The United States Health Care System Essay - 1958 Words

The United States health care system cumbersome and complex; however, there is opportunity to transform the health care system. By providing seamless, affordable, evidence based and patient centered care that is accessible to all, United States will improve patient and community health outcomes. Nursing is the largest sector of the healthcare field and without a doubt has an essential role in addressing the United States health care system crisis. Care within hospital and community settings has become more complex. This requires nurses to make critical decisions associated with care for sicker, frailer patients and work with sophisticated, life-saving technology. Nurses are also being called upon to fill primary care roles and to help patients manage chronic illnesses, thereby preventing acute care episodes and disease progression. â€Å"Nurses have considerable opportunity to act as full partners with other professionals to lead in the improvement and redesign of the health care s ystem and its practice environment† (Black, 2014, pp.1). The Affordable Care Act [ACA] represents the broadest changes to the health care system since the creation of the Medicare and Medicaid programs in 1965. This program is expected to provide insurance coverage for an additional 32 million previously uninsured Americans (Institute of Medication [IOM], 2014). While the passage of the ACA is historic, it will require that action oriented individuals team together to bring the vision outlined aboveShow MoreRelatedThe United States Health Care System1369 Words   |  6 Pagesplans for the United States health care system. The United States health care system has been in need of adjustment for years, with prices being paid over double per capita compared to other countries. While they have some similar views on current issues, there are drastic differences in the candidates’ ideas for change. To begin, Bernie Sanders, a Democratic candidate, believes that health care in the United States is a human right regardless of a person’s income. Universal health care is a foundationRead MoreThe United States Health Care System1449 Words   |  6 PagesThe United States health care system is the most expensive in the world. It spends more than 16% of its gross domestic product (GDP) on health care, (the highest per person in the world), but ranks behind most countries on many measures of health outcomes, quality, and efficiency. In 2012, over 47 million people were un-insured and millions were under-insured⠁ ´. The cost of health care is rising at least twice as fast as the rate of economic growth. Major companies are passing more of the cost ofRead MoreThe United States Health Care System Essay1905 Words   |  8 PagesThe United States health care system is lacking the needs to create a reliable system to achieve quality, access, cost, and educate for the consumers. Despite the efforts of the government to find a common ground to meet the standard for the societies, the system has yet to have a major improvement. These issues must be reexamined to fix the broken system. The United States health care expenditure is another issue that needs to be addressed to achieve the future goals of the healthcare system in theRead MoreThe Quality Of Care Of The United States Health Care System2125 Words   |  9 PagesThe quality of care In the United States Health Care System, unlike a lot of people’s perceptions, is not the best in the world. In fact, Rose Ann DeMoro, the Executive Director of National Nurses United, Which happens to be the nation’s largest professional association and union for registered nurses, wrote in â€Å"How US Private Insurance Healthcare is Failing,† â€Å"A study published [in June 2011] from the university of Washington in collaboration with researchers at Imperial College London found lifeRead MoreThe H ealth Care System Of The United States As A Whole Essay1369 Words   |  6 Pagesthe health care system in the United States as a whole. Within this article, the subjects of health care that are reviewed are a) the US government’s position as the insurer for roughly 60 percent of the healthcare spending in the US via the public sector, b) the analysis of the funding for government health care programs such as Medicare, Medicall, and Medicaid and c) the programs in place for the health care of children and program administration for war veterans. The author discusses health careRead MoreUnited States Health Care System Essay3779 Words   |  16 Pages17 Nov 2006 US Health Care System: Does the Public Get the Best Return vs. Investment The United States spends more of the Gross Domestic Product (GDP) on healthcare then any other industrialized country in the world and because of this one would think that the U.S. provides one of the top universal healthcare plans for all citizens without health insurance. Furthermore, the U.S.’s overall health system performance is 37 out of 191 (qtd in U.S. Census Bureau), obviously 37 out of 191 is horribleRead MoreComparing The Canadian And The United States Health Care System1151 Words   |  5 Pagesthe United States health care system. the first part of the paper will focus on describing each country health care system. The second part will focus on analyzing, evaluating and comparing these two countries system efficiency and benefits. The last part, is an overview of the recent policies changes and its effect (positive and negative) on each country citizens and proposed future reforms for better coverage in these countries. Canada health system Canada provides a national universal care thatRead MoreSafety Net Hospitals And The United States Health Care System903 Words   |  4 Pageshospitals have played an important role in the United States health care system. They provide a significant amount of care to low-income, uninsured, and vulnerable populations. While treating these types of populations, they are still able to provide high cost services such as trauma and burn care. They often take on additional roles and responsibilities such as the training of medical and nursing students (Coughlin et al., 2014). These hospital systems are well known for their open door policy (WynnRead MoreComparing The United States Health Care System With The Federal Republic Of Germany2322 Words   |  10 PagesTHE UNITED STATES HEALTH CARE SYSTEM WITH THE FEDERAL REPUBLIC OF GERMANY During the past few decades in the United States, health care cost has been skyrocketing, and many people have lost their insurance as result of the high cost. Approximately 45 million American s are uninsured or they don’t have a real health care plan that can cover all their needs. Some Americans have the perception that even with coverage, cost and other problems in the system, the quality of the Healthcare System in theRead MoreThe Health Care System Of The United States857 Words   |  4 Pages 1.) Briefly describe the US Health Care system. Identify the people, professionals and organizations that have something to say about how health care is delivered -- and paid for -- in the US. The Health Care System in the United States is provided by many organizations. The Healthcare facilities are largely owned by private sector businesses. A large part of community hospitals are non-profit and government owned, and only a small percent is for profit. The non-profit hospitals include 60 to

