Conjugation of the Spanish Verb Dar

Conjugation of the Spanish Verb Dar Here are the simple conjugations of dar, a common Spanish verb that usually is translated as to give. English translations are given for convenience; in many situations, other translations may be possible. In addition to the conjugations listed below, the perfect tenses can be formed by combining the past participle dado with forms of haber, and progressive tenses can be formed by combining the gerund dando with forms of estar. Also note that Spanish pronouns listed below can usually be omitted but are included here for clarity. Irregular forms are shown in boldface. Infinitive (infinitivo): dar (to give) Gerund (gerundio): dando (giving) Participle (participio): dado (given) Present indicative (presente del indicativo): yo doy (I give), tà º das (you give), usted/à ©l/ella da (you give / he/she gives), nosotros/as damos (we give), vosotros/as daà ­s (you give), ustedes/ellos/ellas dan (you/they give) Preterite (pretà ©rito): yo di (I gave), tu diste (you gave), usted/à ©l/ella dio (you/he/she gave), nosotros/as dimos (we gave), vosotros/as disteis (you gave), ustedes/ellos/ellas dieron (you/they gave) Imperfect indicative (imperfecto del indicativo): yo daba (I used to give), tà º dabas (you used to give), usted/à ©l/ella daba (you/he/she used to give), nosotros/as dbamos (we used to give), vosotros/as dabais (you used to give), ustedes/ellos/ellas daban (you/they used to give) Future (el futuro): yo darà © (I will give), tà º dars (you will give), usted/à ©l/ella dar (you/she/she will give), nosotros/as daremos (we will give), vosotros/as darà ©is (you will give), ustedes/ellos/ellas darn (you/they will give) Conditional (condicional): yo darà ­a (I would give), tà º darà ­as (you would give), usted/à ©l/ella darà ­a (you/he/she would give), nosotros/as darà ­amos (we would give), vosotros/as darà ­ais (you would give), ustedes/ellos/ellas darà ­an (you/they would give) Present subjunctive (presente del subjuntivo): que yo dà © (that I give), que tà º des (that you give), que usted/à ©l/ella dà © (that you/he/she give), que nosotros/as demos (that we give), que vosotros/as deis (that you give), que ustedes/ellos/ellas den (that you/they give) Imperfect subjunctive (imperfecto del subjuntivo): que yo diera/diese (that I gave), que tà º dieras/dieses (that you gave), que usted/à ©l/ella diera/diese (that you/he/she gave), que nosotros/as dià ©ramos/dià ©semos (that we gave), que vosotros/as dierais/dieseis (that you gave), que ustedes/ellos/ellas dieran/diesen (that you/they gave) Imperative (imperativo): da tà º (give), no des tà º (dont give), dà © usted (give), demos nosotros/as (lets give), dad vosotros/as (give), no deis vosotros/as (dont give), den ustedes (give) Sample Sentences Showing Conjugation of Dar El dar es siempre una prueba de madurez. (Giving is always a gift of maturity. Infinitive.) He dado la vida por este equipo. I have given my life for this team. (Present perfect.) Nunca te doy la pelota. No es mi estilo y lo sabes. (I will never give you the ball. It isnt my style, and you know it.) Present indicative.) Los romanos dieron a los judà ­os en ese tiempo un autogobierno limitado. (The Romans at that time gave the Jews a limited self-government. Preterite.) Me daba apuro hablar de eso delante de mis padres. (I felt uncomfortable talking about that in front of my parents. Imperfect.) El asteroide nos dar un susto. (The asteroid will give us a scare. Future.) La madre dijo que le darà ­a un pulmà ³n a su hijo. (The mother said she would donate a lung to her son.  Conditional.) Es importante que des la informacià ³n correcta. (It is important that you provide the correct information. Present subjunctive.) Las aplicaciones maliciosas eran capaces de engaà ±ar a los usuarios para que dieran sus contraseà ±as. (The malicious applications were capable of tricking their users into giving up their passwords. Imperfect subjunctive.)  ¡Dmelo ahora! (Give it to me now! Imperative.)

Launching our Reedsy Project Protection

Launching our Reedsy Project Protection Launching our Reedsy Project Protection Establishing a safe place for authors and publishersOur goal with Reedsy since the very beginning has been to create a safe place for authors and publishers to work seamlessly with the best publishing talent. We envisioned a place where they could be certain that every single collaboration would be a success.Although our careful curation process has helped bring about this reality, we wanted to make it more official. That’s why we just released our Reedsy Project Protection  policy, contained within our Terms of Use.  Here is an excerpt:Service Provider Reedsy account should be suspended or terminated for breaching the Terms of Use.Furthermore, both clients (authors, publishers) and service providers (editors, designers, marketers, ghostwriters, etc.) are bound by the  Mandatory Terms  of their  Service Contracts on Reedsy. These relate to the client materials, IP rights, payments, warranties, cancellation periods, confidentiality and data protection. More about it i n section 5. of our Terms of Use.A unique value propositionOf course, we're not the only services company in the publishing industry to offer similar protection and guarantees on projects. A lot of places will claim they have "satisfaction" or "money-back guarantees". What is really powerful about ours, though, is that it applies to a marketplace  - a network of very different individuals. Whoever the author or publisher chooses to work with on Reedsy, we protect their project. You don’t just get safety, you get safety and choice. Why is choice important? If you’re an author, we believe that one of the most crucial steps in your career is finding the right editor. We encourage authors to contact more than one editor on our marketplace, because doing so increases your chances of finding someone with a communication style you understand, someone you really connect with.If you’re a publisher, you will have to work on different books, from different authors, and often across different genres. Because of this, you will likely need different professionals and skill-sets to meet the editorial needs across your list. Reedsy provides you with a wide range of accessible talent and â€Å"insures† your collaboration with every single one of them.Now that you know why we’re doing this, let’s explain why we can.It’s all about curationWe have had over 1,500 collaborations  on the Reedsy platform so far, and only in 1% of the cases have we  had to step in and mediate, or issue a refund as a third party.There is a very simple reason for that: we put in a lot of  work to vet every single professional who applies to our marketplace, and only accept around 2% of applicants. Moreover, once they’re â€Å"in†, we monitor their response rates and activity on the marketplace to make sure they keep up to our standards of responsiveness and professionalism.It’s actually very easy for us to tell you â€Å"you won’t be disappointed† and put our money where our mouth is, because we know our professionals. We’ve hand-picked them ourselves, we know they do a good job.Let us prove it to you. And as always, let us know in the comments if you have any questions.

