were largely the result of an individual’s childhood traumas and that the childhood experiences of the individual was ultimately reflected in adult personality and in the collective institutions of a given culture. (Robinson 1969). The Object Relations Theory places less emphasis on Freud’s biological drives of aggression and sexuality as motivational forces and more emphasis on early relationships, primarily mother and child. Object Relations theorists believe that we are relationship seeking rather than pleasure seeking. Melanie Klein was a main contributor to the Object Relations Theory. Klein, Fairbairn and Winnicott, have moved, in varying degrees, toward a model in which an ‘object’ is the target of relational needs in human development. The infant’s first object is a part object, e.g. the mother’s breast, a supplier of needs. The ego is strengthened by the finding of ‘good’ objects. Segal (1992) writes about Klein, how she developed the model of ‘good objects’ and ‘bad objects’ as a different type of conflict to that between Freud’s Id and super-ego. Seeing the breast relationship as significant; as the child feeds, it feels gratified and satiated when the breast produces sufficient milk, and so feels loved and cherished. But if prematurely withdrawn or the breast does not provide sufficient food, the child is frustrated and the breast is hated and receives hostile thoughts (Good breast: bad breast). Klein suggests this conflict is essential for normal personality/ego growth. I.e. conflict and the ability to overcome it. Splitting occurs to allow the infant to deal with the conflict i.e. good and bad in the same object. This has similarities to Jung’s coincidence of opposite’s concept. Objects can be people (mother, father, others), parts of people or objects/symbols with which we form attachments eg infants can form relationships with toys and pets (transitional objects) even blankets and items of clothes. These objects and the developing child’s relationship with them are how humans form and preserve a sense of self, as well as relationships with others; if disrupted then there begins the development of an affected child or adult later on. Bowlby and Winnicott put emphasis for human behaviour on environmental factors, including relationships with others. Winnicott’s theory rests easily alongside Bowlby’s (1988) theory of attachment which proposed that attachment bonding between individuals develops only to have certain biological drives met. A securely attached child is able to explore and move away from mother to engage with a wider world, not only physically but internally i.e. self contained, having internalised the love of their caretaker and so comfortable with self ie attachment actually fosters independence rather than dependence. Abuse by a primary caregiver damages the most fundamental relationship as a child-that you will safely, reliably get your physical and emotional needs met by the person who is responsible for your care. Without this base, it is very difficult to learn to trust people or know who is trustworthy. This can lead to difficulty maintaining relationships due to fear of being controlled or abused. It can also lead to unhealthy relationships because the adult doesn’t know what a good relationship is. Bowlby (1988) was also critical of Klein’s emphasis on the internal process at the expense of the relationships with real objects. He also argued that Winnicott’s theory of ‘a good enough mother’ puts expectation on the mother that she must shoulder the responsibility for the outcome of her child. Pines (2005) however felt: “Winnicott did a great favour to concerned mothers by assuring them that in order to raise an emotionally healthy baby you do not need to be a perfect mother, only a “good enough mother” ” (P.118). Carl Rogers (1951) proposed that the sense of self which emerges from childhood, be it healthy or psychologically problematic, is dependent on these relationships: “As a result of interaction with the environment, and particularly as a result of evaluational interaction with others, the structure of self is formed…” (p498) And: “Psychological maladjustment exists when the organism denies to awareness significant sensory and visceral experiences…” (p510) Jacobs (2007) raises concern that these theories can lead us to put people ‘in boxes’, labelling them normal or abnormal depending on whether or not they have successfully negotiated a particular stage or phase in their life. Klein tried to address this by building on Freud’s psychosexual stages theory using positions not stages. Freud suggested we move through the stages, oral to anal then genital , whereas Klein believed we are never free of issues; adults and children move back and forth between positions all the time (e.g. paranoid-schizoid position and depressive position). Klein ‘depressive position’ has been used to describe a child’s growing perception that early good and bad experiences come from the same source. Referring to Lewins Field Theory Neumann (2011) writes: “Lewin highlighted the importance of characterising the atmosphere (e.g. emotional tone or climate) and the amount of freedom existing in the situation. This overall perspective counteracts the pull to repeat the same unsuccessful attempts at change and development. Concluding that such a pull to repetition comes from forces within the field.” Erikson accepted most of Freud’s work, but proposed that there were not five stages of development as Freud psychosexual stages proposed, but eight. Erikson believed that every human being goes through a predetermined unfolding of personality in his ‘Eight Ages of Man’ theory to reach full development. Jacobs (2007) summarises: ‘Erikson’s theory frames the issues of each age as being much more than erotic pleasure or frustration, and much more than the satisfaction of bodily desires’.