Causes and Stages of Cancer Free Essays

Introduction The World Heath Organisation (2011) estimates that without intervention 84 million people will die from cancer between 2005 and 2015. In 2008 156,723 people died in the UK alone of malignant neoplasm and 1 in 3 people will be diagnosed with the disease in their lifetime. There were 12. We will write a custom essay sample on Causes and Stages of Cancer or any similar topic only for you Order Now 7 million new cases diagnosed worldwide in the same year which led to 7.6 million deaths. (Cancer Research UK, 2011). There are over 200 different types of cancer but lung, breast, prostate and colorectal account for over 50% of cancer cases. The percentage of deaths caused by cancer varies by region with 4% in Africa, 12% in Asia, 19% in Europe, 21% in Oceania and 23% in North America (National Cancer Institute, 2010). Cancer is used to define the group of diseases in which extensive cellular proliferation occurs alongside the invasion of surrounding tissues. Cancer cells can spread through the body via the blood and lymph systems and ultimately cause death of multi-cellular organisms (National Cancer Institute, 2010). Cancer is caused by the accumulation of genetic mutations which leads to instability of genetic regulators and alters gene expression. Cancer represents not a single disease but a group of heterogeneous diseases that share the fundamental biological characteristics of immortalisation, invasion, genetic instability, erratic differentiation and uncontrolled proliferation (Vogelstein and Kinzler, 2008). Despite advances in detection and treatment of metastatic cancer, specifically breast, mortality rates still remain high because current therapies are limited by the emergence of therapy resistant cancer cells (Al-Hajj, et al, 2003). It has been documented that tumorous cells possess key stem cell characteristics such as high migration, self-renewal, drug resistance and extensive differentiation which leads to the production of a heterogeneous population. Tissue specific cells are able to self-renew and produce differentiated and functional cells within an organ. These differentiated cells are short lived and are produced from a small pool of long lived stem cells which lasts throughout the organism’s lifetime (Seo, 2007). Stem cells are essential for tissue development, replacement and repair however their longevity means they are susceptible to the accumulation of genetic damage and thereby providing a growth route for cancer recurrence following treatment (Clarke, 2005). Dean, Fojo and Bates (2005) suggest that cancer stem cells can survive chemotherapy and sustain the re-growth of a malignant tumour. Therefore if cancer stem cells are present in a tumour then they must be targeted in order to achieve a cure. Prospectively identifying cancer stem cells will allow investigation of the pathways and key molecules that can be targeted to eliminate these malignant cells (Clarke Fuller, 2006). There have been many studies which imply the existence of a sub-population of cells within tumours termed cancer stem cells which drive tumourgenesis. This paper therefore aims to isolate and characterise different sub-populations of cancer stem cells through physiological stress in human and murine models (DLD-1 and CT-26 respectively). There has been extensive evidence that CD133 and CD44 are reliable cancer stem cell markers therefore it can be hypothesised that CD133 and CD44 positive cells would demonstrate resistance to chemotherapeutic agents. This statement formed the basis of the protocol developed by Sharma (2010) where the novel technique of exposing parental cancer cells to the chemotherapy drug doxorubicin in-vitro to isolate cells resistant to drug exposure. The resulting cells will them be characterised by their ability to form spheroids and the performance of Q-PCR, immunofluorescence and western blotting to identify the presence of the CD133, CD44 and CD26 specific cancer stem cell markers. The ultimate aim is then perform microarray on parental and cancer stem cell populations to compare the difference in gene expression of the two populations. Literature Review On a cellular level cancer is caused by uncontrolled cell proliferation which enables abnormal growth leading to cancerous tumours. Just 5-10% of cancer cases can be attributed to genetic defects whereas the remaining cases (in order of influence) are a result of environmental factors such as diet, tobacco, infections, obesity, alcohol, radiation, stress and physical activity (Anand, et al, 2008). These factors lead to tumour growth as they induce DNA alterations or loss of the ability to repair DNA damage which deregulates standard gene expression (Vogelstein and Kinzler, 1998). Carcinogenesis is the term used to define the creation of cancer by which normal cells are transformed into cancer cells. This is due to the accumulation of genetic mutations and the resultant misbalance in cell death and proliferation (King Robins, 2006). Cell production is a complicated process which is kept in apoptosis via cell regulation by numerous classes of genes including oncogenes and tumour suppressor genes (Vogelstein and Kinzler, 1998). Carcinogenesis occurs when there is a genetic mutation which upsets the normal balance between cell death and proliferation. The multi-step process is driven by the accumulation of genetic alterations which gives rise to highly malignant derivatives which have the ability to elude apoptosis, invade tissues and possess unlimited potential for replication (Hanahan and Weinberg, 2000). The inheritance of a defective gene itself is not sufficient for development of cancer. Cancer manifests from the accumulation of additional somatic mutation s which occur as a result of imperfect DNA replication or DNA damage caused by environmental mutagens. Genes that, when mutated, lead to cancer predisposition normally have the function of suppressing tumourgeneis. If one allele of such gene mutates in the germ line then the cell still has the product of the wild type as a back up. If a mutation occurs in the wild type then the cell has no functional suppressor gene product remaining. The cell therefore proliferates abnormally leading to clonal expansion. Cells of