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By: D. Rufus, M.S., Ph.D.
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What was learned: At the local level hypertension 99791 buy aceon 2mg lowest price, the team leadership prehypertension headaches discount aceon 8 mg with amex, the efficacy of the mentormentee duo blood pressure percentile by age purchase online aceon, the commitment of the local government blood pressure ranges in pregnancy aceon 2 mg free shipping, the partnerships with local associations are decisive in succeeding and reaching a sustainable model. Although, it is acknowledged that early detection and prompt action reduces mortality, 80% of newly diagnosed breast cancer patients delay presentation. Due to lack of awareness about cancers and late reporting of the cases, a lot of cancer patients get very little intervention and support and that explains why most cancer deaths occur in Africa, especially women in rural areas. Aim: To maximize personal and community wellness through community participation, excellence in public health education, empowering people to save lives and to end late-stage presentation of breast cancer in Ghana. Strategy/Tactics: To enhance early detection and reduce late-stage presentation of breast cancer in Ghana by disintegrating the myths and misconception about breast cancer. The involvement of breast cancer survivors to share their testimonies on various platforms to demystify breast cancer as an incurable disease and the misconceptions of it being from ancestral curses. Okorafor8 University of Nigeria - Teaching Hospital, Radiation Medicine, Enugu, Nigeria; University of Nigeria Enugu Campus, Radiation Medicine, Enugu, Nigeria; 3Public Health Research Unit, Lumenplus Consulting, Ibadan, Nigeria; 4Lakeshore Cancer Center, Lagos, Nigeria; 5 University of Nigeria Teaching Hospital, Enugu, Nigeria; 6University of Nigeria Enugu Campus, Chemical Pathology, Enugu, Nigeria; 7University of Nigeria Enugu Campus, Pain and Palliative, Enugu, Nigeria; 8University of Nigeria - Teaching Hospital, Cancer Registry, Enugu, Nigeria Background and context: Nigeria presently grapples with a high burden of all forms of cancers with breast cancer being the most common and most lethal with estimated 27,304 new cases and 13,960 deaths annually. Poor knowledge of breast cancer and the wrong perception about its treatment is pervasive among many Nigerian women particularly those in rural communities leading to late presentation and poor treatment outcomes. The consortium provides education and supports to breast cancer patients, training support to community health workers for early detection and prompt referral, carry out community outreach and education in both urban and rural communities, free cancer screening services to communities, as well as creating and supporting systems that effectively links cancer patients from the community level to the treatment centers. Aim: To implement a training program aimed at improving community health workers knowledge of and attitude toward breast cancer in selected rural communities in eastern Nigeria. Strategy/Tactics: A cross-sectional study design was used to select total of 521 health workers drawn across the 7 randomly selected local government areas in Enugu state, southeastern Nigeria. What was learned: Community health worker still need more sustained training as they operate at the grass root of health care system. Every little assistance will be translated to reduced cancer morbidity and a lot of lives being saved through early detection. Tran Bright Future Fund, Hanoi, Viet Nam Background and context: In the world, breast cancer is the second most common type of cancer, with. In Vietnam, according to the cancer registry, there are 12,533 new cases of cancer in 2012 and estimated at 22,612 in 2020. Current screening programs in Vietnam are mainly organized in an active way by health workers, not by the "initiative" of the women. Aim: Community awareness raising on prevention and early detection of breast cancer; breast cancer screening for 10,000 Vietnamese women, especially for high-risk women, disadvantaged women, less chance for periodic health examination; mobilize the commitment of businesses to provide screening for womenґs cancer in the regular health check-ups for female employees; make it become lifestyle of women to get screened every year. Strategy/Tactics: Invited women over 40 years old to free breast cancer screening at cancer clinics/hospital in the north, central and south of Vietnam. Suspected women were provided mammography; in addition, ~20 companies/businesses were aware the program and invited to join the screening. Program/Policy process: We have registered counters in hospitals that offer screening. In addition, we have a Web site and a hotline for the reception of screening candidates. We have volunteers who were texting to remind women who have been involved in screening from previous years to continue screening this year. To facilitate the screening of women without affecting their daily work as well as those who are far away, free screening was offered on Saturday and Sunday of 4 consecutive weeks. We also went to businesses where the majority of workers are women to organize screening. We have invited cancer specialists, celebrities and patients with breast cancer who have been cured of the disease to talk about the prevention of breast cancer. Outcomes: 10,095 women came for breast screening, with 1126 mammographies, including 50 suspected cases and 11 cases of cancer. What was learned: After 3 years, our project for screening detection of breast cancer was examination for 32,136 Vietnamese woman; mammography for 2851 woman; detected 130 suspected cases of cancer and 25 cases identified cancer. In cases of suspicion, we