(p11) Alongside Erikson’s stages are tasks that he felt were key issues in each age e.g. Trust v Mistrust during the oral age progressing to the emergence of an identity crisis during the teenage years in which people struggle between feelings of identity versus role confusion. James Marcia (1966) expanded upon Erikson’s theory proposing the Identity Status Theory, as not stages, but rather processes that adolescents go through, in varying sequence, sometimes in two states at any one time. Marcia felt that stages meant people have to progress from one to the next in a fixed sequence, which his theory rejected. He felt the balance between identity and confusion lies in making a commitment to an identity with each state determined by two factors: 1. Is the adolescent committed to an identity, and 2. Is the individual searching for their true identity? The Identity States are: Identity achievement occurs when an individual has gone through an exploration of different identities and made a commitment to one. Moratorium is the status of a person who is actively involved in exploring different identities, but has not made a commitment. Foreclosure status is when a person has made a commitment without attempting identity exploration. Identity diffusion occurs when there is neither an identity crisis or commitment. Those who have made a strong commitment to an identity tend to be happier and healthier than those who have not. Those with a status of identity diffusion tend to feel out of place in the world and don’t pursue a sense of identity. All these theories relate to a development where different parts or objects need to relate together – integration. This appears as us being able to relate socially, to work, ourselves and the environment we live in. With Erikson this is a continuous process of finding identity but there is no doubt that experiences of childhood are vital in our ability to adapt to life. Whatever we call it, we need a secure sense of self, ego, individuality, to meet and work with the changes that growing up and older brings. Freud would say this is living by the principal of reality i.e. ego is balancing the demands of the Id, super ego and environment. Erikson elaborated on this with different strengths at each age stage, finishing at the eighth age of ego integrity knowing ones identity. Jung suggested individuation. Jacobs (2004) Triangle of Insight suggests client do not present themselves to the counselling relationship in isolation. Psychodynamic Theory uses the Triangle of Insight in which past and present, relationships inside and outside therapy and in the external and internal world can be linked, and can be very insightful to the clients picture and their presenting issue: Present. In here. Counsellor-Client Past. Present Back Then. Out There ‘Parent’-Child Client-Others Not only is our present being influenced by our past, our memory of our past is influenced by our present; perceptions and interpretations differ depending on current circumstances, our mood even, so the presenting position may well bias the way we tell our story – perception and reality are both important aspects. Rogers (1951) proposed: “We react to the field as it is experienced and perceived. This perpetual field for the individual is ‘reality'”. P484 Family history, parents and the generations above them, might play itself out in a family. Family therapy has recognised the importance of this influence on a family and individual; it is not just the individual’s history that is relevant here. Fritz Perls first introduced what would become the Cycle of Awareness in Gestalt Therapy. He believed that there exists an instinctive cycle which reflected the “cycle of the interdependency of organism and environment.” (Perls 1969). ACTION MOBILISATION CREATIVE VOID WITHDRAWAL SATISFACTION FULL CONTACT CONTACT SENSATION AWARENESS Fig.1 Clarkson (2004) describes how this cycle (fig.1) demonstrates how past negative events/instruction is detrimental to psychological health and that to process any emotion fully and healthily, we need to pass round the cycle of experience to maintain us and provide for actualisation. She says: “Interruption of the Awareness Cycle limits ‘aliveness’; the point in the cycle the interruption occurs is dictated by the type of toxic introject.” Two categories interfere with this cycle: Absence in the environment of the person or thing necessary to satisfy need. Stopping oneself in the cycle : This requires us to be aware of our wants. To not be aware is to stay in withdrawal even after want has arisen – or to keep it out of awareness. I.e. the decision to self-interrupt this natural process is to leave a need or preference unmet, which accumulates as ‘unfinished’ business. It is in effect avoidance. It is during early development, particularly the first five years, a child is given messages of how to express themselves, verbal and non verbal. Smith (2000) suggests that these are introjected, swallowed whole, and if toxic e.g. ‘big boys don’t cry….mummy won’t love you’: “…can produce a lifelong conflict against ‘aliveness’. The greater number or severity of toxic introjects the less alive the person and inner conflict reigns. To communicate our story or experience we need to understand language and imagery; it lies at the centre of many therapeutic models, particularly so in the psychodynamic approach. In our present we use words, stories and even symbols to illustrate our own story and this can hold so much information as to what we are trying to convey eg how we see the world, a particular problem, a relationship or even what our personality, thoughts or emotions are; our past forms this. Each person has their own language and imagery when speaking, as each has their own personal life experience e.g. ‘I drift along’ as opposed to ‘I was dragged up’. The way we convey our story may give a quite different meaning to the listener. Freud proposed language was linked with our experiences during the psychosexual phases whilst more modern psychologists feel that meanings should be allowed to have a more individual interpretation, with the possibility of common elements, eg different cultures, single parenting and gay relationships will produce a different set of norms and values. The significance of difficult past experience, fact and perception, applies as much to the earliest weeks in a person’s life including antenatal influences. In their article Davis, E., Sandman, C ( 2006) write: “Stress has significant consequences throughout the lifetime. However, when it occurs early in life, the implications may be particularly profound and long lasting”. Ainsworth et al’s (1979) ‘Strange Situation Test’, concluded that there were three major styles of attachment: Secure, Ambivalent-insecure, and Avoidant-insecure. Numerous studies have supported Ainsworth’s conclusions that these early attachment styles can help predict behaviours later in life and have an important impact on later relationships. Hazen and Shaver (1990) for example found that securely attached adults tend to believe that romantic love is enduring, ambivalently attached adults fall in love often, while those with avoidant attachment styles describe love as rare and temporary and tend to have difficulty with intimacy and close relationships. Researching different attachment styles and gender Feeney et al (1993) suggested that attachment style and gender role expectations jointly influence relationship development. The overall view from these theories is that unresolved issues from the past often have a powerful effect on living in the present. Linking past to present can be enlightening, although identifying it with a client can be quite challenging and is why the therapeutic relationship is so important. We come into the world with a genetic encoding that sets the stage for who we will become. However, it is also our interactions with significant others, from birth onward, that shapes how our genetic predispositions will be expressed. Early in life, we have little sense of ourselves, or our identity. It is through our relationships with significant people around us that slowly build a self-structure, which we eventually call a personality. Taking all this evidence into account, my view is no, we can never leave our past behind, it stays with us; it has formed who we are. It explains so much about how we are, good and bad. By understanding the origin of our present day behaviours, biologically and acquired through experience, we can gain a deeper understanding, or a different perspective, which can facilitate the process of further integration with self. It may simply explain why we do what we do. Our maladaptive behaviours, the defence strategies we use to suppress past trauma, once useful and effective, soon become destructive in our lives and those we form relationships with. By uncovering the history surrounding childhood and adolescence we may often be able to locate a point(s) at which trauma occurred and the start of our defensive behaviour. I agree with Jacob (2007) who says: “Past, present and future are linked inseparably in the way we think and act” (p1). It is quite clear that awareness of our past, and the perceptions formed from it, informs the present, the way we may think, be or behave. It is also clear that not only can memories of the past influence the present, but memories of the past may be influenced by present experience. Although psychotherapy is about the present, it works on the premise that understanding the past and its influence on the present, the path towards change becomes clearer. We can never directly observe our clients past, but Jacobson, P. And Steele R (1979) wrote that Freud delved into his clients past attempting to reconstruct it from their present behaviours because he believed that our past does determine our present situation. Of the therapeutic setting they quoted Freud: “What we are in search of is a picture of the clients forgotten years…”. Can We Ever Leave The Past Behind?