Legalization of marijuana Research Paper Example | Topics and Well Written Essays - 1500 words - 1

Legalization of marijuana - Research Paper Example Decriminalizing the drug will present myriad economic and legal positive implications as the discussion below portrays. Possession of marijuana is a criminal offense in the country with law enforcement agencies mandated with containing the use of drugs arresting thousands of peddlers. Such arrests have myriad effects thus slowing the rate of dispensing justice in the society. The law courts and police stations are arguably crowded with thousands of young people charged with being in possession and using marijuana. Congestion in American jails is a major social problem that the government strives to solve. The government uses millions of dollars in maintaining the prison facilities most of which also serve as remands while suspects await their trials. The legal process further slows owing to the huge pile up of cases a feature that makes such processes not only slow but also equally expensive for suspects, their families and the government. As explained earlier, marijuana is one of the most common drug that millions of Americans use for varied reasons including medicinal. This makes the drug a menace that the government continues to invest millions of dollars to contain. Most of the peddlers serving jail terms in American prisons are serving such terms owing to either possessing or using marijuana. Decriminalizing the drug will therefore free up the state facilities thereby cutting the amount of money the government invests in managing such facilities as the courts and prisons. Additionally, this will offer a natural solution to the overcrowding problem in most of the correctional facilities in the country. This will expedite the legislation process thereby making the management of both the courts and the prisons easier. The government has strived to achieve this in the past by investing more money into the departments despite the ailing economy. By legalizing

MENTAL HEALTH Research Paper Example | Topics and Well Written Essays - 1500 words

MENTAL HEALTH - Research Paper Example However, the elder patients are believed to view and imagine nursing staff as their own daughters. In developed nations relationships among children and parents have significantly deteriorated and therefore, elders are becoming lonely and depressed (Werner, 1993). Nevertheless, all patients from different age groups are famous for practically loving their medical staff. But, in case of children, the job of nurses gets tough and challenging because psychologically, one has to become a child in order to play with a junior and because of this reason, it is recommended in multiple studies that nurses with a special kind of personality should be assigned to the children ward. Most of the nurses are notorious for having rude and rough behaviors because they are living under such level of emotional and psychological stress that they become unstable to say the least. But, again when it comes to treating children nurses are supposed to transform healing into a game so that the childrenâ€℠¢s fear can be circumvented (Swanson & Wojnar, 2004). The hospitals are providing a colorful environment for children where there are paintings of famous cartoon characters on the walls and the patients have the facility to play and engage in positive activities such as playing music and listening and watching television. The children are fighters because their bodies have been known to perform at peak proficiencies and therefore, they are not mentally aware and neither they are willing to accept their illnesses (Altimier, 2004). Both of the previously mentioned factors have the power to expedite healing process. The challenge lies in providing a proper reinforcing environment where the belief of a child can become a reality (Pesek, Helton, & Nair, 2006). Still, the nurses must be informed that elders and children heal in two very different ways. The former ones heal with the help of a listener while the latter group wants a companion, a friend, and a player. The nurses then, must a llow the elders to share their experiences and should also provide a silent ear. The hospitals of the 21st century are transforming into community centers because they are taking up the roles of facilities that are helping in bridging the gaps between elders and children (Langsley & Barter, 1983). Quite a significant number of facilities are providing elders with an opportunity to share their life’s experiences with the next generation. The needs of both groups are fulfilled in this fashion because the elders have a profound need to share their knowledge whereas the children’s need to listen bedtime stories from their grandparents is satisfied as well (Doty, 1986). The nursing profession was developed and flourished as a means of assisting the physicians in the terms of devising an effective and efficient way of treating the illness (Bakken, Cashen, Mendonca, O'Brien, & Zieniewicz, 2000). But, according to the literature of modern healthcare, most of the physical disea ses are just manifestation of psychological problems and diseases and therefore, it is highly recommended to cure both dimensions of the illnesses simultaneously (Weatherhead, 1951). Furthermore, the children are by-default positive thinkers but transform into a hopeless individual due to the environment and because of this reason, the hospitals are repeatedly suggested to create and foster

Radiation Therapy Essay Example for Free

Radiation Therapy Essay ABSTRACT:   Ã‚  Ã‚  Ã‚  Ã‚   Radiation Therapy now enjoys its position as a therapeutic and an adjuvant therapy among the cancer patients and cases. The use of radiotherapy is a very serious decision which is taken after much thought about the patient’s case and requires much cooperation from the patient and support from the oncology team that provides it. Current oncology teams work together to create an environment which is both friendly for the patient as well as less confusing, so that the patient is able to go through the phase of treatment with out any complications. Each person in the radiology team takes care of a particular aspect of radiotherapy treatment, and together they ensure a good outcome and result for the patient. THE ROLE OF RADIATION THERAPY IN CANCER MANAGEMENT   Ã‚  Ã‚  Ã‚  Ã‚   Of the many methods used in today’s cancer treatment regimes, radiation therapy has become one of the crucial components of the therapy. The therapy where radiation rays are used to destroy cancer cells has now become an advanced field of research and development. This area has now become a separate area of specialization, and various developments are helping doctors give better prognosis to their patients. Due to minimized anxiety attacks   among patients, they become more optimistic about recovery and are less distressed on the possibility of death. Patients of this kind of therapy have better psychological health and have less depressive symptoms caused by their disease.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Radiation therapy is not required to all cancer patients. It is not always involved in the management of all organs and body sites affected by cancer cells. This treatment is only recommended on certain types of cancer as other situations only call for surgical procedures in preventing further cancer metastasis and to eliminate cancer cells in the body.   An important adjuvant to cancer therapy, it is used as an alternative to surgical procedures that cannot be carried out on a patient. Radiation therapy is a common procedure in breast and lung cancers as well as in brain cancer, colorectal carcinomas and skin cancers of the face. (Florida Cancer Care News, 2006)   Ã‚  Ã‚  Ã‚  Ã‚   In the USA, the main issue of debate and concern among the clinicians is the poorer prognosis rates in the USA patients due to cancer when compared to other countries of Europe. This has been attributed to the type of care given in each country, and has led to intense concentration on methods that improve recovery outcomes.