Saturday, December 28, 2019

Prison Overcrwoding in America and England - 1234 Words

Prison overcrowding in the United States is due to many reoccurring charges that is being sentenced to inmates that have been released and returning. As the increasing inmate population is a growing concern in the U.S, many law enforcement agencies and academic expert have analyzed data about the situation and are working to combat it. Research shows that Drugs are mainly to blame. Of the inmates in federal prison as of September 2011, more than half or 50.4% was serving sentences for drug offenses that were committed including simple offenses. Out of 24,366 related drug offenders, 6,336 were marijuana related offenders and 4,309 were Methamphetamine related offenders. This does not only show that more than half of the prisons are filled with drug offenders but it means that the cells are being used by people who are most likely addicted to the substance. When there are cells being wasted by people who do not or would rather not change their ways, then it is useless. Overpopulated dr ug offenders are the result in prison overcrowding in the United States. In this research paper I will be reviewing the main cause for overcrowding, what overcrowding causes, crime rates and costs, proposition AB 109, and potential solutions to the overcrowding of prison system. There are well known documented issues that have been known to cause overcrowding in prisons. Some of these issues include poverty, lack of education or employment opportunities, drug or alcohol use and abuse, and mental

Friday, December 20, 2019

Child Study - Educational Observation of Development of a...

Introduction Archie is a 10 year old in the fifth grade class here at Friends School. He’s attended this school from preschool until now, a total of seven years. He lives in the neighborhood and tends to be one of the first kids in the classroom every morning. In general he seems to be a happy child, smiling often. He has a tendency to be quite goofy at times and struggles with impulse control, often speaking out in class or being disruptive by talking or making jokes. This seems to stem from his ADHD, which he is on medication for. Though he has many challenges related to his ADHD, he displays an aptitude for math, enjoys reading, loves computers and is full of random facts that he adores to contribute. His general health seems†¦show more content†¦4. Does his behavior change based on the time of day or day of the week? What about subject matter? 5. What are his strengths academically? Weaknesses? 6. Where is he developmentally in comparison to his classmates? National Norms? 7. Physical Development? (coordination, stamina, fine motor skills, rt/lt dominance, nutrition etc) 8. Mental/Cognitive Development? (multiple intelligences, level of executive function etc) 9. Does he have any other health issues? Possible digestive/constipation? 10. What is his background in regard to being adopted and does that have any bearing on his current issues? (ie. Drugs/alcohol birth parent? etc) 11. Does his sister have any similar behavioral or learning issues? 12. Who are his friends and how does he relate to them? Do any of his issues get in the way of those relationships? 13. How does his family amp; life outside of school affect his daily life in school? (ie extracurricular activiti es, consequences, family culture, parental expectations etc) 14. What language and questions are best when communicating with this child? What approaches work? What encourage him vs deflates him? 15. How does he function in large groups, small groups, pairs? 16. 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Thursday, December 12, 2019