have followed up and reminded them to regularly visit and immediately go to hospital if there are abnormal signs. Wiafe Addai1,2 Breast Care International, Kumasi, Ghana; 2Peace and Love Hospital, Kumasi, Ghana Background and context: Breast cancer is rapidly becoming a growing public health problem in sub-Saharan Africa and has the highest mortality among women. Research has demonstrated that African women are diagnosed with breast cancer 10 to 15 years earlier than their counterparts in higher-income countries. Breast cancer accounts for 15% of all malignancies in Ghana and it is estimated that majority of the cases are premenopausal and still in the work forces. Evidence has also shown that women who develop breast cancer at younger ages had more aggressive tumors, higher rate of metastasis, higher clinical stages and lower rate of hormone receptor expression (estrogen receptor and progesterone receptor) than older women.
Seroepidemiological studies have since shown that the virus is a ubiquitous agent; seropositivity increases with age in all communities studied blood pressure chart nih 4 mg aceon visa, so that over 90% of adults worldwide are seropositive pulse pressure ecg order discount aceon on line. These include lymphoproliferative lesions and lymphoma which develop in immunocompromised individuals (Crawford et al arrhythmia specialist purchase aceon paypal. The envelope is essential for infectivity hypertension nursing intervention purchase aceon online from canada, and the sensitivity of the virus to ether and other lipid solvents results from its destruction. The central nucleic acid of the virion is surrounded by an icosahedral capsid consisting of 162 triangular capsomeres and measuring l00 nm in diameter (Figure 2D. This, in turn, is surrounded by an outer, irregularly shaped, lipid-containing envelope giving the mature particle a diameter of 150200 nm. Structurally the genome consists of alternating unique and internal tandem Figure 2D. The genome sequence shows around 70 predicted open reading frames, which are designated by a four-letter and number acronym. Although these types show no specific geographical restriction, in Western countries type 1 viruses are more commonly isolated than type 2. In vitro type 1 viruses are more efficient at immortalising B lymphocytes than type 2; however, neither type has a specific disease association. Variation within types occurs in the number of repeat sequences in each internal repeat, making it possible to define specific isolates by the size of their latent genes and/or their products. Analysis of these genes can therefore be used in epidemiological studies to monitor virus transmission within families or populations. These episomal forms can be activated to a lytic infection with the release of multiple viral progeny and cell death (Figure 2D. The protein is mainly located in the plasma membrane of infected cells, where it associates with the cytoskeleton. However, other studies indicate that the incidence of the deletion in tumours does not exceed the level found in the healthy population in a particular geographical area (Khanim et al. Antibodies to gp340/220 prevent infection by blocking attachment, and the protein has therefore been developed as a vaccine candidate. It is localised in nuclear and cytoplasmic membranes of infected cells but is not detected in the viral envelope. Here it forms a trimolecular complex with gp42 and gp25, which is also present in the viral envelope. A similar molecule found in a subpopulation of squamous epithelial cells may result in infection of these cells in the oropharyngeal cavity, although the extent and role of this infection in normal individuals is a controversial issue. The presence of virus in the sample is indicated by the outgrowth of immortalised B cells into a lymphoblastoid cell line (see below). The technique is very time-consuming and slow to give results, and is therefore not recommended for routine use. Around this time, immunoglobulin (Ig) can be detected in the cytoplasm of many infected B cells and it is subsequently secreted into the culture medium; IgM always predominates. There is therefore general concern about the safety precautions necessary for handling this type of material. In this context it must be remembered that around 90% of the adult population have been infected by the virus and will continue to carry it as a lifelong infection of B lymphocytes and to excrete infectious virus particles into saliva. Thus, a life-long balance between virus infection and immune mechanisms is established which successfully controls the infection at subclinical levels in the healthy host. Two peaks of seroconversion occur, one at 16 years and the other at 1420 years (Figure 2D. These findings are very similar to those from other countries in the Western world. In developing countries seroconversion occurs early in life, with more than 90% of children over the age of 2 years being seropositive. Most seroconversions occur subclinically, but if primary infection is delayed until adolescence or early adult life, acute infectious mononucleosis may result. Oral hairy leukoplakia and lymphoproliferative lesions occur in seropositive individuals in whom immunosuppression has allowed the cell populations naturally harbouring the virus to expand. Further associations have been described with salivary gland tumours (Raab-Traub et al. The origin and longevity of these circulating, infected B cells is much disputed; however, recent experimental evidence suggests that the virus establishes a stable, latent infection in a population of long-lived memory B cells. These cells evade immune surveillance mechanisms by expressing a very restricted number of genes; however, details of the exact gene expression have not been elucidated.