Lung Cancer: Signs and Symptoms. Cancer is related to mutations in the cells that cause on controlled growth of these cells. Cancer of cells results in the formation of masses of cells called tumors, this is due to the increased and uncontrolled division of the cell. So, lung cancer is a disease which affects our respiratory organ (lungs) resulting in uncontrolled growth and division of lung epithelial cells. Lung cancer can be very fatal since the cells that get infected with cancer, can’t perform their respiratory function. Also lung cancer tends to be metastatic which means that it tends to spread and carry cancer from the lungs to other body organs. Lung cancer can arise in any part of the lung but, 90% to 95% of the cases arise from cancer infecting the epithelial cells of the lungs. Lung cancer can infect the cells lining the bronchial airways in this case it is called bronchogenic cancer. Also cancer can infect the pleura which are a layer of cells lining the lungs and the chest wall and in this case it is called mesotheliomas cancer. It is still not clear who is the first scientist that discovered lung cancer but, there is evidence that people noticed this disease hundreds of years ago and it was then considered as a very rare disease. Signs and symptoms of lung cancer: Signs and symptoms differ from one lung cancer patient to another. Signs and symptoms depend on where the tumor is and what is its size wither small or big. The patient can either experience some symptoms or no symptoms at all. In case of no symptoms: Lung cancer is discovered during usual or routine checkup either by a CT-scan or a X-ray of the chest where a small mass of cells appears on the x-ray or CT-scan indicating lung cancer. The numbers of cases discovered by this technique are usually 25% of lung cancer patients. In case of symptoms appearance: After cells become exposed to cancer and start uncontrolled division, many of the following symptoms start to take place: Difficulty in taking breath and wheezing. Chest pain. Hemoptysis where coughing is accompanied by blood. Also if cancer affects nearby nerve cells, it can cause pair in the shoulder and in some cases paralysis. What causes lung cancer? Smoking is the most common cause of lung cancer, it causes lung cancer because there are certain substances that are found within the tobacco that cause the cancer. These substances are called carcinogens (meaning cancer causing agents) that are the reason for the damage of the lung cells and when a cell is damaged it may become cancerous over a period of time. Although its quite difficult to predict the chances of a smoker developing lung cancer, but the chances depend on some factors like: how long this person have smoked, the age that person began smoking, and how many cigarettes a day that person smokes. Other than smoking, there are other causes of lung cancer that include: The exposure to carcinogens through one’s job, like exposure to asbestos in the mining or construction industries. When asbestos particles are inhaled hey remain in the lungs damaging its cells. Other harmful substances are like arsenic, coal products and nickel chromate. Exposure to radiation either through one’s job or for medical reasons like X-rays The presence of Radon gas (which occurs naturally in soil and rocks) is considered harmful and may cause in lung cancer development Air pollution Having a previous lung disease A family history in lung cancer Diet and lowered immunity Mechanism of lung cancer: 1-Ras oncogenes mutations are often present in human cancers as they are responsible for the formation and development of the disease. In more than one quarter of the lung adenocarcinoma patients Ras mutations are present. NF-?B which is a vital controller of cell survival and an essential mediator of tumor progression is activated by Ras mutations and is aided by the atypical PKCs and their adapter p62. however it has been showed in some researches that the effect of the NF-?B is still indeterminate affected by the target organ and the presence of inflammation. However preliminary studies showed that Ras results mostly in adenomas and adenocarcinomas in the presence of the p62. Ras transformations in the absence of p62 were ruined as Ras transformation results in p62 proteins accumulation. 2- Aurora kinase A is a molecule that is present in cells and has numerous tasks in mitosis such as activation of centrosome, microtubule dynamics, spindle assembly checkpoint, chromosome segregation, and cytokinesis. Surprisingly, it was found that in more than half of the lung cancer patients Aurora kinase A was highly expressed which lead to its oncogenic effect. Moreover polyploidization, centrosome amplification, and chromosomal instability which aid in the development of cancer may be resulted from overexpression of the Aurora kinase A . High expression of Aurora kinase A also may result in cells that are taxol-induced apoptosis. Diagnosis: Many ways of identification of lung cancer are present: Imaging studies: X-rays, ultrasound, CAT (computerised axial tomography) scans, MRIs (magnetic resonance imaging), PET (positron emission tomography) scans and bone scans. Sputum tests Diagnosis of sputum samples for the presence of cancerous cells Blood tests: Tissue damage can be tested by the baseline blood tests which include renal and liver function tests, calcium and lactate dehydrogenase levels. Biopsy: A sample of the lung tissue is taken and analyzed for the presence of cancerous cells. More tests are carried if the tissues contain cancerous cells to have further diagnosis. The most common biopsy techniques are: bronchoscopy and thoracocentesis and these analysis methods may also detect the cancer stage. Prevention: To prevent lung cancer, there are some risk factors that need to be avoided or stopped. Also some protective factors should be increased. The risk factors that should be avoided include: Cigarette and pipe smoking are two of the most dangerous risk factors that can greatly cause lung cancer. Also secondhand smoking should be avoided because the smoke entering the lungs can initiate lung cancer. As for environmental risk factors, exposure to radon can lead to lung cancer. Radon is a radioactive element that can be present in a gaseous state and can pass through cracks and holes and reach homes leading to lung cancer and death. 