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   These concerns have led to five areas of intense activity in the area of cancer therapy, as stated by Tattersall and Thomas, (1999). There are now multidisciplinary teams that specialize in one or two specific organs and provide treatment and care to those specific cancer patients. There have been increased efforts to improve the organizational setup of the cancer therapy and delivery setups. Clearer treatment goals now exist, along with increased awareness in the public about the different aspects of cancer, cancer therapy and the role of trials in the development of better alternatives and cures for the future. Now current research is aiming to derive benefits from matrix metallo proteinase inhibitors, gene therapies and cancer vaccines. (Tattersal and Thomas, 1999) All these areas of activity are hoped to increase the patient outcomes significantly in the future and help in creating better alternative solutions to cancer treatments. Team Members in Radiation Therapy Treatment Plans     Ã‚  Ã‚   The advancements in this field have led to increase in the number of professionals in this field. Each has a unique and an important role to play in the treatment procedure. The radiation therapists mainly work in conjunction with the medical doctor and with them discuss the individual cases that are considered for radiation therapy. Of these the suitable cases are selected and the radiation treatment is then started under the guidance of the radiation oncologist The decision making process in radiation therapy is absolutely critical, as the radiation oncologist decides the amount and intensity of the dose each patient will get according to the individual factors and more importantly the state of the cancer.   Ã‚  Ã‚  Ã‚   A radiation department in any organization will consist of multiple workers and members, each having a significant role to play in the treatment of the patient. These include the clinical oncologists or radiologists, the radiographers, radiation therapists and the dosimetrists, the physicist, the mould room technicians, the nursing staff, the students and the R.T aides and assistants and other members such as social workers, palliative care team, counselors, and secretaries and clerical staffs. (Cancer Backup, 2005 and American Society of Radiologic Technologists, 2007). Stimulation is the initial step in the radiation treatment where a radiation therapist takes x-ray images and utilize this to locate the tumor. Other methods such as CT scans can also be used in order to minimize tissue damage in the patient, ensuring that only the carcinogenic cells are destroyed. Together with a radiation oncologist and a dosimetrist, they customize a treatment plan for the patient (Radiation Therapists 2006). Both clinical oncologists and radiologists are concerned with minimal invasive methods in treating cancer cases. According to the Royal   College of Radiologists (2007), radiologists   are medical specialists that conduct imaging services in order to provide patients the proper diagnosis. Oncologists on the other hand are specialists trained to manage cancer in non-surgical forms of treatment. They usually recommend procedures such as chemotherapy, hormone therapy, and radioactive isotopes. After taking the image of the affected organ of the body, this is to be interpreted by another specialist in order to prescribe and execute the proper treatment. This is a task attended by professionals called radiographers (Radiography and Radiographers). Dosimetrists are primarily concerned on the proper dosage to be administered to a patient. They scan patients and use CT data or other measurements in order to provide patients the proper treatment plan (Medical Dosimetrists, 2004).   Ã‚  Ã‚  Ã‚   The members of the radiation team that are outside of the department faculty but help in the procedures include the referring faculties, physicians, radiologists and emergency departments, the industry vendors, the patients and their family members, the instructors or directors of the radiology programs, the insurance companies, the governmental and regulatory agencies and the accrediting agencies, if applicable. (American Society of Radiologic Technologists, 2007)   Ã‚  Ã‚  Ã‚   The radiation team is perhaps the most integrated and interconnected team compared to other sections of the medical health care. The realization of the need for team work in reducing confusion, promoting smoothness and harmony in the care of the patient was realized long ago, however, it was not implemented fully in many medical and surgical areas. The results have shown lags or gaps in the treatment of care. Many of the current radiology departments have learned from the lessons of the past, and now term themselves as the radiology team who take care of the patient through all the stages of the radiotherapy treatment. (Kaprich, 2003) This has led to not only improvement in the care of the patients, but also in the hospital management and organization matters as well as job satisfaction levels. The level of communication between the different contributors of the department has improved and therefore, shows a much prompt and informed response in the care of various pa tients. (Kaprich, 2003) Radiation Therapists   Ã‚  Ã‚  Ã‚   Advancement of technology has given professionals access to different methods that enable the correct identification and location of cancer cells which are the specific targets of the ionizing energy of radiation and preventing tissue cell damage. With this directed and controlled use of radiation, there is a reduced manifestation of side effects due to the treatment patients receive, and there is an expedited recovery of patients. (M.D Anderson Cancer Center, 2007) Together with the doctor, a radiation therapist is responsible for the patients familiarization of the radiation treatment procedure. This will allow the patient to become aware of the possible problems that may arise and to answer any reservations that the patient may have. Therefore, a radiation therapist is expected to be present throughout the treatment period. Nurses in Radiation Oncology   Ã‚  Ã‚  Ã‚  Ã‚   The inclusion of nurses in this field of radiation oncology is fairly recent. However, this has now become an integrated and competent player in the caring of cancer patients in the radiology department.   Ã‚  Ã‚  Ã‚  Ã‚   The role of nurses have evolved in this field, as many of them have been tasked to carry out many of the advanced procedures in the treatment process. Both preoperative and operative care are executed by these nurses, making them indispensable in the success of the patients recovery.   