proliferating clones are likely to accumulate another mutation resulting in further loss of growth control. As gradual clonal expansion takes place a tumour evolves. Oncogenes and cell suppressor cells control cell proliferation, a mutation here leads to the cells to become continually active. Caretaker genes control rates of mutation, defective caretakers therefore acquire mutations (Vogelstein and Kinzler, 1998). The three stages of carcinogenesis are promotion, proliferation and progression. Changes in the genomes structure occur across all three of the stages of neoplasm development. Additionally changes in gene expression take place at cell promotion with selective proliferation of mutation cells. Apoptosis and cell proliferation occur at different rates but still maintain a balance during initiation and promotion but during progression the balance alters and a malignancy arises as seen in figure 1 (Oliveira, 2007). The fundamental progression features of malignancies are invasion and metastasis and it is these traits which distinguish between normal and cancerous cells. Metastasis is characterised as the migration of cancer cells from the site of origin to a secondary point through the lymphatic system, connective tissues and blood supply. At this secondary point the cells then continue to invade and form new tumours (Hanahan, 2000). Cancer immunoediting has been described as the conflicting action of the immune system to protect the host from cancer development through immunosurveillance and promote tumour growth by the promoting action of immunity (Smyth, Gunn and Schreiber, 2006). The interaction of the innate and adaptive anti-cancer immunity dictates the intensity of the outcome of the endogenous anti-cancer response. Stress induced molecules on tumour cells initiates the innate response and presentation and processing of tumour associates antigens leads to an adaptive response. Both of these responses can affect the tumour in different ways. The endogenous reaction could suppress tumour formation whilst at the same time exerting a selection pressure leading to the emergence of escape variants. Additionally the host’s immune response could directly promote tumour growth, invasion and metastasis via elaboration of inflammatory mediators and cytokines. There is a complex network of interactions between tumour cells, immune elements and stromal components in the microenvironment (Jinushi and Dranoff, 2007). However currently only the capability of the immune system to identify and kill cancer cells forms the basis of therapeutic strategies and immunotherapy (Schulz, 2005). Modifications in immunotherapy protocols have been proposed to lessen the effect cancer and improve the therapeutic value of immunological approaches by targeting the elimination of cancer stem cells (Lepisto, McKolanis Finn, 2007). Stem cells originate from the haematopoietic tissue and can be characterised by the unlimited capacity to self renew, which is the result of increases telomere activity (Huntly Gilliand, 2005) and the ability to terminally differentiate into one or more cell types, which is regulated by a niche signalling pathway system (Spradling, Drummond-Barbosa Kai, 2001). The capacity of stem cells to form differentiated offspring is described in terms of their differentiation potential (Friel, Van der Sar Mee, 2005). Totipotent cells have the ability to construct a complete organism, pluripotent cells are descendants of totipotent cells and can differentiate into almost all cells, multipotent cells differentiate into a specific family of cells, oligopotent cells differentiate into lymphoid and myeloid cells and omnipotent cells are only able to produce their own cell type but have the ability of self renewal which distinguishes them from other non-stem cells (Knoepffler, Schipanski Sorgner, 2007). The differentiation of stem cells is regulated by a niche signalling pathway system (Spradling et al, 2001). It has been suggested that cancer stem cells are displaced due to lack of heritable changes in phenotype and genetic alteration leading to an absence in cancer however when stem cells were placed in defective tissue they induced tumour growth (Clarke Fuller, 2006). Charafe-Jauffret, Monville and Ginester (2008) clarify the existence of cancer stem cells which possess tumorgenic, self-renewal and multi-lineage differentiation abilities. Cancer stem cells are defined as a sub-population of cells in a tumour capable of generating phenotypically assorted cells (Gao, 2007). This petite population is accountable for the relapse of tumour growth, progress and invasion after treatment (Clarke Fuller, 2008). Although the concept that germ cells are responsible for oncogenesis has existed since 1855 the first conclusive evidence of cancer stem cell existence was that by Bonnet and Dick (1997) who isolated a CD34+/CD38– sub-population of leukemic cells which were capable of initiating tumours in NOD/SCID mice histologically similar to the donor. The cancer stem cell hypothesis states that the cancer initiating cell is a transformed tissue stem cell which retains the property of self protection through the activity of multiple drug resistant transporters. This drug resistant cell then remains at a low frequency amongst a tumour mass (Donndenberg Donndenberg, 2005). The cancer stem cell theory points to a new era of ca ncer research and is expected to yield alternative cancer treatments. It is now evident that tumours include cancer stem cells which can be isolated by antigenic markers and have the potential to develop into non-adherent spheroids (Wright et al, 2008). This concept has challenged the previous hypothesis that carcinogenesis is a result of ‘clonal evolution’ where every cell present in a tumour is capable of proliferating and forming new tumours (Max et al, 2006). Cancer stem cells have similar properties to stem cells such as similar molecular mechanisms and physiological trafficking which implies that cancer stem cells are a result of consecutive accumulated mutations in embryonic stem cells (Kucia Ratajckzak, 2006). This is supported by the correlation seen in the signalling pathways associated with maintenance of ‘stemness’ in embryonic cells and cancer pathways. These pathways such as JAK/STAT, Notch, MAPK/ERK, P13k/AKT, NF-GB and Wnt are not only inv olved in stem cell renewal governing proliferation but also express key molecules associated with malignant phenotypes which leads to tumour growth (Dreesen Brivanlou, 2007). It has therefore been deduced that normal stem cells are transformed into cancer stem cells via mutations in suppressor genes and oncogenses and mutations in repair genes and histone modifications (Costa, et al, 2006). Embryonic stem cells are dependent on the specialised microenvironment in which they reside. This niche