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.

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.

Racial Profiling Essays (1397 words) - Offender Profiling

Racial Profiling The great era of civil rights started in the 1960s, with Martin Luther King, Jr.'s stirring "I have a Dream" speech at the historic march on Washington in August of 1963. At the same time Birmingham Police Commissioner "Bull" Connor used powerful fire hoses and vicious police attack dogs against nonviolent black civil rights activists. Although these years proved to be the highlight and downfall of civil rights in America, even with the 1964 Civil Rights Act and the 1965 Voting Rights Act being passed, time has repeated these tumultuous events again in the present. Racial profiling has been one of many civil rights issues concerning the unnecessary stopping and arresting of people based on race, color, ethnicity and gender. Skin-color has become evidence of the propensity to commit crime, and police use this "evidence" against minority drivers on the road all the time. This practice is so common that the minority community has given it the derisive term, "Driving While Black or Brown" ? a play on the real offense of "driving while intoxicated". Although many law enforcement officers defend themselves by saying they are fighting against the "War on Drugs" by arresting these law offenders, recent trials and reports show that no basis of arrest have been found against these minorities. Official skin-color prejudice is still reflected throughout the criminal justice system. Today, skin-color makes you a suspect in America. It makes you more likely to be stopped by a law enforcement officer, more likely to be searched, and more likely to be arrested and imprisoned. Tens of thousands of innocent motorists on highways across the country are victims of racial profiling, and these discriminatory police stops have reached epidemic proportions in recent years. Fueled by the "War on Drugs", this fight has given police a pretext to target people who they think fit a "drug courier" or "gang member" profile. At many times, these minorities have been stopped and arrested for illegal offenses, however we are not sure if these stories have been filed truthfully by law enforcement officers. Many police departments face issues concerning racist law enforcement officers who cause the problems of racial profiling. One such example comes from the Hillside Police Department, where several racial bias charges have been made against them. Racial slurs have become common in the Hillside district, where even the department supervisor does background checks on minorities IN the squad, even to kick them off the squad. In this department, only two officers are Hispanic and one is of African decent. The officers, many of whom are white, are encouraged to target minorities first to fill their ticket quotas for the month. Hillside officers defend themselves saying that Hillside is 40 percent black and 20 percent Hispanic. However, the actions taken by Hillside officer, such as targeting to fill quotas and background checking, seem disconcerting. The Reverend Jesse Jackson even needed to call for federal protection for whistleblowing police officers. Because of the Law Enforcement Trust and Integrity Act, passed this year, other officials who witness this discriminating act are protected. It says, "The identity of a law enforcement officer who complains in food faith to a government agency or department about the unlawful practices of a law enforcement agency shall remain confidential and shall not be disclosed by any person except upon the knowing written consent of the law enforcement officer. This section shall not preempt any right of confrontation protected by the Constitution of by Federal, State or tribal law." In many cases, we can not determine whether the racial profiling comes from the individual law enforcer, or the department itself. Many policies have been suggested to either report these discriminatory acts, or to record the ethnicity, race, or gender of the person being stopped. However, without the correct supervision of these officers, we can not truthfully tell whether these policies will be followed. There have been bills proposed to even make the slightest positive effect on racial profiling, yet many have been overlooked. Former California Governor Pete Wilson served as best he could to fight key civil rights issues such as affirmative action and immigrant rights, however Governor Gray Davis has had a disappointing civil rights record. Although he has helped establish new civil rights gains for the lesbian and gay communities, he has also vetoed a number of bills aimed at reducing discrimination against communities of color and immigrants. SB 44, a bill sponsored by Senator Richard Polanco, encourages state and local governments to conduct outreach programs. SB 44 had bipartisan support and was previously endorsed by former