Ã‚  Ã‚  Ã‚  Ã‚   Currently, the responsibilities given to the nursing staff include both basic and advanced tasks. The basic tasks include education and caring of the patient with in the department and helping others in carrying out researches and other projects. Nurses work towards creating an environment both among themselves and among the different staff members to create an open, friendly environment that ensures better outcomes. Along side, the nurses are responsible for their own education and growth within the field, and opportunities to increase and improve competencies within the staff. The nurses are therefore, working primarily in creating an environment that improves the patient care and outcomes, as well as improve the communication between the various contributors to the field. (Kaprich, 2003) In oncology, the roles of nurses in the treatment process is considered an integral part of the overall healthcare. The primary purpose of providing nursing care is to allow the patients to become independent through the development of their physical, psychical, and social abilities. It is significant in preserving, strengthening and protecting health, and nursing patients and rehabilitating them (Basic Principles of Nursing ). Physicists in the Field of Radiation Therapy   Ã‚  Ã‚  Ã‚   Another significant member of the team of professionals in radiation oncology are the physicists. This specialist is responsible for giving the patient optimum radiation therapy procedures that would ensure minimal health risks and maximum efficacy. Due to the delicate nature of their job, these physicists are expected to be highly professional and equipped with the proper training in conducting their tasks. Part of the job that physicists have is that they should select the proper radiation instruments to be used, the budget preparation and the sequence of procedure execution. Due to this technical knowledge, physicists are important in identifying and rectifying problems that could possibly transpire. But this specialist is not confined in his technical role as his position requires that he collaborates with both oncologists and radiation therapists in determining the proper dosage, duration, timing, frequency and type of radiation therapy to be administered to a patient. Since the availability of x-rays, physicists have exploited this technology of medical imaging, which is vital to medical research advancement. Fundamental research in optics, acoustics, electromagnetism, and particle and nuclear physics have led to an array of indispensable medical tools. Magnetic resonance images, CAT scans, PET scans, and various types of radiotherapy are among the physics-based devices that help doctors diagnose and treat ailments ranging from broken bones to cancer. Ultrasound machines, for example, are made possible through our understanding of the physics of sound waves, and the prenatal images they produce are now so common that they are a cultural symbol of the joy of impending parenthood (Genetic Radiotherapy 2002). Cutting-edge techniques presented in the annual AAPM meeting scientific program will ultimately lead to tools as important to the medicine of tomorrow as x-ray and ultrasound images are today. (Asp et al, 1993)   Ã‚  Ã‚  Ã‚   The use of ionizing radiation in the radiation field has led to many questions raised about the safety margins of these procedures. As stated before, there is a fine line of division between the therapeutic effects of radiation and the adverse effects of the radiotherapy. In this regard, the role of dosimetrists is essential to delineate the amount of dose necessary for each case. Dosimetrists play a role in treatment planning, mould room technology, brachytherapy and sealed source management, in-vivo dosimetry, quality control of equipment, and IT support. (Radiotherapy Provision in England, 2006) Dosimetrists for Dose Determination   Ã‚  Ã‚  Ã‚   A dosimetrist is actually responsible for the delivery of the proper dosage to be given to a patient. They are subordinates to doctors who work in close communication with the patient as well as their families. The person who actually delivers the dose of radiation each day is known as dosimetrist. These work under the doctor or the oncologist and are in close communication with the patient as well as the family members of the patient. The radiation dose decided for a patient is given to him or her in divided portions. The session itself is a small one, but the radiation therapist is the one who delivers it and communicates any changes in the patient to the oncologist.    Mental Health Support for Cancer Patients   Ã‚  Ã‚  Ã‚  Ã‚   Radiation therapy is a big step of treatment in cancer patients and therefore, their mental and physical state is a very important clue and guide to the selectivity of the case for the therapy. Such patients begin one of the most difficult incidents of their lives by opting for radiotherapy. In this regard, they need the proper guidance, support, help and boost to help them get through the different stages of radiation therapy, and to improve chances of recovery. In many of such hospitals, the support programs are available which work with various social services to provide such cases with any required information they need. There are many things the patients undergo in this event. They either may undergo external radiation therapy treatment or an internal radiation treatment. In external radiation therapy, the patients are called to the radiation center 5 times a week and radiation is given to them. The two days off from radiation helps the normal cells to recup erate from the damage of the radiation procedure.   Ã‚  Ã‚  Ã‚     Patients after changing in hospital robes are asked to enter the radiation room especially designed for the purpose. After instructing the patient the proper position, the radiotherapist proceeds to his proper location where he would execute his task. The patient is asked to remain in a the said position where he is to receive a fixed radiation dose to the tumor affected area. After the completion of the session, the patient is then directed to leave and attend to normal daily matters. Patients in these stages undergo immense psychological as well as physical stress for which it is advised that they rest more to help the body restore itself in the normal manner. Since depression and anxiety are two most common features, the patients are advised to take part in activities that boost their morale and help them feel good about themselves. The support teams in this regard focus on providing and guiding patients to a good nutrition plan, to aid in better recovery from illness. Nausea is also among the problems that patients encounter but these can be easily handled through medication prescribed by your oncologist. Hair falling is another issue that usually resolves once chemotherapy is over. In summary, the radiation procedure is especially taxing for the patient who may need immense support and care at this crucial time, which becomes the responsibility of the family as well as the radiology team. (WebMD, 2007)    Internal Radiation Therapy   Ã‚  Ã‚  Ã‚   Internal radiation therapy is another frequent option chosen by the oncologist in the treatment plan of many cancer patients. The high dose rate radiation therapy is a type of this internal radiation therapy where radioactive source is removed between treatments. In this case, the source of radiation is placed in direct proximity to the cancer area and is applied with small sophisticated machinery. This is in contrast to the use of heavy extensive radiation and machinery that is used in external radiation procedures. The substances used in these instances include iodine, cesium, iridium, phosphorus and palladium etc. This treatment has been given many names and is also known as brachytherapy, implant radiation therapy, interstitial, intracavitary or passage radiation. Internal radiation therapy however is a procedure that requires hospital care and attention, as well as isolation, for in this therapy; other people may get exposed to high radiation levels. Therefore, many cases of these may keep the patients for a day or two, during which the affect of the radiation substance would have worn off, and become useless. (Cancer Source, 2007)   Ã‚  Ã‚  Ã‚  Ã‚   It is important that once radiation therapy is carried out, the patient is seen and advised further about the future therapies or treatments. This is an essential part of the treatment modality. Mostly prior to the radiation therapy, the oncologist and the radiation therapist carry out the discussion about the possible side effects of the therapy and what a patient may expect