30% of non smokers diagnosed with lung cancer are usually linked to radon exposure. Air pollution Alcohol consumption in large amounts have showed to cause lung cancer in many cases The protective factors that should be increased include: Eating vegetables a lot have showed to decrease the risk of getting lung cancer. Exercise makes physically active people to be highly unlikely to get infected with lung cancer even if they smoke, in contrast to physically inactive people which showed high risk to have lung cancer. Treatment: When treating lung cancer, it should be first taken into consideration whether SCLC or NSCLC is present, the stage the tumor has reached, and a person’s overall general physical condition. The most common methods to treat lung cancer are: surgery, chemotherapy and radio therapy. They can be used all together or each one on its own. The factors that are taken into consideration when choosing the type of treatment needed are: The general health of the patient The stage the Cancer has reached to Where the cancer is within the lung The type of lung cancer the patient has Results of scans and blood tests If the patient has small cell lung cancer its mostly treated with chemotherapy because the surgery wouldn’t be useful at such a stage where the cancer has already spread by the time it was diagnosed. But if the patient has non-small cell lung then the cancer can be treated with chemotherapy, surgery, radiotherapy or any combination of these. Treatment by stage for small cell lung cancer if a patient has an early stage of small cell lung cancer, they are most likely to be treated by chemotherapy and radiotherapy to the lung. Its common for this type to spread to the patients brain and this is why doctors usually recommend that patients with small cell lung cancer to be treated with radiotherapy on the brain too in order to kill any cancer cells that may have spread but might be too small to be seen on scans. If another patient has small cell lung cancer too but it didn’t spread onto the lymph nodes in the centre if the chest then this case can be treated by surgery in order to remove the portion of the lung containing the tumor. But if the small cell cancer has already spread to the lymph nodes or to other body parts then the Chemotherapy and radiotherapy treatments will be given in order to relieve the symptoms and to help shrink the lung tumor down. Treatment by stage for non-small cell lung cancer: Stage 1. This stage is uncommon but usually the treatment for it is surgery by removing the part of lung containing the tumor and if that’s not possible then the patient is treated with radiotherapy try to cure the cancer Stage 2. Depending on the position of the tumor its either treated by surgery and then by chemotherapy to avoid it coming back or by radiotherapy if the surgery is not possible due to health reasons. Stage 3. By this stage the surgery may be done as a way of treatment but tit will be by removal of the lung and that will only happen when the tumor is far from the heart and safe enough t operate the surgery there, if not then the patient is treated with chemo and radiotherapy. Stage 4. During this stage the aim of the treatment is to control the cancer long enough to be able to make it shrink in order to reduce the symptoms. the treatment is by chemotherapy and biological therapies that help reduce the symptoms aiming for the patient to live longer. Summary: Lung cancer is a disease caused by the uncontrolled cell division in epithelial cells of the lungs. It can be metastatic and can transfere cancer to other parts of the body. Cancer can infect different cells of the lungs as well as the bronchial pathways and in some rare cases it infects neurons. Symptoms and signs vary according to how big is the tumor and where it is. Some patients may not experience symptoms and the lung cancer is detected by x-ray and ct-scan. In other patients where symptoms appear, there is heavy coughing accompanied with blood also heavy breathing and wheezing occurs. There are many causes of lung cancer, for example heavy smoking causes lung cancer also air pollution, consumption of alcohol in large amounts and finally radon gas which is a radioactive element that can cause lung cancer and exposure to x-rays. Diagnosis of lung cancer requires many blood tests as well as biopsy to search for the cells that have cancer inside the cell. Also the mechanism by which lung cancer takes place had two different pathways one is caused by ras oncogens and the other is Aurora kinase A. To prevent lung cancer, smoking must be stopped as well as secondhand smoking because they greatly affect the lung also exposure to radon should be avoided.exercise should be increased as well as eating vegetables since they protect the body from lung cancer. Role of each participant: Shady wasfy: what is lung cancer? Signs and symptoms Prevention Matthews magdy: mechanism of lung cancer Diagnosis Veronica ashraf : treatment. Causes of lung cancer. Lung Cancer: Signs and Symptoms
GED 215 California Coast University Unconscious Desires and Urges Essay.
I’m working on a writing project and need support to help me learn.