Essay on How I Met Your MotherEssay Writing Service

Essay on How I Met Your MotherEssay Writing Service Essay on How I Met Your Mother Essay on How I Met Your MotherHow I Met Your Mother is an American sitcom about five friends who live in New York City and look for their happiness in different ways. The main character is Ted Mosby who in 2030 tells his children the story of meeting their mother. Looking for the love of his life, Ted spends much time in doomed relationships. At the same time, two of his friends, Marshall and Lily inspire him as an example of true love and commitment. Another friend, Barney Stinson, is, on the contrary, mad about women and spends his time abusing them in different ways, which he has particularly described in his legendary Playbook. One of the main characters, Robin Scherbatsky ends marrying Barney, but being focused on her career, feels her marriage as a burden and gets divorced. She also used to date with Ted, and in 2030 Ted receives his children’s blessing for being with Robin as their mother died six years ago.Robin Scherbatsky is an emigrant from Canada who came to New Yo rk to make the career of a news anchor. The show bristles with jokes about Canada and its citizens, and these jokes may be interpreted as cultural oppression. However, most of the chauvinist jokes are expressed by Barney who also appears to be a quarter Canadian himself. In the meantime, it should be underlined that while the Canadians are allegedly lashed in the show, the creators tried their best to make a positive image of this nation focusing on their politeness, fortitude, and faithfulness.Further on, another example of cultural oppression is James Stinson, Barney’s stepbrother. James is an African American who prefers men to women. Being an effective homosexual charmer, he suddenly marries Tom despite the initial protests of Barney. It is necessary to stress that Barney is not against a gay marriage, but at the moment James and Tom are engaged, he is totally against monogamy and lifetime commitment (von Matterhorn). Unfortunately, James is still a playboy by the end of the series, and his marriage is going to break up because of his endless cheating. The only continual African American character in the show is simultaneously homosexual and having problems with steadiness in relationship, but the authors of the show managed to make him charismatic, talented, and possessing a number of positive features like helpfulness, sympathy, and, of course, sense of humor.The two examples listed above demonstrate how uncomfortable themes concerning cultural and social differences can be played up effectively and carefully at the same time. It seems to be a fascinating trick to express tolerance when these differences are focused on instead of being ignored or mitigated like they are something unpleasant or inconvenient. Instead, the authors afford themselves to laugh at the differences sincerely and in this way to make the similarities more visible.What is more, it is typical for How I Met Your Mother to use comic euphemisms for culturally sensitive issues (Kr ause) including smoking marijuana, giving the middle finger or loud sex acts. Extensive use of euphemisms makes the show free from abusive scenes that can injure vulnerable social strata. Besides, the role of euphemisms even became the ground for one of the episodes in which the need to visit a bathroom is substituted by the need â€Å"to read a magazine.†

A narrowed aspect of National Park Essay Example | Topics and Well Written Essays - 750 words

A narrowed aspect of National Park - Essay Example Snowmobiling in the Yellowstone national park is disputable on a few fronts. Moderates are worried about how snowmobiles, and snowmobile outflows specifically, may affect natural life, air and water quality, commotion levels, and the pristine aesthetic of the Yellowstone wilderness. An alternate concern is for the well being impacts upon both snowmobile riders and park officers who are laid open to fumes and high clamor levels for huge measures of time. Supporters of snowmobiling point to different contemplations, for example, economic benefits to local communities and the importance of preserving access to public lands. Adding further, several individuals are of the view that more up to date innovations make cleaner, quieter snowmobiles that relieve the impacts of snowmobile use on air, water and commotion contamination. Quantitative research on this issue remains inadequate and numerous inquiries stay unanswered. There are 185 miles of cleared and paved roads especially constructed for snowmobile use in the Yellowstone National park, the vast majority of which are adjoining to streams, rivers and lakes. Considering the dissemination of pollutants in the snowpack and the impacts of poisons on oceanic creature, there is potential for surface water tainting from snowmelt spillover. For example, separation of polluted snowpack from water body, contaminant level versus weakening component and so on. Human recreational exercises have a major impact on aquatic resources directly and by through implication as well. Winter recreation influences aquatic organisms principally by aberrant affects because of contamination. Two-stroke motors can store contaminants on snow, prompting ground and surface water quality corruption, which along these lines may affect aquatic life. Protection of the aquatic resources of park, including the aquatic assets, and rebuilding of local species are essential administration objectives of the National Park Service.

Internal & external analyses of Lion Nathan Essay

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WEEK 8 journal 6500 Essay Example | Topics and Well Written Essays - 250 words

WEEK 8 journal 6500 - Essay Example n for errors to occur during practice, but failure to report these errors could lead a habit that may end up causing serious problems in the future especially when patient safety is concerned. When the nursing students were checking blood sugars, the nurse on the hall wanted them to dry their finger that had been wiped with alcohol by fanning it finger using their hand. According to patient safety, procedure in preventing that would be a wrong technique. The finger should air-dry. The nursing students did it the way the nurse wanted them to even though it was wrong so as not to upset the nurse on the hall. Nursing students need to understand that patient safety comes first, and it is okay to report an error or raise concern if they notice an error being committed by a senior nurse or physician. Having an error-reporting system is one important strategy for improving the healthcare system. Apart from offering safety through reporting and tracing underlying causes, it further offers information about potential future errors and problems (Kim, Kim, Kim, & Kim, 2007). According to Wolf & Hughes, (2008) â€Å"ethical principles of beneficence (doing well) and non-maleficence (preventing harm) are violated when errors are not reported or disclosed†. The situation I observed at the practicum site mirrors what research has found to be key reasons that lead to medication administration errors, which is a real world problem. A study carried out to identify barriers to the reporting of medication errors found â€Å"Administrative barriers and fear were found to be the top two reasons for not reporting medication administration errors among nursing students† (Koohestani & Nayereh, 2010). Kim, M.-S., Kim, J. S., Kim, Y. H., & Kim, H. J. (2007). The effectiveness of the error reporting promoting program on the nursing error incidence rate in Korean operating rooms. Journal of Korean Academy of Nursing, 185-191. Wolf, Z. R., & Hughes, R. G. (2008). Chapter 35. Error Reporting