prevents tumorgenesis by supplying signals to inhibit differentiation and proliferation. Additional signals are also provided to allow stem cell promotion, self-renewal or differentiation when necessary (Scadden, 2006). Stem cells are dependent on this niche for survival alternatively cancer stem cells do not appear to be dependant on this niche in the same way. Some believe that cancer stem cells have evolved to escape the control of a local environment whereas an additional theory suggests the cells do reside in a niche which has undergone changes itself which encourages cell growth (Burness Sipkins, 2010). Cancer stem cells are thought to evolve from an intrinsic mutation leading to self-sufficient proliferation and deregulation as the cancer cell overtakes the molecular machinery used by normal stem cells (Li Neaves, 2006). These tumour initiating cells are the source of recu rring tumours in many types of cancer (Foltz et al, 2009). Cancer stem cells make up less than 5% of a tumour and have been found in blood-borne, brain, breast, ovarian and colon cancers (National Cancer Institute, 2010). These cells are highly resistant to both chemotherapy and radiotherapy and in order to develop successful therapy it is essential to identify the cell surface markers unique to cancer stem cells and interpret their signalling pathways, figure 2 (Foltz et al, 2009). Figure 2: The impact of cancer stem cells on tumour growth and response therapy. A: Subset of cells within the tumour has the ability to replicate and sustain tumour growth. TA cell is suspected to be responsible for a majority of tumour growth and is susceptible to cancer therapy. Cancer stem cells give rise to identical immortal daughter cells. B: Possible outcome of targeting tumour cancer stem cells verses present cancer therapy techniques which do not affect cancer stem cells (Houghton et al, 2007). The developmental concept of cancer denotes the presence of a hierarchy of cells within a tumour which refers to the differences of cancer cells within a tumour where all cells do not express the same antigens. Additionally functional assays show that only a specific sub-population of cells within a tumour can propagate tumour growth. It appears that cancer cells capable of tumour growth are able to self-renew as well as generate cells which cannot propagate tumour growth (Cho Clarke, 2008). Cancer stem cells have therefore developed the ability for self-renewal and differentiation into a heterongenous population as well as the tumour related properties of uncontrolled growth and ability to form metastasis (Dalerba, et al, 2007). The ability that cancer stem cells share with stem cells to renew has changed perspectives leading to new approaches to treating the disease (Li and Neaves, 2006). Cancer stem cells show resistance to both chemotherapy and radiotherapy making them a crucial target for treatment, it is therefore essential to identify the markers present on these cells in order to therapeutically target them (Foltz, et al, 2009). Current therapeutic strategies attempt to target cancer stem cells and its microenvironment whereas Tang, Ang Pervaiz (2007) identified a novel approach of targeting the reactive oxygen species in a cancer stem cell which would facilitate apoptotic death over proliferation. Additionally the development of monoclonal antibodies to recognise cancer stem cell markers would allow for more efficient destruction of these tumour forming cells (Okamoto Perez, 2008). The use of immunocompromised mouse model have shown to reliably capulate the molecular, biological and clinical features of the human disease. With such models defining the stages of tumour development, homogenised breeding and environmental conditions. This has therefore led to the development of the concept that plasma from genetically modified cancer models contains tumour derived proteins that may be relevant in the development of markers for human cancer (Kuick, et al, 2007). There are numerous studies which cites the use of immuno-comprised mice as vehicles for cancer stem cell isolation. Mouse models have been established as highly trusted in the development of human cancer treatment through verify the cancer stem cell extent of a tumour. This has been achieved by the opening and repetitive tumour progression in immuno-compromised SCID mice (Laurie, et al, 2007). http://tpx.sagepub.com/content/38/1/62.full.pdf+html Current developed methods to isolate ‘adult’ stem cell populations includes collection of different hematopoietic cells populations staining with the antibodies of interest and sorting by magnetic bead and/or fluorescence activated cell sorters (FACS) followed by in vivo transplant experiments. This allows for the development of understanding of fundamental hematopoietic stem cell characteristics of differentiation and the ability of the cells to give rise to others cells with the same potential for proliferation whilst still maintaining the stem cell pool Cho Clarke, 2008). Additional characterisation of cancer stem cells can be carried out by identifying gene expression and cell markers via immunofluorescence, western blotting and Q-PCR. It has been stated that an immature cell population can be characterised by surface markers CD34+ and CD38+ in AML and that these markers suggest the ability of initiating tumour development (Bonnet Dick 1997). Furthermore the use of a low-adherent growth environment can be used to produce spheroids from tumorgenic cells as a basis of isolation of cancer stem cells (Grange, et al, 2008) As it has been identified that a small minority of cells present in a tumour has the ability to form new tumours. It is therefore possible to distinguish between tumorgenic and non-tumorgenic cells based on the cell surface marker expression. Al-Hajj, et al (2003) were able to isolate breast cancer cells expressing CD44+ and CD24– lineage in as few as 100 cells with tumorgenic capabilities and identified hundreds of thousands of cells with a different phenotype which failed to form new tumours. Furthermore passaging the CD44+ and CD24– lineage led to the creation of phenotypically diverse populations. Sherman, et al (2011) also identified CD133 expression correlated with prognosis of oligodendroglial and astrocytic tumors and here immunofluorescence provided an effective and reproducible assay for identifying marke rs present in cancer stem cells. Fundamentally cancer is resistant to treatment because malignant cells survive chemotherapy, CD133 positive cancer stem cells display strong compatibility with tumours resistant to chemotherapy (Liu, et al, 2006). The use of immunofluorescence to characterise cancer stem cells has been used in a great deal of cases especially where total cell count is reduced CD44+ and CD24+ can be used for markers of colorectal cancer stem