afterwards. The doctor emphasizes the need of follow up care and the role of the patient to show up in time. These include many procedures, including regular medical checkups, screening and diagnostic procedures, endoscopy, blood work etc. All these help the clinician check on the health of the patient and the recovery status, and whether any complication is arising. The patients are asked about the status of their health and any signs and symptoms that the patient may be feeling. Patient is asked about pain, or any physical difficulty being experienced in daily routine. He or she is asked frequently about any medications, supplements and the dietary habits he or she is conducting. Emotional issues and problems as well as family histories are also taken into account in these visits. Such patients may be called after two months of the radiotherapy, and then asked about the status and any necessary investigations may be carried out. These visits may be tapered down to once a year if the prognosis is good and the patient is recovering successfully. The patients are however, asked to maintain the record of their illness and all of the treatment modalities carried out including medications and previous test results for future references. (National Cancer Institute, 2007) Effect of Radiotherapy on Nutritional State of Cancer Patients   Ã‚  Ã‚     Nutrition is a very important aspect in proceeding with the treatment. There are currently many studies conducted in determining the proper nutrition a cancer patient must receive. This is due to the fact that cancer treatments cause high energy expenditure among patients, leaving then in nutritional deficiency as they undergo radiation therapy. Several factors contribute to this problem. First is the fatigue that develops as a result of the treatment, which takes away the ability of the patient to take balanced nutrition. Second is the lack of hunger in such patients and third is the increased vomiting and nausea that these patients encounter during the treatment phase. In all these scenarios, the net result is the reduction in the nutritional capacity of the patients. This is especially true for patients who have cancers of the oral cavity, pharynx, esophagus or the gastrointestinal tract. Dietary and/or external supplementary nutritional sources are extremely important in such cases. Isenring, Capra and Bauer in 2004, claimed that nutritional therapy is an essential feature of the patient recovery plan in cancer radiotherapy. (Isenring et al, 2004)   Ã‚  Ã‚  Ã‚   Researches conducted reveal the negative impact of radiation therapy on the patients nutritional health. There are obvious evidences that nutritional deficiencies are common to cancer patients, especially those suffering from cancer of the GI tract. Due to the imbalance between food intake and energy loss, malnutrition is inevitable. Most patients suffer from malnutrition in the radiation phase, because of this many hospitals now recommend that a compulsory health program be imposed on patients to ensure the proper provision of their nutrition. There are different claims as how to properly design these programs. Some suggest that amino acids and essential fatty acids are important in increasing bodys defenses and to improve patient recovery. A reduced fat diet, live yoghurt and fermented milk product use are now one of the most important components in the cancer nutrition plan. (Internet Health Library, 2007)   Ã‚  Ã‚  Ã‚   Studies indicate the biggest danger due to malnutrition is the intense weight loss that the patient suffers from, which can lead to increased morbidity and mortality rates, reduction of the body’s defense systems and increased possibility of the return of the cancer, should any remaining cancerous tissue remains. While initial weight loss is of no serious consequence, continued weight reduction is a sign of concern. For many of the symptoms that the patient encounters, the options are presented for the specific issue. For example, mouth dryness is a common problem for the cancer patients. This increases their chances of oral infections, and therefore, patients are advised to chew on sugarless gums, increased intake of water, and using high moisture foods and fruits. Patients are advised to take small but frequent meals that are low on fat, to aid in digestion. Appetite stimulants are another good method of improving diet and appetite in such patients. Iron supplementation is advised to counter the effects of anemia, exercise may help in dealing with changes like menopausal states which cannot be given estrogen therapies. Patients in cancer cases tend to opt for more supplements and become less careful about the food that they eat. This should be the other way round, for natural food is the best nutritional supplement and helps in recovery faster. Fruits and vegetables are a high source of vitamins and minerals and can help in the recovery of the patients’ appetites. (Cancer Journal for Clinician, 2001) Physical and Mental Health Maintenance   Ã‚  Ã‚  Ã‚   As stated before, the cancer therapy is an intensely physically as well as emotionally demanding phase of treatment to a patient. In such circumstances, the need is for intense emotional support and encouragement. It is estimated that up to 40% of the patients may experience immense emotional distress during the cancer treatment, and therefore identification with proper counseling and guidance is very important for such cases. (Sollner et al, 2001) The problem lies in the correct identification of the cases undergoing distress and to understand the severity of the issue before hand. Many of the oncologists however, are unable to identify cases of distress which may cause complications at a later date. (Sollner et al, 2001) It is very important that oncologists are able to identify such cases and work accordingly for the benefit of the patient. Many social support groups are available in the hospitals that aim to help and guide the patients as well as their families t o better radiotherapy experience.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The concept of hospice has been indeed one of the methods with which care can be given to patients undergoing therapy. Somewhat of a recent concept in oncology care, hospice care has fast become a popular method among the patients. While hospice care is a good method, there are only three percent of the total cancer patients in a hospital that undergo radiation therapy. The issues here are different as the approvals for radiation are hard to get for the patient. Most of the hospice patients are senior age individuals with a mean age of 63 years admitted in the UK hospitals. (Lutz, Ashworth and Connor, 2005)   Ã‚  Ã‚  Ã‚   The use of hospice care therefore becomes a complicated issue when decision to conduct radiotherapy for such individuals is considered. Many of the patients in this regard are actually cases of terminal cancer who need palliative care through radiotherapy. It is important to address the need of the dying patients and to provide them with the necessary care to help them get through the process with as minimum pain as possible. (Lutz, Ashworth and Connor, 2005)   Ã‚  Ã‚  Ã‚  Ã‚   Usually there are three kinds of patients that undergo hospice care during radiotherapy. The first are those patients who do not have any one to take care of them during their radiotherapy session, and therefore the hospital provides it to them. The second are the patients who do not forgo the hospital admission, and third are those who are getting parenteral and tube nutrition, radiotherapy and chemotherapy and are getting transfusions. (Lorenz et al, 2004) In many of such cases the patients may have difficulty getting admission in the hospitals, despite falling into one of the above three categories. Access in such cases needs to be made smoother for the patients. (Lorenz et al, 2004)   Ã‚  Ã‚  Ã‚   Current hospices are now a combination of inpatient and home care services. In the past this was not the case. Hospices and palliative care were considered a separate department and were accordingly handled. The development in this area has led to modern hospices with a home like feel for the patients to help them recover and feel psychologically better. It is to remember that hospice care in many patients is essentially palliative care, and includes symptom control, effective communication between patients and the doctors, rehabilitation and continuation of care, terminal care, support provision in bereavement, education and research.