Looking to have a paper written for GED215 – Psychology of Adjustment class, needs to be 350-500 words (1-2 pages) in length. Times New Roman size 12. All responses must be typed double spaced. Question is:1. You are now aware that psychology is a science, committed to the empirical study of behavior. Do you think it’s possible to apply this scientific approach to the study of unconscious desires and urges, as postulated by Freud’s theory of personality?Need 3 references, including textbook:Psychology Applied to Modern Life: Adjustment in the 21st Century Wayne Weiten, Dana S. Dunn, and Elizabeth Yost Hammer, 2018 Cengage LearningISBN.13: 978-1-305-96847-9
GED 215 California Coast University Unconscious Desires and Urges Essay
The Terrible Human Tragedy: 2001 Gujarat Earthquake
Research Paper It was supposed to be a day of celebration on January 26th, 2001, not a human tragedy for the state of Gujarat, India. 2001 Gujarat Earthquake, also known as the Bhuj Earthquake stuck the Indian State of Gujarat, on the border of Pakistan (“2001 Gujarat earthquake”, n.d.). Earthquake can be defined as a sudden shaking of the ground due to seismic waves through the Earth rocks (Bolt, 2018). Seismic tremors happen regularly along geologic faults, restricted zones where shake masses move in connection to each other (Bolt, 2018). 2001 Gujarat Earthquake was one of the greatest disasters in the Indian history with a magnitude of 7.7 on Richter scale with an epicenter of a drought-affected area – Bhuj, in the state of Gujarat (Nandi, Mazumdar
Independent Learning For Nursing Nursing Essay
order essay cheap Share this: Facebook Twitter Reddit LinkedIn WhatsApp Reflection is a way to look back on what a person experienced on a certain event. The purpose of this reflective essay is for me to mull over on what I have learned from my direct experience on placement. I opt to utilise on this reflective essay “A Model of Structured Reflection” by Driscoll (2007). This Model has three questions, ‘what’, ‘so what’ and ‘now what’ for me to answer and at the same time to ponder about my practice experience; hence I chose to take advantage on Driscoll’s model as it is very handy to apply even with or without a paper and pen, as all I need to bring to mind is the above aforementioned three questions. I will tackle what I think it matters to me most from my two weeks practice placement, share some learning needs from the learning plan and analysing whether I gained knowledge and understanding that can be applied in a new situation (Howatson-Jones, 2010). I was in the ward on my two weeks introductory period of practice experience. On my first day, the Ward Manager introduced me to her team. She had told me that my mentor was not around at that time; hence she handed me over to one of the nurses’ in-charge. As I came on an early shift, I have observed the patients hand over from night staff (Wywialowski, 2003). They printed out a handover sheet for each one of us. At first, I was a bit muddled up on how the night nurse was endorsing the patient, maybe because I am new, and not use to it. There are acronyms that they usually use, and I was telling myself that I have to familiarise the medical terms used so I could understand and comprehend, even I am supernumerary I want to be part of the team whilst learning (Jelphs and Dickinson, 2008). After the handover, the nurse asked me to be with the Health Care Assistant (HCA) at the moment, for me to be acquainted with the patients and adapt with the daily routine. I am fortunate that the HCA was helpful, and she taught me a lot about how to assist patient on personal hygiene. She showed me how to use the Blood Glucose monitor and plot it down on patient’s chart (The Global Diabetes Community, 2013). In addition, she taught me that they usually take the observation every four hourly if the patient is not on close observation. The days have gone by so quick; I was productive on my day to day experience as a student nurse. I never wasted my time just standing there without accomplishing anything at the end of my shift. With my passion of caring to patients, I become accustomed on dealing with the patient, assisted to go to the toilet, gave a hand to those who are not able to care for themselves, especially the immobilised patients. I became certain on writing down the nursing care plan of a patient (Lloyd, 2010), observed the Nasogastric tube (NGT) (Macmillan Cancer Support, 2013) and Electrocardiogram (ECG) procedures done by the staff nurse and HCA respectively (British Heart Foundation, 2013). I volunteered myself as well to get the take away medication of the patient in the Pharmacy. Furthermore, I have learned how to fill up the Nursing Assessment forms for a new patient admitted; I have done the said forms by means of communicating with the patient and family. I have mentioned the word communicating as there was a non-spoken English patient admitted because of back pain. In complying with the Nursing and Midwifery Council (NMC) Code of Professional Conduct (2010) about confidentiality, I will be using a false name for her. It was hand over to the day staff that English is not her first language; hence, Mrs. C cannot speak and comprehend well. When I went