cells. CD44/CD24 cells are enriched for spheroid colonies and can reform all four CD44/CD24 subpopulations (Yeung, Wilding Bodmer, 2009). Additionally a population of CD26+ cells present in a sub-population of colorectal cancer stem cells led to the development of distant metastasis when injected into a mouse cecal wall. These CD26+ cells were also associated with enhanced invasiveness and chemoresistance (Pang, et al, 2010). Lgr-5 has also been identified as a key marker expressed in cancer stem cells of colorectal cancer associated with the activation of the Wnt signalling pathway which plays a key role in cancer development (Takahashi, et al, 2010). The first report indicating the difference in gene expression of cancer cells exhibiting cancer stem cell properties and those which did not was published in 2007 by Seo, et al. Amongst the 61 differently expressed genes 12 genes were considered up-regulated in the sub-population whereas 49 were downgraded validation of these gene expressions was validated using quantitative real time reverse transcriptase PCR. It was found that genes related to drug resistance such as AKR1C1/C2 and NR0B1, or cancer metastasis (TM4SF1) were up-regulated. Further more the up-regulated gene ABCG2 could be of use as an indicator for sorting. AKR1C has been identified as a catalyst of metabolic reduction and either activates or inactivates several xenobiotics. The public database (Gene expression Omnibus) has shown significant up-regulation in expression of AKR1C1 in smokers. Reference AL-HAJJ, M., et al. 2003. Prospective identification of tumorgenic breast cancer cells. Proceedings of the National Academy of Science USA, 100(7), pp. 3983-3988. ANAND, P., et al. 2008. Cancer is a preventable disease that requires major lifestyle changes. Pharmaceutical Research, 25(9), pp. 2097-2116. BONNET, D. DICK, J. 1997. Human acute myeloid leukaemia is organized as a hierarchy that originates from a primitive hematopoietic cell. Nature Medicine, 3(7), pp. 730-737. BURNESS, M. SIPKINS, D. 2010. The stem cell niche in health and malignancy. Seminars in Cancer Biology, 20(2), pp. 107-115. CHO, R. CLARKE, M. 2008. Recent advances in cancer stem cells. Current Opinions in Genetics Development, 18(1), pp. 48-53. CLARKE, M. FULLER, M. 2006. Stem cells and cancer: two faces of evil. Cell, 124(6), pp. 1111-1115. CLARKE, R. 2005. Isolation and characterization of human mammary stem cells. Cell Proliferation, 38(6), pp. 375-386. COSTA, F., LE BLANC, K. BRODIN, B. 2006. Cancer/testis antigens, stem cells and cancer. Stem Cells, 25(3), pp. 707-711. DALEBRA, P., et al. 2007. Phenotypic characterization of human colorectal cancer stem cells. Proceedings of the National Academy of Science, USA, 104(24), pp. 10158-10163. DREESEN, O. BRIVANLOU, A. 2007. Signalling pathways in cancer and embryonic stem cells. Stem Cell Reviews, 3(1), pp. 7-17. FRIEAL, R., VAN DER SAR, S. MEE, P. Embryonic stem cells: understanding their history, cell biology and signalling. Advanced Drug Delivery Reviews, 57(13), pp. 1894-1903. GAO, J. 2008. Cancer stem cells: the lessons learnt from pre-cancerous stem cells. Journal of Cellular and Molecular Medicine, 12(1), pp. 67-96. GRANGE, C., et al. 2008. Sca-1 indentifies the tumor-initiating cells in mammary tumors of BALB-neuT transgenic mice. Neoplasia, 10(12), pp. 1433-1443. HANAHAN, D. 2000. The hallmarks of cancer. Cell, 100(1), pp. 57-70. HANAHAN, D. WEINBERG, R. 2000. The hallmarks of cancer. Cell, 100, pp. 57-70. HOUGHTON, J., et al. 2007. Stem cells and cancer. Seminars in Cancer Biology, 17, pp. 191-203. HUNTLY, B. GILLIAND, G. 2005. Leukaemia stem cells and the evolution of cancer stem cell research. Nature Reviews Cancer, 5(4), pp. 311-321. JINUSHI, M. DRANOFF, G. 2007. Immunosurveillance: innate and adaptive antitumor immunity. Cancer Immunotherapy: Immune Suppression and Tumor Growth, pp. 29-41 KING, R. ROBINS, M. 2006. Cancer Biology. 3rd Edition. Essex: Pearson Education Limited. KNOEPFFLER, N., SCHIPANSKI, D. SORGNER, S. 2007. Human biotechnology as social challenge: an interdisciplinary introduction to bioethics. England: Ashgate Publishing Ltd. KUCIA, M. RATAJCZJAK, M. 2006. Stem cells as a two edged sword-from regeneration to tumour formation. Journal of Physiology and Pharmacology, 57(7), pp. 5-16. KUICK, R., et al. 2007. Discovery of cancer biomarkers through the use of mouse models. Cancer Letters, 249(1), pp. 40-48. LEPISTO, A., MCKOLANIS, J. FINN, O. 2007. Cancer immunotherapy: challenges and opportunities. Cancer Immunotherapy: Immune Suppression and Tumor Growth, pp. 167-181. LI, L. NEAVES, W. 2006. Normal stem cells and cancer stem cells: the niche matters. Cancer Research, 66(9), pp. 4553-4557. LUI, G., et al. 2006. Analysis of gene expression and chemoresistance of CD133+ cancer stem cells in glioblastoma. Molecular Cancer, 5(1), pp. 67-79. MAX, L., et al. 2006. Electrocervical potentials: are they pathognomonic of cancerCancer, 6(1), pp. 77-79. NATIONAL CANCER INSTITUTE, 2011. What is cancer[online]. US National Institute of Health. Available at: http://www.cancer.gov/cancertopics/cancerlibrary/what-is-cancer [Accessed on 7th February 2011]. OKAMOTO, O. PEREZ, J. 2008. Targeting cancer stem cells with monoclonal antibodies: a new perspective in cancer therapy and diagnosis. Expert Review of Molecular Diagnostics, 8(4), pp. 387-393. OLIVEIRA, P., et al. 2007. Chemical carcinogenesis. Anais da Academia Brasileira de Ciencias, 79(4). PANG, R., et al. 2010. A Subpopulation of CD26+ Cancer Stem Cellshttp://www.sciencedirect.com/science?_ob=ArticleURL_udi=B8G3V-5075DHJ-R_user=2471587_coverDate=06%2F04%2F2010_alid=1706053035_rdoc=4_fmt=high_orig=search_origin=search_zone=rslt_list_item_cdi=41804_st=13_docanchor=view=c_ct=4194_acct=C000057461_version=1_urlVersion=0_userid=2471587md5=c4c6cd7408c3db836492bfe7e2665c5esearchtype=a – hit2 with Metastatic Capacity in Human Colorectal Cancer. Cell Stem Cell, 6(6), pp. 603-615. SCADDEN, D. 2006. The stem-cell niche as an entity of action. Nature, 441 (7097), pp. 1075-1079. SCHULZ, W., 2005, Molecular biology of human cancers: an advanced student’s textbook. The Netherlands: Springer. SEO, D., et al. 2007. Gene expression profiling of cancer stem cells in human lung adenocarcinoma A549 cells. SHARMA, M. 2010. Cancer stem cell isolation and characterisation in murine models. MRes thesis, Nottingham Trent University. SPRADLING, A., DRUMMOND-BARBOSA, D. KAI, T. 2001. Stem cells find their niche. Nature, 414(6859), pp. 98-104. TAKAHASHI, H., et al. 2010. Significance of Lgr5(+ve) cancer stem cells in the colon and rectum. Annals of Surgical Oncology, 18(4), pp. 1166-1174. TANG, C., ANG, B. PERVAIZ, S. 2007. Cancer stem cell: target for anti-cancer therapy, The FASEB Journal, 21(14), pp. 3777-3784. VOGELSTEIN, B. KINZLER, K. 1998. The genetic basis of human cancer. 2nd Ed. New York: McGraw-Hill. WORLD HEALTH ORGANISATION, 2011. World cancer day [online]. World Health Organisation. Available at: http://www.who.int/mediacentre/events/annual/world_cancer_day/en/ [Accessed on 7th February 2011]. WRIGHT, M., et al. 2008. Brca1 breast tumours contain distinct CD44+/CD24- and CD133+ cells with cancer stem cell characteristics. Breast Cancer Research, 10(2), p. 105. YEUNG, T., WILDING, J. BODMER, W. 2009. Colorectal cancer stem cells: characterization and functional analysis. Journal of Clinical Oncology, 27(15). P. 4124. KUICK, R., et al. 2007. Discovery of cancer biomarkers through the use of mouse models. Cancer Letters, 249(1), pp. 40-48. How to cite Causes and Stages of Cancer, Essay examples