(Neill and Fallon, 1997) In other words current hospice is a refuge, a recuperant and an area of research all combined. Palliative care is again the domain of specialists in oncology and in other disciplines so as to give the best care there is possible to the patient. In cancer terminal patients, many efforts are carried out to make the stay of the patient more comfortable. After thorough evaluation and identifying the cause of pain in such patients, the administration of analgesics is undertaken. While primary drugs remain the same during the course of the treatment, the secondary drugs or the adjuvant drugs are added as the case may need. These may include some other drugs depending on the patient symptoms such as steroids, anti inflammatories, antidepressants, anti convulsants, and anti arrhythmic drugs. Issues of tolerance and toxicity are taken very seriously and patient progress in this regard is taken under constant observation. (Neill and Fallon, 1997)   Ã‚  Ã‚  Ã‚  Ã‚   There are many reasons cited by the patients about their preference of hospice care to home care. These include high professional care, easy to communicate and clarify issues of health and cancer stages, ease in the visitation in between the radiotherapy sessions with ample time for rest, and provision of support to the patient as well as the family members in the hospital settings. Such patients were satisfied about the exclusive team of care givers in the radiotherapy department, and a faculty that focuses on cancer patients only. However, areas of dissatisfaction among the patients include the problems encountered with the radiation units and machines, occasional lack of communication between the various members of the staff leading to problems in care provision, and problems in transporting patients from one department to the next. (Gavin et al, 2002) CONCLUSIONS:   Ã‚  Ã‚  Ã‚   Radiotherapy is a field of intensive research and activity and is undergoing many changes and developments. Now there is a shift and interest from the conventional external beam radiotherapy procedures and there is more emphasis on the use of fractionation doses rather than single ones. This is especially seen to be beneficial for cases of head and neck cancers and improve the prognosis of the patients, as well as give them ample time to recover during the procedures. Some of the rules however, follow. For example the dosage of radiation is decided depending upon the size of the tumor mass. The larger the mass, the more it must receive the dosage of the radiation. Other methods of providing doses include hyperfractionation, which is twice daily delivery of the radiation, the accelerated fractionation, which aims to decrease the treatment period and to prevent the tumor from regrowing. Some of the techniques employed that prove to have relatively positive impacts are the concomitant boost technique, given once a day for three and a half weeks and twice a day in the final two week period, and the accelerated hyperfrationation, which combines the effects of both hyperfractionation and acclerated dosing. (Chow et al, 2001)   Oxygenation of tumor is also considered for treatment. It has been established that oxygen has the ability to modify radiation damage, that in malignant tumors, both oxygenation and tumor cell proliferation determine local tumor management after radiotherapy. However, there are currently insufficient explanations in correlating oxygenation status and tumor cell kinetics (Nordsmark et al. 1996). But according to the Mayo Foundation for Medical Education and Research (2005), Oxygen therapy uses ozone or hydrogen peroxide to supposedly add extra oxygen to your body. Proponents believe cancer cells need a low-oxygen environment to survive, and that flooding your body with extra oxygen will kill cancer cells. Ozone gas can be mixed with water or air, and users usually drink or inhale the solution. It can also be injected into a muscle. Hydrogen peroxide is sometimes injected into a vein, though it can also be administered rectally. Oxygen therapy hasnt been studied in people. Hydrogen peroxide bubbles in the blood can block blood flow and lead to death. An alternative cure or disease management for cancer patients is for them to undergo surgical procedures. This can be done for several reasons, it can be preventive or prophylactic, for diagnostic, staging, curative, and others. It is one of the oldest forms of cancer treatment that removes tumor and saves normal tissues (American Cancer Society 2007).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Current treatment regimes are now utilizing the use of more sophisticated machinery that is able to specify the location of the tumor and provide therapy to that area only, so as to prevent damage to the normal tissues. The external beam therapy advancements are leading to improvements in the outcomes of the cancer patients and therefore is becoming a widely used procedure in cancer therapy. Internal radiation therapy is somewhat limited to the surgical procedures, where removal of the tumor is promptly followed by radiation therapy to ensure the removal of any viable cancer cells.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Cancer chemotherapy is advancing at a rapid rate and is now a need for the future. The increase in the rates of cancers worldwide has led to the formation of specified task forces aimed to identify the similarities of the problems faced by the patients, their families as well as the doctors in the care of such cases. With the increased length of the treatment with frequent recalls and visits, it is important that such treatments be carried out in coordination with the different members of the radiology team. The roles of the various team members are important and each has a very important role to contribute in the cancer care.   Ã‚  Ã‚  Ã‚  Ã‚   The introduction of social programs is a very positive effort by the health care administrations which aim to educate and help the patients during the various phases of the cancer treatments. The understanding of the physical and emotional distress and needs of the patients and rectifying it helps to improve the outcomes many times and ensures the best of treatment provision. The role of nutrition as mentioned above is again a contributing factor in the rehabilitation of the patient and can help in speedier recovery. In short, radiotherapy is a major decision for a cancer patient which needs to be taken into account during all stages of the therapy with proper support and guidance for better outcomes. REFERENCES The American Society of Radiologic Technologists. The Interdisciplinary Team in Radiological Technology .  Ã‚   http://www.asrt.org/content/RecruitmentRetention/RetentionTools/Interdisciplinary_Team.aspx Lloyd Asp, Morris Bank, Theodore Fields, William Hendee, Douglas Jones, Cohn Orton, Vincent Sampiere, George Starckschall, K. David Steidley and Bruce Thomadsen, 1993. The Role of a Physicist in Radiation Oncology. American Association of Physics in Medicine by the American Institute of Physics. Cancer Backup, 2005. Staff in Radiotherapy Department. Site last accessed on November 7th, 2007 from http://www.cancerbackup.org.uk/Treatments/Radiotherapy/Beingtreated/Staff Cancer Source, 2007. Internal Radiation Therapy: What to Expect. Site last accessed on November 8, 2007 from http://www.cancersource.com/CancerBasics/CancerTreatment/RadiationTherapy/45,25508-7 Rachel H Chow, Kenneth M. Forster, Richard B Wilder, Micheal S Wong, 2001.   