to her bedside to take her vital signs, I asked if she has any pain at the moment, she nodded her head and touched her back (White, 2005). I have seen the grimace caused of pain on her back. I reported to the nurse right away that Mrs. C is in pain, and she is due for another dose of pain killer based on her Drug Chart; as a result, Mrs. C has taken the said medication. I informed Mrs. C with the use of verbal and non-verbal gestures that she will undergo Colonoscopy to check what’s causing her pain (Sully and Dallas, 2010). We waited for her nephew before accompanying them in the Gastroenterology Department as she needs somebody to translate the conversation on her behalf. Since it was my first time to watch a patient doing the procedure, I grabbed the opportunity to request from the Specialist Nurse if I can go inside and observe the procedure which she willingly accepted. I also asked permission from Mrs. C through her nephew; I was grateful when he told me his aunt wanted me to come with her in the colonoscopy room. During the procedure, I sat next to Mrs. C whilst holding her hand as she was feeling uneasy with the endoscope inserted into her anus. The Specialist Nurse has given me a few insights in relation to what she was trying to look inside the colon of Mrs. C. I was privileged for having an exquisite time of basic understanding about Colonoscopy (BUPA, 2011). After the procedure, Mrs. C has given me a hug and was thankful. I smiled and responded that it was my pleasure to help her. We went back to the ward, and before I leave Mrs. C on her bed with the assurance that she was comfortable and safe, her nephew expressed his appreciation for looking after his aunt whilst he was not around. Moreover, Mrs. C told him about me being there rubbing her back when she was in agony. I was overwhelmed on how they recognised my presence of comforting her for a short span of time and without much verbal communication. On the above scenario, I have achieved one of my learning needs, the effective communication between patient and me as a student nurse. Despite the inability of Mrs. C to express herself verbally, I was so sensitive observing her gestures and actions thus I can extend the appropriate care and assistance she needed. By intently looking at her countenance, I can interpret what she was trying to convey to me; henceforth I was able to address her needs. I have realised how vital is verbal and non-verbal communication in nursing. As a student nurse, I should be sensitive to the patient’s nonverbal message. I should not let language be a hindrance in giving the nursing intervention for the patient to recover and return in optimal health (Andrews and Boyle, 2008). Care of people is the priority of all nurses; this is one of the four principles of NMC Code (2010). The provision of care for the patient should be done in a holistic approach that includes the activities of their daily living (Newton, 1995). A simple act of care means a lot to the patient; consequently, I will put into practice again what I have learned from this in the future. Another learning need that I partially accomplished was being able to observe how to perform the Colonoscopy procedure. I partially achieved it because we have no time to explore the method used to find any abnormalities or inflammation from the patient; however, I did some informative readings about the procedure. To summarise what I have learned on my placement, I was able to see the nurses’ responsibilities. How they manage to give the best nursing interventions in a busy ward. How they collaborate to other health professionals for updating the patients’ care plan. I have proved to myself that most patients usually depend on nurses as they are the one who provide direct care on them (Altman, 2010). I do believe that nursing is a never ending process of learning; thereby ensuring that nurses are up to date with their trainings and education; otherwise the highest possible care for the patients will not be met. As a student, I have to be dedicated, motivated and inspired to achieve my ambitions in life (Maslow, 1954); continually accepting any challenges for my personal development. For the meantime, I will set my goals on what I want to learn; recognising any learning outcome on my learning plan as this will draw me closer to my aspiration, to be a Qualified Nurse (Peate, 2006). My two weeks practice experience was superlative. The Faculty of Nursing in the hospital provided teaching sessions that will develop us to be competent (McNiff, 1993). All the staff in the ward where I worked with were supportive and compassionate. I am looking forward for my next placement, for me to implement what I have learned from my previous one, and be able to identify new learning opportunities. In conclusion, practice placement is a day of experience, a day of new learning. Share this: Facebook Twitter Reddit LinkedIn WhatsApp
Please refer below attached Annotated Bibliography SAMPLE
Please refer below attached Annotated Bibliography SAMPLE. Please refer below attached Annotated Bibliography SAMPLE
Delaware County College English Language Learners Video Observation Paper
Delaware County College English Language Learners Video Observation Paper.