Romantic Poetry Analysis free essay sample

These two themes go hand in hand when interpreting romantic poetry, with the development of the hectic industrial cities many poets longed for the simplicity that nature had to offer. Poems such as Wordsworth’s â€Å"Resolution and Independence†, Coleridge’s â€Å"The Dungeon† and Shelley’s â€Å"To Night† embody the themes of nature and reminiscence. William Wordsworth is said to be one of the most influential poets of the Romantic Era. Wordsworth’s religion of nature was influenced by his childhood, growing up in the Lake District of northwestern England and through his travels to foreign countries. Resolution and Independence† was written in 1802, roughly four years into the Romantic Period. The poem is about a man walking through the countryside after a night of rain, he reflects on the livelihood of the creatures that surround him and initially share their joy until his mind wanders to the dejection he feels for what man has become. He comes across an old man, who he envies because his job is to collect leeches for medical purposes. The traveller envies the old man because he gets to work in nature. The theme of nature is prevails in this poem as well as the theme of nostalgia. Wordsworth writes â€Å"The birds are singing in the distant woods; over his own sweet voice the Stock-dove broods; the Jay makes answer as the Magpie chatters; and all the air is filled with pleasant noise of waters. † Wordsworth describes the sounds of nature that the traveler hears, clearly showing his appreciation of nature when he describes the birds singing as â€Å"pleasant noise†. As the poem continues the traveler demeanor embodies the same joy that the creatures of nature are feeling, yet his jubilation diminishes when he reflects on what man has become. â€Å"The pleasant season did my heart employ: my old remembrances went from me wholly; and all the ways of men, so vain and melancholy. † The traveler is displeasured with what man has become, describing him as â€Å"vain and melancholy†, such displeasure can be interpreted as the theme of nostalgia. William Wordsworth’s â€Å"Resolution and Independence† embodies the dominating themes of nostalgia and nature in romanticism. Samuel Taylor Coleridge is better known for his influence on literary criticism rather than his poetry. Between 1797 and 1803 Coleridge’s best poetry is said to be produced. â€Å"The Dungeon† was written in 1797 and is about a dungeon in which criminals are forced to reside in. The first verse of â€Å"The Dungeon† is dreary and very critical of using dungeons to punish criminals. The emphasis on industrialized cities and the insignificance of rural areas and the upset it causes romantic poets can be seen in this poem. â€Å"Is this the only cure? Merciful God! Each pore and natural outlet shrivell’d up by Ignorance and parching Poverty, his energies roll back upon his heart, and stagnate and corrupt; till chang’d to poison, they break out on him, like a loathsome plague-spot;† Coleridge’s text is trying to convey that when man is separated from his natural environment he might turn to crime. The theme of nostalgia can be seen in â€Å"The Dungeon† through Coleridge’s emphasis on nature over civilization, because industrialism is a new concept for romantics. Essentially Coleridge believes that nature betters a man and believes that sending a criminal to a dungeon only turns them into savages rather than letting them find harmony in the natural world. â€Å"With other ministrations thou, O Nature! Healest thy wandering and distemper’d child: Thou pourest on him thy soft influences, the sunny hues, fair forms, and breathing sweets, thy melodies of woods, and winds, and waters,† This quote can be interpreted as Coleridge’s way of expressing how nature can heal man. Samuel Taylor Coleridge exemplifies the themes of nostalgia and nature in his poem â€Å"The Dungeon† through his message of nature having the power to better man. Percy Bysshe Shelley is categorized as the perfect romantic poet due to his quest for truth and justice. Shelley’s poetry peaked in 1816 until he died in 1822. The poem â€Å"To Night† is about Shelley’s longing for the day to end and night to come. Shelley wants to escape the day and find refuge in the night, although he never explains why in his poem. In the third stanza Shelley writes â€Å"When I arose and saw the dawn, I sighed for thee; when light rode high, and the dew was gone, and noon lay heavy on flower and tree, and the weary Day turned to his rest, lingering like and unloved guest, I sighed for thee. † When Shelley writes â€Å"and the dew was gone† it shows that he is fond of the nature that occurs at night such as the dew on the grass when the night ends. In the second stanza Shelley anticipates night’s arrival â€Å"Wrap thy form in mantle gray, star-inwrought! † Shelley describes another aspect of nature at night; the sky changing colors and the emerging stars. Themes of nostalgia can also be detected in â€Å"To Night† but are interpreted differently in comparison to other poems. â€Å"Sleep will come when thou art fled; of neither would I ask the boon I ask of thee, beloved Night – swift be thine approaching flight, come soon, soon! † Shelley longs for the night on a daily basis; the difference of nostalgia in this poem is that his melancholy demeanor is relieved when night begins unlike other poems that reminisce on the old ways of life. â€Å"To Night† exemplifies a different interpretation of the romantic themes such as nature and nostalgia. Themes of the Romantic Era dictated the literary works during the 18th and 19th centuries. The most influential theme was nature and poets developed this theme through their works. Nostalgia was also a common theme in romantic literature, as industrialization grew in popularity, many romantics opposed the new way of life and longed for the way things used to be. William Wordsworth’s â€Å"Resolution and Independence†, Samuel Taylor Coleridge’s â€Å"The Dungeon†, and Percy Bysshe Shelley’s â€Å"To Night† all exemplify the themes of nature and nostalgia through their poetry.