Recent Advances in Radiotherapy for Head and Neck Cancers. ENT Journal.   Site last accessed on November 7, 2007 from http://www.encyclopedia.com/doc/1G1-80193510.html Florida Health Care News, 2006. The Role of Radiation in Cancer Treatment. Site last accessed on November 7th, 2007 from www.floridacancerinstitute.us Gavin KT, Brady M ,Hollywood D , Meagher E,   O’Cathail S, Browne C, 2002. Radiotherapy Services: Evaluation of Patient Preferences and Priorities. Site last accessed on November 8th, 2007 from http://www.isqua.org/isquaPages/Conferences/paris/ParisAbstractsSlides/Wednesday/A23b/pdf/383%20-%20Gavin.pdf Nordsmark, M., Hoyer, M., Keller, J., Nielsen, O.S., Jensen, O.M., and Overgaard, J. 1996. The relationship between tumor oxygenation and cell proliferation in human soft tissue sarcomas. Elsevier.   1;35(4):701-8. Internet Health Library 2007. Health in Hospitals Radiotherapy. Site last accessed on November 8th, 2007 from http://www.internethealthlibrary.com/HealthinHospitals/RadioTherapy-Nutrition.htm E A Isenring, S Capra and J D Bauer, 2004. Nutrition Intervention is Beneficial in Oncology Outpatients Receiving Radiotherapy to the Gastrointestinal or Head and Neck Area. British Journal of Cancer, 91, 447-452 Suz Kaprich, 2003. Radiology Nursing- Team Building. Nursing News Quaterly. Site last accessed on November 7, 2007 from http://www.uihealthcare.com/depts/nursing/news/nnq/may03_pg4.pdf Karl A Lorenz,Steven M Asch, Kenneth E. Rosenfeld, Hui Liu, and Susan L Ettner, 2004.   Hospice Admission Practices: Where Does Hospice Fit in the Continuum of Care? Journal of American Geriatrics Society, VOl. 52, No. 5, pp. 725-730 Lutz, J. Ashworth, C. Spence and S. Connor, 2005. The Use of Radiotherapy in Hospice Patients: A Population Based Study From the National Hospice Outcomes Project. Journal of Clinical Oncology, 2005, vol. 23 number 169, Part I of II. Martin H N Tattersall and Hilary Thomas, 1999. Recent Advances, Oncology. Clinical Review, BMJ 1999: 318: 445-448 National Cancer Institute, 2007. Follow up Care After Cancer Treatment: Questions and Answers. Site last accessed on November 7th, 2007 from http://www.cancer.gov/cancertopics/factsheet/Therapy/followup Bill O Neill and Marie Fallon, 1997. ABC of Palliative Care: Principals of Palliative Care and Pain Control. BMJ, 315: 801-804 About the RCR. The Royal College of Radiologists. Site last accessed on December 7, 2007   Ã‚  Ã‚   from http://www.rcr.ac.uk/index.asp?PageID=9 Basic Principles of Nursing Care in the Institute of Oncology and Radiology of Serbia. Institute of Oncology and Radiology of Serbia: National Cancer Research Center. Site last accessed on December 7, 2007 from http://www.ncrc.ac.yu/onkoeng/principi.html Complementary and alternative cancer treatment: Get the facts 2005. Mayo Foundation for Medical Education and Research. Site last accessed on December 7, 2007 from http://www.mayoclinic.com/health/cancer-treatment/CM00002 Genetic radiotherapy, PET scans for animals, novel spinal surgery. Scienceblog. Site last accessed on December 7, 2007 from http://www.scienceblog.com/community/older/2002/B/2002681.html Medical Dosimetrists. University of Washington Medical Center. Site last accessed on December 7, 2007 from http://www.uwmedicine.org/PatientCare/MedicalSpecialties/SpecialtyCare/UWMEDICALCENTER/Cancer/SpecialtyServices/dosimetrists.htm Nutrition During and After Cancer Treatment: A Guide for Informed Choices by Cancer Survivors. Cancer Journal for Clinicians 2001: 51:182-187 Radiotherapy Provision in England. A Report from the National Radiotherapy Advisory Group-Workforce Subgroup, 2006. site last accessed on November 7th, 2007 from http://www.cancer.nhs.uk/documents/nrag_files/Workforce%20sub%20group%20report%20-%20fin.pdf Radiography and Radiographers. Professional Info from Radiographers.org. Site last accessed on December 7, 2007 from http://www.radiographers.org/professionalinfo/radiography_radiographers.htm Radiation Therapists. US Department of Labor: Bureau of Labor Statistics. Site last accessed on December 7, 2007 from http://www.bls.gov/oco/ocos299.htm Surgery. American Cancer Society 2007. Site last accessed on December 7, 2007 from http://www.cancer.org/docroot/ETO/content/ETO_1_2X_Surgery.asp The Role of Radiation Oncology in Cancer Treatment. MD Anderson Cancer Center. Site last accessed on November 7, 2007 from http://www.mdanderson.org/departments/andersonnet/display.cfm?id=BF82D669-17DA-11D5-811000508B603A14method=displayfull W Sollner,   A DeVries, E Steixner, P Lukas, G Sprinzl, G Rumpold and S Maislinger, 2001.   How Succesful are Oncologists in Identifying Patient Distress, Perceived Social Suport and Need for Psychosocial Counselling. British Journal of Cancer, 2001: 84, 179-185 WebMD,   2007.   Breast Cancer: Radiation Therapy: What to Expect. Site last accessed on November 7th, 2007 from http://www.webmd.com/breast-cancer/breast-cancer-radiation-therapy-what-expect

Importance of Sleep in Shakespeares Macbeth Essay -- GCSE English Lit

Macbeth: The Importance of Sleep Macbeth Sleep is a time when our minds are at rest and the subconscious comes out to play. Sleep is oftentimes considered the place where we are able to see into our future and perhaps figure out how to solve our problems. Sleep is also what heals and cures our minds and bodies. Without sleep we slowly begin to disintegrate. Mind and body no longer cooperate without the healing force sleep brings with it. Shakespeare uses sleep both as a reward and as a consequence in his plays. If a character is innocent and pure, he is allowed restful, fulfilling sleep. If the character lacks these traits of goodness, he is condemned to a lifetime of insomnia and other problems. In Shakespeare’s tragedy, Macbeth, the reader can see this idea manifest itself in many different ways. From the beginning, when Macbeth hears the voice to the end of the play when Lady Macbeth sleepwalks, the reader sees many examples of this use of sleep. One first encounters the idea of sleep in Macbeth when the central character, Macbeth, murders the sleeping king. After the murder, Macbeth believes he hears a voice cry out, "Sleep no more†¦ Glamis hath murder'd sleep, and therefore Cawdor shall sleep no more, Macbeth shall sleep no more"(II.ii.58-60)! At this point the reader does not really think much of this warning, assuming it to merely be Macbeth's guilty conscience rather than anything important. But as the signs of the voice's prophecy begin to surface like the symptoms of a disease, Macbeth slowly becomes irrational and ruthless. This is partially due to the, "terr... ...ally 'good' people were changed drastically after sleep was withheld from them. King Duncan and his sons, Malcolm and Donalbain, were considered innocent in this play and therefore they were allowed to sleep. Their sleep was a restful, healing sleep that gave them clear judgment and, in the case of the sons, the will to avenge the wrongful death of their beloved father. For their 'good behaviour' they were able to sleep unhindered. Innocence and purity in a Shakespearean play have rewards attached to them. If a character is good, he is allowed a deep, peaceful, refreshing sleep. If he is evil, he is barred from sleep as a reminder of and a punishment for his wrongdoing. This, in turn, leads to a decline in his mental, emotional and physical well being as is evidenced in Macbeth by the plight of both Macbeth and Lady Macbeth.