If you are prone to the self-serving bias arteria jelentese aceon 4mg otc, you will attribute this positive event to some enduring quality that you Mood believe you possess: intelligence prehypertension eyes purchase genuine aceon online, perseverance blood pressure negative feedback loop aceon 4mg free shipping, ability arrhythmia jantung order aceon 2 mg with mastercard, or some similarly positive A persistent emotion that is not attached trait. People to a stimulus; it exists in the background who are depressed rarely display the self-serving attributional bias, which is conand influences mental processes, mental contents, and behavior. Understanding Psychological Disorders: the Neuropsychosocial Approach 5 7 sistent with their negative view of themselves, their past, and their future (Mezulis et al. This bias, although present in all cultures, is less evident among members of Asian cultures than among members of Western cultures (Mezulis et al. For instance, Walter Scott and colleagues (2003) found that, among depressed individuals, those who were irritable and hostile were more likely to blame their negative life events on others, whereas those who were predominantly sad were more likely to blame themselves for such negative events. N P S Emotions, Moods, and Psychological Disorders Many psychological disorders are marked by impaired or inappropriate emotions, emotional experiences, or emotional expression. For example, excesses of mood, as occur in depression (prolonged and profound sadness) and mania (prolonged and inappropriate elation or euphoria), are part of mood disorders. Furthermore, some dissociative disorders, which involve a separation of normally integrated mental processes, include the absence of the normal emotional experiences (Hunter et al. We are all likely to feel anxious and afraid if faced with a car that seems to be out of control and barreling toward us, but most of us will not experience that same level of anxiety or fear when simply driving across a bridge, giving a presentation, seeing a spider, or getting a tetanus shot. In addition, psychological disorders may arise from or produce difficulty in regulating emotions-such as an inability to dampen down anxiety when its intensity is inappropriate. Difficulty in regulating emotions and related thoughts and behaviors can lead to three types of problems (Cicchetti & Toth, 1991; Weisz et al. They are called externalizing problems because their primary effects are on others and/ or their environment; these problems are usually observable to others. Internalizing problems are so named because their primary effect is on the troubled individual rather than on others; such problems are generally less observable to others. This "other" category includes eating disorders and learning disorders (Achenbach et al. Significant difficulty in regulating emotions can begin in childhood and last through adulthood, forming the basis for some disorders. For example, personality disorders are inflexible and maladaptive stable personality traits that lead to distress or dysfunction (Gratz et al. As we discuss in Chapter 13, several personality disorders are characterized by difficulties in emotional regulation, marked by impulsive behavior or rapid changes in emotion. Problems in regulating emotion can also occur in some forms of eating disorders and substance-related disorders (Sim & Zeman, 2005; Thorberg & Lyvers, 2006). Brain Bases of Emotion Emotion is a psychological response, but it is also a neurological response. We can learn much about the psychological aspects of emotion by considering how it arises from brain function. The ease of treating an emotional problem may be related to the nature of the underlying mechanism that gives rise to the experience of that emotion. Approach emotions are positive emotions, such as love and happiness, and tend to activate the left frontal lobe more than the right. Withdrawal emotions are negative emotions, such as fear and sadness, and tend to activate the right frontal lobe more than the left (Davidson, 1992a, 1992b, 1993, 1998, 2002; Davidson et al. Researchers have also found that people who generally have more activation in the left frontal lobe tend to be more optimistic than people who generally have more activation in the right. This is important because depression has been associated with relatively less activity in the left frontal lobe (Davidson, 1993, 1994a, 1998; Davidson et al. As a result of genetics, learning, or (most likely) some combination of the two, some people are temperamentally more likely to experience positive (approach) emotions, whereas others are more likely to experience negative (withdrawal) emotions (Fox et al. Joseph LeDoux (1996) has further suggested that different brain systems contribute to different emotions. This is important for psychopathology and its treatment because some of these systems lie outside of awareness and are not easy to control voluntarily. In contrast, other brain systems rely on conscious interpretation of stimuli or events, and hence might be more easily targeted during psychotherapy.