Video Field Observation_Paper 2Please write a 5-10 page paper that describes and analyzes your field observation experience. Your paper must discuss all of the following:Rubric_Requirements:You must utilize MORE THAN 8 key terms in your Video Field Observation Paper 2You must include and cite MORE THAN 6 videos from our required videos list.EDU 208_ Required Course Youtube Videos-v2**Be fully advised that you are strongly encouraged to exceed the “more than” minimums stated.Theme A-Culture in the Classroom*In this section you are required to cite MORE than 3 videos from our course (focus on videos found in Theme 2 and 3) .Macro Prompt: Please write a 2-4 page response where you demonstrate your understanding of how culture influences the classroom as well as discuss how schools/teachers can address cultural issues related to educating English Language Learners.Make sure you connect your discussion to specific information from our YouTube videos, class notes and readings/textbook content. In your writing you MUST answer all of the below prompts:Based on what you have learned from this course identify two best practices teachers/schools can incorporate to strive for equity and address the achievement gap.Discuss how what you learned from this course (textbook/reading, videos, discussions. etc.) about the concept of culture relates to what takes place in a Pk-12 classroom.Which of the following concept best aligns with what occurs in classrooms: cultural congruence; cultural difference (cultural mismatch theory) OR cultural deprivation (cultural deficit theory)?Which model best aligns with your personal understanding of how cultures interact (cultural diversity) in America; the melting pot model, or the salad bowl model?In answering each prompt you are required to provide evidence from our course content (YouTube videos, readings/textbook and class notes etc.) to enhance your discussion. Theme B- Best Practices*In this section you are required to cite MORE than 3 videos from our course (focus on videos found in Theme 2 and 3) .Directions: In this section you will write a 3-6 page response comparing what you learned from our course YouTube videos, class notes and readings/textbook content.In your writing you MUST answer all of the below prompts:Based on what you have learned from our course content (YouTube videos, readings/textbook and class notes etc.) discuss the following:What are two best practices for engaging in multiculturalism?What are two best practices for developing a positive home-school partnership?What are two effective strategies for evaluating and assessing ELLs?Video Analysis: Watch the below and answer the prompts based on the video*ESL Support in Elementary Schoolhttps://youtu.be/jnR5FDL0NCsDiscuss the differences in how each teacher goes about supporting ELLsIdentify concepts that distinguishes Mrs. Varela’s approach from Mrs. Reynolds?Identify a concept that is present in Mrs. Reynolds teaching (within the video) that connects to her reading approach?*Identify two specific concepts from our course that were utilized/described by Mrs. Amanda Reynolds (0m-2m25s).*Identify two specific concepts from our course that were utilized/described by Mrs. Elizabeth Varela (2m25s-5m38s).Which cultural theory/concept best describes how the different groups interacted in the video? Cultural Deprivation Theory, Assimilation, Cultural Difference Theory OR Cultural congruence (select one).In answering each prompt you are required to provide evidence from our course content (YouTube videos, readings/textbook and class notes etc.) to enhance your discussion. —————————————————————————————————————————————–Rubric_Requirements:You must utilize MORE THAN 8 key terms in your Video Field Observation Paper 2You must include and cite MORE THAN 6 videos from our required videos list.EDU 208_ Required Course Youtube Videos-v2**Be fully advised that you are strongly encouraged to exceed the “more than” minimums stated.Format for Writing Assignments: All out-of-class writing assignments MUST be typed, and formatted according to these specifications: Times New Roman, double-spaced, 1-inch margins, 12-point font, APA style citations. Points will be deducted for grammar/spelling/punctuation mistakes on each assignment- please be sure to proofread your papers!Include a works cited and key terms section.You will be required to attach and paste your assignments to Canvas.All assignments must use the following format for filenames: “FirstName_LastName-Name of Assignment.” So if I submit journal 1 the filename would read Kelechi_Ajunwa-Journal1 (italics not needed).Citing YouTube Videos:To cite a video within your text you will need the title of the video, e.g. “(The IEP Team).”If you are citing a video within your text and you are referring to a specific scene or quoting a line then you will need the title of the video and the specific time marker e.g. “(The IEP Team, 1m:25s).”To cite the video in your works cited section you will need the name of the website, the title of the video and the URL address (do not add the quotation marks).Citing Lecture Notes :In text, within your writing: (Ajunwa Lecture Notes, YEAR).In your works cited section: Ajunwa Lecture Notes, Title of Lecture Note. Year.
Delaware County College English Language Learners Video Observation Paper