Commentary on One Character in the Great Gatsby – Nick Carraway

Nick Carraway contributes to the Great Gatsby as the unbiased narrator. The tragic love story of 1922 is accounted through Nick’s eyes, with Nick serving as an observer of the relationship between the characters, in particular Gatsby and Daisy’s, the main lovers of the story. Nick’s retrospective view of the story emphasizes his dynamic character as his thoughts and perceptions of the characters display his loyalty towards Gatsby, and justice and honesty towards the judgement of events, though it is seen by the end of the story that his moral values have been debased by the shallow and corrupted lifestyle of the East. The Great Gatsby is told entirely through Nick’s perspective; this can be said that he is observing the events of the story instead of being involved in it directly. Nick can be seen as a trustworthy narrator, as he learned from his father that he should be ‘inclined to reserve all judgements. ’ Furthermore, Nick takes pride in his honesty, ‘I am one of the few honest people I have ever known. ’ This suggests that Nick gives an unbiased account of the events and a fair judgement on all the characters in the story. However, this is changed by the end of the novel as Nick judges both Tom and Daisy; he ‘objects to shaking hands’ with Tom during their brief encounter in New York, and describes the Buchanans as ‘careless people†¦smashes up things and creatures†¦let other people clean up the mess they had made’. This sheds light on Nick’s harsher perceptions of the Buchanans after Gatsby’s death, in contrast to his ‘inclinations to reserve all judgement’ in the beginning, accentuating his change of character and morality in effect of living in the East with the wealthy but shallow. In addition, Nick’s account of the story creates a stark contrast between the lifestyle in the East and the West. The West is associated with traditional, conservative values, in paradox to the urbanized, controversial and racy lifestyle in the East. As Nick attends a party in New York in Tom’s mistress’ apartment, he is ‘simultaneously enchanted and repelled by the inexhaustible variety of life’. This mirrors Nick engrossed with the glamour of the East yet ‘repelled’ by it at the same time. Nick is also seen as the dependable companion of Gatsby. In the beginning, Nick befriends Gatsby whilst attending his party, and was already treated exceptionally well by Gatsby with Nick ‘at his (Gatsby) urgent invitation, making frequent use of the beach. ’ This is revealed in Chapter 4 that Gatsby was using Nick to facilitate the rekindling romance between him and Daisy, Nick’s cousin. Despite this, Nick is a trustworthy friend of Gatsby; he serves as Gatsby’s confidant through him and Daisy’s affair, for example expressing his feelings to Nick about ‘feeling far away from her’ after he found Daisy seemingly repelled by one of his lavish parties. Though Gatsby is emotionally close with Nick, his business connections remain mysterious and unsolved. Nick’s relationship with Gatsby is enhanced by his death; he is the only one concerned and ‘finds himself on Gatsby’s side, and alone’ when he found that all Gatsby’s closest associates, including Daisy, had deserted him. ‘Just trust me and I’ll get somebody for you-‘ emphasizes Nick’s persisting strong bond with Gatsby. Nick also shows his admirable loyalty towards Gatsby by trying to reach his close partner, Wolfshielm, and many other guests in his parties to attend his funeral, ‘however it wasn’t in any use. Nobody came’ show his efforts in vain and him helpless. Nevertheless Nick and Gatsby shared a compatible friendship with Nick as a supportive companion. Nick contributes to the Great Gatsby as the moral compass. He showed his attentive attitude through ‘making an attempt to find his host’ whilst attending Gatsby’s party whereas the others merely gossiped about Gatsby, ‘I think he killed a man’. Furthermore, Nick refuses Gatsby’s offer of a dubious scheme that could earn him ‘a nice bit of money’, displaying his honest moral values in contrast to Gatsby’s shady business associations. However, Nick’s amorality heightens throughout the novel as he pursues a relationship with a woman who he states to be ‘incurably dishonest’, and enjoys her company as she is beautiful and is a golf celebrity, therefore is willing to make an excuse that ‘dishonesty in a woman is a thing you never blame deeply’. Additionally, Nick praises Catherine for lying to a judge, ‘she showed a surprising amount of character about it’, showing Nick’s morality contaminated by the dishonest, shallow values of the East. In conclusion, Nick Carraway contributes to the Great Gatsby as the narrator of the events, where he shows an impartial view of the characters. Furthermore, he is a reliable friend to Gatsby and the only concerning friend when Gatsby dies, suggesting his loyalty to him. Nick also possesses ethical moral principles, having come from the west, and was taught to ‘reserve all judgements’; however this is significantly changed by the end of the story as Nick becomes judgemental towards Tom and Daisy and shows praise for Catherine for lying to a judge about Myrtle and Tom’s affair. Nonetheless, Nick serves the role as the relatively unbiased judge of the story and a trustworthy confidant and companion of Gatsby.