Breast Cancer Treatment

Question: Write about theBreast Cancer Treatment. Answer: Introduction: Tamoxifen is a medication that is provided orally to the patients who are suffering from breast cancer. Previous guidelines have instructed physicians to prescribe the medicines for only two to five years as various complaints of side effects were associated with the medication (Ganz et al. 2014). However, the medicine is an excellent inhibitors of the cell cycling systems that prevents apoptosis if the cancerous cells. In turn they promote various factors that increase the rate of apoptosis of the cancer cells and are therefore more effective in treatment of patients (Leyland-Jones et al. 2015). A case study was provided where a patient is seen to recur the symptoms of breast cancer after her stoppage of the taking of the medication after five years. Therefore the report will mainly contain literature reviews that will shed light in the reason about the recurrence of the breast cancer symptoms and what should be done so that similar patients do not get recur their breast cancer after recovery from it. Pico-Analysis: In order to find the correct articles that will help us to know the main reason for the recurrence of breast cancer in the patient after 5 years. In order to find correct articles, a proper Pico question is to be prepared which would help in answering the research topic properly. Population Intervention Comparison outcome Women suffering from breast cancer Tamoxifen administration Medication taken over five to ten years in comparison to early stoppage Recurrence of breast cancer The Pico question which is to be formed is that whether early stoppage of taking tamofexin for women suffering from breast cancer causes recurrence of the disorder in comparison to those who have continued the medication for about five to ten years Databases and Keywords: Different databases have been searched in order to get the correct articles. This usually involves the Google scholars, Cinhal, Cochrane library, Wiley online library, Elsevier, Science direct and others. The main key words which were used are effect of stoppage of tamoxifen, tamoxifen for breast cancer patient, Cancer recurrence for tamoxifen stoppage, side effects of tamoxifen and others. Literature Review: In the works of Rajput et al., one can clearly understand the working mechanism of tamoxifen in the treatment of breast cancer. XIAP protein called the X-linked inhibitor of apoptotic protein which mainly functions in the inhibition of apoptosis. They mainly inactivate caspase 3, caspase 7 as well as caspase 9 which are responsible for carrying out successful apoptosis. In this case, the researchers have proved that with the help of another medicine called thymoquinone, tamoxifen take an active part in the cell apoptosis system of breast cancer. They have mainly reached the conclusion after they had conducted experiments to confirm the anti-angiogenic as well as the anti-invasive potential of the TQ as well as the TAM mainly through a large number of in vitro studies. They have suggested that the medication mainly works by lowering the expression of XIAP expression at a molecular level. This helps in the binding followed the activation of the caspase 9 in the cascade of apoptosis. Th ey further interfere with the survival of the cells through the PI-K/Akt pathway (Jordan 2014). They mainly inhibit the Akt phosphorylation. Thereby in course of time, caspase 9 gets cleaved which then processes a list of other cellular death substrates. This includes the PARP. This makes the entire mechanism shift from the phosphorylation mechanism to apoptosis. Not only are this they are also found to effect the Akt Phosphorylation pathway. They down regulate the pathway by acting on the downstream effectors like the Bcl-xL, Bcl-2. They in turn increase the expression of other factors like Bax, AIF, cytochrome C and p-27. This mainly leads to regulation of a large number of cell signaling mechanism that in turn results in the activation of the AKT as well as XIAP degradation (Feng et al., 2014). Therefore, this made the author to come to a conclusion where the both the medicines play an important role by inhibiting XIAP and this was confirmed through the siRNA-XIAP cotransfection studies. Herein one can easily understand that indeed tamoxifen plays a very crucial part in treating of breast cancer in patients. Another important experiments was carried out by a large number of scientists is the year 2013 as a large randomized trail recruiting more than 12000 participants were included suffering from breast cancer. Davies eta l. in the year 2013 had laid down many important facts that might be helpful for the providing more light to the case. The researcher has stated that previously tamoxifen was prescribed to the patient for only two years which showed recurrence of the cancer disorder. Therefore the period of the administration of tamoxifen was increased to four years and then it was increased to five years . While this experiment was conducted I had shown that effects of the tamoxifen can contribute for up to 15 years showing great amount of reduction in not only recurrence rate but also in mortality rates. However they have clearly mentioned that there was reduction in recurrence rate in comparison to control but they have never mentioned that it had completely stopped recurrence of the disease. Further they have also stated that they had also conducted experiment where they had made the participants to continue the medication up to 10 to 15 years and they have clearly stated astonishing results. They have