He finally found a group of 15 blots that seemed to do the job and could be administered in a single session arrhythmia update 2010 discount 8 mg aceon with visa. Rorschach never had the opportunity to learn how popular and influential his inkblot test would become blood pressure medication joint pain proven 8 mg aceon. Sadly arrhythmia light headed buy genuine aceon on-line, 7 months after the publication of the test that bears his name artaria string quartet discount aceon 4mg with mastercard, Rorschach died at age 37 of complications from a ruptured appendix (Exner, 2002). Five of the inkblots are black and white, and the other five have color (see Figure 3. Each inkblot is printed on a separate card, which is handed to subjects in sequence. Subjects are asked to tell the examiner what the blot might be or what it reminds them of. Then, they are asked to explain what features of the blot (its color, form, or texture) they used to form their perceptions. Clinicians who use the Rorschach form interpretations based on the content and the form of the responses. For example, they may infer that people who use the entire blot in their responses show an ability to integrate events in meaningful ways. Those who focus on minor details of the blots may have obsessivecompulsive tendencies, whereas clients who respond to the negative (white) spaces may see things in their own idiosyncratic ways, suggesting underlying negativism or stubbornness. A response consistent with the form or contours of the blot is suggestive of adequate reality testing. People who see movement in the blots may be revealing intelligence and creativity. For example, adult clients who see animals but no people may have problems relating to people. Clients who appear confused about whether or not percepts of people are male or female may, according to psychodynamic theory, be in conflict over their own gender identity. Apperception is a French word that can be translated as "interpreting (new ideas or impressions) on the basis of existing ideas (cognitive structures) and past experience. Respondents are asked to describe what is happening in each scene, what led up to it, what the characters are thinking and feeling, and what will happen next. Psychodynamic theorists believe that people will identify with the protagonists in their stories and project underlying psychological needs and conflicts into their responses. More superficially, the stories suggest how respondents might interpret or behave in similar situations in their own lives. Evaluation of Projective Techniques the reliability and validity of projective techniques continues to be a subject of extensive research and ongoing debate. Rorschach assumed that people project aspects of their own personalities into their responses, but controversy still whirls around the question of whether the test yields scientifically valid conclusions. Although more comprehensive scoring systems have improved standardization of scoring the Rorschach, the reliability of the test continues to be debated (see Acklin et al. Even if a Rorschach response can be scored reliably, the interpretation of the response-what it means-remains an open question (Garb et al. For example, Rorschach indicators may be useful in distinguishing between different types of psychological disorders (Dao & Prevatt, 2006; Kubiszyn et al. However, other reviewers claim the Rorschach fails to meet overall tests of scientific utility or validity (Garb et al. The debate over the validity and clinical utility of the Rorschach continues to rage between supporters and detractors with no clear resolution in sight. Moreover, allowing subjects freedom of expression through projective testing reduces the tendency of individuals to offer socially desirable responses. George Stricker (2003) appraised the present standoff in the field as follows: "The field remains divided between believers and nonbelievers, and each is able to marshal considerable evidence and discount the evidence of their opponents to support their point of view" (p. The person is also asked to describe what events led up to the scene and how the story will turn out. Neuropsychological Assessment neuropsychological assessment Measurement of behavior or performance that may be indicative of underlying brain damage or defects.
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