Relations Between People Essays - Dan Humphrey, Alex Udinov

Relations Between People Most people believe that their relationship is not like others. They don't have problems. These kinds of people also think that their partner won't cheat on them or do anything wrong. But the truth is that almost all relationships won't last forever. A few reasons relationships fall apart are one partner cheats, they lose interest in each other, lack of communication which causes problems, if you try to change someone and it backfires, and if you hide something you should have told the other person and then they find out about it later. In a relationship you can tell when you're losing interest in each other. Some signs are that you don't talk much with each other, you don't spend time together anymore instead it's spent with your friends away from home. Some signs to tell if the other person in the relationship is cheating is by the person starts to come home from work later than they usually do, they start to smell like perfume that neither of you have, when you confront them about cheating and they get all nervous and deny it, when you ask them why they've been coming home late from work lately and they makeup stupid excuses. Sometimes they say they are going somewhere but when you phone to see if they are there they aren't. If you're in a relationship and the person does any of these things, your relationship could be falling apart. In this kind of abusive relationship, you should know it is time to leave. The reason you should leave an abusive relationship is because if you don't, you could end up hurting yourself. Most of the time when a person is in this kind of a position, they are too scared to leave it. Because they think the one who is abusing will hurt them more. In some cases they could. Therefore, it is important to leave. Another thing about people who are in this position is that if you suspect they are being abused and you confront them about it, they will deny it and change the subject. A few other signs of someone being abused is if they always have bruises all over their body and you ask them what happened, it takes them a while to answer and finally when they do answer its something like I accidentally fell down the stairs or I walked into something. These kinds of people should get help fast, like going to the police before something serious happens and they get hurt really bad and end up in the hospital. People define a soul mate as someone who likes the same things as they do, they get along with each other perfectly, and they know everything about each other. A few other definitions of a soul mate are that they feel complete when they are with each other and both of them believe it's true love. Some people never marry only date because they believe that someday the right person will come along and may just happen to be their soul mate. Many others don't believe in soul mates because they think it's impossible to find someone that likes exactly what they do and gets along fine no matter what. Sometimes people do find their soul mates and sometimes people spend their whole lives looking for theirs. As you can see, I think that relationships aren't impossible but it is hard to find a good one where both of you get along fine and there aren't many problems. In every relationship there will always be problems no matter what you do. There are no such things as relationships with any problems.

The Double-Edged Swords of Autonomy and External Knowledge by M. R Article

The Double-Edged Swords of Autonomy and External Knowledge by M. R Article The Double The paper "The Double-Edged Swords of Autonomy and External Knowledge by M. R. Haas" is a delightful example of an article on management. The purpose of Haas article is to explore the importance of both autonomy and external knowledge in self-managing teams within an organization. Since both autonomy and external knowledge have their benefits and risks, Haas aims to provide information in recognizing the auspicious conditions to minimize the risks related to autonomy and external knowledge. Haas gathered data from a multinational organization employing over 10,000 employees worldwide. Data gatherings methods used were semi-structured interviews, and quantitative data from the companys project evaluation unit, team member surveys, and archival project records (p.994). He used two dependent variables, strategic effectiveness, and operational effectiveness, and quantified the data using ordinal scales (p.995). Additionally, he also utilized controlled variables, namely team location, te am satisfaction, and team size. These variables were also quantified using the ordinal scales. The results show that both autonomy and external knowledge complement each other in increasing team effectiveness (p.1001). Research results demonstrate that there is increased strategic and operational effectiveness in teams with higher autonomy and external knowledge compared to the teams with low autonomy and high external knowledge, or teams with high autonomy and low external knowledge (p.1006). Combining autonomy and external knowledge increased strategic and operational effectiveness when the required knowledge is non-organizational, but not when they were organizational. They also increased the two types of effectiveness when the required knowledge was in short supply, but not when it was general. Therefore, the combination of autonomy and external knowledge promote effective performance for self-managing teams because it will allow them to make decisions that are independent yet i nformed, and avoid possible risks of too much influence or too rigid isolation.

How To Use Email Marketing For Lead Conversion

How To Use Email Marketing For Lead Conversion Besides social media, email marketing is the first thing that I tell anyone to do when it comes to online marketing. To succeed online, you absolutely must be using email effectively. The evidence doesnt lie. In a 2012 survey conducted by McKinsey Company, they found  that for e-commerce companies e-mail remains a significantly more effective way to acquire customers than social media- nearly 40 times that of Facebook and Twitter combined. Woah! E-mail is still a significantly more effective way to acquire customers than social media. While you may not be running an e-commerce company yourself, the implications seem to be well accepted across  the industry. Social media scientist Dan Zarrella of Hubspot came to a similar conclusion in research that he completed in 2012. Email converts well, and  is a key part of the customer acquisition process. Conversion rate scores as compiled by Hubspot. If youre not using email marketing, you could be missing out on huge potential for your company or blog. More than that, if you arent using email to convert readers into paying customers – YOU ARE DOING IT WRONG. You might be leaving sales on the table! Here at , we have nearly 20,000  email subscribers that continually bring in new customers to our service. We like to think about it as a slow and steady drip. We keep sending out great content, and our readers  keep coming to us for help with their scheduling and social media needs. Its a great fit, and one that works because our email marketing is focused on building trust with our audience. So, how can you create an email program that converts for your own brand or business? Its actually not that hard if you are focused on the right things. Here are the top 5 ways that you can embrace email and turn your email marketing program into a lead conversion machine. Heres How To  Turn Your Email Marketing Into A Lead Conversion Machine #1. Designate A Clear Call To Action On Your Blog The first  lesson about creating an effective   email marketing program is getting good at collecting email addresses. There are many ways to go about this, and several plugins that you can start using right now to jump start your lead collection process, but the point is that you need to be making a concentrated effort on collecting emails or else your marketing list will never actually materialize. Mention.com offers a great call to action when you visit their blog. It is also important to make sure that your blog is properly configured to drive visitors to the lead collection option. This means reducing you sidebar clutter, and continuously driving your reader to a lead collection form. This is about creating a simpler blog layout. Email marketing is 40 times more effective at acquiring customers than social media. For example, on the blog there are only three things you can do once visiting a page. You can read another blog post, learn about itself, or signup to recieve our email-based content. It is as simple as that. I always say that each page on your website should really be about having your readers complete one thing. At , we tend to make that one thing an email newsletter conversion. You will easily see that it is one of the  most prominent things on our page. #2. Keep Your Calls To Action Strong If youve ever worked in sales, youve heard the phrase always be closing. While it may be tacky, it certainly isnt wrong. Not only do you need to be creating opportunities for your customers to convert (by including lead collection