stated that continuing it for longer number of times had resulted in further decrease in the rate of recurrence and mortality than using it for 5 years. Therefore in the case of the patient of the case study, she has recurred breast cancer may be due to the hereditary instances as the literature of the article shows that the people who have used tamoxifen have very few evidences of recurrence. Therefore it cannot be exactly said that whether the occurrence of the disorder has been mainly due to withdrawal of the tamoxifen or due to heredity factors. However this literature review have suggested that the side effects are indeed visible after five years and therefore if the medication is continued for ten years the side effects may also increase but it will howeve r reduce the recurrence rate and recurrence chances further by a large number. Therefore if the patient had continued it for large number of years her chance of recurrence would have been decreased. Therefore it can be concluded from the paper that she should have continued the medication for 10 years to completely eradicate the chance of recurrence of the cancer (Li et al. 2013) . A study conducted by the Early Breast Cancer Trialists' Collaborative Group (EBCTCG) in the year 2015 had also provided extensive information about the affectivity of the use of tamoxifen in breast cancer. They have clearly stated that if treatment is conducted by the use of tamoxifen in breast cancer patients, the medication is found to reduce the rate of recurrence by about half especially during the time of treatment. Not only is that it also believed that they can reduce the chance of occurrence by one third in the subsequent five years (Sandell et al. 2017). They have also supported the view that if the treatment is conducted properly they can further reduce the rate of mortality by almost one third throughout the first fifteen years. It has been also found that the authors have stated that if the treatment is conducted for about 10 to 14 years, there will be further reduction in mortality rate. Although the present concern in the case study is not considering the menopausal wom en but in order to mention the researchers view it can be said that they had stated that if tamoxifen is followed by aromatase inhibitor after 2 to 3 days of follow up by tamoxifen, it would provide better results. Another very good article has been found that had been provided by Flanagan et al. in the year 2012 who has provided a large number of important facts that had been extremely helpful in reaching the conclusion of the case. The researchers have stated that anti estrogen therapy had been found to be extremely helpful and tamoxifen and aromatase inhibitors have been extremely helpful. Tamoxifen as said by them is extremely helpful as it can work irrespective of the age and the menopausal status of the woman. They are not only helpful is treating estrogen positive cases of breast cancer and node positive breast cancer, they are also helpful for reducing the risk for contra lateral breast cancers. Just like the previous authors, those have also stated that Aromatase inhibitors are extremely helpful for treating menopausal women with breast cancer especially by following the treatment of tamoxifen and then starting it after two to five years. Herein the authors had exactly discussed the ma in query of the case study that one needs to solve. The author had stated that a large number of side effects have been found to be associated with the treatment of tamoxifen like arthralgias, weight gain and fatigue. The patients have also complained of changes in mood, hot flashes, decreased libido as well as changes in memory. The researchers have stated that it had greatly affected the capability of the woman to adhere to the treatment and therefore they are often seen to coax their guides to withdraw the medication after prescribed years. Non adherence rates had been noted to be about 25% in the first year and to about 50% after fourth year. Many women who have stopped the use of the medication due to the side effects have resulted in the increase of the mortality rates. On the other hand it was found that women who experienced higher side effects had better chanced of survivability rate. Stopping treatment earlier die to side effects had the potential to decrease the rate of t he patients survival from breast cancer. They gad got evidences which suggest that the patients suffering from greater side effects are actually gaining better treatment effect. Therefore the author had advised the nurses to understand the physiological and psychosocial necessities of the women so that they can assess the patients response in ongoing treatments, improve their surveillance care and overall provide quality care to develop the quality of their lives. Another important article was found which was provided by Burstein et al., in the year 2014. Here the researchers have conducted a systematic review of different trials including the biggest three historic trials in order to develop the clinical practice guidelines that are present on the adjuvant endocrine therapy utilized in breast cancer in patients. They have provided a number of recommendations that are indeed necessary to be followed by the nurses. The nurses should then guide the patients accordingly. The patients who are suffering from the disease are in need of conducting the medication regime up to ten years of in the premenopausal stage which is unlike the previous guidelines which stated that the menopause should be conducted for only 5 years. Moreover they have also recommended that for post menopausal women, the treatment should contain 5 years of tamoxifen followed by switching to aromatase inhibitor which would lead to a total of 10 years of treatment. Discussions and Conclusion: From the above reviews provided from different important articles it was found that most for the researchers are of the opinion that although the trials have shown that a 5 year tamoxifen treatment to be effective but no one has confirmed that it would never result in the recurrence of the breast cancer, however it had been mostly seen that most of the researchers have stated that it would be right to continue the treatment for about up to ten years to reduce the risk of recurrence and also the mortality rate of the patients. Therefore the patient of the case study should not have stopped her medication after the side effects became intense. Breast cancer is hereditary and there remains a high chance of the occurrence of the disorder but none of the authors have pointed this fact to be the reason of the recurrence. They have mainly stated that in order to reduce the risk of the breast cancer, the nurses should educate the patients to manage their side effects and continue the importa nt medication of tamoxifen. References: Binkhorst, L., Mathijssen, R.H., Jager, A. and van Gelder, T., 2015. Individualization of tamoxifen therapy: much more than just CYP2D6 genotyping.Cancer treatment reviews,41(3), pp.289-299. Burstein, H.J., Temin, S., Anderson, H., Buchholz, T.A., Davidson, N.E., Gelmon, K.E., Giordano, S.H., Hudis, C.A., Rowden, D., Solky, A.J. and Stearns, V., 2014. Adjuvant endocrine therapy for women with hormone receptorpositive breast cancer: American Society of Clinical Oncology clinical practice guideline focused update.Journal of Clinical Oncology,32(21), pp.2255-2269. Dauchy, R.T., Xiang, S., Mao, L., Brimer, S., Wren, M.A., Yuan, L., Anbalagan, M., Hauch, A., Frasch, T., Rowan, B.G. and Blask, D.E., 2014. Circadian and melatonin disruption by exposure to light at night drives intrinsic resistance to tamoxifen therapy in breast cancer.Cancer research,74(15), pp.4099-4110. Davies, C., Pan, H., Godwin, J., Gray, R., Arriagada, R., Raina, V., Abraham, M., Alencar, V.H.M., Badran, A., Bonfill, X. and Bradbury, J., 2013. Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial.The Lancet,381(9869), pp.805-816. Early Breast Cancer Trialists' Collaborative Group, 2015. Aromatase inhibitors versus tamoxifen in early breast cancer: patient-level meta-analysis of the randomised trials.The Lancet,386(10001), pp.1341-1352. Feng, Q., Zhang, Z., Shea, M.J., Creighton, C.J., Coarfa, C., Hilsenbeck, S.G., Lanz, R., He, B., Wang, L., Fu, X. and Nardone, A., 2014. An epigenomic approach to therapy for tamoxifen-resistant breast cancer.Cell research,24(7), pp.809-819. Flanagan, J., Winters, L.N., Habin, K. and Cashavelly, B., 2012, January. Women's experiences with antiestrogen therapy to treat breast cancer. InOncology nursing forum(Vol. 39, No. 1). Ganz, P.A., Petersen, L., Castellon, S.A., Bower, J.E., Silverman, D.H., Cole, S.W., Irwin, M.R. and Belin, T.R., 2014. Cognitive function after the initiation of adjuvant endocrine therapy in early-stage breast cancer: an observational cohort study.Journal of Clinical Oncology,32(31), pp.3559-3567. Gnant, M., Mlineritsch, B., Stoeger, H., Luschin-Ebengreuth, G., Knauer, M., Moik, M., Jakesz, R., Seifert, M., Taucher, S., Bjelic-Radisic, V. and Balic, M., 2014. and Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria. Zoledronic acid combined with adjuvant endocrine therapy of tamoxifen versus anastrozol plus ovarian function suppression in premenopausal early breast cancer: final analysis of the Austrian Breast and Colorectal Cancer Study Group Trial 12.Ann Oncol [Epub ahead of print]. Goldhirsch, A., Winer, E.P., Coates, A.S., Gelber, R.D., Piccart-Gebhart, M., Thrlimann, B., Senn, H.J., Albain, K.S., Andr, F., Bergh, J. and Bonnefoi, H., 2013. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013.Annals of oncology,24(9), pp.2206-2223. Jordan, V.C., 2014. Tamoxifen as the first targeted long-term adjuvant therapy for breast cancer.Endocrine-related cancer,21(3), pp.R235-R246. Leyland-Jones, B., Gray, K.P., Abramovitz, M., Bouzyk, M., Young, B., Long, B., Kammler, R., DellOrto, P., Biasi, M.O., Thrlimann, B. and Harvey, V., 2015. ESR1 and ESR2 polymorphisms in the BIG 1-98 trial comparing adjuvant letrozole versus tamoxifen or their sequence for early breast cancer.Breast cancer research and treatment,154(3), pp.543-555. Li, J., Humphreys, K., Eriksson, L., Edgren, G., Czene, K. and Hall, P., 2013. Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer.Journal of Clinical Oncology,31(18), pp.2249-2256. Rajput, S., Kumar, B.P., Sarkar, S., Das, S., Azab, B., Santhekadur, P.K., Das, S.K., Emdad, L., Sarkar, D., Fisher, P.B. and Mandal, M., 2013. Targeted apoptotic effects of thymoquinone and tamoxifen on XIAP mediated Akt regulation in breast cancer.PLoS One,8(4), p.e61342. Sandell, R., Hoskin, T., Frost, M., Degnim, A. and Visscher, D.W., 2017, February. Histological Findings in Benign Breast Biopsies After Tamoxifen Therapy for Breast Cancer. InLaboraratory Investigation(Vol. 97, pp. 69A-69A). 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA: Nature Publishing Group. Zembutsu, H., Nakamura, S., Akashi, S.T., Kuwayama, T., Watanabe, C., Takamaru, T., Takei, H., Ishikawa, T., Miyahara, K., Matsumoto, H. and Hasegawa, Y., 2016. Significant Effect of Polymorphisms in CYP2D6 on Response to Tamoxifen Therapy for Breast Cancer; a Prospective Multicenter Study.Clinical Cancer Research, pp.clincanres-1779.