points), but you also need to be positioning your copy in a way that specifically asks them to subscribe. While it technically does its job, its not quite a call to action. I cant tell you how many times Ive seen a bland call to action like this one above. Im sorry folks, but please join my email list just isnt going to do it for many people. Whats in it for them? Why should they? Take a look at a few examples of people doing it right. What do you see? They all identify a clear benefit that the reader will receive when they subscribe. They all offer a clear command or directive  such as subscribe now. This isnt a suggestion, it is a command. Many of them offer the reader social proof and provide good reasons for them to consider subscribing or at least taking the offer seriously. The point is that you cant  forget to be a pitch man  and downright ask for the sale on occasion. It may sound  tacky, but it certainly doesnt have to be implemented that way. #3. Send Email More Often Than You Think You Should Many marketers and bloggers like yourself instinctively shutter at the idea of sending more email, but  you  can probably send a whole lot more than you think. In a recent study, Hubspot found that there was essentially no correlation between both unsubscribes and click-through rates and the frequency of email being sent. There is almost no correlation between send frequency and click through rates. There is little correlation between the number of times you send your email and the number of unsubscribes you will receive. What they actually found was that if your email list is willing to put up with 5-10 emails per month, they are probably just as likely to put up with 15 or 20. From Hubspot: The more emails that were sent to the lists in my dataset, the fewer people unsubscribed. This is probably because if you’re sending very  infrequently, it can be easy to forget why I joined your list in the first place, but if  you’re sending regularly, I remember your newsletter.   #4. Make Your Email Something That People Actually Want To Read Never underestimate the importance of reader value. Everything that you do in marketing should offer your readers value. I like to think of it in terms of what you are trading them for their time. What you are  giving your readers in exchange for their time spent with your marketing. Social media consultant Jay Baer describes it another way as marketing so good that they would be willing to pay for it. Shoot for [Email] Marketing so good that your readers  would be willing to pay for it! #ContentNo matter how you describe it, you dont have an easy job ahead of you, your readers want it all. They want helpful content, they want it free, and they want it at a time when its convenient  for them. Who are you to let them down? One of the most common mistakes I see companies make is creating email-based content that is all about them. Wrong! What are your readers getting in exchange for their time? We always try to pack our emails with helpful information that our readers will appreciate. This is why at , we brand our email marketing around the theme of our Content Marketing Update. This weekly email includes helpful content from our blog and some of the best articles around the web. It is usually chock full of great tips and almost always worth the time and the price for admission. #5. Experiment With Your Email Template/Headline/Send Times One great way to continually improve your email marketing is to continually experiment with how and when you are sending it. At , there are a few ways that we do this. A/B  Test Your Subject Lines Honesty, this one is so easy that you should be doing it with every email that you send. Each time we send an email here at , we make sure to test our subject line using the automated A/B testing tool built into our email software (Campaign Monitor). This tool allows us to pre-send our email to a few hundred people with a couple different subject line options. Once a clear winner is found (and there almost always is one), our email tool will send the winning subject line to remaining portion of our list. After doing this for months, we were even able to pullout some key data points and define some email subject line best practices. Try  A New Design (Or None At All) Another great way to improve your email  marketing is to continually adjust your email template. Using the A/B testing tool build into Campaign Monitor and many other email marketing programs, you should be able to easily evaluate the effectiveness of one template over another. Many companies (including itself) have found that sometimes email is best sent without a design template at all. Each week we send thousands of emails using a variety of well-designed email templates and plain text versions. The results usually show us that plain-text emails (or emails that look like plain text) constantly drive higher click-through rates than those with more design. Of course, results may vary. Take this with a grain of salt, and always test your own results. Experiment With Different Send Times In his slide deck The Science of Email Marketing social media scientist Dan Zarrella  dug up a ton of fascinating data about when to send email. For example, he found that email click-through rates tended to be  almost twice as high  on Saturdays and Sundays – a slap in the face to  the traditional  idea that marketing only takes place on weekdays. Email sent on Saturday and Sunday get more clicks. He also found that emails sent  earlier in the morning tended to get more clicks as well. The results may not apply to everyone, but it is very good food for thought. 6a.m. just might be the best time to send an email if you want someone to actually read it. The point here is that you should never be satisfied with the status-quo, even if it is yours. Always be testing your marketing so that you can get the best results.

Political ideologies a comparative approach Research Paper

Political ideologies a comparative approach - Research Paper Example Anti-rationalismIn should be realized that fascism was borne mostly after the Second World War. Given this situation, fascism was necessitated by the upheavals and thus became anti-rationality. This is corroborated by what Friedrich Nietzsche said that human being is motivated by nothing other than the ‘will power’ and not the rationality of the mind. Fascism then seemed to have consumed this as their driving force and a core belief. In another instance, the Italian dictator Benito Mussolini also coined a slogan from the same belief and believed in ‘Actions not talk’ and that the state of inactivity is analogous to death. Mussolini devalued the intellectual life and described it as cold, lifeless, and dry. This connotation shows how fascism was against rational and objective minds. StruggleThe other core principle of fascism was the struggle, those who subscribed to the fascism believed in the role of struggle to achieve the desires and liberation. Given the context in which the movement was borne (after the Second World War), it is understandable that the movement was hatched in the aftermath of a struggle and had to follow suit. Leadership and ElitismFascism appreciated the endowment of different people with different abilities and believed in the role of elitism as the ruling class even if they are the minority. Fascism contradicts the conventional political thoughts and radically believes in the rejection of the principle of equality. In Fascism, there was the belief of three castes of leadership in the society.... Given the context in which the movement was borne (after the Second World War), it is understandable that the movement was hatched in the aftermath of a struggle and had to follow suit. Leadership and Elitism Fascism appreciated the endowment of different people with different abilities and believed in the role of elitism as the ruling class even if they are the minority. Fascism contradicts the conventional political thoughts and radically believes in the rejection of the principal of equality. In Fascism, there was the belief of three castes of leadership in the society; the one who possess the unrivalled authority was regarded as the first layer and the warrior forming the second class and finally the masses that majorly comprised of those described as the inert, weak, and ignorant with a characteristic unquestionable obedience (Rejai, 1995). Socialism Even though fascism and socialism had different ideological difference and became rivalries, fascism had unexplained affinity for socialism. Both Mussolini and Hitler showed great involvement in the socialist ideology and this can be manifested by their role in socialism. Hitler developed the philosophy of socialism and Mussolini at some point became the editor of the Avanti newspaper that was owned by the socialists. Fascism also believed in ultranationalism as their core principle. These core principles define the beliefs of the fascism that reigned in most of the countries soon after the Second World War (Rejai, 1995). Core Beliefs of Feminism Feminism has been defined as the collection of the likeminded ideological and movement that are aimed at giving women equal right in the social, political, and economic issues