Wednesday, December 4, 2019

Dover Beach Poetry Analysis Essay Research Paper free essay sample

Dover Beach Poetry Analysis Essay, Research Paper DOVER BEACH Dover Beach is a really # 8216 ; temper # 8217 ; arousing verse form. We are first met with an grasp for the sea and different emotions that is draws to the perceiver. However as the verse form progresses we are bit by bit introduced to a big metaphor for love and like the sea is able to arouse many tempers, and different emotions, whether comfortable or decayed. The poet describes the emotions with utmost passion and possibly with little crazes. We are given as sense of loss by this craze which becomes clearer in the last stanza. The rubric of this verse form, # 8216 ; Dover Beach # 8217 ; , truly sets the scene to the reader about immediately. Dover, with its white drops, giving us a sense of laterality and impressiveness. The poet may hold done this as to put the temper for the gap stanza.For others it may arouse a idea or memory of the yesteryear. We will write a custom essay sample on Dover Beach Poetry Analysis Essay Research Paper or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Possibly on childhood vacations with your parents. The could be arousing these ideas so that you can sympathize subsequently to what he is sing in the verse form. This puting for many, will of class conveying the Channel to mind, a mammoth image, arousing once more ideas, this clip of France. The rubric itself nevertheless does non give you any emotional penetration into the verse form. I feel the poet did this as to non alarm the reader to what is traveling to exceed upon them further in the verse form. The verse forms opening stanza is to get down with really soft and tranquil, # 8216 ; The sea is unagitated tonight # 8217 ; . The words the poet utilizations are delighting, # 8216 ; Gleams, Sweet, gleaming # 8217 ; . The temper for the verse form is being set. The reader is filled with visions of peace and a sense of being content # 8216 ; sweet is the dark air! # 8217 ; .However the temper of the verse form dramatically alterations. The poet begins to utilize words which changes the temper and are immensely different from the old lines, # 8216 ; howl, decelerate, unhappiness # 8217 ; . This sudden emotional alteration to me is a symbol of his love or life. Once the poets life was calm like the seas # 8217 ; in the gap line. The poets life has no changed into a convulsion of emotions, which are charged like the sea, # 8216 ; the moving ridges suck back, and crack, At their return # 8217 ; This sudden alteration in temper in the verse form is really simil Ar to the altering temper of the sea, for which the first stanza is explicating. In the 2nd stanza we are really able to larn more of the poets analogy. The poet believes that the noise of the sea, can convey in the # 8216 ; flow // Of human wretchedness # 8217 ; . This is what he claims happened to Sophocles. This analogy is possibly what besides happened to the poets life. The composure see turned into a continual waring swash in his psyche which brought with it wretchedness. However the last line of the stanza tells us that this noise does non convey with it merely human wretchedness but besides a idea, the poet does non lucubrate this theory so we are left to presume this alterations from individual to individual. # 8216 ; in the sound a thought. # 8217 ; The sea once more in the 3rd stanza represents his loss of religion. This loss of religion is intricately described as disappearance in the darks wind # 8216 ; to the breath of the night-wind # 8217 ; .Here the poet builds up a clear image of the air current being personified, # 8216 ; to the breath # 8217 ; and taking this religion down to the # 8216 ; huge borders # 8217 ; and with it besides the # 8216 ; bare herpes zosters of the universe # 8217 ; This thought of bare herpes zosters, is possibly how the poet feels himself to be. Isolated from anyone else, left stripped naked to hold all of his ideals taken off from him by the simple component the air current. By utilizing the different # 8216 ; tempers # 8217 ; of the sea, composure and powerful, the poet is able to do a connexion to life. The manner the sea continuously knocks, hurtling stones up against the strand, gives us a sense of inexorability of some emotional strain on his life, # 8216 ; Begin, and cease, and so once more begin # 8217 ; . The concluding stanza is an incorporation of the whole verse form, every bit good as corroborating to the reader what it is the poet is seeking to explain.The concluding stanza, begins like that of the gap stanza, utilizing a really appealing, soft gap, every bit good as words to back up this, # 8216 ; love, true, dreams, beautiful and new # 8217 ; .However once more like the stanzas predating it, changes temper once more, to seek and state us that non count what happens, whether we are true, or in love, we will neer understand the this beauty, either the poet here is mentioning to love, life or the existent beauty of the sea and Dover Beach we do non cognize, nevertheless it points to these subjects.